Sample records for agent percutaneous vapor

  1. Evaluation of Chemical Warfare Agent Percutaneous Vapor Toxicity: Derivation of Toxicity Guidelines for Assessing Chemical Protective Ensembles.

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    Watson, A.P.


    Percutaneous vapor toxicity guidelines are provided for assessment and selection of chemical protective ensembles (CPEs) to be used by civilian and military first responders operating in a chemical warfare agent vapor environment. The agents evaluated include the G-series and VX nerve agents, the vesicant sulfur mustard (agent HD) and, to a lesser extent, the vesicant Lewisite (agent L). The focus of this evaluation is percutaneous vapor permeation of CPEs and the resulting skin absorption, as inhalation and ocular exposures are assumed to be largely eliminated through use of SCBA and full-face protective masks. Selection of appropriately protective CPE designs and materials incorporates a variety of test parameters to ensure operability, practicality, and adequacy. One aspect of adequacy assessment should be based on systems tests, which focus on effective protection of the most vulnerable body regions (e.g., the groin area), as identified in this analysis. The toxicity range of agent-specific cumulative exposures (Cts) derived in this analysis can be used as decision guidelines for CPE acceptance, in conjunction with weighting consideration towards more susceptible body regions. This toxicity range is bounded by the percutaneous vapor estimated minimal effect (EME{sub pv}) Ct (as the lower end) and the 1% population threshold effect (ECt{sub 01}) estimate. Assumptions of exposure duration used in CPE certification should consider that each agent-specific percutaneous vapor cumulative exposure Ct for a given endpoint is a constant for exposure durations between 30 min and 2 hours.

  2. Antiseptic skin agents for percutaneous procedures. (United States)

    Lepor, Norman E; Madyoon, Hooman


    Infections associated with percutaneously implanted devices, such as pacemakers, internal cardiac defibrillators, and endovascular prostheses, create difficult and complex clinical scenarios because management can entail complete device removal, antibiotic therapy, and prolonged hospitalization. A source for pathogens is often thought to be the skin surface, making skin preparation at the time of the procedure a critical part of minimizing implantation of infected devices and prostheses. The most common skin preparation agents used today include products containing iodophors or chlorhexidine gluconate. Agents are further classified by whether they are aqueous-based or alcoholbased solutions. Traditional aqueous-based iodophors, such as povidone-iodine, are one of the few products that can be safely used on mucous membrane surfaces. Alcohol-based solutions are quick, sustained, and durable, with broader spectrum antimicrobial activity. These agents seem ideal for percutaneous procedures associated with prosthesis implantation, when it is critical to minimize skin colony counts to prevent hardware infection.

  3. Precise determination of refractometric parameters for anesthetic agent vapors. (United States)

    Allison, J M; Birch, K P; Crowder, J G


    The absolute refractive indices of the anesthetic agent vapors isoflurane, sevoflurane, enflurane, halothane, and desflurane are determined to a typical uncertainty of 1 part in 10(7) over the respective temperature and pressure ranges of 15-40 °C and 5-45% of their saturated vapor pressures at wavelengths of 632.99, 594.10, and 543.52 nm. The specific refraction, second virial coefficients, and dispersion constants are also derived for each agent, from which an equation for the calculation of agent refractivity is established that is in agreement with the measured data to within 2 × 10(-8).

  4. Percutaneous exposure to the nerve agent VX: Efficacy of combined atropine, obidoxime and diazepam treatment

    NARCIS (Netherlands)

    Joosen, M.J.A.; Schans, M.J. van der; Helden, H.P.M. van


    The nerve agent VX is most likely to enter the body via liquid contamination of the skin. After percutaneous exposure, the slow uptake into the blood, and its slow elimination result in toxic levels in plasma for a period of several hours. Consequently, this has implications for the development of t

  5. Fingerprinting malathion vapor: a simulant for VX nerve agent (United States)

    Song, Renbo; Ding, Yujie J.; Zotova, Ioulia B.


    Being motivated by the possibility of fingerprinting and detecting VX nerve agent, we have investigated its stimulant, i.e. malathion vapor, which is less toxic and commercially available, in the far-infrared/THz transition region and THz frequency range. Such a spectroscopic study was carried out by using Fourier transform infrared spectroscopy (FTIR). Our intention is to obtain a specific spectroscopic signature of VX nerve agent as a chemical warfare agent. Following our experimental result, we have successfully observed eleven new absorption peaks from malathion vapor in the spectral ranges from 15 cm -1 to 68 cm -1 and from 75 cm -1 to 640 cm -1. Specifically, in the far-infrared/THz transition region, we have observed eight peaks and whereas in the THz region we have identified three relatively weak transition peaks. In addition, we have investigated the dependence of the absorption spectra on temperature in the range from room temperature to 60°C. In both of the frequency ranges, we have found that absorption coefficients significantly increase with increasing temperature. By comparing the transition peaks in the two frequency ranges, we have concluded that the frequency range of 400-640cm -1 is an optimal range for fingerprinting this chemical specie. We have designated two peaks for effectively and accurately identifying the VX nerve agents and one peak for differentiating between malathion and VX nerve agent.

  6. Percutaneous exposure to the nerve agent VX: Efficacy of combined atropine, obidoxime and diazepam treatment. (United States)

    Joosen, Marloes J A; van der Schans, Marcel J; van Helden, Herman P M


    The nerve agent VX is most likely to enter the body via liquid contamination of the skin. After percutaneous exposure, the slow uptake into the blood, and its slow elimination result in toxic levels in plasma for a period of several hours. Consequently, this has implications for the development of toxic signs and for treatment onset. In the present study, clinical signs, toxicokinetics and effects on respiration, electroencephalogram and heart rate were investigated in hairless guinea pigs after percutaneous exposure to 500 microg/kg VX. We found that full inhibition of AChE and partial inhibition of BuChE in blood were accompanied by the onset of clinical signs, reflected by a decline in respiratory minute volume, bronchoconstriction and a decrease in heart rate. Furthermore, we investigated the therapeutic efficacy of a single dose of atropine, obidoxime and diazepam, administered at appearance of first clinical signs, versus that of repetitive dosing of these drugs on the reappearance of signs. A single shot treatment extended the period to detrimental physiological decline and death for several hours, whereas repetitive administration remained effective as long as treatment was continued. In conclusion, percutaneous VX poisoning showed to be effectively treatable when diagnosed on time and when continued over the entire period of time during which VX, in case of ineffective decontamination, penetrates the skin.

  7. Hemostatic agents for access tract in tubeless percutaneous nephrolithotomy: Is it worth? (United States)

    Sepulveda, Francisco; Aliaga, Alfredo; Fleck, Daniela; Fernandez, Mario; Mercado, Alejandro; Vilches, Roberto; Moya, Francisco; Ledezma, Rodrigo; Reyes, Diego; Marchant, Fernando


    Introduction: The role of hemostatic agents as an adjunct for closure of the nephrostomy tract in tubeless percutaneous surgery (tubeless percutaneous nephrolithotomy [tPNL]) has been previously evaluated, observing a potential benefit in terms of reduced bleeding and urinary leakage. We assessed the rate of postoperative complications after the use of hemostatic agents for sealing the nephrostomy tract in patients undergoing tPNL at our institution. Subjects and Methods: We performed a retrospective analysis of 52 consecutive patients undergoing tPNL at our center between January 2010 and December 2013. No substance was placed within the tract in 25 patients (Group 1). A cylinder of Surgicel® in addition to 1 unit of Gelita® were placed within the access tract in 27 patients (Group 2). We accounted for demographic variables, stone size, operative time, postoperative pain, development of hematoma, postoperative hematocrit drop, urinary leakage, residual lithiasis, and hospital stay length. Results: Age and sex differed significantly between the two groups (P = 0.0002 and P = 0.048 respectively). However, there were no significant differences in terms of body mass index and stone burden. No significant differences between groups were found with regards to operative time, postoperative hematocrit drop, postoperative pain and presence of residual lithiasis. Conclusion: The use of Gelita® and Surgicel® as hemostatic agents in tPNL is safe, but we were not able to demonstrate any significant benefit in terms of postoperative morbidity after comparing the use of these agents in tPNL. We concluded that the uses of hemostatic agents needed to be evaluated in prospective randomized trials to define its benefits. PMID:27141194

  8. Quantitative Infrared Spectra of Vapor Phase Chemical Agents

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    Sharpe, Steven W.; Johnson, Timothy J.; Chu, P M.; Kleimeyer, J; Rowland, Brad; Gardner, Patrick J.


    Quantitative high resolution (0.1 cm -1) infrared spectra have been acquired for a number of pressure broadened (101.3 KPa N2), vapor phase chemicals including: Sarin (GB), Soman (GD), Tabun (GA), Cyclosarin (GF), VX, nitrogen mustard (HN3), sulfur mustard (HD) and Lewisite (L).

  9. Quantitative Infrared Spectra of Vapor Phase Chemical Agents

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    Sharpe, Steven W.; Johnson, Timothy J.; Chu, P. M.; Kleimeyer, J.; Rowland, Brad


    Quantitative, moderately high resolution (0.1 cm-1) infrared spectra have been acquired for a number of nitrogen broadened (1 atm N2) vapor phase chemicals including: Sarin (GB), Soman (GD), Tabun (GA), Cyclosarin (GF), VX, Nitrogen Mustard (HN3), Sulfur Mustard (HD), and Lewisite (L). The spectra are acquired using a heated, flow-through White Cell1 of 5.6 meter optical path length. Each reported spectrum represents a statistical fit to Beer’s law, which allows for a rigorous calculation of uncertainty in the absorption coefficients. As part of an ongoing collaboration with the National Institute of Standards and Technology (NIST), cross-laboratory validation is a critical aspect of this work. In order to identify possible errors in the Dugway flow-through system, quantitative spectra of isopropyl alcohol from both NIST and Pacific Northwest National Laboratory (PNNL) are compared to similar data taken at Dugway proving Grounds (DPG).

  10. Toxicokinetics of the nerve agent (+/-)-VX in anesthetized and atropinized hairless guinea pigs and marmosets after intravenous and percutaneous administration. (United States)

    van der Schans, Marcel J; Lander, Brenda J; van der Wiel, Herma; Langenberg, Jan P; Benschop, Hendrik P


    In continuation of our investigations on the toxicokinetics of the volatile nerve agents C(+/-)P(+/-)-soman and (+/-)-sarin, we now report on the toxicokinetics of the rather nonvolatile agent (+/-)-VX. A validated method was developed to determine blood levels of (+/-)-VX by means of achiral gas chromatography at blood levels > or =10 pg/ml. The ratio of the two enantiomers of VX in blood could be measured at levels > or =1 ng/ml by using chiral HPLC in combination with off-line gas chromatographic analysis. In order to obtain basic information on the toxicokinetics of (+/-)-VX, i.e., under conditions of 100% bioavailability, the blood levels of this agent were measured in hairless guinea pigs at iv doses corresponding with 1 and 2 LD50. The derived AUCs indicate a reasonable linearity of the toxicokinetics with dose. Also, the toxicokinetics in marmoset primates was studied at an absolute iv dose corresponding with 1 LD50 in the hairless guinea pig which led to approximately the same levels of (+/-)-VX in blood as observed at 2 LD50 in the hairless guinea pig. Finally, the toxicokinetics of (+/-)-VX were measured in hairless guinea pigs via the most relevant porte d' entrée for this agent, which is the percutaneous route at a dose corresponding with 1 LD50 (pc). Large variations were observed between individual animals in the rate of penetration of (+/-)-VX and in concomitant progression of AChE inhibition in blood of these animals. Blood levels of (+/-)-VX increased gradually over a 6-h period of time. After a 7-h penetration period, the total AUC corresponded with 2.5% bioavailability relative to iv administration. In contrast with the G-agents C(+/-)P(+/-)-soman and (+/-)-sarin, stereospecificity in the sequestration of the two enantiomers of (+/-)-VX is not a prominent phenomenon. It appears that (+/-)-VX is substantially more persistent in vivo than the two G-agents. This persistence may undermine the efficacy of pretreatment with carbamates of percutaneous

  11. Hemostatic agents for access tract in tubeless percutaneous nephrolithotomy: Is it worth?

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    Francisco Sepulveda


    Conclusion: The use of Gelita® and Surgicel® as hemostatic agents in tPNL is safe, but we were not able to demonstrate any significant benefit in terms of postoperative morbidity after comparing the use of these agents in tPNL. We concluded that the uses of hemostatic agents needed to be evaluated in prospective randomized trials to define its benefits.

  12. Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems

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    Yagci, Cemil, E-mail:; Ustuner, Evren, E-mail:; Atman, Ebru Dusunceli, E-mail: [Ankara University, Department of Radiology, School of Medicine (Turkey); Baltaci, Sumer, E-mail: [Ankara University, Department of Urology, School of Medicine (Turkey); Uzun, Caglar, E-mail:; Akyar, Serdar, E-mail: [Ankara University, Department of Radiology, School of Medicine (Turkey)


    Percutaneous nephrostomy (PCN) in a nondilated pelvicaliceal system is technically challenging. We describe an effective method to achieve transient dilatation of the pelvicaliceal system via induction of diuresis using infusion of a diuretic agent in normal saline, therefore allowing easier access to the pelvicaliceal system. Under real-time ultrasound guidance, the technique had been tested in 22 nephrostomies with nondilated system (a total of 20 patients with 2 patients having bilateral nephrostomies) during a 5-year period. Patients were given 40 mg of furosemide in 250 ml of normal saline solution intravenously by rapid infusion. As soon as maximum calyceal dilatation of more than 5 mm was observed, which is usually 15 min later after the end of rapid infusion, patients were positioned obliquely, and PCN procedure under ultrasound guidance was performed. The procedure was successful in 19 of the nephrostomies in 17 patients with a success rate of 86.36 % per procedure and 85 % per patient in nondilated pelvicaliceal systems. No major nephrostomy-, drug-, or technique-related complications were encountered. The technique failed to work in three patients due to the presence of double J catheters and preexisting calyceal perforation which avoided transient dilation of the pelvicaliceal system with diuresis. Diuretic infusion in saline is a feasible and effective method for PCN in nondilated pelvicaliceal systems.

  13. Dermostyx (IB1) - High efficacy and safe topical skin protectant against percutaneous toxic agents. (United States)

    Dachir, Shlomit; Barness, Izhak; Fishbine, Eliezer; Meshulam, Jacob; Sahar, Rita; Eisenkraft, Arik; Amir, Adina; Kadar, Tamar


    Prevention of the penetration of toxic agents through the skin is crucial for both military troops and civilian populations. We have developed a novel topical skin protectant (TSP), coded as IB1 and commercially available as Dermostyx protective solution (Rekah Pharm, Israel). The formulation afforded significant protection against chemical warfare agents such as sulfur mustard (SM) and VX (2LD50), pesticides such as parathion and irritants such as acrolein. The efficacy of the protectant was evaluated in the pig model using clinical, histological and biochemical monitoring. A single topical application prior to exposure to the toxic agents reduced significantly the size and severity of skin lesions and ameliorated or prevented systemic clinical symptoms. The barrier properties of IB1 are immediate upon application and remain effective for at least 12 h. It is absorbed into the stratum corneum of the skin and remains there until rinsing with water, yet the ingredients are not absorbed into the body. The formulation is a hydrophilic water-based solution, composed of magnesium sulfate and glycerin that are widely used in cosmetic and medicine, and was shown to be safe in preclinical and in Phase I clinical studies. The suggested mode of action is based on the unique interaction of glycerin with the stratum corneum, changing its properties to hydrophilic and on the "salting out" effect of magnesium sulfate. The expected use of the TSP is by application on exposed skin areas and sensitive skin sites (e.g. armpits, groin, waist), when necessary. A quantity of 10 ml is sufficient for one application covering approximately 20% of the body surface area. The formulation was approved for human use by the Israel Ministry of Health and a CE mark certificate in Europe has been recently issued (Class I). Dermostyx has been adopted by the IDF and first responders as a skin protectant for special needs.

  14. In vitro and in vivo percutaneous absorption of seleno-L-methionine, an antioxidant agent, and other selenium species

    Institute of Scientific and Technical Information of China (English)

    Chih-hung LIN; Chia-lang FANG; Saleh A AL-SUWAYEH; Shih-yun YANG; Jia-you FANG


    To investigate the in vitro and in vivo percutaneous absorption of seleno-L-methionine (Se-L-M),an ultraviolet (UV)-protecting agent,from aqueous solutions.Methods:Aqueous solutions of Se-L-M were prepared in pH 4,8,and 10.8 buffers.The pH 8 buffer contained 30% glycerol,propylene glycol (PG) and polyethylene glycol (PEG) 400.The in vitro skin permeation of Se-L-M via porcine skin and nude mouse skin was measured and compared using Franz diffusion cells.The in vivo skin tolerance study was performed,which examined transepidermal water loss (TEWL),skin pH and erythema.Results:In the excised porcine skin,the flux was 0.1,11.4 and 8.2 μg·cm-2·h-1 for the pH 4,8,and 10.8 buffers,respectively.A linear correlation between the flux and skin deposition was determined.According to permeation across skin with different treatments (stripping,delipidation,and ethanol treatments),it was determined that the intracellular route comprised the predominant pathway for Se-L-M permeation from pH 8 buffer.Aqueous solutions of seleno-DL-methionine (Se-DL-M),selenium sulfide and selenium-containing quantum dot nanoparticles were also used as donor systems.The DL form showed a lower flux (7.0 vs 11.4 μg·cm2·h-1) and skin uptake (23.4 vs 47.3 μg/g) as compared to the L form,indicating stereoselective permeation of this compound.There was no or only negligible permeation of selenium sulfide and quantum dots into and across the skin.With in vivo topical application for 4 and 8 h,the skin deposition of Se-L-M was about 7 μg/g,and values were comparable to each other.The topical application of Se-L-M for up to 5 d did not caused apparent skin irritation.However,slight inflammation of the dermis was noted according to the histopathological examination.Conclusion:Se-L-M was readily absorbed by the skin in both the in vitro and in vivo experiments.The established profiles of Se-L-M skin absorption will be helpful in developing topical products of this compound.

  15. Haemostatic agents of the gelatin matrix for a large liver wound by percutaneous injection without pressure under the guidance of contrast-enhanced ultrasound

    Institute of Scientific and Technical Information of China (English)

    YU Teng-fei; L(U) Fa-qin; LI Zhi-yan; LIU Ling; LIU Qiang; LIU Ai-jun; HUANG Ya-qin; TANG Jie


    Background The non-operation treatment of intra-abdominal trauma guided contrast enhanced ultrasound (CEUS) is one of the hottest research topic. Gelatin/thrombin/calcium (GTC) was developed as a novel haemostatic agent for non-operable intra-abdominal trauma. We hypothesized that GTC can achieve haemostasis (without the use of pressure)within a short time in a large wound model by percutaneous injection under CEUS guidance.Methods Forty Wister rats received large liver injuries by haemostatic clamp and were randomly divided into four groups, according to the haemostatic agent used. These included normal saline (NS) group A, lyophilising thrombin powder (LTP) group B, GTC group C, and absorbable α-cyanoacrylate (ACNA) group D. Each injury site was treated with one of the above materials and total bleeding time was recorded. All liver wounds were evaluated using CEUS at three periods: pre-injury, injury and post-treatment. The liver wounds were also evaluated by histology 3, 6, and 9 days after injury and the extents of abdominal adhesions were recorded.Results The sensitivity of CEUS (100%) in detecting blunt traumatic liver lesions was significantly higher than conventional ultrasound (42.5%). Bleeding times at the injury site in the GTC group C ((129.3±14.0) seconds) and ACNA group D ((5.2±1.0) seconds) were significantly shorter than those in the NS group A ((369.5±48.8) seconds, P <0.01) and LTP group B ((324.7±52.22) seconds, P <0.01). The LTP group B showed no significant difference compared with the NS group A. Gross examination of liver tissue revealed that there were fewer intra-abdominal adhesions in the GTC group C (10%) than in the ACNA group D (100%). Histopathologic examination showed that GTC was completely absorbed after nine days.Conclusions GTC, delivered by percutaneous injection under CEUS, may achieve haemostasis (without the use of pressure) within a short time in a large wound model. GTC is absorbable and may prevent intra

  16. Percutaneous dissolution of renal calculi. (United States)

    Dretler, S P; Pfister, R C


    The use of percutaneous nephrostomy catheters has allowed access to intrarenal urinary calculi for dissolution. Renacidin is the successful agent for dissolving struvite stones. THAM-E is the most effective agent for the intrarenal dissolution of cystine stone. Calcium oxalate stones are still resistant to dissolution techniques.

  17. Ion mobility spectrometric analysis of vaporous chemical warfare agents by the instrument with corona discharge ionization ammonia dopant ambient temperature operation. (United States)

    Satoh, Takafumi; Kishi, Shintaro; Nagashima, Hisayuki; Tachikawa, Masumi; Kanamori-Kataoka, Mieko; Nakagawa, Takao; Kitagawa, Nobuyoshi; Tokita, Kenichi; Yamamoto, Soichiro; Seto, Yasuo


    The ion mobility behavior of nineteen chemical warfare agents (7 nerve gases, 5 blister agents, 2 lachrymators, 2 blood agents, 3 choking agents) and related compounds including simulants (8 agents) and organic solvents (39) was comparably investigated by the ion mobility spectrometry instrument utilizing weak electric field linear drift tube with corona discharge ionization, ammonia doping, purified inner air drift flow circulation operated at ambient temperature and pressure. Three alkyl methylphosphonofluoridates, tabun, and four organophosphorus simulants gave the intense characteristic positive monomer-derived ion peaks and small dimer-derived ion peaks, and the later ion peaks were increased with the vapor concentrations. VX, RVX and tabun gave both characteristic positive monomer-derived ions and degradation product ions. Nitrogen mustards gave the intense characteristic positive ion peaks, and in addition distinctive negative ion peak appeared from HN3. Mustard gas, lewisite 1, o-chlorobenzylidenemalononitrile and 2-mercaptoethanol gave the characteristic negative ion peaks. Methylphosphonyl difluoride, 2-chloroacetophenone and 1,4-thioxane gave the characteristic ion peaks both in the positive and negative ion mode. 2-Chloroethylethylsulfide and allylisothiocyanate gave weak ion peaks. The marker ion peaks derived from two blood agents and three choking agents were very close to the reactant ion peak in negative ion mode and the respective reduced ion mobility was fluctuated. The reduced ion mobility of the CWA monomer-derived peaks were positively correlated with molecular masses among structurally similar agents such as G-type nerve gases and organophosphorus simulants; V-type nerve gases and nitrogen mustards. The slope values of the calibration plots of the peak heights of the characteristic marker ions versus the vapor concentrations are related to the detection sensitivity, and within chemical warfare agents examined the slope values for sarin, soman

  18. Percutaneous cholecystostomy

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    Akhan, Okan E-mail:; Akinci, Devrim; Oezmen, Mustafa N


    Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis.

  19. Percutaneous gastroenterostomy

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    Wittich, G.R.; Van Sonnenberg, E.; Casola, G.; Jantsch, H.; Walter, R.; Lechner, G.


    Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocartechniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelyhood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

  20. Effectiveness and reaction networks of H2O2 vapor with NH3 gas for decontamination of the toxic warfare nerve agent, VX on a solid surface. (United States)

    Gon Ryu, Sam; Wan Lee, Hae


    The nerve agent, O-ethyl S-[2-(diisopropylamino)ethyl] methylphosphonothioate (VX) must be promptly eliminated following its release into the environment because it is extremely toxic, can cause death within a few minutes after exposure, acts through direct skin contact as well as inhalation, and persists in the environment for several weeks after release. A mixture of hydrogen peroxide vapor and ammonia gas was examined as a decontaminant for the removal of VX on solid surfaces at ambient temperature, and the reaction products were analyzed by gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance spectrometry (NMR). All the VX on glass wool filter disks was found to be eliminated after 2 h of exposure to the decontaminant mixtures, and the primary decomposition product was determined to be non-toxic ethyl methylphosphonic acid (EMPA); no toxic S-[2-(diisopropylamino)ethyl] methylphosphonothioic acid (EA-2192), which is usually produced in traditional basic hydrolysis systems, was found to be formed. However, other by-products, such as toxic O-ethyl S-vinyl methylphosphonothioate and (2-diisopropylaminoethyl) vinyl disulfide, were detected up to 150 min of exposure to the decontaminant mixture; these by-products disappeared after 3 h. The two detected vinyl byproducts were identified first in this study with the decontamination system of liquid VX on solid surfaces using a mixture of hydrogen peroxide vapor and ammonia gas. The detailed decontamination reaction networks of VX on solid surfaces produced by the mixture of hydrogen peroxide vapor and ammonia gas were suggested based on the reaction products. These findings suggest that the mixture of hydrogen peroxide vapor and ammonia gas investigated in this study is an efficient decontaminant mixture for the removal of VX on solid surfaces at ambient temperature despite the formation of a toxic by-product in the reaction process.

  1. Percutaneous Achilles Tendon Lengthening (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Percutaneous Achilles Tendon Lengthening Page Content ​ Pre-operative incision markings along ... What is the goal of a percutaneous Achilles tendon lengthening? The goal of this procedure is to ...

  2. Percutaneous Abscess Drainage (United States)

    ... Physician Resources Professions Site Index A-Z Percutaneous Abscess Drainage An abscess is an infected fluid collection ... are the benefits vs. risks? What is Percutaneous Abscess Drainage? An abscess is an infected fluid collection ...

  3. Toxicokinetics of the nerve agent (±)-VX in anesthetized and atropinized hairless guinea pigs and marmosets after intravenous and percutaneous administration

    NARCIS (Netherlands)

    Schans, M.J. van der; Lander, B.J.; Wiel, H. van der; Langenberg, J.P.; Benschop, H.P.


    In continuation of our investigations on the toxicokinetics of the volatile nerve agents C(±)P(±)-soman and (±)-sarin, we now report on the toxicokinetics of the rather nonvolatile agent (±)-VX. A validated method was developed to determine blood levels of (±)-VX by means of achiral gas chromatograp

  4. Physics-Based Modeling of Permeation: Simulation of Low-Volatility Agent Permeation and Aerosol Vapor Liquid Assessment Group Experiments (United States)


    test, including material composition, thickness, and stress state;1,2 agent–material chemical interactions; environmental conditions such as... Environmental Impacts of Chemical Agents in Marine Environments. Chem. Rev. 2009, 109 (1), 236–256. 22. Nitsche, J.M.; Kasting, G.B. A Microscopic...model was shown to provide a reasonable worst-case scenario for permeation into skin in a real-world scenario because good contact is maintained

  5. Radiologic imaging and percutaneous treatment of pelvic lymphocele

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    Karcaaltincaba, Musturay [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey); Akhan, Okan [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey)]. E-mail:


    Pelvic lymphocele, also known as lymphocyst, is a cystic structure caused by lymphatic injury usually secondary to pelvic lymphadenectomy and renal transplantation. Lymphoceles can cause morbidity and rarely mortality by compression of adjacent structures and infectious complications. This review discusses etiology and treatment options for pelvic lymphoceles including surgical and percutaneous methods with emphasis on percutaneous techniques particularly in conjunction with sclerotherapy. Percutaneous catheter drainage with sclerotherapy procedure with various sclerosing agents is described in detail. Ethanol, povidone-iodine, tetracycline, doxycycline, bleomycin, talc and fibrin glue can be used as sclerosing agents. Combination of sclerosing agents to percutaneous catheter drainage significantly improves success rate in the treatment of pelvic lymphoceles. Infected lymphoceles are usually treated solely with percutaneous catheter drainage. Percutaneous treatment can be tailored according to volume of lymphoceles. We generally prefer single session sclerotherapy and 1 day catheter drainage in lymphoceles less than 150 mL, and larger ones are treated by multi-session sclerotherapy until daily drainage decreases below 10 mL. Percutaneous treatment preferably with sclerotherapy should be considered as the first-line treatment modality for pelvic lymphoceles due to its effectiveness, widespread applicability on an outpatient basis, ease of procedure and low complication rate.

  6. Comparative biorelease study of fluticasone in combination with antibacterial (Neomycin and or antifungal (coltrimazol, miconazole agents by histamine percutaneous reaction method in healthy volunteers

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    Shahani S


    Full Text Available Fluticasone propionate is a novel, potent and topically active synthetic corticosteroid preparation with a much reduced potential, in relation to its anti-inflammatory potency, for unwanted systemic side effects. It is indicated for the treatment of eczema, dermatitis etc. The objective of the present study was to evaluate and compare the biorelease of fluticassone with placebo (base formulation; its combination with antifungal (miconazole, clotrimazole and / or antibacterial agents based on the attenuation of histamine induced wheal and flare reaction and flare intensity (on visual analouge scale by McNemar test. In the present study, fluticasone alone and in combination with clotrimazole, miconazole and neomycin significantly reduced the wheal and flare response of histamine prick test. The flare intensity response was also significantly inhibited by these treatments. Furthermore, there was no difference in the anti-inflammatory activity of various treatment groups. It may, therefore, be concluded that antibacterial (neomycin and / or antifungal (miconazole, clotrimazole agents in combination with steroid (fluticasone do not alter the pharmacodynamic response of the latter.

  7. Percutaneous forefoot surgery. (United States)

    Bauer, T


    Percutaneous methods can be used to perform many surgical procedures on the soft tissues and bones of the forefoot, thereby providing treatment options for all the disorders and deformities seen at this site. Theoretical advantages of percutaneous surgery include lower morbidity rates and faster recovery with immediate weight bearing. Disadvantages are the requirement for specific equipment, specific requirements for post-operative management, and lengthy learning curve. At present, percutaneous hallux valgus correction is mainly achieved with chevron osteotomy of the first metatarsal, for which internal fixation and a minimally invasive approach (2 cm incision) seem reliable and reproducible. This procedure is currently the focus of research and evaluation. Percutaneous surgery for hallux rigidus is simple and provides similar outcomes to those of open surgery. Lateral metatarsal malalignment and toe deformities are good indications for percutaneous treatment, which produces results similar to those of conventional surgery with lower morbidity rates. Finally, fifth ray abnormalities are currently the ideal indication for percutaneous surgery, given the simplicity of the procedure and post-operative course, high reliability, and very low rate of iatrogenic complications. The most commonly performed percutaneous techniques are described herein, with their current indications, main outcomes, and recent developments.

  8. Percutaneous liver biopsy. (United States)

    Rustagi, Tarun; Newton, Eric; Kar, Premashish


    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  9. Antiplatelet and anticoagulant therapy in elective percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Verheugt Freek WA


    Full Text Available Abstract Thrombosis plays a major role in acute vessel closure both after coronary balloon angioplasty and after stenting. This review will address the role of antiplatelet and anticoagulant therapy in preventing early thrombotic complications after percutaneous coronary intervention. The focus will be on agents that are routinely available and commonly used.

  10. Echogeleide percutane drainage : toepassingen in het abdomen

    NARCIS (Netherlands)

    J.S. Laméris (Johan )


    textabstractDit proefschrift behandelt een aantal toepassingen van de echogeleide punctie en drainagetechniek in het abdomen, namelijk: - de percutane abcesdrainage - de percutane galblaasdrainage - de percutane galwegdrainage Abdominale abcessen zijn in de chirurgische praktijk altijd een groot pro

  11. Complications of percutaneous vertebroplasty


    Saracen, Agnieszka; Kotwica, Zbigniew


    Abstract Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins—osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area ...

  12. Percutaneous vertebroplasty: technical considerations

    Institute of Scientific and Technical Information of China (English)

    Gao-jun TENG; Shi-cheng HE


    Percutaneous vertebroplasty (PVP) is a relative new interventional technique, which is widely used in treatment of vertebral collapse caused by vertebral neoplasms and osteoporotic compression fractures. The general technical considerations of PVP techniques are discussed based on authors' experience obtained over 400 patients in the past years in this article, including preparation of PMMA, instrument of PVP, guidance and puncture approaches, and technique of the procedure, etc. The conclusion is that PVP is a safe procedure if the physicians handle it properly.

  13. Vapor Bubbles (United States)

    Prosperetti, Andrea


    This article reviews the fundamental physics of vapor bubbles in liquids. Work on bubble growth and condensation for stationary and translating bubbles is summarized and the differences with bubbles containing a permanent gas stressed. In particular, it is shown that the natural frequency of a vapor bubble is proportional not to the inverse radius, as for a gas bubble, but to the inverse radius raised to the power 2/3. Permanent gas dissolved in the liquid diffuses into the bubble with strong effects on its dynamics. The effects of the diffusion of heat and mass on the propagation of pressure waves in a vaporous bubbly liquid are discussed. Other topics briefly touched on include thermocapillary flow, plasmonic nanobubbles, and vapor bubbles in an immiscible liquid.

  14. [Treatment of atherosclerosis. New percutaneous intraluminal techniques]. (United States)

    Lablanche, J M


    Balloon-catheter angioplasty was introduced by Gruntzig in 1977 and has since proved effective, but 3 problems are still encountered: immediate reobstruction, restenosis during the first 3 months and extension of the procedure to a greater number of cases. In an attempt to solve these problems, other percutaneous/technics, associated or not with balloon angioplasty, have been devised. They are: (1) intraluminal stents which perfectly keep the vessel open after balloon angioplasty; (2) vaporization of atheromatous plaques by laser, and notably excimer laser which results in immediate recanalization, later completed by balloon angioplasty; (3) heating balloons which stick dissections and improve the immediate success rate; (4) atheroma-cutting and storing systems, such as Simpson's atherocath, cutting and aspirating systems, such as Stack's transluminal extraction catheter, or erasing systems, such as Auth's rotablator; (5) other sources of energy, such as ultrasounds, microwaves and radiofrequencies, will perhaps, be used in the near future. None of these new technics has solved the restenosis problem, but all have proved effective in suppressing the obstacle, there by giving hopes of reducing immediate complications and gradually widening the indications of percutaneous revascularization.

  15. [Ultrasound guided percutaneous nephrolithotripsy]. (United States)

    Guliev, B G


    The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2)--only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

  16. Percutaneous Nephrolithotomy in Children

    Directory of Open Access Journals (Sweden)

    Romano T. DeMarco


    Full Text Available The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi.

  17. Advances in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    Christopher Hartman


    Full Text Available Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND The increasing global prevalence of nephrolithiasis continues to burden the health care delivery systems of developing nations. Percutaneous Nephrolithotomy (PCNL is considered the standard treatment for many types of calculi. This study focuses on the complications of PCNL in private practice setting at a peripheral center using the modified Clavien system and role of Guy’s stone score as a predictor of stone free rate and complications. METHODS This is a prospective cohort study of 480 patients who underwent PCNL during August 2011 to July 2015. The complications were classified according to modified Clavien system and correlated with the stone complexity as per the Guy’s stone score. RESULTS It was found that overall 120 complications were reported in 480 patients with the incidence of complications of Grade I, II, IIIa, IIIb, IVb being 48 (10%, 38 (7.9%, 15 (3.5%, 12 (2.5% and 4 (0.8% respectively. As per the Guy’s stone score there were 336, 104 and 40 cases belonging to GSS I, II and III respectively. All grades of complications were more common in GSS II and III. The stone clearance was found to be complete in 95%, 82% and 75% of GSS I, II, III respectively. CONCLUSION The stone complexity is related to complication rate and GSS helps to predict stone free rate and complications

  19. Percutaneous renal tumour biopsy. (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo


    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  20. Alternative Treatment for Bleeding Peristomal Varices: Percutaneous Parastomal Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Pabon-Ramos, Waleska M., E-mail: [Duke University Hospital, Department of Radiology (United States); Niemeyer, Matthew M. [Washington University Medical Center, Mallinckrodt Institute of Radiology (United States); Dasika, Narasimham L., E-mail: [University of Michigan Health System, Department of Radiology (United States)


    Purpose: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach. Methods: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded. Median fluoroscopy time and bleeding-free interval were calculated. Results: Seven patients underwent eight parastomal embolizations. The technical success rate was 88 % (one failure). All embolizations were performed with coils combined with a sclerosant, another embolizing agent, or both. Of the seven successful parastomal embolizations, there were three cases of recurrent bleeding; the median time to rebleeding was 45 days (range 26-313 days). The remaining four patients did not develop recurrent bleeding during the follow-up period; their median bleeding-free interval was 131 days (range 40-659 days). Conclusion: This case review demonstrated that percutaneous parastomal embolization is a feasible technique to treat bleeding peristomal varices.

  1. Nephrostomy in percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Preminger, Glenn; Saussine, Christian


    PURPOSE: To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). METHODS: The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at...

  2. Percutaneous drainage of abdominal abcess

    Energy Technology Data Exchange (ETDEWEB)

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


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

  3. Image guided percutaneous splenic interventions

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Mandeep [Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012 (India)], E-mail:; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit [Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012 (India); Rajwanshi, Arvind [Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012 (India)


    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery.

  4. Complications of percutaneous vertebroplasty (United States)

    Saracen, Agnieszka; Kotwica, Zbigniew


    Abstract Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins—osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation. One thousand one hundred PVP were analyzed, performed in 616 patients. There were 468 (76%) women and 148 men (24%), 24 to 94-year old, mean age 68 years. From 1100 procedures, 794 treated osteporotic and 137 fractures due to malignant disease, 69 PVP were made in traumatic fractures. One hundred patients had painful vertebral hemangiomas. Seven hundred twenty-six (66%) lesions were in thoracic, and 374 (34%) in lumbar area. Results of treatment were assessed using 10 cm Visual Analogue Scale (VAS) 12 hours after surgery, 7 days, 30 days, and then each 6 months, up to 3 years. Before surgery all patients had significant pain 7 to 10 in VAS scale, mean 8.9 cm. Twelve  hours after surgery 602 (97.7%) reported significant relief of pain, with mean VAS of 2,3 cm. Local complications occurred in 50% of osteoporotic, 34% of neoplastic, 16% of traumatic fractures, and 2% of vertebral hemangiomas. The most common was PMMA leakage into surrounding tissues—20%; paravertebral vein embolism—13%; intradiscal leakage—8%; and PMMA leakage into the spinal canal—0.8%. Results of treatment did not differ between patients with and without any complications. From 104 patients who had chest X-ray or CT study performed

  5. Post-exposure therapy with recombinant human BuChE following percutaneous VX challenge in guinea-pigs


    Mumford, Helen; Troyer, John K.


    Poisoning by nerve agents via the percutaneous (p.c.) route is an issue because the slow absorption of agent could result in poisoning which outlasts the protection provided by conventional pharmacological therapy. The bioscavenger approach is based on the concept of binding nerve agent in the bloodstream, thus preventing nerve agent from reaching the target tissues and inhibiting acetylcholinesterase activity. One bioscavenger that has been extensively studied is human butyrylcholinesterase ...

  6. 经皮注射淋巴结超声造影在乳腺癌患者前哨淋巴结中的诊断价值%The daignostic value of contrast-enhanced ultras ound with percutaneous injection of contrast agents for the sentinel lymph nodes in breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    王泽爱; 樊云清; 王兴田


    Objective To compare the diagnostic values of conventional ultrasound and contrast -enhanced ultra-sound with percutaneous injection of contrast agents in the lymph nodes for the sentinel lymph nodes in breast cancer pa -tients.Methods A total of79 breast cancer patients who were admitted into our hospital from February 2013 to April 2015were enrolled into the current study .They were percutaneously injected with lyophilized powders for ultrasound ex -amination of the sentinel lymph nodes ,with methylene blue as a contrast agent .Meanwhile , they were subjected to con-ventional ultrasound .Results Among 42 patients performing contrast -enhanced ultrasound were 29 patients with the sentinel lymph nodes ( 38 lymph nodes ) , including 19 sentinel lymph nodes ( where 15 nodes were pathological diag-nosed), and 19 non-metastatic lymph nodes (where 17 nodes were pathological diagnosed ), achieving 83.3%sensitiv-ity, 92.3%specificity and 93.1% accuracy.Meanwhile, 21 lymph nodes were found in 37 patients after conventional ultrasound , including 13 sentinel lymph nodes ( where 10 nodes were pathological diagnosed ) , and 8 non-metastatic lymph nodes(where 6 nodes were pathological diagnosed ), achieving 37.5%sensitivity, 42.9%specificity and 53.8%accuracy.Compared with conventional ultrasound , contrast-enhanced ultrasound could produce significant improvement in sensitivity, specificity and accuracy for diagnosis of the sentinel lymph nodes in breast cancer patients ( P<0.05 ). Conclusion Contrast-enhanced ultrasound with percutaneous injection of contrast agents in the lymph nodes can well determine the sentinel lymph nodes in breast cancer patients , with superior clinical values to conventional ultrasound .%目的:探讨经皮注射淋巴结超声造影与常规超声对乳腺癌前哨淋巴结显像及转移的诊断价值。方法对79例乳腺癌患者进行研究,以手术过程中的亚甲蓝染色作为对比,应用经皮注射冻干粉剂对这些患者

  7. Percutaneous nephrolithotomy in early pregnancy. (United States)

    Shah, A; Chandak, P; Tiptaft, R; Glass, J; Dasgupta, P


    Most cases of urolithiasis in pregnancy are managed conservatively either with ureteric stents or percutaneous nephrostomy tubes, which need to be changed at regular intervals. Definitive management of the stone is usually delayed till after delivery. We describe a patient who presented with pyonephrosis in the fifth week of gestation, due to a stone obstructing the right ureteropelvic junction. This was managed by insertion of a nephrostomy tube. She declined nephrostomy tube/stent changes during the rest of her pregnancy and requested termination as an alternative. She successfully underwent percutaneous nephrolithotomy in the 14th week of pregnancy, with radiation exposure strictly localised to the kidney for 6 s. A healthy male baby was delivered at term.

  8. An update on percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Tefekli, A; Cordeiro, E; de la Rosette, J J M C H


    Since its introduction in late 1970's, percutaneous nephrolithotomy (PNL) has undergone an evolution in both equipment and technique. This evolution still continues today in the era of minimally invasive treatment options, and is evidenced by the numerous publications. PNL is generally advantageo...... patients managed with PNL worldwide and analyzed the data in detail, producing more than 25 scientific papers. And this update focuses on the lessons learned from the CROES PCNL Global Study....

  9. Morbidity after percutaneous liver biopsy.


    Lichtman, S; Guzman, C; Moore, D.; Weber, J L; Roberts, E.A.


    The safety of percutaneous liver biopsy with a 1.2 mm Menghini needle in infants aged one year or less was investigated. One hundred and eighty four procedures performed from 1975 to 1985 were reviewed. There were no deaths or major complications within 48 hours associated with the procedure. In five instances specific complications occurred: a drop in haemoglobin concentration (three), transient hypotension (one), and haematoma at the biopsy site (one). The result of liver biopsy was diagnos...

  10. Percutaneous ethanol injection therapy of autonomous (toxic)thyroid nodules

    Institute of Scientific and Technical Information of China (English)

    Dieter Erich Apitzsch. M.D.; Staedtische Paracelsusklinik; Marl, Germany


    @@ Percutaneous ethanol injection therapy(PElT) has been established as an interventional method of the ablation of hepatic malignancies, especially hepatocellular carcinoma(HCC), since long. Its effects are based on cellular dehydration,toxic and coagulation necrosis and thrombosis of small venules within the tumour. The result is fibrosis of the damaged tissue, loss of function and shrinkage. Hence the "ablative" effect of absolute(95%) ethanol. The more confined ally lesion the better the ablative effect due to the high concentration of the toxic liquid. Highest effects will be achieved in encapsulated nodules which prevent diffusion of the toxic agent into surrounding normal tissue which is the case in HCC.

  11. Percutaneously implanted markers in peripheral lung tumours

    DEFF Research Database (Denmark)

    Persson, G.F.; Josipovic, Mirjana; Nygaard, Ditte Eklund;


    A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications.......A letter to the editor is presented which is concerned with research which investigated percutaneously implanted markers in peripheral lung tumours and their complications....


    Directory of Open Access Journals (Sweden)

    V. A. Sulimov


    Full Text Available Possibilities of modern antiplatelet and antithrombotic therapy at percutaneous coronary interventions in patients with coronary artery disease are surveyed. Data of multicenter randomized clinical trials and meta-analyses are discussed. Possibilities of various drugs at percutaneous coronary interventions are reported from position of the international clinical guidelines.

  13. MR guided percutaneous laser lumbar disk hernia ablation

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Takuo; Terao, Tohru; Ishibashi, Toshihiro; Yuhki, Ichiro; Harada, Junta; Tashima, Michiko [Jikei Univ., Chiba (Japan). Kashiwa Hospital; Abe, Toshiaki


    An MRI unit for interventional procedure is very useful for minimally invasive surgery of the brain and spine. Percutaneous laser disc decompression (PLDD) utilizing X-ray fluoroscopy is a relatively new less invasive procedure for treatment of lumbar disc herniation. MR guided laser surgery is applied to patients with disc herniation at our department. Approaching the target of the disc protrusion was easily conducted and vaporizing the disc hernia directly using a laser was possible under MR fluoroscopy. The purpose of the present study is to evaluate the usefulness of MR guided percutaneous laser disc hernia ablation (MR-guided PLDHA). As subjects, 36 patients with lumbar disc herniation, including 23 cases with L4/5 involvement and 13 cases with L5/S1 involvement were studied. Among these, 26 were males and 10 were females, age ranging from 24 to 62. We used an open type MR system (Hitachi, Airis 0.3T), a permanent, open configuration MR system. A YAG laser (LaserScope, USA) was used for PLDHA. An MR compatible 18G titanium needle 15 cm in length was used to puncture the herniated discs. The MR compatible needle was clearly visualized, and used to safely and accurately puncture the target herniated disc in each case with multidimensional guidance. Application of the laser was performed with MR guidance. The energy dose from the laser ranged from 800 to 2100 joules. In most cases, signs and symptoms improved in the patients immediately after disc vaporization. The overall success rate was 88.9%. The complication rate was 2.8%, including one case of discitis after PLDHA. MR fluoroscopy sequence permits near real time imaging and provides an easy approach to the therapeutic target of disc herniation. MR guided PLDHA is a minimally invasive procedure and is very useful for the treatment of lumbar disc protrusion. (author)

  14. Vapor Pressure of N,N’-Diisopropylcarbodiimide (DICDI) (United States)


    physical property that is critical for understanding the behavior of chemicals in the laboratory as well as in the environment. Knowledge of vapor...diisopropylcarbodiimide, also known as DICDI, is a stabilizer for chemical warfare nerve agents such as VX and GD. The vapor pressure of DICDI was measured using...and unpublished data cited in this report. This report includes derived properties, such as volatility, temperature-dependent heats of vaporization

  15. Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review. (United States)

    Vogel, Arndt; Gupta, Sanjay; Zeile, Martin; von Haken, Rebecca; Brüning, Roland; Lotz, Gösta; Vahrmeijer, Alexander; Vogl, Thomas; Wacker, Frank


    The Hepatic CHEMOSAT(®) Delivery System is an innovative medical device for the treatment of patients with unresectable primary liver tumors or unresectable hepatic metastases from solid organ malignancies. This system is used to perform chemosaturation percutaneous hepatic perfusion (CS-PHP), a procedure in which a high dose of the chemotherapeutic agent melphalan is delivered directly to the liver while limiting systemic exposure. In a clinical trial program, CS-PHP with melphalan significantly improved hepatic progression-free survival in patients with unresectable hepatic metastases from ocular or cutaneous melanoma. Clinically meaningful hepatic responses were also observed in patients with hepatocellular carcinoma or neuroendocrine tumors. Furthermore, the results of published studies and case reports demonstrated that CS-PHP with melphalan resulted in favorable tumor response rates in a range of tumor histologies (ocular or cutaneous melanoma, colorectal cancer, and hepatobiliary tumors). Analyses of the safety profile of CS-PHP revealed that the most common adverse effects were hematologic events (thrombocytopenia, anemia, and neutropenia), which were clinically manageable. Taken together, these findings indicate that CS-PHP is a promising locoregional therapy for patients with primary and secondary liver tumors and has a acceptable safety profile.

  16. Recent Advances in Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Erem Kaan Basok


    Full Text Available The continuous innovations in technology, instrumentations, and techniques allow urologists to perform percutaneous nephrolithotomy (PCNL with increasing efficacy. Although recent advances have facilitated the procedure, some steps are still challenging. A thorough review of the recent urologic literature was performed to identify these improvements in PCNL technique. The newer developments mainly focused on multimodal imaging techniques, miniaturisation of instruments, tracking and navigation systems during access to the stone, and robotic systems. Further studies are necessary to better define the benefits of these new fruitful developments which remain an active research field.

  17. Percutaneous Surgery of the Forefoot. (United States)

    Redfern, David; Vernois, Joel; Legré, Barbara Piclet


    This article describes some of the common techniques used in percutaneous surgery of the forefoot. Techniques such as minimally invasive chevron Akin osteotomy for correction of hallux valgus, first metatarsophalangeal joint cheilectomy, distal minimally invasive metatarsal osteotomies, bunionette correction, and hammertoe correction are described. This article is an introduction to this rapidly developing area of foot and ankle surgery. Less invasive techniques are continually being developed across the whole spectrum of surgical specialties. The surgical ethos of minimizing soft-tissue disruption in the process of achieving surgical objectives remains at the center of this evolution.

  18. Pharmacology of antiplatelet agents. (United States)

    Kalra, Kiran; Franzese, Christopher J; Gesheff, Martin G; Lev, Eli I; Pandya, Shachi; Bliden, Kevin P; Tantry, Udaya S; Gurbel, Paul A


    Pharmacotherapies with agents that inhibit platelet function have proven to be effective in the treatment of acute coronary syndromes, and in the prevention of complications during and after percutaneous coronary intervention. Because of multiple synergetic pathways of platelet activation and their close interplay with coagulation, current treatment strategies are based not only on platelet inhibition, but also on the attenuation of procoagulant activity, inhibition of thrombin generation, and enhancement of clot dissolution. Current strategies can be broadly categorized as anticoagulants, antiplatelet agents, and fibrinolytics. This review focuses on the pharmacology of current antiplatelet therapy primarily targeting the inhibition of the enzyme cyclooxygenase 1, the P2Y12 receptor, the glycoprotein IIb/IIIa receptor, and protease-activated receptor 1.

  19. On the acoustic properties of vaporized submicron perfluorocarbon droplets. (United States)

    Reznik, Nikita; Lajoinie, Guillaume; Shpak, Oleksandr; Gelderblom, Erik C; Williams, Ross; de Jong, Nico; Versluis, Michel; Burns, Peter N


    The acoustic characteristics of microbubbles created from vaporized submicron perfluorocarbon droplets with fluorosurfactant coating are examined. Utilizing ultra-high-speed optical imaging, the acoustic response of individual microbubbles to low-intensity diagnostic ultrasound was observed on clinically relevant time scales of hundreds of milliseconds after vaporization. It was found that the vaporized droplets oscillate non-linearly and exhibit a resonant bubble size shift and increased damping relative to uncoated gas bubbles due to the presence of coating material. Unlike the commercially available lipid-coated ultrasound contrast agents, which may exhibit compression-only behavior, vaporized droplets may exhibit expansion-dominated oscillations. It was further observed that the non-linearity of the acoustic response of the bubbles was comparable to that of SonoVue microbubbles. These results suggest that vaporized submicron perfluorocarbon droplets possess the acoustic characteristics necessary for their potential use as ultrasound contrast agents in clinical practice.

  20. Percutaneous treatment of liver hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan; Oezmen, Mustafa N


    Hydatic disease caused by Echinococcus granulosus is an endemic disease and an important public health problem in some countries of the world. The results of surgical treatment are associated with a high rate of mortality, morbidity, postoperative recurrence and a long period of hospital stay and the medical treatment results are still controversial. Although the percutaneous aspiration and treatment of liver hydatid cysts were considered to be contraindicated due to risks of anaphylactic shock and dissemination of clear-crystal fluid into the abdomen, several reports of successful percutaneous treatment of liver hydatid cysts have been published in the literature. Today, percutaneous treatment of liver hydatid cysts is the most effective and reliable treatment procedure in the selected cases. In this review, indications, contraindications, method and techniques, healing criteria, complications, results and importance of the percutaneous treatment of liver hydatid cysts are discussed.

  1. Prone and supine percutaneous nephrolithotomy. (United States)

    Lucarelli, G; Breda, A


    Since the first successful stone extraction through a nephrostomy in 1976, percutaneous nephrolithotomy (PCNL) has became the preferred procedure especially for treatment of large, complex and staghorn calculi. For decades this method has been performed with the patient in the prone position. More recently, particular interest has been taken on supine PCNL due to less anestesiological risks and the possibility of simultaneous anterograde and retrograde access to the whole urinary tract. Although many retrospective studies have been published, only two prospective trials comparing the two positions are reported in the literature. The best access to PCNL represents still a controversial issue. The overall experience reported in literature indicates that each modality is equally feasible and safe. Therefore, to date the surgeon's preference is the prime indication to one access over the other.

  2. Pulmonary Cement Embolism following Percutaneous Vertebroplasty

    Directory of Open Access Journals (Sweden)

    Ümran Toru


    Full Text Available Percutaneous vertebroplasty is a minimal invasive procedure that is applied for the treatment of osteoporotic vertebral fractures. During vertebroplasty, the leakage of bone cement outside the vertebral body leads to pulmonary cement embolism, which is a serious complication of this procedure. Here we report a 48-year-old man who was admitted to our hospital with dyspnea after percutaneous vertebroplasty and diagnosed as pulmonary cement embolism.

  3. Duodenal damage complicating percutaneous access to kidney


    Antonio Corrêa Lopes Neto; Marcos Tobias-Machado; Roberto Vaz Juliano; Marco Aurélio Lipay; Milton Borrelli; Eric Roger Wroclawski


    CONTEXT: Since the first percutaneous nephrostomy performed by Goodwin in 1954, technical advances in accessing the kidneys via percutaneous puncture have increased the use of this procedure and thus the complications too. Among these complications, digestive tract damage is not common. DESIGN: Case report. CASE REPORT: We report a duodenal lesion that was corrected using surgical exploration and we touch on the therapeutic options, which may be conservative or interventionist. We chose conse...

  4. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj;


    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  5. [Percutaneous myocardial laser revascularization (PMR)]. (United States)

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G


    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity. Between January 1997 and November 1999, this "percutaneous myocardial laser revascularization" (PMR) has been performed in 101 patients at the Herzzentrum Leipzig. In 63 patients, only 1 region of the heart (anterior, lateral, inferior or septal) was treated with PMR, in 38 patients 2 or 3 regions were treated in 1 session. There were 12.3 +/- 4.5 (range 4 to 22) channels/region created into the myocardium. After 3 months, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3 +/- 0.4, after 6 months: 1.6 +/- 0.8) (p PMR, the CCS class after 2 years was 1.3 +/- 0.7, exercise capacity was 500 +/- 193 s. However, thallium scintigraphy failed to show increased perfusion in the PMR treated regions. The pathophysiologic mechanisms of myocardial laser revascularization is not yet understood. Most of the laser channels are found occluded after various time intervals after intervention. Other possible mechanisms include myocardial denervation or angioneogenesis after laser revascularization, however, unequivocal evidence for these theories is not yet available. In conclusion, PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity, whereas evidence of increased perfusion after laser

  6. Bivalirudin in percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Sam J Lehman


    Full Text Available Sam J Lehman, Derek P ChewDepartment of Medicine, Flinders University, South Australia, AustraliaAbstract: Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants. It has been evaluated as an alternative to unfractionated and low-molecular-weight heparins in the settings of percutaneous coronary intervention (PCI and acute coronary syndrome (ACS. Results of clinical trials to date suggest bivalirudin is a viable alternative to the use of a heparin combined with a glycoprotein (GP IIb/IIIa inhibitor in these settings. Thrombin has a central role in coagulation and platelet activation in ACS and during PCI. Its direct inhibition is an attractive target for therapy in these settings. Bivalirudin is a 20 amino acid polypeptide hirudin analog. It displays bivalent and reversible binding to the thrombin molecule, inhibiting its action. Direct inhibition of thrombin with bivalirudin has theoretical pharmacokinetic and pharmacodynamic advantages over the indirect anticoagulants. A reduction in rates of bleeding without loss of anti-thrombotic efficacy has been a consistent finding across multiple clinical trials. There may be economic benefits to the use of bivalirudin if it permits a lower rate of use of the GP IIb/IIIa inhibitors. This article reviews the pharmacology of bivalirudin and clinical trial evidence to date. There are now data from multiple clinical trials and meta-analyses in the setting of ACS and PCI. Early results from the acute catheterization and urgent intervention strategy (ACUITY trial are discussed. Keywords: bivalirudin, direct thrombin inhibitor, acute coronary syndrome, percutaneous coronary intervention

  7. Percutaneous catheter drainage of intrapulmonary fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Park, E. D.; Kim, H. J.; Choi, P. Y.; Jung, S. H. [Gyeongsang National University Hospital, Chinju (Korea, Republic of)


    With the success of percutaneous abdominal abscess drainage, attention is now being focused on the use of similar techniques in the thorax. We studied to evaluate the effect of percutaneous drainage in parenchymal fluid collections in the lungs. We performed percutaneous drainage of abscesses and other parenchymal fluid collections of the lungs in 15 patients. All of the procedures were performed under the fluoroscopic guidance with an 18-gauge Seldinger needle and coaxial technique with a 8-10F drainage catheter. Among 10 patients with lung abscess, 8 patients improved by percutaneous catheter drainage. In one patient, drainage was failed by the accidental withdrawal of the catheter before complete drainage. One patient died of sepsis 5 hours after the procedure. Among three patients with complicated bulla, successful drainage was done in two patients, but in the remaining patient, the procedure was failed. In one patient with intrapulmonary bronchogenic cyst, the drainage was not successful due to the thick internal contents. In one patient with traumatic hematoma, after the drainage of old blood clots, the signs of infection disappeared. Overally, of 14 patients excluding one who died, 11 patients improved with percutaneous catheter drainage and three patients did not. There were no major complications during and after the procedure. We conclude that percutaneous catheter drainage is effective and safe procedure for the treatment of parenchymal fluid collections of the lung in patients unresponsive to the medical treatment.

  8. Process to produce silicon carbide fibers using a controlled concentration of boron oxide vapor (United States)

    Barnard, Thomas Duncan (Inventor); Lipowitz, Jonathan (Inventor); Nguyen, Kimmai Thi (Inventor)


    A process for producing polycrystalline silicon carbide by heating an amorphous ceramic fiber that contains silicon and carbon in an environment containing boron oxide vapor. The boron oxide vapor is produced in situ by the reaction of a boron containing material such as boron carbide and an oxidizing agent such as carbon dioxide, and the amount of boron oxide vapor can be controlled by varying the amount and rate of addition of the oxidizing agent.

  9. Percutaneous local therapies for hepatocellular carcinoma impair gastric function

    Institute of Scientific and Technical Information of China (English)

    Fumihiko Kinekawa; Shigeki Kuriyama; Kazuya Matsuda; Tsutomu Masaki; Kazutaka Kurokohchi; Hirohito Yoneyama; Hideyuki Inoue; Hirohide Kurata; Yoshihito Uchida; Seishiro Watanabe


    @@ TO THE EDITOR Percutaneous local therapies, such as percutaneous ethanol injection (PEI), microwave coagulation and radiofrequency ablation (RFA), are frequently used worldwide for the treatment of hepatocellular carcinoma (HCC) because of their high effectiveness.

  10. [Percutaneous diagnostic angioscopy. Primary lesions]. (United States)

    Carlier, C; Foucart, H; Baudrillard, J C; Cécile, J P


    Efficacy of percutaneous treatments of arterial affections requires the correct choice of indications, necessitating precise knowledge of elementary arterial lesions. Arterial endoscopy appears to be more specific than angiography for this use, since it allows direct vision in vivo of the lesion, a histopathologic approach compared with the non univocal images produced by angiography (for example, an arterial obstruction can result from varied causes). Different accidents to the endothelial surface can be observed: golden yellow atheromatous elevations on a straw yellow background, intimal flaps, mobile intra-luminal vegetations. Established atheromatous stenosis are smooth and regular, or on the contrary ulcerated and edged with irregular flaps capable of provoking an eccentric residual lumen. The vegetating atheromatous lesions may project into the lumen, often as calcified and thus pearly white scales adhering to the wall, or as larger occlusive lesions. When capable of being isolated, a thrombus often completes the stenosis: its recognition is therefore fundamental since its removal exposes the subjacent lesions to be treated. The fresh clot is coral shaped, bright red and mobile in the blood flow. Established clots are compact and greenish brown. At an advanced stage of atheroma the surface of the occluding clot is covered with a regular straw yellow endothelium. In the presence of a dissecting vessel the fibroscope may be introduced into the false channel, no longer showing typical endothelium but a coagulated mass interspersed with fibrous bands. Prosthetic stenosis result from either intimal hyperplasia or a suturing fault with plication.

  11. [Current options for percutaneous endoscopic access to the digestive tract

    NARCIS (Netherlands)

    Romkens, T.E.H.; Jong, D.J. de; Kristinsson, J.O.; Wanten, G.J.A.


    Four patients, aged 67, 52, 56 and 64 years, respectively, undergoing percutaneous colostomy or jejunostomy are presented to illustrate current options for percutaneous endoscopic access to the digestive tract. The first patient had Parkinson's disease and required percutaneous jejunostomy for conti

  12. A novel approach to assessing percutaneous VX poisoning in the conscious guinea-pig. (United States)

    Mumford, Helen; Price, Matthew E; Wetherell, Janet R


    Nerve agents like VX (S-2-diisopropylaminoethyl-O-ethyl-methylphosphonothiolate) are potent irreversible acetylcholinesterase (AChE) inhibitors. Following percutaneous nerve agent exposure there is a slower rate of absorption, later onset and longer duration of signs of poisoning. Relatively little is known about the physiological effects of percutaneously applied nerve agent in unanaesthetised laboratory animals. Heart rate (ECG), brain electrical activity (EEG), body temperature, locomotor activity and clinical signs were monitored following percutaneous application of VX to conscious guinea-pigs.A fall in heart rate (bradycardia) preceded incapacitation following the highest VX dose, and occurred in the absence of incapacitation at the lower doses. Following the highest dose of VX (0.592 mg kg(-1)) three out of four animals died within 24 h. The lower two doses of VX (0.296 and 0.148 mg kg(-1)), produced extended periods of bradycardia in the absence of observable signs of poisoning. Bradycardia preceded, or occurred in the absence of, a temperature decrease; seizure-like EEG changes were not observed at any of the VX doses tested. Acetylcholinesterase activity was significantly inhibited in the blood and most brain areas at 48 h. There were significant dose-related decreases in body weight at 24 and 48 h following VX. This preliminary study suggests that decreased heart rate may be an early sign of the toxic effects of VX, whereas temperature and observable clinical signs are not good early indicators of percutaneous VX poisoning in this animal model. Future studies will use this model to assess the benefit of administering medical countermeasures in response to a defined decrease in heart rate.

  13. Thermodynamics and Kinetics of Silicate Vaporization (United States)

    Jacobson, Nathan S.; Costa, Gustavo C. C.


    Silicates are a common class of materials that are often exposed to high temperatures. The behavior of these materials needs to be understood for applications as high temperature coatings in material science as well as the constituents of lava for geological considerations. The vaporization behavior of these materials is an important aspect of their high temperature behavior and it also provides fundamental thermodynamic data. The application of Knudsen effusion mass spectrometry (KEMS) to silicates is discussed. There are several special considerations for silicates. The first is selection of an appropriate cell material, which is either nearly inert or has well-understood interactions with the silicate. The second consideration is proper measurement of the low vapor pressures. This can be circumvented by using a reducing agent to boost the vapor pressure without changing the solid composition or by working at very high temperatures. The third consideration deals with kinetic barriers to vaporization. The measurement of these barriers, as encompassed in a vaporization coefficient, is discussed. Current measured data of rare earth silicates for high temperature coating applications are discussed. In addition, data on magnesium-iron-silicates (olivine) are presented and discussed.

  14. Percutaneous isolated limb perfusion with thrombolytics for severe limb ischemia. (United States)

    Ali, Ahsan T; Kalapatapu, Venkat R; Bledsoe, Shelly; Moursi, Mohammed M; Eidt, John F


    Patients with severe tibioperoneal disease are poor candidates for a distal bypass. Absence of a distal target, lack of conduit, or multiple medical problems can make these patients a prohibitive risk for revascularization. Acute on chronic ischemia in this group poses a greater challenge. Thrombolytic therapy for acute ischemia can be prolonged and carries a significant risk of bleeding if continued beyond 24 hours. However, if the ischemic limbs can be isolated from the systemic circulation, a higher dose of the lytic agent can be given with lower risk. These are the initial results of a series of 10 patients who underwent percutaneous isolated limb perfusion with a high dose of thrombolytics for severe ischemia. Ten patients (lower extremity 8 and upper extremity 2) presented with severe limb-threatening ischemia. Mean ankle/brachial index (ABI) was 0.15 for the lower extremity, and there were no recordable digital pressures in patients with upper extremity ischemia. No distal target was visible on the initial arteriogram. These patients were then taken to the operating room, and under anesthesia, catheters were placed in an antegrade fashion via femoral approach in the popliteal artery and vein percutaneously. For upper extremity, the catheters were placed in the brachial artery and vein. A proximal tourniquet was then applied. This isolated the limb from the systemic circulation. Heparinized saline was infused through the arterial catheter while the venous catheter was left open. A closed loop or an isolated limb perfusion was confirmed when effluent became clear coming out of the venous port. A high dose of thrombolytic agent (urokinase 500,000 to 1,000,000 U) was infused into the isolated limb via the arterial catheter and drained out of the venous catheter. After 45 minutes, arterial flow was reestablished. In 4 patients, Reopro((R)) was used in addition to thrombolytics. Postprocedure angiograms showed minimal changes, but patients exhibited marked

  15. AMTEC vapor-vapor series connected cells (United States)

    Underwood, Mark L.; Williams, Roger M.; Ryan, Margaret A.; Nakamura, Barbara J.; Oconnor, Dennis E.


    An alkali metal thermoelectric converter (AMTEC) having a plurality of cells structurally connected in series to form a septum dividing a plenum into two chambers, and electrically connected in series, is provided with porous metal anodes and porous metal cathodes in the cells. The cells may be planar or annular, and in either case a metal alkali vapor at a high temperature is provided to the plenum through one chamber on one side of the wall and returned to a vapor boiler after condensation at a chamber on the other side of the wall in the plenum. If the cells are annular, a heating core may be placed along the axis of the stacked cells. This arrangement of series-connected cells allows efficient generation of power at high voltage and low current.

  16. Pulse sequences for uniform perfluorocarbon droplet vaporization and ultrasound imaging. (United States)

    Puett, C; Sheeran, P S; Rojas, J D; Dayton, P A


    Phase-change contrast agents (PCCAs) consist of liquid perfluorocarbon droplets that can be vaporized into gas-filled microbubbles by pulsed ultrasound waves at diagnostic pressures and frequencies. These activatable contrast agents provide benefits of longer circulating times and smaller sizes relative to conventional microbubble contrast agents. However, optimizing ultrasound-induced activation of these agents requires coordinated pulse sequences not found on current clinical systems, in order to both initiate droplet vaporization and image the resulting microbubble population. Specifically, the activation process must provide a spatially uniform distribution of microbubbles and needs to occur quickly enough to image the vaporized agents before they migrate out of the imaging field of view. The development and evaluation of protocols for PCCA-enhanced ultrasound imaging using a commercial array transducer are described. The developed pulse sequences consist of three states: (1) initial imaging at sub-activation pressures, (2) activating droplets within a selected region of interest, and (3) imaging the resulting microbubbles. Bubble clouds produced by the vaporization of decafluorobutane and octafluoropropane droplets were characterized as a function of focused pulse parameters and acoustic field location. Pulse sequences were designed to manipulate the geometries of discrete microbubble clouds using electronic steering, and cloud spacing was tailored to build a uniform vaporization field. The complete pulse sequence was demonstrated in the water bath and then in vivo in a rodent kidney. The resulting contrast provided a significant increase (>15 dB) in signal intensity.

  17. Percutaneous epidural drainage through a burr hole

    Directory of Open Access Journals (Sweden)

    Priscila M Falsarella


    Full Text Available Intracranial extradural collection may cause an increase in intracranial pressure, requiring rapid emergency treatment to reduce morbidity and mortality. We described an alternative CT-guided percutaneous access for extradural collection drainage. We report a case of a patient with previous craniectomy for meningioma ressection who presented to the Emergency Department with symptoms of intracranial hypertension. Brains CT showed a extradural collection with subfalcine herniation. After multidisciplinary discussion a CT-guided percutaneous drainage through previous burr hole was performed. The patient was discharged after 36 hours of admission, without further symptoms. We describe a safe and effective alternative percutaneous access for extradural collection drainage in patients with previous burr hole.

  18. Vapor Control Layer Recommendations

    Energy Technology Data Exchange (ETDEWEB)



    This information sheet describes the level of vapor control required on the interior side of framed walls with typical fibrous cavity insulation (fibreglass, rockwool, or cellulose, based on DOE climate zone of construction.

  19. Gasoline Vapor Recovery (United States)


    Gasoline is volatile and some of it evaporates during storage, giving off hydrocarbon vapor. Formerly, the vapor was vented into the atmosphere but anti-pollution regulations have precluded that practice in many localities, so oil companies and storage terminals are installing systems to recover hydrocarbon vapor. Recovery provides an energy conservation bonus in that most of the vapor can be reconverted to gasoline. Two such recovery systems are shown in the accompanying photographs (mid-photo at right and in the foreground below). They are actually two models of the same system, although.configured differently because they are customized to users' needs. They were developed and are being manufactured by Edwards Engineering Corporation, Pompton Plains, New Jersey. NASA technological information proved useful in development of the equipment.

  20. Percutaneous tricuspid valve replacement in childhood

    Directory of Open Access Journals (Sweden)

    Mathias Emmel


    Full Text Available Percutaneous replacement of the tricuspid valve with a bovine jugular venous valve (melody valve was successfully undertaken in a 9-year-old boy. The patient had a previous history of bacterial endocarditis of the native tricuspid valve in infancy. Initially, a pericardial patch valve was created, followed by surgical replacement of the valve using a biological tissue valve at 4 years of age. Progressive stenosis and regurgitation of the biological valve, with severe venous congestion and resulting hepatic dysfunction prompted percutaneous valve replacement.

  1. New developments in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    S. Derisavifard


    Full Text Available Percutaneous stone surgery is the gold standard in removing large renal calculi. In light of the increase in prevalence and size of renal stones being addressed in recent years, numerous advances have been made in attempts of improving the morbidity, efficacy, and technical ease of stone clearance. In this review article, we assess new advancements in percutaneous stone surgery including diagnosis and surgical planning, methods of renal access, patient positioning, tract dilation, nephroscopes, lithotripsy, and post-operative drainage and antibiotic prophylaxis.

  2. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F., E-mail: [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)


    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  3. Percutaneous endoscopic gastrostomy in children

    Directory of Open Access Journals (Sweden)

    Jye Hae Park


    Full Text Available Purpose: Percutaneous endoscopic gastrostomy (PEG can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6 months. Results: Mean patient age was 9.4 (4.5 years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD. The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87% had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  4. Nitric acid vapor removal by activated, impregnated carbons

    Energy Technology Data Exchange (ETDEWEB)

    Wood, G.O.


    Laboratory and industrial workers can be exposed to vapors of nitric acid, especially in accidents, such as spills. Nitric acid can also be a product of incineration for energy production or waste (e.g., CW agent) disposal. Activated carbons containing impregnants for enhancing vapor and gas removal have been tested for effectiveness in removing vapors of nitric acid from air. The nitric acid vapor was generated from concentrated acid solutions and detected by trapping in a water bubbler for pH measurements. Both low and moderate relative humidity conditions were used. All carbons were effective at vapor contact times representative of air-purifying respirator use. One surprising observation was the desorption of low levels of ammonia from impregnated carbons. This was apparently due to residual ammonia from the impregnation processes.

  5. Improvements in Intracorporeal Lithotripters for Percutaneous Nephrolithotomy (United States)

    Kuo, Ramsay L.


    Percutaneous nephrolithotomy (PNL) is an effective minimally invasive surgical approach for the treatment of large renal stone burden. Intracorporeal lithotripters (ICL) are utilized during PNL to fragment calculi, with some devices capable of concurrently removing fragments as well. Much progress has been made in the design of ICL devices, resulting in potentially more efficient treatment of nephrolithiasis.

  6. Exit strategies following percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Gonzalez, Gaspar Ibarlucea; Tolley, David


    PURPOSE: To compare the characteristics and outcomes of exit strategies following percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. MATERIALS AND METHODS: Two matched data sets were prepared in order to compare...... was associated with significantly longer operating times (p = 0.029) and longer hospital stay (p ...

  7. Percutaneous penetration studies for risk assessment

    NARCIS (Netherlands)

    Sartorelli, P.; Andersen, H.R.; Angerer, J.; Corish, J.; Drexler, H.; Göen, T.; Griffin, P.; Hotchkiss, S.A.M.; Larese, F.; Montomoli, L.; Perkins, J.; Schmelz, M.; Sandt, J. van de; Williams, F.


    During the last few years the general interest in the percutaneous absorption of chemicals has increased. It is generally accepted that there is very few reliable quantitative and qualitative data on dermal exposure to chemicals in the general population and in occupationally exposed workers. In ord

  8. Appropriateness of Percutaneous Coronary Intervention (United States)

    Chan, Paul S.; Patel, Manesh R.; Klein, Lloyd W.; Krone, Ronald J.; Dehmer, Gregory J.; Kennedy, Kevin; Nallamothu, Brahmajee K.; Douglas Weaver, W.; Masoudi, Frederick A.; Rumsfeld, John S.; Brindis, Ralph G.; Spertus, John A.


    Context Despite the widespread use of percutaneous coronary intervention (PCI), the appropriateness of these procedures in contemporary practice is unknown. Objective To assess the appropriateness of PCI in the United States. Design, Setting, and Patients Multicenter, prospective study of patients within the National Cardiovascular Data Registry undergoing PCI between July 1, 2009, and September 30, 2010, at 1091 US hospitals. The appropriateness of PCI was adjudicated using the appropriate use criteria for coronary revascularization. Results were stratified by whether the procedure was performed for an acute (ST-segment elevation myocardial infarction, non–ST-segment elevation myocardial infarction, or unstable angina with high-risk features) or nonacute indication. Main Outcome Measures Proportion of acute and nonacute PCIs classified as appropriate, uncertain, or inappropriate; extent of hospital-level variation in inappropriate procedures. Results Of 500 154 PCIs, 355 417 (71.1%) were for acute indications (ST-segment elevation myocardial infarction, 103 245 [20.6%]; non–ST-segment elevation myocardial infarction, 105 708 [21.1%]; high-risk unstable angina, 146 464 [29.3%]), and 144 737 (28.9%) for nonacute indications. For acute indications, 350 469 PCIs (98.6%) were classified as appropriate, 1055 (0.3%) as uncertain, and 3893 (1.1%) as inappropriate. For nonacute indications, 72 911 PCIs (50.4%) were classified as appropriate, 54 988 (38.0%) as uncertain, and 16 838 (11.6%) as inappropriate. The majority of inappropriate PCIs for nonacute indications were performed in patients with no angina (53.8%), low-risk ischemia on noninvasive stress testing (71.6%), or suboptimal (≤1 medication) antianginal therapy (95.8%). Furthermore, although variation in the proportion of inappropriate PCI across hospitals was minimal for acute procedures, there was substantial hospital variation for nonacute procedures (median hospital rate for inappropriate PCI, 10

  9. Vapor pressures and enthalpies of vaporization of azides

    Energy Technology Data Exchange (ETDEWEB)

    Verevkin, Sergey P., E-mail: [Department of Physical Chemistry, University of Rostock, Dr-Lorenz-Weg 1, D-18059 Rostock (Germany); Emel' yanenko, Vladimir N. [Department of Physical Chemistry, University of Rostock, Dr-Lorenz-Weg 1, D-18059 Rostock (Germany); Algarra, Manuel [Centro de Geologia do Porto, Faculdade de Ciencias, Universidade do Porto, Rua do Campo Alegre 687, 4169-007 Porto (Portugal); Manuel Lopez-Romero, J. [Department of Organic Chemistry, University of Malaga. Campus de Teatinos s/n, 29071 Malaga (Spain); Aguiar, Fabio; Enrique Rodriguez-Borges, J.; Esteves da Silva, Joaquim C.G. [Centro de Investigacao em Quimica (CIQ-UP), Faculdade de Ciencias da Universidade do Porto, Rua do Campo Alegre 687, 4169-007 Porto (Portugal)


    Highlights: > We prepared and measured vapor pressures and vaporization enthalpies of 7 azides. > We examined consistency of new and available in the literature data. > Data for geminal azides and azido-alkanes selected for thermochemical calculations. - Abstract: Vapor pressures of some azides have been determined by the transpiration method. The molar enthalpies of vaporization {Delta}{sub l}{sup g}H{sub m} of these compounds were derived from the temperature dependencies of vapor pressures. The measured data sets were successfully checked for internal consistency by comparison with vaporization enthalpies of similarly structured compounds.

  10. Development of a Model for Nerve Agent Inhalation in Conscious Rats (United States)


    Toxicol Mech Meth 14:183–94. Bajgar J. (2004). Organophosphates /nerve agent poisoning : mechanism of action, diagnosis, prophylaxis, and treatment. Adv...See reprint. 15. SUBJECT TERMS Chemical warfare, cholinesterases, inhalation exposure, nerve agents, organophosphates , vapor 16. SECURITY...exposure system for assessing respiratory toxicity of vaporized chemical agents in untreated, non-anesthetized rats. The organophosphate diisopropyl

  11. Percutaneous coronary intervention in the elderly with ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Gao L


    Full Text Available Lei Gao,* Xin Hu,* Yu-Qi Liu, Qiao Xue, Quan-Zhou FengInstitute of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workAbstract: As a result of increased life expectancy, octogenarians constitute an increasing ­proportion of patients admitted to hospital for ST-segment elevation myocardial infarction (STEMI. Primary percutaneous coronary intervention is currently the treatment of choice for octogenarians presenting with STEMI. The recent literature on this topic has yielded controversial results, even though advances in drug-eluting stents and new types of antithrombotic agents are improving the management of STEMI and postoperative care. In this paper, we review the current status of percutaneous coronary intervention in the elderly with STEMI, including the reasons for their high mortality and morbidity, predictors of mortality, and strategies to improve outcomes.Keywords: octogenarians, percutaneous coronary intervention, ST-segment elevation myocardial infarction

  12. Percutaneous heart valves; past, present and future. (United States)

    Rozeik, M M; Wheatley, D J; Gourlay, T


    Percutaneous heart valves provide a promising future for patients refused surgery on the grounds of significant technical challenges or high risk for complications. Since the first human intervention more than 10 years ago, over 50 different types of valves have been developed. The CoreValve and Edwards SAPIEN valves have both experienced clinical trials and the latter has gained FDA approval for implantation in patients considered inoperable. Current complications, such as major vascular bleeding and stroke, prevent these valves from being commonly deployed in patients considered operable in conventional surgery. This review focuses on the past and present achievements of these valves and highlights the design considerations required to progress development further. It is envisaged that, with continued improvement in valve design and with increased clinical and engineering experience, percutaneous heart valve replacement may one day be a viable option for lower-risk operable patients.

  13. Percutaneous penetration through slightly damaged skin

    DEFF Research Database (Denmark)

    Nielsen, Jesper B


    Guidelines for experimental studies of percutaneous penetration prescribe optimal barrier integrity of the skin. The barrier integrity of the skin exposed in occupational or household situations is, however, not always ideal, and skin problems are among the most dominant reasons for absence from...... work. We have therefore evaluated an experimental model for percutaneous penetration through slightly damaged skin. The influence of a slight damage to the skin was evaluated using five pesticides covering a wide range of solubilities. We used an experimental model with static diffusion cells mounted...... with human skin. A slight damage to the barrier integrity was induced by pre-treatment of the skin with sodium lauryl sulphate (SLS) before pesticide exposure. The experimental model with 3 h pre-treatment with SLS (0.1% or 0.3%) assured a significant but controlled damage to the barrier integrity, a damage...

  14. Percutaneous treatment in patients presenting with malignant cardiac tamponade

    Energy Technology Data Exchange (ETDEWEB)

    Marcy, P.Y. [Antoine Lacassagne Center, Interventional Radiology Department, Nice (France); Bondiau, P.Y. [Antoine Lacassagne Center, Radiation Therapy Department, Nice (France); Brunner, P. [Centre Hospitalier Princesse, Grace (Monaco). Interventional Radiology Department


    The percutaneous treatment of pericardial effusion resulting in cardiac tamponade has undergone an evolution in recent years with the use of less invasive drainage techniques in selected cases. To determine optimal therapy modalities for oncology patients with malignant pericardial tamponade (MPT), the authors review their institutional experience with percutaneous needle puncture routes, means of imaging-guided drainage and percutaneous management of the pericardial fluid effusion (pericardial sclerosis and balloon pericardiotomy). Advantages and limits of the percutaneous techniques will be compared to the surgical treatment. (orig.)

  15. Percutaneous ultrasound guided umbilical cord blood sampling

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hyup; Choi, B. I.; Kim, C. W.; Youn, B. H.; Shin, H. C.; Kim, S. O. [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    This report describes a technique and the result of percutaneous ultrasound-guided umbilical cord blood sampling and its potential use in the management of diagnostic problems in the second and third trimester of pregnancy. This method has been employed in the prenatal assessment of 19 fetuses at risk for chromosomal disorders, fetal hypoxia and hematologic disorders. This simple and rapid procedure offers a safe access to the fetal circulation

  16. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik;


    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the ...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  17. Ultrasound Guided Percutaneous Nephrostomy For Obstructive Uropathy

    Directory of Open Access Journals (Sweden)

    Abdullah Gedik


    Full Text Available We retrospectively evaluated the indications and complications in our patients that were performed of percutaneous nephrostomy applications with ultrasonography guidance.We evaluated 371 all patients whom applied percutaneous nephrostomy with ultrasonography guidance between January 2002 and December 2005 were evaluated retrospectively. The demographic data, cause of the obstruction, minor and major complications of patients were discussed.In this period, totally 455 Percutaneous nephrostomies (84 bilaterally, 287 unilaterally in 371 patients (were placed in 113 females (30.45 % and 258 males were placed. The male (69.55% patients whom mean age of the patients were 32.17 year (range 5 months to 85 years. In 17 of 371 (3.73% patients, it was determined with antegrade pyelography that nephro stomy catheters were not in the kidney. Total success ratio was 96.37%. Causes of the obstructions were malignant diseases in for 76 patients (20.48% and were benign diseases in for 295 patients (79.52%. The major complications were determined twenty-four of patients (6.46%. Major complications included macroscopic hematuria which needs transfusion (7 patients, septicemia (14 patients, and retroperitoneal colon perforation with needle (3 patients were observed in 24 of the 371 patients. Minor complications were observed in 51 of the 371 patients (13.74 %. All of the minor complications were macroscopic hematuria that resolved in less than 24 hours. In conclusion, percutaneous nephrostomy with ultrasonography guidance were found as an effective and, safe and successful method for the drainage of upper urinary tract in the obstructive uropaty.

  18. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik;


    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  19. A Percutaneous Knotless Technique for SLAP Repair. (United States)

    Tennent, Duncan; Pearse, Eyiyemi


    We describe a percutaneous technique for repair of type II SLAP lesions. Through the Neviaser portal, a spinal needle is used to pass a FiberStick suture (Arthrex, Naples, FL) through the labrum to create 2 mattress sutures that are secured with PushLock anchors (Arthrex). This technique is simple, reproducible, and knotless and requires no cannulas. At the end of the procedure, minimal suture material remains in the joint.

  20. Percutaneous Zenith endografting for abdominal aortic aneurysms. (United States)

    Heyer, Kamaldeep S; Resnick, Scott A; Matsumura, Jon S; Amaranto, Daniel; Eskandari, Mark K


    A completely percutaneous approach to infrarenal abdominal aortic aneurysm (AAA) endografting has the theoretic benefits of being minimally invasive and more expedient. Our goal was to demonstrate the utility of this approach using a suprarenal fixation device and a suture-mediated closure system. We conducted a single-institution, retrospective review of 14 patients who underwent percutaneous AAA repair with the Zenith device between August 2003 and March 2007. Immediate and delayed access-related outcomes were examined over a mean follow-up of 12.1+/-2.0 months. Mean AAA size was 5.6 cm. Immediate arterial closure and technical success rate was 96% (27/28 vessels). One immediate hemostatic failure required open surgical repair. Over follow-up, one vessel required operative repair for new-onset claudication. No other immediate or delayed complications (thrombosis, pseudoaneurysm, infection, or deep venous thrombosis) were detected. A percutaneous approach for the treatment of AAA has several advantages over femoral artery cutdown but also has its own unique set of risks in the immediate and late postoperative period. Ultimately, the "preclose technique" can be safely applied for the Zenith device despite its large-bore delivery system.

  1. Percutaneous Cryoablation for Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Tsitskari Maria


    Full Text Available Renal cell carcinoma (RCC is the most common type of kidney cancer in adults. Nephron sparing resection (partial nephrectomy has been the “gold standard” for the treatment of resectable disease. With the widespread use of cross sectional imaging techniques, more cases of renal cell cancers are detected at an early stage, i.e. stage 1A or 1B.  This has provided an impetus for expanding the nephron sparing options and especially, percutaneous ablative techniques.  Percutaneous ablation for RCC is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection or when there is a need to preserve renal function due to comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. During the last few years, percutaneous cryoablation has been gaining acceptance as a curative treatment option for small renal cancers. Clinical studies to date indicate that cryoablation is a safe and effective therapeutic method with acceptable short and long term outcomes and with a low risk, in the appropriate setting.  In addition it seems to offer some advantages over radio frequency ablation (RFA and other thermal ablation techniques for renal masses.

  2. Imaging in percutaneous ablation for atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica [Erasmus Medical Center, Department of Radiology, GD Rotterdam (Netherlands); Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia); Dill, Thorsten [Kerckhoff-Heart Center, Department of Cardiology, Bad Nauheim (Germany); Ristic, Arsen D.; Seferovic, Petar M. [Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia)


    Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients. (orig.)

  3. Use of clopidogrel in the reduction of myocardial damage during percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Arijit Dasgupta


    Full Text Available Arijit Dasgupta, Debabrata MukherjeeGill Heart Institute, University of Kentucky, Lexington, KY, USAAbstract: It is estimated that approximately a quarter of patients undergoing coronary intervention may have significant post-procedural creatinine (CK/creatinine kinase myocardial band (CK-MB elevations and approximately half may have post-procedural troponin elevations. Current data suggest that periprocedural infarction is associated with short-, intermediate-, and long-term adverse outcomes, most notably mortality. This review examines the role of clopidogrel in decreasing periprocedural myonecrosis following percutaneous coronary intervention (PCI. Clopidogrel is an important pharmacologic agent used to reduce myocardial infarction post-coronary intervention as assessed directly by the evaluation of cardiac biomarkers and indirectly by the evaluation of short-term ischemic events. The optimal dose of clopidogrel is considered to be at least 300 mg given 6 to 15 hours prior to PCI but there is considerable evidence to suggest that a loading dose of 600 mg given 2 to 6 hours prior to PCI may be more efficacious in limiting post-coronary intervention events. The benefit obtained from clopidogrel appears independent of and incremental to that of other antiplatelet and antithrombotic agents used during and after coronary intervention.Keywords: percutaneous coronary intervention, myonecrosis, clopidogrel, antiplatelet agents, myocardial infarction 

  4. Female rats are less susceptible during puberty to the lethal effects of percutaneous exposure to VX


    Wright, Linnzi K.M.; Lee, Robyn B.; Clarkson, Edward D.; Lumley, Lucille A


    Nerve agents with low volatility such as VX are primarily absorbed through the skin when released during combat or a terrorist attack. The barrier function of the stratum corneum may be compromised during certain stages of development, allowing VX to more easily penetrate through the skin. However, age-related differences in the lethal potency of VX have yet to be evaluated using the percutaneous (pc) route of exposure. Thus, we estimated the 24 and 48 h median lethal dose for pc exposure to ...

  5. Percutaneous management of tumoral biliary obstruction in children

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe School of Medicine, Department of Radiology, Sihhiye, Ankara (Turkey); Ekinci, Saniye [Hacettepe School of Medicine, Department of Paediatric Surgery, Sihhiye, Ankara (Turkey); Akcoren, Zuhal [Hacettepe School of Medicine, Department of Paediatric Pathology, Sihhiye, Ankara (Turkey); Kutluk, Tezer [Hacettepe School of Medicine, Department of Paediatric Oncology, Sihhiye, Ankara (Turkey)


    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  6. A Rare Complication of Percutaneous Nephrolithotomy: Biliary Peritonitis

    Directory of Open Access Journals (Sweden)

    Sadi Turkan


    Full Text Available Percutaneous nephrolithotomy is a common method in stone therapy in the last 30 years. High success rates as well as high complication rates are also available. We present offer patient who developing gallbladder injury and peritonitis in percutaneous nephrolithotomy for the right renal pelvis, mid, and lower calyces stone.

  7. A Rare Complication of Percutaneous Nephrolithotomy: Biliary Peritonitis


    Sadi Turkan


    Percutaneous nephrolithotomy is a common method in stone therapy in the last 30 years. High success rates as well as high complication rates are also available. We present offer patient who developing gallbladder injury and peritonitis in percutaneous nephrolithotomy for the right renal pelvis, mid, and lower calyces stone.

  8. Renal lymphangiomatosis during pregnancy: management with percutaneous drainage

    Energy Technology Data Exchange (ETDEWEB)

    Oezmen, M.; Akata, D.; Akhan, O. [Hacettepe Univ., Ankara (Turkey). Dept. of Radiology; Deren, Oe.; Durukan, T. [Hacettepe Univ., Ankara (Turkey). Dept. of Obstetrics and Gynecology; Oezen, H. [Hacettepe Univ., Ankara (Turkey). Dept. of Urology


    We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated. (orig.)

  9. Influence of Hydration State on Permeation Testing and Vapor Transport Properties of Protective Clothing Layers

    Directory of Open Access Journals (Sweden)

    Phillip W. Gibson, Ph.D


    Full Text Available Protective clothing systems composed ofpermselective polymer film laminates are analternative to standard air-permeable garments basedon activated carbon. These polymer layers aredesigned with high water vapor permeation rates andlow permeation of chemical warfare agents. Polymerfilms that have a significant water vapor flux usuallyalso have an affinity for water, and will hydrate andswell significantly at high humidity levels. Thepolymer film’s increase in water content has thepotential to affect the transport rate of chemicalwarfare agents in vapor and liquid form, and usuallyalso has a large effect on the intrinsic water vaporpermeability of the membrane.

  10. Timing of decontamination and treatment in case of percutaneous VX poisoning: a mini review. (United States)

    Joosen, Marloes J A; van der Schans, Marcel J; Kuijpers, Willem C; van Helden, Herman P M; Noort, Daan


    Low volatile organophosphorous nerve agents such as VX, will most likely enter the body via the skin. The pharmacokinetics of drugs such as oximes, atropine and diazepam, are not aligned with the variable and persistent toxicokinetics of the agent. Repeated administration of these drugs showed to improve treatment efficacy compared to a single injection treatment. Because of the effectiveness of continuous treatment, it was investigated to what extent a subchronic pretreatment with carbamate (pyridostigmine or physostigmine combined with either procyclidine or scopolamine) would protect against percutaneous VX exposure. Inclusion of scopolamine in the pretreatment prevented seizures in all animals, but none of the pretreatments affected survival time or the onset time of cholinergic signs. These results indicate that percutaneous poisoning with VX requires additional conventional treatment in addition to the current pretreatment regimen. Decontamination of VX-exposed skin is one of the most important countermeasures to mitigate the effects of the exposure. To evaluate the window of opportunity for decontamination, the fielded skin decontaminant Reactive Skin Decontaminant Lotion (RSDL) was tested at different times in hairless guinea pigs percutaneously challenged with 4× LD50 VX in IPA. The results showed that RSDL decontamination at 15 min after exposure could not prevent progressive blood cholinesterase inhibition and therefore would still require additional treatment. A similar decontamination regimen with RSDL at 90 min showed that it still might effectively increase the time window of opportunity for treatment. In conclusion, the delay in absorption presents a window of opportunity for decontamination and treatment. The continuous release of VX from the skin presents a significant challenge for efficacious therapy, which should ideally consist of thorough decontamination and continuous treatment.

  11. Long-Term Results of Percutaneous Management of Liver Hydatid Cysts: - Experience of a University Hospital in Endemic Region –

    Directory of Open Access Journals (Sweden)

    Younès Cherradi


    Full Text Available Background and objective: Surgery was considered for years the standard treatment for all stages of liver hydatid cysts (LHC. Percutaneous treatment has becomes a fast, reliable and more efficient method in selected cases. The purpose of this study is to evaluate the effectiveness of percutaneous treatment of LHC on the basis of our department long-term results. Patients and Methods: This study includes all patients who benefited from percutaneous treatment for LHC from December 1998 to April 2012. Puncture aspiration, injection, and re-aspiration (PAIR were used for hydatid cysts smaller than 6 cm. Larger cysts, infected cysts and those with biliary fistula were treated by puncture associated to drainage (PA-PD. Absolute alcohol was used as sclerosing agent. Reduction of the size of the cyst more than 50%, pseudo-tumour echo pattern and disappearance of the cyst at the follow-up were retained as criteria of treatment efficacy. Results: Two hundred thirty patients (136 female and 94 male; mean age: 35 years old with 278 LHC underwent percutaneous treatment. Mean initial cyst diameter was 76.8 mm [20-180 mm]. According to Gharbi’s classification, types I and II LHC accounted for 74% and 25% respectively. Fourteen patients (6% presented with an infected cavity and 27 patients (12% had a biliary fistula at diagnosis (12%. PA-PD was initially performedin 23 patients. No mortality, abdominal dissemination, or tract seeding occurred. Minor complications like urticaria, cutaneous rash and fever were reported in 24 patients (10%. One case of anaphylactic shock was reported with good evolution. Mean hospitalization time was 3 days ± 1.5 for uncomplicated cases and 16.5 days± 4.2 for complicated cases. 229 out of 230 patients were cured, whereas one recurrence has been reported. Conclusion: Percutaneous treatmentis efficient and safe and offers complete cure in selected patients with the advantage of short hospitalization.

  12. Emergency percutaneous needle decompression for tension pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Körner Markus


    Full Text Available Abstract Background Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and sometimes to capacity constraints of medical staff and equipment in the clinic. Methods This is a retrospective analysis of cases of pneumoperitoneum and tension pneumoperitoneum due to iatrogenic bowel perforation. All patients admitted to our surgical department between January 2005 and October 2010 were included. Tension pneumoperitoneum was diagnosed in those patients presenting signs of hemodynamic and ventilatory compromise in addition to abdominal distension. Results Between January 2005 and October 2010 eleven patients with iatrogenic bowel perforation were admitted to our surgical department. The mean time between perforation and admission was 36 ± 14 hrs (range 30 min - 130 hrs, between ER admission and begin of the operation 3 hrs and 15 min ± 47 min (range 60 min - 9 hrs. Three out of eleven patients had clinical signs of tension pneumoperitoneum. In those patients emergency percutaneous needle decompression was performed with a 16G venous catheter. This improved significantly the patients' condition (stabilization of vital signs, reducing jugular vein congestion, bridging the time to the start of the operation. Conclusions Hemodynamical and respiratory compromise in addition to abdominal distension shortly after endoscopy are strongly suggestive of tension pneumoperitoneum due to iatrogenic bowel perforation. This is a rare but life threatening condition and it can be managed in a preclinical and clinical setting with emergency percutaneous needle decompression like tension pneumothorax. Emergency percutaneous decompression is no

  13. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Directory of Open Access Journals (Sweden)

    Logroscino Giandomenico


    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.

  14. Spondylodiscitis: a rare complication following percutaneous nephrostomy. (United States)

    Chiancone, Francesco; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Fabiano, Marco; Fedelini, Paolo


    Spondylodiscitis is an inflammation of the intervertebral disc and the adjacent vertebral bodies. The spondylodiscitis can not only be a complication of medical interventions such as an operation near spinal column but also urogenital and vascular interventions and intravenous catheter use. A 71-year-old man was admitted to our emergency department with fever and severe abdominal pain. Antibiotic therapy had been performed with intravenous administration of 2 g of ceftriaxone and the patient underwent the placement of a percutaneous nephrostomy according to Seldinger technique. After 1 week, the patient experienced a severe pain at the lumbar tract of the vertebral column associated with a moderate abdominal pain and septic fever. A magnetic resonance imaging (MRI) of the lumbar spine showed widespread impregnation of the upper portion of L3 and the lower portion of L2 compressing the spinal roots as well as the ileopsoas muscle such as a spondylodiscitis. Liquor culture showed an increase of liquor immunoglobulin G, total liquor protein and was positive for Extended-spectrum beta-lactamases (ESBL) - producing Escherichia coli. After the antibiotic therapy, the spondylodiscitis resolves without important sequelae. In the present case report, we describe a very rare complication of percutaneous nephrostomy tube placement, despite of the prophylactic antibiotic therapy according to the most recent guidelines. Predisposing factors to spondylodiscitis include the very young and elderly, the immunosuppressed, diabetic individuals and a general debilitating disease such as renal failure. This case suggests the importance of remembering spondylodiscitis when septic fever and back pain occurs following the placement of a percutaneous nephrostomy in a septic patient.

  15. Percutaneous renal puncture: requirements and preliminary results

    CERN Document Server

    Leroy, A; Payan, Y; Richard, F; Chartier-Kastler, E; Troccaz, J; Leroy, Antoine; Mozer, Pierre; Payan, Yohan; Chartier-Kastler, Emmanuel; Troccaz, Jocelyne


    This paper introduces the principles of computer assisted percutaneous renal puncture, that would provide the surgeon with an accurate pre-operative 3D planning on CT images and, after a rigid registration with space-localized echographic data, would help him to perform the puncture through an intuitive 2D/3D interface. The whole development stage relied on both CT and US images of a healthy subject. We carried out millimetric registrations on real data, then guidance experiments on a kidney phantom showed encouraging results.

  16. Percutaneous treatment of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Leonardi, M.; Resta, F.; Bettinelli, A. [Ospedale Maggiore di Milano (Italy); Lavaroni, A.; Fabris, G. [Ospedale Civile di Udine (Italy); Abelli, F. [Fondazione Clinica del Lavorno, Pavia (Italy)


    918 patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels. Chemonucleolysis was carried out on 733 patients (79.8%). Automated discectomy has been carried out in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy has proved to be an effective method in 74.6% of cases. (author). 7 refs, 6 figs, 1 tab.

  17. Percutaneous nephrolithotomy and ureteroscopy in children: evolutions. (United States)

    Long, Christopher J; Srinivasan, Arun K


    The increasing incidence of pediatric stone disease has coincided with significant advances in technology and equipment, resulting in drastic improvements in management. Miniaturization of both ureteroscopes and percutaneous nephrolithotomy (PCNL) equipment has facilitated access to the entirety of the urinary tract and has made ureteroscopy a first-line therapy option along with shock-wave lithotripsy for kidney and ureteral stones. Advances in PCNL have decreased patient morbidity while preserving stone clearance rates. In this review, the advances in operative approach for ureteroscopy and PCNL in children and its applicability to current surgical management of pediatric stone disease are discussed.

  18. Percutaneous catheter dilatation of carotid stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Mathias, K.; Mittermayer, C.; Ensinger, H.; Neff, W.


    Thirty-one carotid artery stenoses were produced in thirty dogs by three different techniques. Twenty-three of these could be cured by transfemoral percutaneous catheter dilatation. High grade tight stenoses may present resistance which cannot be overcome by the catheter. Histological examination of the dilated vessels showed circumscribed changes in the vessel wall, with destruction of elastic membranes. From our experience of catheter dilatation of pelvic and lower limb arteries and of renal arteries, we consider it feasible to use this technique in selected patients with carotid stenosis.

  19. Determination of threshold adverse effect doses of percutaneous VX exposure in African green monkeys. (United States)

    Genovese, Raymond F; Benton, Bernard J; Oubre, John L; Byers, Christopher E; Jakubowski, E Michael; Mioduszewski, Robert J; Settle, Timothy J; Steinbach, Thomas J


    Percutaneous exposure to the chemical warfare nerve agent VX was evaluated in African green monkeys (n=9). Doses of VX (7.5-100 μg/kg) were applied to the skin for 60 min and residual agent was quantified (before decontamination) to estimate the absorbed dose. Monkeys were evaluated for the presence or absence of clinical signs of toxicity and blood was sampled periodically (30 min--12 weeks) following exposure to measure the degree of circulating acetylcholinesterase (AChE) inhibition. Monkeys were also evaluated for behavioral changes from VX exposure using a serial probe recognition (SPR) task. The lowest observable adverse effect level (LOAEL) for the production of major clinical signs was determined to be 42.22 μg/kg (absorbed dose estimate=17.36 μg/kg) and the LOAEL for AChE inhibition was 13.33 μg/kg (absorbed dose estimate=6.53 μg/kg). Behavioral performance was unaffected at doses that, while producing substantial AChE inhibition, did not produce clinical signs. VX represents a substantial threat as a contact hazard and these results complement previous studies using the percutaneous route of exposure with VX and extend the findings to a non-human primate species.

  20. Female rats are less susceptible during puberty to the lethal effects of percutaneous exposure to VX

    Directory of Open Access Journals (Sweden)

    Linnzi K.M. Wright


    Full Text Available Nerve agents with low volatility such as VX are primarily absorbed through the skin when released during combat or a terrorist attack. The barrier function of the stratum corneum may be compromised during certain stages of development, allowing VX to more easily penetrate through the skin. However, age-related differences in the lethal potency of VX have yet to be evaluated using the percutaneous (pc route of exposure. Thus, we estimated the 24 and 48 h median lethal dose for pc exposure to VX in male and female rats during puberty and early adulthood. Pubescent, female rats were less susceptible than both their male and adult counterparts to the lethal effects associated with pc exposure to VX possibly because of hormonal changes during that stage of development. This study emphasizes the need to control for both age and sex when evaluating the toxicological effects associated with nerve agent exposure in the rat model.

  1. Percutaneous transhepatic obliteration and percutaneous transhepatic sclerotherapy for intractable hepatic encephalopathy and gastric varices improves the hepatic function reserve. (United States)

    Ishikawa, Toru; Imai, Michitaka; Ko, Masayoshi; Sato, Hiroki; Nozawa, Yujiro; Sano, Tomoe; Iwanaga, Akito; Seki, Keiichi; Honma, Terasu; Yoshida, Toshiaki


    Percutaneous transhepatic obliteration (PTO) and percutaneous transhepatic sclerotherapy (PTS) are widely performed as an emergency measure in cases of variceal hemorrhage and intractable hepatic encephalopathy. The PTO/PTS technique is capable of directly blocking the blood supply in cases in which balloon-occluded retrograde transvenous obliteration (B-RTO) is not effective, or in cases with complicated collateral flow. Although PTO/PTS is not currently the first choice due to the invasiveness of transhepatic puncture, this procedure can modify the blood flow in an antegrade manner. The present study examined the changes in hepatic function reserve following PTO/PTS for intractable hepatic encephalopathy and/or gastric varices. In total, the study included 37 patients (mean age, 61.75±12.77 years; age range, 32-88 years; male to female ratio, 23:14) with a variety of gastrorenal shunts, or B-RTO-intractable hepatic encephalopathy and gastric varices without gastrorenal shunts. The patients underwent PTO/PTS by embolizing a microcoil or injection of a sclerosing agent (5% ethanolamine oleate iopamidol). Alterations in hepatic function reserve prior to and following the procedure were compared. The patients were treated for hepatic encephalopathy in 11 patients, gastric varices in 19 patients, and both conditions in 7 patients. The results indicated that the blood ammonia level improved from 135.76±75.23 mg/dl to 88.00±42.16 and 61.81±33.75 mg/dl at 3 and 6 months after therapy, respectively. In addition, the Child-Pugh score improved from 8.48±2.01 prior to therapy to 7.70±1.84 and 7.22±2.01 at 3 and 6 months after the procedure, respectively. Although there was a concern that PTO/PTS may cause complications due to an increase in portal venous pressure (PVP) arising from shunt occlusion, no severe complications were observed. In conclusion, for patients with various gastrorenal shunts or those with B-RTO-intractable hepatic encephalopathy and gastric

  2. Percutaneous cholecystostome; 60 cases of experience

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sung Gwon; Song, Ho Young; Yoon, Hyun Ki; Lee, Young Suk; Ki, Won Woo; Sung, Gyu Bo [Ulsan Univ College of Medicine, Seoul (Korea, Republic of)


    To review the effectiveness and complication of percutaneous cholecystostomy (PCCS). We performed PCCS in 60 patient who presented with acute cholecystitis. The causes of acute cholecystitis were as follows; acalculous cholecystitis(n=8), calculous cholecystitis(n=23), GB hydrops (n=3), GB empyema(n=15), septic cholangitis(n=11). Of 60 patients, 36 patients had high risk factor for cholecystectomy; underlying malignancy(n=13), severe trauma(n=6). Cholecystostomy was done under ultrasonographic and fluoroscopic guide. The cholecystostomy was successfully in 59 patients, and failed in 1 patient. 15 patients improved without other procedure. 16 patients underwent cholecystectomy after improvement of their general condition. Severe complications of PCCS are as follows; bile peritonitis(n=6), hemoperitoneum(n=1), subphrenic abscess(n=1). Mild complication, such as pain, occurred in most patients. Emergency operation was done in one patient who developed bile peritonitis. Cholecystostomy is effective and safe, especially in cases of inoperable patients who represent acute cholecystitis. Percutaneous cholecystostomy may substitute surgical cholecystostomy.


    Directory of Open Access Journals (Sweden)

    S Falahatkar


    Full Text Available "nPercutaneous nephrolithotomy (PNL is commonly used to treat patients with complex renal calculi. Placing a nephrostomy tube is the last step after completing PNL. Significant early postoperative discomfort after percutaneous procedure is usually secondary to nephrostomy tubes. The goal of this study is to evaluate the safety of tubeless PNL. A total of 45 patients with mean age of 46.6 years entered the study. Tubeless PNL was performed in 28 patients and 17 patients were treated with standard PNL. The results of 2 groups were compared with t test. In both groups, PNL was performed successfully without any significant complication. Postoperative hospitalization in standard group was 3.71 day and in tubeless group was 1.65 day that significant statistical difference was observed (P < 0.05. Analgesic dose using in standard group was 101.56 mg (pethidine vs 99.07 mg (pethidine in tubeless group, with no significant statistical difference. There wasn't any organ trauma. Rate of complications, including hematuria, extravasation, fever, UTI and urosepsis, didn't have any significant statistical difference in two groups. It seems that tubeless PNL may be an effective and safe method in renal stone treatment in selected patients. In comparison with standard PNL, tubeless PNL has some benefits including reduction the length of hospitalization. Further studies on more patients are needed to determine the advantages of this technique.

  4. Midazolam sedation for percutaneous liver biopsy. (United States)

    Alexander, J A; Smith, B J


    Control of patient respiration is needed to safely perform percutaneous liver biopsy (PLB) and may be adversely affected by sedation. The purpose of this study was to evaluate the safety of PLB with intravenous midazolam and to evaluate patient acceptance of PLB with and without sedation. Two hundred seventeen consecutive patients underwent 301 percutaneous liver biopsies. One hundred fifty-one of the biopsies were done after the patients were sedated with intravenous midazolam immediately before the biopsy. The last 61 patients were questioned after the biopsy to evaluate the discomfort of the procedure, their memory of the procedure, and their willingness to undergo another PLB. The major complication rate was similar in the midazolam-treated (0.7%) and untreated (0.7%) groups. The midazolam-treated patients had a numerically lower mean pain score (1.5 +/- 0.4 vs 4.0 +/- 0.7) (mean +/- SEM) (P = 0.07) and significantly lower mean memory score (4.8 +/- 0.7 vs 9.9 +/- 0.1) (P < 0.01) than the untreated patients. The treated and untreated groups had similar mean willingness for repeat PLB scores (9.3 +/- 0.3 vs 9.1 +/- 0.6). We conclude that: (1) there is no increased risk of PLB with midazolam and (2) patients have less memory of the procedure with midazolam.

  5. Percutaneous drainage of pelvic fluid collection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Young; Sohn, Cheol Ho [School of Medicine Keimyung University, Daegu (Korea, Republic of)


    To evaluate safe access route and success rate of percutaneous drainage of pelvic fluid collection. The 35 percutaneous drainages of pelvic fluid collection under the CT and fluorosocpic guidance were done in 32 patients. The anterior transabdominal approach was done in 20 patients, while the nine patients used the transgluteal approach through greater sciatic foramen. Three patients, who had septated or noncommunicating abscesses, underwent drainage using both approaches. The catheter was removed when the patient's symptom and laboratory data were improved or the amount of drainage and the size of fluid collection were markedly reduced. Success, partial success and failure were classified. The causes of fluid collection were complication of intraabdominal operation in 27 patient. The diagnosis after drainage included abscess (21), loculated ascites (6), and hematoma (4). The 27 cases (30 procedure) were treated successfully and the mean duration of catheter insertion was 10 days. The partial successes were two cases (2 procedures), which had palliative purpose. Three cases (3 procedures) were failed, which were multiple loculated ascites of pancreatic origin (2) and recurrent abscess (1). The significant complication during the procedure or drainage was not noted.

  6. Percutaneous cryotherapy for inoperable lung malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eun Hae; Jin, Gong Yong; Han, Young Min; Lee, Yong Chul; Kwon, Keun Sang [Chonbuk National Univ. Medical School and Hospital, Jeonju, (Korea, Republic of)


    To evaluate the therapeutic efficacy of percutaneous cryotherapy for inoperable patients with malignant pulmonary nodules. We enrolled 14 patients (7 males, 7 females, average age 68.8 years) who had inoperable lung malignancy in this study from August 2006 through July 2009. We evaluated the therapeutic efficacy of cryotherapy for complete or incomplete ablation by follow up chest CT. Using Kaplan Meier statistical methods, we estimated the survival of patients who had undergone cryotherapy and we investigated post cryotherapy complications. Five of the 14 patients underwent complete ablation (35.7%), while 9 of 14 patients underwent incomplete ablation (64.3%). The change in mean size before procedure and at last follow up CT in the complete and incomplete ablation were as follows: 13.2 {+-} 7.6 mm {yields} 3.8 {+-} 2.7 mm, and 18.1 {+-} 6.2 mm {yields} 33.7 {+-} 17.9 mm, respectively. The median survival of patients in the complete and the incomplete groups were 51.5 months and 24 months, respectively. One patient developed a small pneumothorax, which resolved spontaneously. Two patients developed hemoptysis after the procedure, which was controlled within a day. Percutaneous cryotherapy may be an effective and safe therapeutic method for inoperable patients with malignant pulmonary nodules.

  7. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, F.A. [Dept. of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gow, K.; Davidoff, A. [Dept. of Surgery, St. Jude Children' s Research Hospital, Memphis, TN (United States); Flynn, P.M. [Dept. of Infectious Diseases, St. Jude Children' s Research Hospital, Memphis, TN (United States)


    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  8. Polymeric micelles as carriers of diagnostic agents. (United States)



    This review deals with diagnostic applications of polymeric micelles composed of amphiphilic block-copolymers. In aqueous solutions these polymers spontaneously form particles with diameter 20-100 nm. A variety of diagnostic moieties can be incorporated covalently or non-covalently into the particulates with high loads. Resulting particles can be used as particulate agents for diagnostic imaging using three major imaging modalities: gamma-scintigraphy, magnetic resonance imaging and computed tomography. The use of polyethyleneoxide-diacyllipid micelles loaded with chelated (111)In/Gd(3+) as well as iodine-containing amphiphilic copolymer in percutaneous lymphography and blood pool/liver imaging are discussed as specific examples.

  9. Iron bromide vapor laser (United States)

    Sukhanov, V. B.; Shiyanov, D. V.; Trigub, M. V.; Dimaki, V. A.; Evtushenko, G. S.


    We have studied the characteristics of a pulsed gas-discharge laser on iron bromide vapor generating radiation with a wavelength of 452.9 nm at a pulse repetition frequency (PRF) of 5-30 kHz. The maximum output power amounted to 10 mW at a PRF within 5-15 kHz for a voltage of 20-25 kV applied to electrodes of the discharge tube. Addition of HBr to the medium produced leveling of the radial profile of emission. Initial weak lasing at a wavelength of 868.9 nm was observed for the first time, which ceased with buildup of the main 452.9-nm line.

  10. Solvents and vapor intrusion pathways. (United States)

    Phillips, Scott D; Krieger, Gary R; Palmer, Robert B; Waksman, Javier C


    Vapor intrusion must be recognized appropriately as a separate pathway of contamination. Although many issues resemble those of other forms of contamination (particularly its entryway, which is similar to that of radon seepage), vapor intrusion stands apart as a unique risk requiring case-specific action. This article addresses these issues and the current understanding of the most appropriate and successful remedial actions.

  11. Acoustic droplet vaporization

    NARCIS (Netherlands)

    Shpak, O.


    Current tumor chemotherapy is associated with severe side effects caused by adverse effects of the drugs on healthy tissue. A local delivery of the drug has the advantage of a more controlled biodistribution of the therapeutic agent, which will reduce the side-effects, and offers the potential to us

  12. Percutaneous Procedures for the Treatment of Trigeminal Neuralgia. (United States)

    Bender, Matthew T; Bettegowda, Chetan


    Three major percutaneous procedures are currently used to treat trigeminal neuralgia (TN). Percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation interrupt afferent pain fibers by injury to the trigeminal nerve root or ganglion. Each is capable of offering immediate and durable pain relief. Each is associated with relatively low, but variable rates of complications. Patient heterogeneity, technical variation, and nonstandard outcomes plague the existing outcomes literature and limit comparisons of treatments. Rendering treatment selection a function of individual physician preference and practice patterns. Randomized, prospective trials are needed; in the meantime, percutaneous rhizotomy remains an excellent treatment for selected patients.

  13. Giant small bowel diverticulum presenting after percutaneous gastrostomy: case report

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, G.J.; Clark, J.A.; Pugash, R.A. [St. Michael' s Hospital, Wellesley Central Site, Dept. of Medical Imaging, Toronto, Ontario (Canada)


    The standard technique for percutaneous gastrostomy requires insufflation of air into the stomach via a nasogastric tube before percutaneous gastric puncture. We present a previously undescribed complication in which the insertion of a percutaneous gastrostomy tube resulted in the distention of a previously undiagnosed giant small bowel diverticulum. This led to discomfort for the patient, further radiologic investigation and a delay in discharge. Symptoms resolved with conservative management. We suggest a strategy for avoiding this complication, as well as for reducing the incidence of post-procedure ileus. (author)

  14. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications

    Directory of Open Access Journals (Sweden)

    Joshua Halpern


    Full Text Available There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele.

  15. Percutaneous pulmonary valve endocarditis: incidence, prevention and management. (United States)

    Patel, Mehul; Malekzadeh-Milani, Sophie; Ladouceur, Magalie; Iserin, Laurence; Boudjemline, Younes


    The epidemiology of infective endocarditis is changing rapidly due to the emergence of resistant microorganisms, the indiscriminate use of antibiotics, and an increase in the implantation of cardiovascular devices including percutaneous valves. Percutaneous pulmonary valve implantation has achieved standard of care for the management of certain patients with right ventricular outflow tract dysfunction. With its expanding use, several cases of early and delayed infective endocarditis with higher morbidity and mortality rates have been reported. This review summarizes the trends in percutaneous pulmonary valve infective endocarditis, postulates proposed mechanisms, and elaborates on the prevention and management of this unique and potentially fatal complication.

  16. Vapor phase heat transport systems

    Energy Technology Data Exchange (ETDEWEB)

    Hedstrom, J.C.; Neeper, D.A.


    This report describes progress in theoretical and experimental investigations of various forms of a vapor transport system for solar space heating, which could also be applied to service water heating. Refrigerant is evaporated in a solar collector, which may be located on the external wall or roof of a building. The vapor is condensed in a passively discharged thermal storage unit located within the building. The condensed liquid can be returned to the collector either by a motor-driven pump or by a completely passive self-pumping mechanism in which the vapor pressure lifts the liquid from the condenser to the collector. The theoretical investigation analyzes this self-pumping scheme. Experiments in solar test cells compare the operation of both passive and active forms of the vapor system with the operation of a passive water wall. The vapor system operates as expected, with potential advantages over other passive systems in design flexibility and energy yield.

  17. 33 CFR 154.828 - Vapor recovery and vapor destruction units. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Vapor recovery and vapor... SECURITY (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Vapor Control Systems § 154.828 Vapor recovery and vapor destruction units. (a) The inlet to a vapor recovery unit...

  18. A Lithium Vapor Box similarity experiment employing water vapor (United States)

    Schwartz, Ja; Jagoe, C.; Goldston, Rj; Jaworski, Ma


    Handling high power loads and heat flux in the divertor is a major challenge for fusion power plants. A detached plasma will likely be required. However, hydrogenic and impurity puffing experiments show that detached operation leads easily to X-point MARFEs, impure plasmas, degradation in confinement, and lower helium pressure at the exhaust. The concept of the Lithium Vapor Box Divertor is to use local evaporation and strong differential pumping through condensation to localize the gas-phase material that absorbs the plasma heat flux, and so avoid those difficulties. In order to design such a box first the vapor without plasma must be simulated. The density of vapor required can be estimated using the SOL power, major radius, poloidal box length, and cooling energy per lithium atom. For an NSTX-U-sized machine, the Knudsen number Kn spans 0.01 to 1, the transitional flow regime. This regime cannot handled by fluid codes or collisionless Monte Carlo codes, but can be handled by Direct Simulation Monte Carlo (DSMC) codes. To validate a DSMC model, we plan to build a vapor box test stand employing more-convenient water vapor instead of lithium vapor as the working fluid. Transport of vapor between the chambers at -50C will be measured and compared to the model. This work supported by DOE Contract No. DE-AC02-09CH11466.

  19. Vapor pressure measured with inflatable plastic bag (United States)


    Deflated plastic bag in a vacuum chamber measures initial low vapor pressures of materials. The bag captures the test sample vapors and visual observation of the vapor-inflated bag under increasing external pressures yields pertinent data.

  20. [Uricosuric agent]. (United States)

    Ohno, Iwao


    Urate lowering treatment is indicated in patients with recurrent acute attacks, tophi, gouty arthropathy, radiographic changes of gout, multiple joint involvement, or associated uric acid nephrolithiasis. Uricosuric agents like benzbromarone and probenecid are very useful to treat hyperuricemia as well as allopurinol (xanthine oxidase inhibitor). Uricosuric agents act the urate lowering effect through blocking the URAT1, an urate transporter, in brush border of renal proximal tubular cells. In order to avoid the nephrotoxicity and urolithiasis due to increasing of urinary urate excretion by using uricosuric agents, the proper urinary tract management (enough urine volume and correction of aciduria) should be performed.

  1. Percutaneous Microwave Ablation of Renal Angiomyolipomas

    Energy Technology Data Exchange (ETDEWEB)

    Cristescu, Mircea, E-mail: [University of Wisconsin, Department of Radiology (United States); Abel, E. Jason, E-mail: [University of Wisconsin, Department of Urology (United States); Wells, Shane, E-mail:; Ziemlewicz, Timothy J., E-mail: [University of Wisconsin, Department of Radiology (United States); Hedican, Sean P., E-mail: [University of Wisconsin, Department of Urology (United States); Lubner, Megan G., E-mail:; Hinshaw, J. Louis, E-mail:; Brace, Christopher L., E-mail:; Lee, Fred T., E-mail: [University of Wisconsin, Department of Radiology (United States)


    PurposeTo evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML).Materials and MethodsFrom January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4–4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits.ResultsAll ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60–70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3–8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8 % (3.4–3.3 cm) and 1.7 % (27.5–26.3 cm{sup 3}), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9–47) demonstrated mean tumor diameter and volume decreases of 29 % (3.4–2.4 cm) and 47 % (27.5–12.1 cm{sup 3}), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation.ConclusionOur early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.

  2. Acute stent thrombosis after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Wiberg, Sebastian; Van't Hof, Arnoud;


    OBJECTIVES: This study sought to determine clinical, procedural, and treatment factors associated with acute stent thrombosis (AST) in the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial. BACKGROUND: Bivalirudin started during transport for primary percutaneous coronary int...

  3. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    deMuinck, ED; denHeijer, P; vanDijk, RB; Crijns, HJGM; Hillige, HL; Lie, KI


    Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty (PTCA)-with an autoperfusion balloon or active system-facilitates prolonged balloon inflation. Prolonged inflations may tack up intimal dissections and improve the primary angioplasty result in complex lesions. Addit

  4. Impact of diabets on clinical outcomes following multivessel percutaneous interventions

    Institute of Scientific and Technical Information of China (English)



    Objective To compare the rates of mortality,mycardial infarction (MI) ,repeat revascularization and stent thrombosis after percutaneous coronary intervention (PCI) with implantation of stents for diabetics versus nondiabetics with multivessel disease to evaluate the im-

  5. Antibiotic Agents (United States)

    ... Superbugs and Drugs" Home | Contact Us General Background: Antibiotic Agents What is an antibacterial and how are ... with the growth and reproduction of bacteria. While antibiotics and antibacterials both attack bacteria, these terms have ...

  6. Vasoactive Agents


    Husedzinovic, Ino; Bradic, Nikola; Goranovic, Tanja


    This article is a short review of vasoactive drugs which are in use in todays clinical practice. In the past century, development of vasoactive drugs went through several phases. All of these drugs are today divided into several groups, depending on their place of action, pharmacological pathways and/or effects on target organ or organ system. Hence, many different agents are today in clinical practice, we have shown comparison between them. These agents provide new directions in the treatmen...

  7. Results of percutaneous transhepatic cholangiography drainages (PTCD)

    Energy Technology Data Exchange (ETDEWEB)

    Schoenemann, J.; Willems, M.; Wolf, G.; Fromme, M.


    From September 1980 to December 1986, 72 percutaneous transhepatic cholangiography drainages (PTCD) were performed in 64 patients (58 palliative in malignant obstructions, 14 temporary). The median duration of drainage was 26.8 days (2-183 days). The median survival time in 37 patients with palliative tumour drainage was 55.3 days (7-473 days). 9/37 patients survived longer than 3 months (max. 15.5 months). Complications occurred in 29.5% (10.3% severe). 3/64 patients (4.7%) died. Patients with palliative transpapillary drainages (23), especially with endoprostheses (14), survived longer, and the complication rate was lower. Therefore, we prefer the endoscopic transpapillary approach. PTCD patients must be selected carefully.

  8. Percutaneous endoscopic gastrostomy and early mortality. (United States)

    Clarkston, W K; Smith, O J; Walden, J M


    To assess morbidity, mortality, and benefit associated with percutaneous endoscopic gastronomy (PEG), we retrospectively studied 42 patients who had had PEG. Mortality was exceptionally high during the first 60 days after PEG (43%), and then stabilized. In nearly half of the cases (20/42) the PEG tube was removed during the first 60 days because of either death or improvement. Patients with malignancy had a significantly higher morbidity and 60-day mortality than the neurologically impaired. We concluded that patients should be carefully selected for PEG because early mortality is high; a 60-day trial of soft nasogastric feedings should be considered before PEG, and could reduce by nearly half the number of patients failing to receive long-term benefit; and patients with malignancy have significantly greater morbidity and mortality after PEG and may not receive the same advantage from the procedure.

  9. Status quo of percutaneous nephrolithotomy in children. (United States)

    Bogris, Sotirios; Papatsoris, Athanasios G


    Paediatric nephrolithiasis is quite challenging in terms of management because of the smaller size of the urinary tract and the bigger risk for stone recurrence. Children bear a higher risk of metabolic and infectious causes of stone disease and a longer lifetime risk for recurrence, especially in cases of residual fragments. Complete stone clearance should become the absolute objective and clinically insignificant residual fragments should be avoided. Nowadays, percutaneous nephrolithotomy (PCNL) arises as a logical first-line treatment option for considerable paediatric nephrolithiasis as miniaturization of endoscopes and advances in energy sources for stone fragmentation have facilitated stone-free rates. In this review we present the evolution of PCNL in children and we demonstrate its safety and efficacy. As appropriate instruments are available and relevant surgical experience is accumulating, age should no longer exist as a limiting factor for performing PCNL.

  10. Percutaneous Valvuloplasty for Bioprosthetic Tricuspid Valve Stenosis (United States)

    Malhotra, Rohit; Sharma, Anjali; Kakouros, Nikolaos


    Percutaneous transcatheter tricuspid balloon valvuloplasty (PTTBV) is an accepted treatment option for symptomatic severe native tricuspid valve stenosis, although surgical tricuspid valve replacement remains the treatment of choice. There have been few reports of successful PTTBV for bioprosthetic tricuspid valve stenosis. We present case reports of 3 patients from our hospital experience. Two of the 3 cases were successful, with lasting clinical improvement, whereas the 3rd patient failed to show a reduction in valve gradient. We describe the standard technique used for PTTBV. We present results from a literature review that identified 16 previously reported cases of PTTBV for bioprosthetic severe tricuspid stenosis, with overall favorable results. We conclude that PTTBV should perhaps be considered for a select patient population in which symptomatic improvement and hemodynamic stability are desired immediately, and particularly for patients who are inoperable or at high surgical risk.

  11. Percutaneous transarterial embolization of extrahepatic arteroportal fistula

    Institute of Scientific and Technical Information of China (English)

    Gianluca Marrone; Settimo Caruso; Roberto Miraglia; Ilaria Tarantino; Riccardo Volpes; Angelo Luca


    Arteroportal fistula is a rare cause of prehepatic portalhypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding.Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the colorDoppler by a turbulent flow, and arterialization of portal vein flow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confirming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed.Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.

  12. Percutaneous Nephrolithotomy and Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Sairam, Krish; Scoffone, Cesare M; Alken, Peter;


    by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were...... available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously...... underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse...

  13. Percutaneous transhepatic cholangiography using special needle

    Energy Technology Data Exchange (ETDEWEB)

    Auh, Yong Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Using the special needle (22 Gauze, 17 cm long, flexible needle) percutaneous transhepatic cholangiography were performed in 23 cases at Seoul National University Hospital during the period from July 1973 to August 1974. The results were as follows:1. Successful cholangiograms are obtained in 20 cases among the total of 23 cases. The 3 cases of the unsuccessful are two cases of sclerosing cholangitis and one case of hepatoma. 2. Average attempts of puncture in successful care are 3. It was not necessary to puncture more than 6 times to visualize biliary tree in dilated biliary tree. 3. Lateral approach (midaxillary line and 8th or 9th intercostal space) was used. The advantage of this method was briefly discussed. 4. Over all complication are occurred in 6 cases. 3 cases: transient fever 1 case: bile leakage without peritonitis 1 case: local peritonitis probably due to bile leakage 1 case: septicemia (the organism can not be detected even after blood culture)

  14. Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    Federico De Iure


    Full Text Available We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months, and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

  15. Current status and perspective of percutaneous coronary intervention in China

    Institute of Scientific and Technical Information of China (English)


    @@ The first percutaneous transluminal coronary angioplasty (PTCA) in China was performed in 1984. Since then the progresses in this field have been achieved gradually. The development process can be divided into 3 phases roughly. According to a national survey organized by Chinese Society of Cardiology,1-3 from 1984 to 1996, as the first phase, percutaneous coronary intervention (PCI) can only be performed in a few centers by a few cardiologists.

  16. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail:; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)


    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  17. Percutaneous nephrolithotomy in children: A preliminary report

    Directory of Open Access Journals (Sweden)

    Ahmad A. Elderwy


    Full Text Available Objectives: The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. Materials and Methods: During the period of the month between May 2011 and April 2013, 38 children (47 renal units underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24. Results: The median age at presentation was 8-year (range: 3-12. The operative time ranged from 30 to 120 min (median 90. Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3. Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6% of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1 and were managed conservatively. Conclusions: Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

  18. Analysis of percutaneous nephrostomy in 72 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Chul; Park, Jae Hyung; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)


    Percutaneous nephrostomy has been effectively performed 107 times in 72 patients for relief of obstruction, drainage of urinary fistula and renal or extrarenal fluid collection, and functional preservation of urinary system, and follow-up check has been made for recent 3 years at Department of Radiology in Seoul National University Hospital. All procedures were successful and bilateral nephrostomy was done in 1 case of bilateral congenital UPJ obstruction. Percutaneous nephrostomy was done in left kidney in 38 cases (52.8%), permanent drainage was done in 55 cases (76.4%) and external drainage was done in 65 cases (90.3%), and the duration of follow-up was up to 8 months. Underlying diseases were supravesical obstruction in 63 cases (87.5%), urinary fistula in 3 cases, inflammatory disease in 5 cases and intravesical obstruction in 1 case. Satisfactory outcomes were made in 68 patients, whose BUN and serum creatinine levels have decreased near to upper normal range in at least 3 weeks. Major complications have occurred in 7 cases; symptomatic urinary infection in 3 cases, fracture of the catheter in 2 cases, pneumothorax in 1 case and sepsis in 1 case. Minor complications have occurred in 76 cases; catheter dislodgement or obstruction in 42 cases, fever in 10 cases, perirenal extravasation in 2 cases and periureteral leakage in 2 cases, etc. These complications can be prevented by adequate method using Seldinger technique under ultrasonography, CT or fluoroscopy, prophylactic and post-nephrostomy antibiotics, use of disposable catheter kits, frequent irrigation of the catheter and dressing of catheter fixation site when contaminated, prevention of extraction of the catheter due to patient's carelessness, adequate fixation of the catheter to skin, and continuous follow-up of patients. It is expected that the territory of this interventional procedure will be extended by instrument insertion and drug instillation through the nephrostomy tract.

  19. Multiwavelength Strontium Vapor Lasers (United States)

    Soldatov, A. N.; Yudin, N. A.


    Based on an analysis of experimental and theoretical works, modern notion on conditions of forming of population density inversion on self-terminating IR transitions of alkali-earth metals is given. It is demonstrated that there is a significant difference in the inversion formation in lasers on self-terminating transitions in the visible and near-IR ranges and lasers on self-terminating transitions of alkali-earth metals lasing IR lines in the mid-IR range. It is shown that in the discharge circuit of lasers on self-terminating metal atom transitions (LSMT) there are processes strengthening the influence of the known mechanism limiting the frequency and energy characteristics (FEC) of radiation caused by the presence of prepulse electron concentration. The mechanism of influence of these processes on FEC of the LSMT and technical methods of their neutralization are considered. The possibility of obtaining average lasing power of ~200 W from one liter volume of the active medium of the strontium vapor laser is demonstrated under conditions of neutralization of these processes.

  20. Archimedes Mass Filter Vaporizer (United States)

    Putvinski, S.; Agnew, A. F.; Cluggish, B. P.; Ohkawa, T.; Sevier, L.; Umstadter, K. R.; Dresvin, S. V.; Kuteev, B. V.; Feygenson, O. N.; Ivanov, D. V.; Zverev, S. G.; Miroshnikov, I. V.; Egorov, S. M.; Kiesewetter, D. V.; Maliugin, V. I.


    Archimedes Technology Group, Inc., is developing a plasma mass separator called the Archimedes Filter that separates waste oxide mixtures ion by ion into two mass groups: light and heavy. Since high-level waste at Hanford has 99.9its radioactivity associated with heavy elements, the Archimedes Filter can effectively decontaminate over three-quarters of that waste. The Filter process involves some preprocessing followed by volatilization and separation by the magnetic and electric fields of the main plasma. This presentation describes the approach to volatilization of the waste oxy-hydroxide mixture by means of a very high heat flux (q > 10 MW/m2). Such a high heat flux is required to ensure congruent evaporation of the complex oxy-hydroxide mixture and is achieved by injection of small droplets of molten waste into an inductively coupled plasma (ICP) torch. This presentation further addresses different issues related to evaporation of the waste including modeling of droplet evaporation, estimates of parameters of plasma torch, and 2D modeling of the plasma. The experimental test bed for oxide vaporization and results of the initial experiments on oxide evaporation in 60 kW ICP torch will also be described.

  1. Percutaneous pulmonary and tricuspid valve implantations: An update

    Institute of Scientific and Technical Information of China (English)

    Robert; Wagner; Ingo; Daehnert; Philipp; Lurz


    The field of percutaneous valvular interventions is one of the most exciting and rapidly developing within interventional cardiology.Percutaneous procedures focusing on aortic and mitral valve replacement or interventional treatment as well as techniques of percutaneous pulmonary valve implantation have already reached worldwide clinical acceptance and routine interventional procedure status.Although techniquesof percutaneous pulmonary valve implantation have been described just a decade ago,two stent-mounted complementary devices were successfully introduced and more than 3000 of these procedures have been performed worldwide.In contrast,percutaneous treatment of tricuspid valve dysfunction is still evolving on a much earlier level and has so far not reached routine interventional procedure status.Taking into account that an "interdisciplinary challenging",heterogeneous population of patients previously treated by corrective,semi-corrective or palliative surgical procedures is growing inexorably,there is a rapidly increasing need of treatment options besides redo-surgery.Therefore,the review intends to reflect on clinical expansion of percutaneous pulmonary and tricuspid valve procedures,to update on current devices,to discuss indications and patient selection criteria,to report on clinical results and finally to consider future directions.

  2. Acoustic Droplet Vaporization in Biology and Medicine

    Directory of Open Access Journals (Sweden)

    Chung-Yin Lin


    Full Text Available This paper reviews the literature regarding the use of acoustic droplet vaporization (ADV in clinical applications of imaging, embolic therapy, and therapeutic delivery. ADV is a physical process in which the pressure waves of ultrasound induce a phase transition that causes superheated liquid nanodroplets to form gas bubbles. The bubbles provide ultrasonic imaging contrast and other functions. ADV of perfluoropentane was used extensively in imaging for preclinical trials in the 1990s, but its use declined rapidly with the advent of other imaging agents. In the last decade, ADV was proposed and explored for embolic occlusion therapy, drug delivery, aberration correction, and high intensity focused ultrasound (HIFU sensitization. Vessel occlusion via ADV has been explored in rodents and dogs and may be approaching clinical use. ADV for drug delivery is still in preclinical stages with initial applications to treat tumors in mice. Other techniques are still in preclinical studies but have potential for clinical use in specialty applications. Overall, ADV has a bright future in clinical application because the small size of nanodroplets greatly reduces the rate of clearance compared to larger contrast agent bubbles and yet provides the advantages of ultrasonographic contrast, acoustic cavitation, and nontoxicity of conventional perfluorocarbon contrast agent bubbles.

  3. Percutaneous coronary interventions and antiplatelet therapy in renal transplant recipients. (United States)

    Summaria, Francesco; Giannico, Maria Benedetta; Talarico, Giovanni Paolo; Patrizi, Roberto


    Cardiovascular disease is the leading cause of mortality and morbidity following renal transplantation (RT), accounting for 40-50% of all deaths. After renal transplantation, an adverse cardiovascular event occurs in nearly 40% of patients; given the dialysis vintage and the average wait time, the likelihood of receiving coronary revascularization is very high. There is a significant gap in the literature in terms of the outcomes of prophylactic coronary revascularization in renal transplantation candidates. Current guidelines on myocardial revascularization stipulate that renal transplant patients with significant coronary artery disease (CAD) should not be excluded from the potential benefit of revascularization. Compared with percutaneous coronary intervention (PCI), however, coronary artery bypass grafting is associated with higher early and 30-day mortality. About one-third of renal transplant patients with CAD have to be treated invasively and so PCI is currently the most popular mode of revascularization in these fragile and compromised patients. A newer generation drug-eluting stent (DES) should be preferred over a bare metal stent (BMS) because of its lower risk of restenosis and improved safety concerns (stent thrombosis) compared with first generation DES and BMS. Among DES, despite no significant differences being reported in terms of efficacy, the newer everolimus and zotarolimus eluting stents should be preferred given the possibility of discontinuing, if necessary, dual antiplatelet therapy before 12 months. Since there is a lack of randomized controlled trials, the current guidelines are inadequate to provide a specifically tailored antiplatelet therapeutic approach for renal transplant patients. At present, clopidogrel is the most used agent, confirming its central role in the therapeutic management of renal transplant patients undergoing PCI. While progress in malignancy-related mortality seems a more distant target, a slow but steady reduction in

  4. [Gadolinium as an alternative radiocontrast agent in patients with allergy to iodine-based contrast provide for useful diagnostic imagings and safely treatment of biliary tract diseases]. (United States)

    Natsume, Makoto; Sano, Hitoshi; Fukusada, Shigeki; Kachi, Kenta; Inoue, Tadahisa; Anbe, Kaiki; Nishie, Hirotada; Nishi, Yuji; Yoshimura, Norihiro; Mizushima, Takashi; Okumura, Fumihiro; Miyabe, Katsuyuki; Naitoh, Itaru; Hayashi, Kazuki; Nakazawa, Takahiro


    Diagnosis and treatment of biliary tract disease requires an intraductal radiocontrast agent. Although iodine-based contrast medium is commonly used, some patients show severe allergy to iodinated contrast agent. We have retrospectively reviewed the usefulness and safety of gadolinium as an alternative radiocontrast agent in 3 patients with allergy to iodine-based contrast medium in the diagnosis and treatment of biliary tract diseases. In case 1, percutaneous transhepatic biliary drainage and cholangiography were performed successfully and it was possible to visualize an intrahepatic bile duct stone. Percutaneous transhepatic cholangioscopic lithotomy was performed and the intrahepatic bile duct stone was removed. In case 2, endoscopic biliary lithotripsy was performed. In case 3, percutaneous transhepatic cholangiography and cholangioscopy provided a diagnosis of moderately differentiated carcinoma. He underwent pancreatoduodenectomy. Postoperative cholangiograms were also obtained successfully. Gadolinium contrast agent is an alternative to iodine-based cholangiography for the patients with allergy to iodine.

  5. [Inotropic agents]. (United States)

    Sasayama, Shigetake


    Depression of myocardial contractility plays an important role in the development of heart failure and many inotropic agents were developed to improve the contractile function of the failing heart. Agents that increase cyclic AMP, either by increasing its synthesis or reducing its degradation, exerted dramatic short-term hemodynamic benefits, but these acute effects were not extrapolated into long-term improvement of the clinical outcome of heart failure patients. Administration of these agents to an energy starved failing heart would be expected to increase myocardial energy use and could accelerate disease progression. The role of digitalis in the management of heart failure has been controversial, however, the recent large scale clinical trial has ironically proved that digoxin reduced the rate of hospitalization both overall and for worsening heart failure. More recently, attention was paid to other inotropic agents that have a complex and diversified mechanism. These agents have some phosphodiesterase-inhibitory action but also possess additional effects, including cytokine inhibitors, immunomodulators, or calcium sensitizers. In the Western Societies these agents were again shown to increase mortality of patients with severe heart failure in a dose dependent manner with the long-term administration. However, it may not be the case in the Japanese population in whom mortality is relatively low. Chronic treatment with inotropic agent may be justified in Japanese, as it allows optimal care in the context of relief of symptoms and an improved quality of life. Therefore, each racial group should obtain specific evidence aimed at developing its own guidelines for therapy rather than translating major guidelines developed for other populations.

  6. Modeling vapor dominated geothermal reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Marconcini, R.; McEdwards, D.; Neri, G.; Ruffilli, C.; Schroeder, R.; Weres, O.; Witherspoon, P.


    The unresolved questions with regard to vapor-dominated reservoir production and longevity are reviewed. The simulation of reservoir behavior and the LBL computer program are discussed. The geology of Serrazzano geothermal field and its reservoir simulation are described. (MHR)

  7. Vapor Intrusion Facilities - South Bay (United States)

    U.S. Environmental Protection Agency — POINT locations for the South Bay Vapor Instrusion Sites were derived from the NPL data for Region 9. One site, Philips Semiconductor, was extracted from the...

  8. Sunscreening Agents (United States)

    Martis, Jacintha; Shobha, V; Sham Shinde, Rutuja; Bangera, Sudhakar; Krishnankutty, Binny; Bellary, Shantala; Varughese, Sunoj; Rao, Prabhakar; Naveen Kumar, B.R.


    The increasing incidence of skin cancers and photodamaging effects caused by ultraviolet radiation has increased the use of sunscreening agents, which have shown beneficial effects in reducing the symptoms and reoccurrence of these problems. Many sunscreen compounds are in use, but their safety and efficacy are still in question. Efficacy is measured through indices, such as sun protection factor, persistent pigment darkening protection factor, and COLIPA guidelines. The United States Food and Drug Administration and European Union have incorporated changes in their guidelines to help consumers select products based on their sun protection factor and protection against ultraviolet radiation, whereas the Indian regulatory agency has not yet issued any special guidance on sunscreening agents, as they are classified under cosmetics. In this article, the authors discuss the pharmacological actions of sunscreening agents as well as the available formulations, their benefits, possible health hazards, safety, challenges, and proper application technique. New technologies and scope for the development of sunscreening agents are also discussed as well as the role of the physician in patient education about the use of these agents. PMID:23320122

  9. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Directory of Open Access Journals (Sweden)

    Liehua Liu


    Full Text Available Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females with osteoporotic vertebral compression fractures with a mean age of 71.4±8.8 years (range: 60 to 89 received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA. Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5±0.7 and 4.3±1.0, respectively, and there was significant difference (P=0.001. In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

  10. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty (United States)


    Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of 71.4 ± 8.8 years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA). Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5 ± 0.7 and 4.3 ± 1.0, respectively, and there was significant difference (P = 0.001). In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty. PMID:27766261

  11. Mobile Agents (United States)

    Satoh, Ichiro

    Mobile agents are autonomous programs that can travel from computer to computer in a network, at times and to places of their own choosing. The state of the running program is saved, by being transmitted to the destination. The program is resumed at the destination continuing its processing with the saved state. They can provide a convenient, efficient, and robust framework for implementing distributed applications and smart environments for several reasons, including improvements to the latency and bandwidth of client-server applications and reducing vulnerability to network disconnection. In fact, mobile agents have several advantages in the development of various services in smart environments in addition to distributed applications.

  12. Dispensing fuel with aspiration of condensed vapors

    Energy Technology Data Exchange (ETDEWEB)

    Butkovich, M.S.; Strock, D.J.


    A vapor recovery process is described, comprising the steps of: fueling a motor vehicle with gasoline by discharging gasoline into a fill opening or filler pipe of a tank of said vehicle through a fuel outlet conduit of a nozzle; emitting gasoline vapors from said tank during said fueling; substantially collecting said vapors during said fueling with a vapor return conduit of said nozzle and passing said vapors through said vapor return conduit in counter current flow relationship to said discharging gasoline in said fuel conduit; conveying said vapors from said vapor return conduit to a vapor return hose; at least some of said vapors condensing to form condensate in said vapor return hose; substantially removing said condensate from said vapor return hose during said fueling with a condensate pickup tube from said nozzle by passing said condensate through said condensate pickup tube in counter current flow relationship to said conveying vapors in said vapor return hose; sensing the presence of gasoline with a liquid sensing tube in said vapor return conduit of said nozzle between inner and outer spouts of said nozzle to detect when said tank of said vehicle is filled with said fuel conduit being within the inner spout of said nozzle; and automatically shutting off said fueling and condensate removing when said liquid sensing tube detects when said tank of said vehicle is filled and fuel enters said vapor return conduit.

  13. Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Sh, Hongjian [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)], E-mail:; Huang Youhua; Shen Tao; Xu Qiang [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)


    Purpose: To evaluate the efficacy of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in the treatment of massive symptomatic lower limb deep venous thrombosis (DVT). Materials and methods: One hundred and three clinically confirmed DVT patients were discharged from our institution. Sixteen patients with massive lower limb DVT were included in this retrospective study. After prophylactic placement of inferior vena cava filters (IVCFs), percutaneous mechanical thrombectomy (ATD, n = 10; Straub, n = 6) and catheter-directed thrombolysis were performed in all patients. Complementary therapy included percutaneous transluminal venous angioplasty (PTA, n = 3) and stent placement (n = 1). The doses of thrombolytic agents, length of hospital stay, peri-procedure complications and discharge status were reviewed. Oral anticoagulation was continued for at least 6 months during follow-up. Results: The average hospital stay was 7 days. The technical success rate (complete and partial lysis of clot) was 89%, the other 11% patients only achieved less than 50% clot lysis. The mean dose of urokinase was 3.3 million IU. There were no significant differences of clinical outcome between the ATD and Straub catheter group. The only major complication was an elderly male who experienced a fatal intracranial hemorrhage while still in the hospital (0.97%, 1/103). Minor complications consisted of three instances of subcutaneous bleeding. No transfusions were required. Vascular patency was achieved in 12 limbs during follow-up. No pulmonary emboli occurred. There is one recurrent DVT 4.5 months after the treatment. Conclusions: Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis is an effective and safe method for the treatment of symptomatic DVT. A randomized prospective study is warranted.

  14. Modern antiplatelet agents in coronary artery disease.

    LENUS (Irish Health Repository)

    Power, Rachel F


    Dual antiplatelet therapy is well recognized in the prevention of thrombotic complications of acute coronary syndrome and percutaneous coronary interventions. Despite clinical benefits of aspirin and clopidogrel therapy, a number of limitations curtail their efficacy: slow onset of action, variability in platelet inhibitory response and potential drug-drug interactions. Furthermore, the single platelet-activation pathway targeted by these agents allows continued platelet activation via other pathways, ensuring incomplete protection against ischemic events, thus, underscoring the need for alternate antiplatelet treatment strategies. A number of novel antiplatelet agents are currently in advance development and many have established superior effects on platelet inhibition, clinical outcomes and safety profile than clopidogrel in high-risk patients. The aim of this review is to provide an overview of the current status of P2Y12 receptor inhibition and PAR-1 antagonists in determining a future strategy for individualized antiplatelet therapy.

  15. Unexplained occurrence of multiple de novo pseudoaneurysms in patients with chronic kidney disease undergoing angioembolization for bleeding following percutaneous renal intervention: Are we dealing with infection or vasculitis?

    Directory of Open Access Journals (Sweden)

    Debansu Sarkar


    Full Text Available Background and Objectives: Patients with chronic kidney disease (CKD are more prone for bleeding following percutaneous renal intervention, as compared to those with normal renal function. Causes are multi-factorial. Finding multiple aneurysms away from the site of renal intervention following initial angioembolization for hemorrhage is very unusual in these patients. Materials and Methods: Clinical and radiological findings of all the patients who underwent renal angiography for post-intervention bleed for a period of 5 years were reviewed and analyzed. Results: A total of 29 patients required angiography for post-intervention hemorrhage. Six patients had recurrence of hemorrhage for which they underwent repeat angiography. Four of these patients had appearance of multiple new aneurysms away from the site of percutaneous nephrostomy (PCN/percutaneous nephrolithotomy (PNL puncture and the site of previous bleeding. All the patients had CKD (creatinine >2.5 mg/dl. They were on prolonged preoperative urinary diversion and had polymicrobial urinary infection. Three patients had candiduria. None of these patients had re-bleeding after repeat embolization and treatment with antibacterial and antifungal agents. Conclusions: Development of multiple aneurysms away from the sites of punctures in patients with CKD following percutaneous intervention is very unusual. Its causation including infection with bacteria and fungus, reaction of embolizing material, and angiopathy needs to be explored.

  16. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)


    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  17. Percutaneous dilatational tracheostomy without fiber optic bronchoscopy-Evaluation of 80 intensive care units cases

    NARCIS (Netherlands)

    J.A. Calvache (Jose Andrés); R.A. Molina García (Rodrigo); A.L. Trochez (Adolfo); J. Benitez (Javier); L.A. Flga (Lucía Arroyo)


    textabstractBackground: The development of percutaneous dilatational tracheostomy techniques (PDT) has facilitated the procedure in Intensive Care Units (ICU). Objective: To describe the early intra and post-operative complications in ICU patients requiring percutaneous dilatational tracheostomy usi

  18. The CROES percutaneous nephrolithotomy global study: the influence of body mass index on outcome

    DEFF Research Database (Denmark)

    Fuller, Andrew; Razvi, Hassan; Denstedt, John D;


    In addition to more commonly forming stones, obese patients present a number of challenges when undergoing percutaneous nephrolithotomy. We evaluated percutaneous nephrolithotomy outcomes in 3,709 patients stratified by body mass index....

  19. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)


    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  20. A Review of Vapor Intrusion Models


    Yao, Yijun; Suuberg, Eric M.


    A complete vapor intrusion (VI) model, describing vapor entry of volatile organic chemicals (VOCs) into buildings located on contaminated sites, generally consists of two main parts-one describing vapor transport in the soil and the other its entry into the building. Modeling the soil vapor transport part involves either analytically or numerically solving the equations of vapor advection and diffusion in the subsurface. Contaminant biodegradation must often also be included in this simulatio...

  1. Recent advances in vapor intrusion site investigations. (United States)

    McHugh, Thomas; Loll, Per; Eklund, Bart


    Our understanding of vapor intrusion has evolved rapidly since the discovery of the first high profile vapor intrusion sites in the late 1990s and early 2000s. Research efforts and field investigations have improved our understanding of vapor intrusion processes including the role of preferential pathways and natural barriers to vapor intrusion. This review paper addresses recent developments in the regulatory framework and conceptual model for vapor intrusion. In addition, a number of innovative investigation methods are discussed.

  2. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail:; Akkaya, Selçuk, E-mail: [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: [Hacettepe University, Department of Radiology, School of Medicine (Turkey)


    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  3. Percutaneous microballoon compression for trigeminal neuralgia

    Institute of Scientific and Technical Information of China (English)

    LIU Hong-bing; MA Yi; ZOU Jian-jun; LI Xin-gang


    Background Percutaneous microballoon compression (PMC) for trigeminal neuralgia is an important therapeutic method. The aim of this study was to review the effects of PMC for trigeminal neuralgia in 276 patients.Methods From December 2000 to May 2003, 276 patients with trigeminal neuralgia were treated with PMC. The course of the disease ranged from 3 months to 38 years. Under the guidance of C-arm X-ray, 14# needle was placed into the foramen ovale using the classical Hakanson's technique. Fogarty balloon catheter was navigated into the Meckel's cave tenderly. A small amount of Omnipaque was slowly injected to inflate the balloon and compress the trigeminal ganglion for 3 to10 minutes.Results A total of 290 PMC were performed on the 276 patients. Among them, 252 had immediate relief from pain. The patients were followed up for a mean of 18.7 months (range, 4 to 32), 14 of them had a recurrence. Of the 14 patients, 12 were re-operated with PMC, and the pain was all controlled successfully.Conclusions PMC is an effective and technically simple method for trigeminal neuralgia. For older patients with trigeminal neuralgia, it may be the first choice.

  4. Minimizing radiation exposure during percutaneous nephrolithotomy. (United States)

    Chen, T T; Preminger, G M; Lipkin, M E


    Given the recent trends in growing per capita radiation dose from medical sources, there have been increasing concerns over patient radiation exposure. Patients with kidney stones undergoing percutaneous nephrolithotomy (PNL) are at particular risk for high radiation exposure. There exist several risk factors for increased radiation exposure during PNL which include high Body Mass Index, multiple access tracts, and increased stone burden. We herein review recent trends in radiation exposure, radiation exposure during PNL to both patients and urologists, and various approaches to reduce radiation exposure. We discuss incorporating the principles of As Low As reasonably Achievable (ALARA) into clinical practice and review imaging techniques such as ultrasound and air contrast to guide PNL access. Alternative surgical techniques and approaches to reducing radiation exposure, including retrograde intra-renal surgery, retrograde nephrostomy, endoscopic-guided PNL, and minimally invasive PNL, are also highlighted. It is important for urologists to be aware of these concepts and techniques when treating stone patients with PNL. The discussions outlined will assist urologists in providing patient counseling and high quality of care.

  5. Incidence of retrorenal colon during percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Mehmet Balasar


    Full Text Available Objective The aim of this study was to investigate retrorenal colon incidence in percutaneous nephrolithotomy (PNL interventions made in our clinic. Materials and Methods Clinical data of 804 PNL patients, accumulated over a 7 year period (2006-2012, was surveyed. The patient files were reviewed retrospectively, and only those who had abdominal computed tomography (CT images before PNL intervention were included in the study. In the CT images, the position of both the ascending and descending colon in relation to the right and left kidneys were evaluated. Results According to our hospital reports, 394 patients with CT images were included in the present study 27 patients (6.9% had retrorenal colon, of which 18 (4.6% were on the left side, 4 (1.0% on the right side and 5 (1.3% had bilateral retrorenal colons. Colonic perforation complication was seen only in two patients and the colonic perforation rate was 0.3%. These two cases had no CT images. Conclusions PNL, in the process of becoming the standard treatment modality, is a safe and reliable technique for renal stone treatment. Colonic injury should be taken into consideration during PNL interventions of the lower pole of the kidney (especially on the left side due to the location of retrorenal colon.

  6. Percutaneous transhepatic cholangiography using fine needle

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kyoo Byung; Kim, Yun Hwan; Lee, Nam Joon; Suh, Won Hyuck [College of Medicine, Korea University, Seoul (Korea, Republic of)


    In recent years, percutaneous transhepatic cholangiography (PTC) using fine needle has become widely employed as the procedure of choice for direct opacification of the biliary trees because of its high success rate, easy performance and relative low complication rate. Authors present the clinical and PTC findings of experienced cases during last four years, from May 1976 to June 1980, at the Department of Radiology, Korea University Hospital. We tried to study of PTC in 44 cases, 32 males and 12 females, and succeeded in visualization of bile ducts in 41 cases, but the other three cases were failed to visualize the bile ducts. Final confirmative diagnosis was achieved in 29 cases by operation, laparoscopy and other clinical methods. The PTC diagnosis was correct in 24 of 29 cases, and the others were incorrect. The 29 final diagnosis was including 13 cases of biliary stones, 6 cases of biliary cancer, 3 cases of pancreatic cancer, 3 cases of clonorchiasis, one case of CBD ascariasis and 3 cases of others. Incorrect PTC diagnosis was made in five cases. They were one case of nonvisualized intrahepatic stones, one case of hepatoma PTC diagnosed as cholangiocarcinoma, one case of pancreatic cancer diagnosed as cholangiocarcinoma, one case of clonorchiasis diagnosed as biliary stones and one case of normal CBD which was diagnosed as distal CBD cancer. And we experienced one case of bile peritonitis as complication, who was 35 year-old female patient with multiple CBD stones, and aspirated about 500ml of bile stained ascites during operation.

  7. Percutaneous nephrolithotomy through an intercostal approach

    Energy Technology Data Exchange (ETDEWEB)

    Narasimham, D.L.; Jacobsson, B.; Vijayan, P.; Bhuyan, B.C.; Nyman, U.; Holmquist, B. (Hamad General Hospital (Qatar). Dept. of Diagnostic Radiology Hamad General Hospital (Qatar). Dept. of Urology)


    During a 5-year period percutaneous nephrolithotripsy through an intercostal space was performed in 56 of 231 procedures. Minimal thoracic complications were seen in 3 of 53 patients with 11th intercostal space tracts into a lower, middle, or upper pole calyx. A working sheath and a pyelostomy drainage catheter were used in all these cases. Hydro- and pneumothorax requiring treatment occurred in 2 of 3 patients with a 10th intercostal space approach into an upper pole calyx combined with improper use of the working sheath and/or the pyelostomy catheter. Review of the literature also indicates that an intercostal approach appears safe when performed via the 11th intercostal space into a lower or middle pole calyx. Thoracic complications occurred when punctures were made towards an upper pole calyx or above the 11th rib. The complications may be limited by identifying the posterior inferior lung border by fluoroscopy during puncture, and performing it under general anesthesia with controlled breath-holding. The use of a working sheath to seal the pleural opening during the procedure and an efficient pyelostomy drainage catheter to allow free drainage of uring and to tamponade the tract postoperatively are also recommended. (orig.).

  8. Percutaneous vertebroplasty: Current concepts and local experience

    Directory of Open Access Journals (Sweden)

    Hee Hwan


    Full Text Available With the aging population in our country, symptomatic osteoporotic compression fractures are increasingly common. Osteolytic compression fractures from spinal metastasis are also becoming more frequently seen because of the longer life expectancy from improvements in chemotherapy. Percutaneous vertebroplasty with PMMA has been shown to be an efficient procedure to treat pain due to these fractures. It is a minimally invasive procedure performed under local anesthesia and sedation. Injection of PMMA provides immediate stability when it hardens, and permits the patient to ambulate without pain. Appropriate patient selection is the key to clinical success. However, this procedure must be treated with respect, and has to be performed by physicians with the necessary training. Otherwise, increased pain, paralysis, and even death may occur from this seemingly innocuous procedure. In this article, I will deal with the background issues of osteoporotic and osteolytic vertebral compression fractures, patient selection, surgical technique, complications, and review of current literature on vertebroplasty. Key areas of development in this field include the use of kyphoplasty, defining the role of prophylactic augmentation, and improvements in biomaterials.

  9. Percutaneous balloon valvuloplasty in mitral stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Oh, Byung Hee; Park, Kyung Ju; Kim, Seung Hyup; Lee, Young Woo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Percutaneous balloon valvuloplasty(PBV) was successfully performed in 8 mitral stenosis patients for recent 3 months. Five patients have aortic insufficiencies also and two patients have mitral regurgitations below grade II/IV. All patients showed sinus rhythm on EKG, and had no mitral valvular calcification on echocardiography and fluoroscopy. PBV resulted in an increase in mitral valve area from 1.22{+-}0.22 to 2.57{+-}0.86 cm{sup 2}, a decrease in mean left atrial pressure from 23.4{+-}9.6 to 7.5{+-}3.4 mmHg and a decrease in mean mitral pressure gradient from 21.3{+-}9.4 to 6.8{+-}3.1 mmHg. There were no significant complications except 2 cases of newly appeared and mildly aggravated mitral regurgitation. We believe that PBV will become a treatment modality of choice replacing surgical commissurotomy or valve replacement in a group of mitral stenosis patients, because of its effectiveness and safety.

  10. Stage 2 vapor recovery system

    Energy Technology Data Exchange (ETDEWEB)

    Koch, W.H.; Strock, D.J.; Butkovich, M.S.; Hartman, H.B.


    A vapor recovery system is described, comprising: a set of elongated underground storage tanks, each storage tank containing a different grade of gasoline; vent pipes; a series of dispensing units; fuel flow lines; vapor return lines; an array of fuel pumps for pumping gasoline from said storage tanks to said dispenser units; an elongated condensate liquid pickup tube; an elongated inner spout providing a fuel conduit and having an outer tip defining a fuel outlet for discharging gasoline into a filler pipe of a motor vehicle tank during fueling; an outer spout assembly; extending into and engaging said spout-receiving socket, said outer spout assembly comprising an outer spout providing a vapor return conduit and defining apertures providing a vapor inlet spaced from said fuel outlet for withdrawing, removing, and returning a substantial amount of gasoline vapors emitted during said fueling; an elongated liquid sensing tube; a manually operable level; a flow control valve assembly; an automatic shutoff valve assembly; and a venturi sleeve assembly positioned in said venturi sleeve receiving chamber.

  11. The Lithium Vapor Box Divertor (United States)

    Goldston, Robert; Hakim, Ammar; Hammett, Gregory; Jaworski, Michael; Myers, Rachel; Schwartz, Jacob


    Projections of scrape-off layer width to a demonstration power plant suggest an immense parallel heat flux, of order 12 GW/m2, which will necessitate nearly fully detached operation. Building on earlier work by Nagayama et al. and by Ono et al., we propose to use a series of differentially pumped boxes filled with lithium vapor to isolate the buffering vapor from the main plasma chamber, allowing stable detachment. This powerful differential pumping is only available for condensable vapors, not conventional gases. We demonstrate the properties of such a system through conservation laws for vapor mass and enthalpy, and then include plasma entrainment and ultimately an estimate of radiated power. We find that full detachment should be achievable with little leakage of lithium to the main plasma chamber. We also present progress towards solving the Navier-Stokes equation numerically for the chain of vapor boxes, including self-consistent wall boundary conditions and fully-developed shocks, as well as concepts for an initial experimental demonstration-of-concept. This work supported by DOE Contract No. DE-AC02-09CH11466.

  12. 21 CFR 880.5970 - Percutaneous, implanted, long-term intravascular catheter. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Percutaneous, implanted, long-term intravascular... and Personal Use Therapeutic Devices § 880.5970 Percutaneous, implanted, long-term intravascular catheter. (a) Identification. A percutaneous, implanted, long-term intravascular catheter is a device...

  13. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, Stephan, E-mail: [University Hospital Regensburg, Department of Radiology (Germany); Diekmann, Matthias [Radiology Center Rahlstedt (Germany); Manke, Christoph [General Hospital Fulda, Department of Radiology (Germany); Heiss, Peter [University Hospital Regensburg, Department of Radiology (Germany)


    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  14. VX Penetration Following Percutaneous Poisoning: A Dermal Microdialysis Study in the Guinea Pig. (United States)

    Wetherell, Janet R; Armstrong, Stuart J; Read, Robert W; Clough, Geraldine F


    ABSTRACT VX, a potent organophosphorus compound, acts primarily by irreversibly inhibiting acetylcholinesterase resulting in an accumulation of acetylcholine, which produces the characteristic signs of nerve agent poisoning. VX is a low-volatility agent, and therefore the most likely route of absorption into the body is via the skin. This study demonstrates for the first time that it is possible to follow the time course of percutaneous VX penetration using the technique of dermal microdialysis and that VX is absorbed through the skin of the anesthetized guinea pig in a concentration-dependent manner. A linear microdialysis probe (5-kDa cut-off) was implanted in the dermis of the back of the guinea pig and perfused (5 muL/min) with physiological Ringer's solution. VX (296 or 592 mug/kg) was applied (33 muL/kg) over the site of the microdialysis probe and dialysate samples collected for up to 6 h. The VX dialysate concentration was measured by liquid chromatography-tandem mass spectrometry (LC-MS-MS). Quantitation was performed over the range 0.1 to 100 ng/mL and the calibration was linear. VX was detected within 15 min, reaching a peak at 30 min following both VX doses. After this time the VX concentration decreased. There was a clear dose-dependent recovery of VX in the dialysate and the total amount recovered was statistically significant between the two doses. This study has clearly shown that microdialysis can be used to follow the time course of the percutaneous absorption of VX in the anesthetized guinea pig and will be used in future studies to develop improved medical countermeasures. Crown Copyright (c) 2007 Dstl.

  15. Radioprotective Agents (United States)


    claimed to be effective are gallic acid derivatives, eg, sodium gallate 12053-21-61 (295-297) and propyl gallate 1121-79-91 (298). p...inhibition of a-adrenergic receptors can be achieved through the use of the antiradiation agents 2-(5-aminopentylamino)ethanephos- phorothioic acid ...tissue was ap- preciated immediately as a potential medical set, and they were put to use en- thusiastically. Early workers did notice an erythematous

  16. Percutaneous radiofrequency thermocoagulation of osteoid osteomas: factors affecting therapeutic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Cribb, G.L.; Goude, W.H.; Cool, P.; Tins, B.; Cassar-Pullicino, V.N.; Mangham, D.C. [Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (United Kingdom)


    To examine factors which affect local recurrence of osteoid osteomas treated with percutaneous CT-guided radiofrequency thermocoagulation. A prospective study was carried out on 45 patients with osteoid osteoma who underwent percutaneous radiofrequency thermocoagulation with a minimum follow-up of 12 months There were seven local recurrences (16%); all occurred within the first year. Local recurrence was significantly related to a non-diaphyseal location (P<0.01). There was no significant relationship (P=0.05) between local recurrence and age of the patient, duration of symptoms, previous treatment, size of the lesion, positive biopsy, radiofrequency generator used or the number of needle positions. There were no complications. Osteoid osteomas in a non-diaphyseal location are statistically more likely to recur than those in a diaphyseal location when treated with CT-guided percutaneous radiofrequency thermocoagulation. This relationship between local recurrence and location has not been previously reported. (orig.)

  17. Unusual complication of percutaneous nephrostomy in a renal transplant recipient

    Directory of Open Access Journals (Sweden)

    Martina Paetzel


    Full Text Available Context: Ureteral obstruction, resulting in impaired graft function, is a well-known problem following renal transplantation. Management of ureteral complications includes percutaneous nephrostomy, which is considered to be a safe and effective measure. Case Report: Here, we demonstrate a case of a 35-year old renal allograft recipient with primary graft function but stagnating serum creatinine following extraction of the double-J catheter. Ureteral stenosis was suspected by ultrasound imaging and magnetic resonance tomography, and urinary flow was preserved with a percutaneous nephrostomy. However, early displacement of the percutaneous nephrostomy catheter resulted in distinct clinical discomfort. CT imaging suggested an intra-abdominal position of the catheter’s tip, requiring immediate surgical action. Conclusion: The present case demonstrates that performing PCN following renal transplantation may have unexpected risks.

  18. Preparation and Behaviour of New Materials for Percutaneous Access

    Institute of Scientific and Technical Information of China (English)


    The reinforcing effects on hydroxyapatite ( abbreviated HA ) of phosphate glass additives were researched. The samples of reinforced HA ( abbreviated RHA ) and control material were prepared and then percutaneously implanted in the skin of experiment animal. The histomorphology of the part skin tissue were observed.By a biomimetic process, the method and conditions of forming HA coating on the surface of medical silicon rubber(abbreviated MSR) were studied. The results illustrate that the phosphate glass additives have obvious reinforcing effects on HA. In the percutaneous implantation test, neither clear infiltration of inflammatory cells nor marked downgrowth of epidermis was observed for the part tissue surrounded RHA. The surface modification of MSR for percutaneous access could be attained by biomimetic synthesis of HA coating.

  19. Percutaneous peritoneovenous shunt positioning: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene [Division of Radiology, European Institute of Oncology, Milan (Italy); Monti, Cinzia [Institute of Radiology, University of Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, Milan (Italy); Institute of Radiology, University of Milan (Italy)


    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

  20. Treatment of osteoporotic vertebral body compression fractures by percutaneous vertebroplasty

    Institute of Scientific and Technical Information of China (English)

    Hongmin Zang; Yiheng Liu; Junchang Chen


    Objective: To explore the effect of percutaneous vertebroplasty to treat osteoporotic vertebral body compression fractures. Methods: Seventeen patients with compression fractures at 27 different levels came in for percutaneous vertebroplasty. Under the guidance of C-arm image intensifier, bone needle was inserted into the fracture vertebral bodies via a unilateral transpedicular approach.Polymethyl methacrylate (PMMA) was injected slowly under continuous fluoroscopic control. Then the effect was evaluated after operation.Results: Follow-up results among 15 patients were studied, other two patients lost contact. The follow-up period was from three to seven months. No patient had relapse of compression fracture. Leakage of the cement outside the vertebral body was seen in four bodies. All patients had a complete relief after Percutaneous vertebroplasty(PVP). Conclusion: PVP is an efficient minimally invasive technique to treat osteoporotic vertebral body compression fractures.

  1. Post-operative duodenal fistula: percutaneous treatment and review

    Directory of Open Access Journals (Sweden)



    Full Text Available Duodenal fistula is a complex condition, relatively frequent presentation, being in most cases of postoperative origin. Among the latter, 6% to 11% are secondary to surgical treatment of perforated duodenal ulcer, and more unusual, as a complication of cholecystectomy. Two cases treated percutaneous at the Polyclinic Bank city of Buenos Aires are presented. The first, a female patient with a duodenal fistula as a postoperative complication of a perforated duodenal ulcer and the second one patient male with the same pathology but as a complication of cholecystectomy. Percutaneous treatment of this disease has been reported sporadically without having proven its usefulness. Once diagnosed the same Fistulography and obliteration were performed percutaneously achieving complete remission of the disease.

  2. Percutaneous dilatational tracheostomy following total artificial heart implantation. (United States)

    Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Serrano, Maria Rosario; Guersoy, Dilek; Autschbach, Ruediger; Goetzenich, Andreas; Koerfer, Reiner; Tenderich, Gero


    Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation.

  3. Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments

    Directory of Open Access Journals (Sweden)

    Carlos Passos Pinheiro


    Full Text Available Abstract Background: Paravalvular regurgitation (paravalvular leak is a serious and rare complication associated with valve replacement surgery. Studies have shown a 3% to 6% incidence of paravalvular regurgitation with hemodynamic repercussion. Few studies have compared surgical and percutaneous approaches for repair. Objectives: To compare the surgical and percutaneous approaches for paravalvular regurgitation repair regarding clinical outcomes during hospitalization and one year after the procedure. Methods: This is a retrospective, descriptive and observational study that included 35 patients with paravalvular leak, requiring repair, and followed up at the Dante Pazzanese Institute of Cardiology between January 2011 and December 2013. Patients were divided into groups according to the established treatment and followed up for 1 year after the procedure. Results: The group submitted to percutaneous treatment was considered to be at higher risk for complications because of the older age of patients, higher prevalence of diabetes, greater number of previous valve surgeries and lower mean creatinine clearance value. During hospitalization, both groups had a large number of complications (74.3% of cases, with no statistical difference in the analyzed outcomes. After 1 year, the percutaneous group had a greater number of re-interventions (8.7% vs 20%, p = 0.57 and a higher mortality rate (0% vs. 20%, p = 0.08. A high incidence of residual mitral leak was observed after the percutaneous procedure (8.7% vs. 50%, p = 0.08. Conclusion: Surgery is the treatment of choice for paravalvular regurgitation. The percutaneous approach can be an alternative for patients at high surgical risk.

  4. Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments (United States)

    Pinheiro, Carlos Passos; Rezek, Daniele; Costa, Eduardo Paiva; de Carvalho, Edvagner Sergio Leite; Moscoso, Freddy Antonio Brito; Taborga, Percy Richard Chavez; Jeronimo, Andreia Dias; Abizaid, Alexandre Antonio Cunha; Ramos, Auristela Isabel de Oliveira


    Background Paravalvular regurgitation (paravalvular leak) is a serious and rare complication associated with valve replacement surgery. Studies have shown a 3% to 6% incidence of paravalvular regurgitation with hemodynamic repercussion. Few studies have compared surgical and percutaneous approaches for repair. Objectives To compare the surgical and percutaneous approaches for paravalvular regurgitation repair regarding clinical outcomes during hospitalization and one year after the procedure. Methods This is a retrospective, descriptive and observational study that included 35 patients with paravalvular leak, requiring repair, and followed up at the Dante Pazzanese Institute of Cardiology between January 2011 and December 2013. Patients were divided into groups according to the established treatment and followed up for 1 year after the procedure. Results The group submitted to percutaneous treatment was considered to be at higher risk for complications because of the older age of patients, higher prevalence of diabetes, greater number of previous valve surgeries and lower mean creatinine clearance value. During hospitalization, both groups had a large number of complications (74.3% of cases), with no statistical difference in the analyzed outcomes. After 1 year, the percutaneous group had a greater number of re-interventions (8.7% vs 20%, p = 0.57) and a higher mortality rate (0% vs. 20%, p = 0.08). A high incidence of residual mitral leak was observed after the percutaneous procedure (8.7% vs. 50%, p = 0.08). Conclusion Surgery is the treatment of choice for paravalvular regurgitation. The percutaneous approach can be an alternative for patients at high surgical risk. PMID:27305109

  5. Percutaneous vertebroplasty in osteoporotic vertebral body compression fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyuk Jung; Lee, Seon Kyu; Hwang, Hee Young; Kim, Hyung Sik; Ko, Joon Seok; Park Si Hyun; Park, Cheol Hee [Gacheon Medical College, Incheon (Korea, Republic of)


    To determine the clinical efficacy of percutaneous vertebroplasty in cases of painful and medically intractable osteoporotic vertebral compression fracture. Ninety-eight patients (20 men and 78 women: mean age, 69 years) underwent 122 percutaneous vertebroplasty procedures for the treatment of osteoporotic vertical compression fracture. For the evaluation of bone mass, bone densitometry was performed in 45 patients, and to assess the recent evolution of the fracture, all 98 underwent MRI. Percutaneous vertebroplasty involves percutaneous transpedicular puncture of the involved verteb666rae followed by the injection of a polymethylmethacrylate(PMMA)-Barium mixture into the vertebral body. To assess leakage of the mixture into the epidural tissue, neural foramina, venous plexus and paravertebral tissue, we then immediately obtained a computerized tomographic (CT) scan, assessing the clinical efficacy of the procedure on the basis of time required for pain relief (defined as more than 60% reduction of initial pain), and time required for ambulation without significant pain. Percutaneous vertebroplasty was successful in all patients. Pain relief was accomplished within 1-5 (mean, 1.8) days and early ambulation without significant pain was possible within 2-15 (mean, 3.3) days. Post-procedural CT scanning revealed leakage of the PMMA-barium mixture into paravertebral tissue(n=41).the paravertebral venous plexus (n=34) and epidural tissue (n=4). No neural foraminal leakage was identified, and no procedure-related complication requiring surgical treatment occurred. Percutaneous vertebroplasty is an effective new interventional procedure for the treatment of osteoporotic vertebral compression fracture. It relieves pain, provides early mobilization, and strengthens involved vertebral bodies.

  6. Percutaneous toxicity and decontamination of soman, VX, and paraoxon in rats using detergents. (United States)

    Misík, Jan; Pavliková, Růžena; Kuča, Kamil


    Highly toxic organophosphorus compounds (OPs) were originally developed for warfare or as agricultural pesticides. Today, OPs represent a serious threat to military personnel and civilians. This study investigates the in vivo decontamination of male Wistar rats percutaneously exposed to paraoxon and two potent nerve agents--soman (GD) and VX. Four commercial detergents were tested as decontaminants--Neodekont(TM), Argos(TM), Dermogel(TM), and FloraFree(TM). Decontamination performed 2 min after exposure resulted in a higher survival rate in comparison with non-decontaminated controls. The decontamination effectiveness was expressed as protective ratio (PR, median lethal dose of agent in decontaminated animals divided by the median lethal dose of agent in untreated animals). The highest decontamination effectiveness was consistently achieved with Argos(TM) (PR=2.3 to 64.8), followed by Dermogel(TM) (PR=2.4 to 46.1). Neodekont(TM) and FloraFree(TM) provided the lowest decontamination effectiveness, equivalent to distilled water (PR=1.0 to 43.2).

  7. Device entrapment: a rare complication of percutaneous coronary intervention. (United States)

    Rehman, Abdul; Rehman, Abdur; Khan, Javaid Arif; Sial, Javaid A; Baloch, Zafar Haleem


    Device entrapment is a rare complication of percutaneous coronary intervention. It has hazardous potentials for the patient. Emergent cardiac surgery is the only option after failure of retrieval devices. We have described here a case of a 55 years old male. During percutaneous coronary intervention, the balloon inflated only partially at its ends and entrapped in the lesion along with the stent. Multiple attempts at inflation failed and the patient developed severe chest pain for few minutes. Surgery was contemplated but final attempt at inflation was successful and the patient stabilized. It was an emergent situation and could have led to fatal outcome, although this patient escaped narrowly from any fatal outcome.

  8. Training for percutaneous renal access on a virtual reality simulator

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yi; YU Cheng-fan; LIU Jin-shun; WANG Gang; ZHU He; NA Yan-qun


    Background The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators.The PERC MentorTM is designed to train the user in percutaneous renal collecting system access puncture.This study aimed to validate the use of this kind of simulator,in percutaneous renal access training.Methods Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique.An assigned percutaneous renal access procedure was immediately performed on the PERC MentorTM after watching instruction video and an analog operation.Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined.Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days.Twenty-four hours after the training session,trainees were evaluated performing the same procedure.The post-training evaluation was compared to the evaluation of the initial attempt.Results During the initial attempt,none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access.After the short-term training,all trainees were able to independently complete the procedure.Of the 21 trainees,10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy.Trainees were thus categorized into the group of primitive experience and inexperience.The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P=0.03 and 0.02,respectively).Conclusions The training on the virtual reality simulator,PERC MentorTM,can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently.This virtual reality simulator may become an important training and evaluation tool

  9. A case of micro-percutaneous nephrolithotomy with macro complication. (United States)

    Dede, Onur; Utangaç, Mazhar; Dağguli, Mansur; Hatipoğlu, Namık Kemal; Sancaktutar, Ahmet Ali; Bodakçı, Mehmet Nuri


    Percutaneous nephrolithotomy is accepted as the standard management approach for kidney stones that are either refractory to extracorporeal shock wave lithotripsy or are >2 cm in diameter. The recently developed micro-percutaneous nephrolithotomy (microperc) technique provides intrarenal access under full vision using an optic instrument with a smaller calibration. A lesser amount of bleeding has been reported with the use of this method. Here we present a case of a bleeding complication on postoperative day 15 after a microperc procedure used to treat a left kidney stone. The complication led to retention of bloody urine in the bladder and required transfusion of 5 units of whole blood.

  10. Percutaneous transluminal angioplasty of infrarenal arteries in intermittent claudication

    DEFF Research Database (Denmark)

    Henriksen, L O; Jørgensen, B; Holstein, P E;


    Percutaneous transluminal angioplasty was performed on 55 iliac and 31 femoropopliteal arteries in 71 patients with intermittent claudication (23 women, 48 men). The two-year patency rate was 80% after iliac and 41% after femoropopliteal angioplasty. In 17 femoropopliteal cases with lesions greater...... than or equal to 5 cm the 2-year patency rate was only 32%, but the corresponding figure for shorter lesions was 53%. Complicating haematoma appeared in 10% of the cases and the arterial state deteriorated in one patient. There was no distal embolization. Percutaneous transluminal angioplasty...

  11. Percutaneous Ventricular Assist Devices: New Deus Ex Machina?

    Directory of Open Access Journals (Sweden)

    Diego Arroyo


    Full Text Available The development of ventricular assist devices has broadened the means with which one can treat acute heart failure. Percutaneous ventricular assist devices (pVAD have risen from recent technological advances. They are smaller, easier, and faster to implant, all important qualities in the setting of acute heart failure. The present paper briefly describes the functioning and assets of the most common devices used today. It gives an overview of the current evidence and indications for left ventricular assist device use in cardiogenic shock and high-risk percutaneous coronary intervention. Finally, extracorporeal life support devices are dealt with in the setting of hemodynamic support.

  12. Life-threatening paraspinal muscle hematoma after percutaneous vertebroplasty

    Directory of Open Access Journals (Sweden)

    Chang-Hoon Jeon


    Full Text Available Bleeding and hematoma formation is rarely reported in percutaneous vertebroplasty procedure. An 84 year old male presented with a large paraspinal muscle hematoma after a percutaneous vertebroplasty. The patient had neither any prior bleeding disorder nor any anticoagulant treatment. Vital signs of the patient were unstable, and his hemoglobin level decreased daily. After a month of conservative treatment, including transfusion, cryotherapy, pain control and bed rest, his hemoglobin level remained stable and he showed relief from pain. Four months later, hematoma resolved spontaneously and he could walk without back pain.

  13. Percutaneous radiofrequency ablation in painful bone metastases

    Directory of Open Access Journals (Sweden)

    German Garabano


    Full Text Available Backgraund There are different treatment for painful bone metastases (mtts, with different results. CT-guided Percutaneous Radiofrequency Ablation (CT-PRA is one of them. The pupose of this retrospective study was to assess the initial results using this methods, focusing on pain relief, showing details of the surgical technique. Methods 18 patients with an average age of 59.2 years and 15 months follow-up were treated. Nine mtts were located in the femur, 4 dorsal / lumbar spine, 3 in scapula and 2 in Iliac. The Mtts origin were Breast Ca 7 cases, lung in 4, Kidney in 4 and 3 in Thyroid. The rachis mtts were found at more than 10mm of the medullary cavity and mtts of long bones showed low risk of fracture. Lesions >3cm were treated whit CT-PRA  using Valleylab Rita needle and these <3cm with CoolTip needle. Pain was assessed by Visual Analog Scale (VAS preoperatively, at 2, 7 and 30 days, and then at 3 and 6 months. Results Preoperative pain score was 8.33 on average. At 7 days of ablatión de VAS score was 5 on average and at 30 days was 2 points. After at 3 and 6 months de VAS average was 1. This method had excellent patients tolerance and no complications. There were two recurrences which underwent endoprosthesis unconventional proximal femur and knee respectively, evolving favorably. Conclusion CT-guided APRF impresses a promising, simple and effective tool in the treatment of painfull bone mtts, achieving excellent pain control with good tolerance by the patient.

  14. Third-generation percutaneous vertebral augmentation systems (United States)

    Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo


    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater than 30% loss of height. Currently, this type of treatment is not feasible. Herein we review the characteristics and methods of operation of three of the most common percutaneous vertebral augmentation systems (PVAS) for the treatment of OVF: Vertebral Body Stenting® (VBS), OsseoFix® and Spine Jack®. VBS is a titanium device accompanied by a hydraulic (as opposed to mechanical) working system which allows a partial and not immediate possibility to control the opening of the device. On the other hand, OsseoFix® and Spine Jack® are accompanied by a mechanical working system which allows a progressive and controlled reduction of the vertebral fracture. Another important aspect to consider is the vertebral body height recovery. OsseoFix® has an indirect mechanism of action: the compaction of the trabecular bone causes an increase in the vertebral body height. Unlike the Vertebral Body Stenting® and Spine Jack®, the OsseoFix® has no direct lift mechanism. Therefore, for these characteristics and for the force that this device is able to provide. In our opinion, Spine Jack® is the only device also suitable for the treatment OVF, traumatic fracture (recent, old or inveterate) and primary or secondary bone tumors. PMID:27683690

  15. Percutaneous Nephrolithotomy under Spinal Anesthesia with Marcaine

    Directory of Open Access Journals (Sweden)

    S.M.R. Rabani


    Full Text Available Introduction & Objective: The efficacy of Percutaneous Nephrolithotomy (PCNL in the treatment of renal stones has been proven in its indications. The main method of anesthesia in this procedure is general anesthesia. We used spinal anesthesia (SA as an alternative method of anesthesia with many benefits. This study was intended to show the possibility of SA as a more comfortable method of anesthesia for the surgeon , the anesthesiologist and the patient via more cooperation of the patient during changing the position and prevention of some complications mostly in upper extremities and neck. Materials & Methods: In a prospective clinical trial study, a total of 112 patients underwent PCNL under SA with marcaine , from Nov 2004 till Feb 2009. Their mean age was 36 years (22-48, at first the syringe was stained by epinephrine and then 2 -3.5 ml marcaine was used for SA and addition of analgesics , sedatives or both., if needed. The rest of the procedure was done as routine.Results: Stone clearance was achieved in 82% of the patients and the rest were managed by ESWL. The mean operation time was 126 minutes (90-220, 36% of the patients needed sedation, analgesia, or both, specially those with bigger stones. 6% of the patients had upper pole stones .Blood transfusion was needed only in one patient. No significant complication was observed in this study.Conclusion: PCNL under SA afforded the surgeon and the anesthesiologist the opportunity of more patient cooperation during position changes and precludes some morbidities that may happen under general anesthesia because the patient is awake and able to portend.

  16. Trading Agents

    CERN Document Server

    Wellman, Michael


    Automated trading in electronic markets is one of the most common and consequential applications of autonomous software agents. Design of effective trading strategies requires thorough understanding of how market mechanisms operate, and appreciation of strategic issues that commonly manifest in trading scenarios. Drawing on research in auction theory and artificial intelligence, this book presents core principles of strategic reasoning that apply to market situations. The author illustrates trading strategy choices through examples of concrete market environments, such as eBay, as well as abst

  17. Estimated vapor pressure for WTP process streams

    Energy Technology Data Exchange (ETDEWEB)

    Pike, J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Poirier, M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)


    Design assumptions during the vacuum refill phase of the Pulsed Jet Mixers (PJMs) in the Hanford Waste Treatment and Immobilization Plant (WTP) equate the vapor pressure of all process streams to that of water when calculating the temperature at which the vacuum refill is reduced or eliminated. WTP design authority asked the authors to assess this assumption by performing calculations on proposed feed slurries to calculate the vapor pressure as a function of temperature. The vapor pressure was estimated for each WTP waste group. The vapor pressure suppression caused by dissolved solids is much greater than the increase caused by organic components such that the vapor pressure for all of the waste group compositions is less than that of pure water. The vapor pressure for each group at 145°F ranges from 81% to 98% of the vapor pressure of water. If desired, the PJM could be operated at higher temperatures for waste groups with high dissolved solids that suppress vapor pressure. The SO4 group with the highest vapor pressure suppression could be operated up to 153°F before reaching the same vapor pressure of water at 145°F. However, most groups would reach equivalent vapor pressure at 147 to 148°F. If any of these waste streams are diluted, the vapor pressure can exceed the vapor pressure of water at mass dilution ratios greater than 10, but the overall effect is less than 0.5%.

  18. Final OSWER Vapor Intrusion Guidance (United States)

    EPA is preparing to finalize its guidance on assessing and addressing vapor intrusion, which is defined as migration of volatile constituents from contaminated media in the subsurface (soil or groundwater) into the indoor environment. In November 2002, EPA issued draft guidance o...

  19. Simple Chemical Vapor Deposition Experiment (United States)

    Pedersen, Henrik


    Chemical vapor deposition (CVD) is a process commonly used for the synthesis of thin films for several important technological applications, for example, microelectronics, hard coatings, and smart windows. Unfortunately, the complexity and prohibitive cost of CVD equipment makes it seldom available for undergraduate chemistry students. Here, a…

  20. Hydrazine vapor inactivates Bacillus spores (United States)

    Schubert, Wayne W.; Engler, Diane L.; Beaudet, Robert A.


    NASA policy restricts the total number of bacterial spores that can remain on a spacecraft traveling to any planetary body which might harbor life or have evidence of past life. Hydrazine, N2H4, is commonly used as a propellant on spacecraft. Hydrazine as a liquid is known to inactivate bacterial spores. We have now verified that hydrazine vapor also inactivates bacterial spores. After Bacillus atrophaeus ATCC 9372 spores deposited on stainless steel coupons were exposed to saturated hydrazine vapor in closed containers, the spores were recovered from the coupons, serially diluted, pour plated and the surviving bacterial colonies were counted. The exposure times required to reduce the spore population by a factor of ten, known as the D-value, were 4.70 ± 0.50 h at 25 °C and 2.85 ± 0.13 h at 35 °C. These inactivation rates are short enough to ensure that the bioburden of the surfaces and volumes would be negligible after prolonged exposure to hydrazine vapor. Thus, all the propellant tubing and internal tank surfaces exposed to hydrazine vapor do not contribute to the total spore count.

  1. Post-exposure therapy with recombinant human BuChE following percutaneous VX challenge in guinea-pigs. (United States)

    Mumford, Helen; Troyer, John K


    Poisoning by nerve agents via the percutaneous (p.c.) route is an issue because the slow absorption of agent could result in poisoning which outlasts the protection provided by conventional pharmacological therapy. The bioscavenger approach is based on the concept of binding nerve agent in the bloodstream, thus preventing nerve agent from reaching the target tissues and inhibiting acetylcholinesterase activity. One bioscavenger that has been extensively studied is human butyrylcholinesterase (huBuChE). Protexia® is a pegylated form of recombinant huBuChE. We used a guinea-pig model of p.c. nerve agent poisoning, using an implanted telemetry system to collect physiological data. Guinea-pigs were poisoned with the nerve agent VX (0.74 mg/kg) (∼2.5 × LD₅₀). Two hours following VX exposure, Protexia (72 mg/kg) or saline control was administered intramuscularly. All guinea-pigs treated with Protexia (n=8) survived, compared to no survivors in a saline-treated control group (n=8). Survival following VX and Protexia treatment was associated with minimal incapacitation and observable signs of poisoning, and the mitigation or prevention of the detrimental physiological changes (e.g. seizure, bradycardia and hypothermia) observed in control animals. The opportunity for post-exposure treatment may have utility in both civilian and military scenarios, and this is a promising indication for the use of a bioscavenger.

  2. Boiler for generating high quality vapor (United States)

    Gray, V. H.; Marto, P. J.; Joslyn, A. W.


    Boiler supplies vapor for use in turbines by imparting a high angular velocity to the liquid annulus in heated rotating drum. Drum boiler provides a sharp interface between boiling liquid and vapor, thereby, inhibiting the formation of unwanted liquid droplets.

  3. 冠状动脉球囊成形术及支架术后再狭窄%Restenosis after percutaneous transluminal coronary angioplasty and stent implantation

    Institute of Scientific and Technical Information of China (English)



    Percutaneous transluminal coronary angioplasty (PTCA) has become one of the most important treatment method in coronary artery disease along with coronary bypass operation and medicine in recent years.Restenosis after intervention becomes the Achili's heel in our daily treatment.In some degree stenting can reduce restenosis,but the restenosis after stenting is still over 20%.The focus of the treatment of restenosis over the last 2 decades has been through the application of pharmacologically active agents and mechanical approaches using a host of different devices.But this frequent and costly complication of percutaneous revascularization techniques has proved refractory to all such therapies.This review will focus on the studies that have been done during recent years,it will cover the mechanism of restenosis after PTCA and stenting,the risk factors involved in the restenosis,and the prevention and treatment of restenosis.

  4. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal

    Directory of Open Access Journals (Sweden)

    Madhu Sudan Agrawal


    Full Text Available Introduction: Percutaneous nephrolithotomy (PCNL has witnessed rapid advancements, the latest being ultra-mini-percutaneous nephrolithotomy (UMP, which makes the use of 11-13F sheaths as compared to 24-30F sizes used in conventional PCNL. This miniaturization aims to reduce morbidity and improve patient outcomes. We evaluated the safety and efficacy of UMP and report our ourtcomes. Patients and Methods: A total of 120 patients underwent UMP from July 2012 to March 2014. These patients had a single unilateral renal stone measuring between 8 and 20 mm. All patients underwent UMP using a 3F nephroscope, 7.5F inner sheath, and 11F or 13F outer metallic cannula, which served as the Amplatz sheath. Stone fragmentation and clearance were achieved with holmium laser. No nephrostomy or stent was used routinely. Results: Complete stone fragmentation was achieved in 114 out of 120 patients (95% using UMP; whereas the remaining 6 were converted into mini-PCNL using a 12.5F nephroscope and 15F Amplatz sheath. The mean operative time was 39.7 ± 15.4 min, and the mean postoperative hospital stay was 22.3 ± 2.2 h. Postoperatively, 6 (5% patients had residual fragments measuring ≤4 mm. At the 2 weeks follow-up, the stone-free status was >99% (119/120. There were no significant postoperative complications. Conclusion: This study shows UMP to be an effective and safe procedure for managing stones up to 20 mm. This procedure offers an attractive alternative to shock wave lithotripsy and retrograde intrarenal surgery for managing small stones.

  5. Mechanisms of suppressing cup-burner flame with water vapor

    Institute of Scientific and Technical Information of China (English)

    CONG BeiHua; LIAO GuangXuan


    The mechanisms of suppressing a laminar methane-air co-flow diffusion flame formed on a cup burner with water vapor have been studied experimentally and numerically. The methane burned in a steel cup surrounded by a glass chimney. A mist generator produced fine droplets delivered though the glass chimney with air. These droplets were heated into water vapor when they went though the diffuser. The extinguishing limit was obtained by gradually increasing the amount of water vapor to replace the air in the coflowing oxidizer stream. Results showed that the agent concentration required for extinguishment was constant over a wide range of the oxidizer velocity, i.e., a so-called "plateau region". The measured extinguishing mass fractions of the agents were: (16.7±0.6)% for H2O, (15.9±0.6)% for CO2, and (31.9±0.6)% for N2. The computation used the Fire Dynamics Simulator (FDS) de-veloped by the NIST. The numerical simulations showed that the predicted water vapor extinguishing limits and the flickering frequency were in good agreements with the experimental observations and, more importantly, revealed that the sup-pression of cup-burner flames occurred via a partial extinction mechanism (in which the flame base drifts downstream and then blows off) rather than the global extinction mechanism of typical counter-flow diffusion flames. And the flame-base oscillation just before the blow-off was the key step for the non-premixed flame extinction in the cup burner.

  6. Mechanisms of suppressing cup-burner flame with water vapor

    Institute of Scientific and Technical Information of China (English)


    The mechanisms of suppressing a laminar methane-air co-flow diffusion flame formed on a cup burner with water vapor have been studied experimentally and numerically. The methane burned in a steel cup surrounded by a glass chimney. A mist generator produced fine droplets delivered though the glass chimney with air. These droplets were heated into water vapor when they went though the diffuser. The extinguishing limit was obtained by gradually increasing the amount of water vapor to replace the air in the coflowing oxidizer stream. Results showed that the agent concentration required for extinguishment was constant over a wide range of the oxidizer velocity, i.e., a so-called "plateau region". The measured extinguishing mass fractions of the agents were: (16.7 ± 0.6)% for H2O, (15.9 ± 0.6)% for CO2, and (31.9 ± 0.6)% for N2. The computation used the Fire Dynamics Simulator (FDS) de- veloped by the NIST. The numerical simulations showed that the predicted water vapor extinguishing limits and the flickering frequency were in good agreements with the experimental observations and, more importantly, revealed that the sup- pression of cup-burner flames occurred via a partial extinction mechanism (in which the flame base drifts downstream and then blows off) rather than the global extinction mechanism of typical counter-flow diffusion flames. And the flame-base oscillation just before the blow-off was the key step for the non-premixed flame extinction in the cup burner.

  7. Manually controlled steerable needle for MRI-guided percutaneous interventions

    NARCIS (Netherlands)

    Henken, Kirsten R; Seevinck, Peter R; Dankelman, Jenny; van den Dobbelsteen, John J


    This study aims to develop and evaluate a manually controlled steerable needle that is compatible with and visible on MRI to facilitate full intra-procedural control and accurate navigation in percutaneous interventions. The steerable needle has a working channel that provides a lumen to a cutting s

  8. Percutaneous biliary drainage in acute suppurative cholangitis with biliary sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Lyul; Cho, June Sik; Kwon, Soon Tae; Lee, Sang Jin; Rhee, Byung Chull [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)


    Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as result of partial or complete obstruction of the bile duct, and may manifest clinically severe form of disease, rapidly deteriorating to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying cause were 12 benign disease(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis(n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients resulting in improvement of general condition and failed in three patients. The procedure were preterminated due to the patient's condition in two and biliary-proto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggest that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.

  9. Successful management of dislodged stents during percutaneous coronary intervention. (United States)

    Farman, Muhammad Tariq; Sial, Jawaid Akbar; Saghir, Tahir; Rizvi, Syed Nadeem Hasan; Rasool, Syed Ishtiaq; Jamal, Syed Zahid


    Stent dislodgement is a very rare but recognized and potentially serious complication of percutaneous coronary intervention (PCI). This case series describe the incidence and etiology of such cases at National Institute of Cardiovascular Diseases, Karachi during the year 2008 and the method of treatment of this complication.

  10. Percutaneous Gastronomy and Jejunostomy: Lessons from the First Decade

    Directory of Open Access Journals (Sweden)

    John S Goff


    Full Text Available Percutaneous gastrostomies and jejunostomies have increasingly been used for long term enteral feeding in patients with functioning gastrointestinal tracts but who are unable, for a variety of reasons, to use the standard oropharyngeal route. Since these devices can be placed without the use of general anesthesia, the morbidity and mortality generally are less than for placement of a surgical gastrostomy. A permanent gastrostomy tube is easy to manage in most patients who require prolonged tube feeding. There are four basic types of percutaneous gastrostomy techniques; three employ an endoscope and one uses only radiographic or ultrasonic guidance. All gastrostomy tubes may be convened to feeding jejunostomies if the clinical situation warrants. Jejunal feeding tubes are prone to many technical problems and do not always solve the problems of gastric dysfunction and reflux that make gastrostomy tubes less desireable. Percutaneous endoscopic gastrostomics are technically simple to perform and have become the main method for access to the gastrointestinal tract in many patients. If judiciously used, the percutaneous enterostomy offers many benefits over a nasogastric tube for long term enteral feeding.

  11. Clinical outcome after percutaneous flexor tenotomy in forefoot surgery. (United States)

    Debarge, Romain; Philippot, Rémy; Viola, Jérémy; Besse, Jean Luc


    The aim of this study was to evaluate the outcome of the percutaneous flexor tenotomy. We compared the results of two groups. The first group included 23 patients who underwent forefoot surgery without percutaneous flexor tenotomy, and the second group included 50 patients who underwent the same procedure combined with percutaneous flexor tenotomy for claw toe deformities, secondary to shortening metatarsal Scarf osteotomy. The average follow-up was 11.6 months. Three algoneurodystrophies were noted. No delayed wound healing was observed. Functional dissatisfaction rate (18% vs.17.4%) and toe pulp contact defect (12% vs. 8.7%) were not significantly different in the two groups. Toe grasping defect rate (10% vs. 4.3%) was superior in the tenotomy group. Five recurring claw toe deformities of the second toe were noted in the tenotomy group. Percutaneous flexor tenotomy is a simple, rapid, and efficient method to correct reducible secondary claw toe deformities. However, despite a significant postoperative loss of toe grasping function, no patient reported major dissatisfaction.

  12. Intrarenal pseudoaneurysm after percutaneous nephrolithotomy: angiotomographic assessment and endovascular management

    Directory of Open Access Journals (Sweden)

    M. F. Massulo-Aguiar


    Full Text Available We report a case of intrarenal pseudoaneurysm of the right kidney after percutaneous nephrolithotomy (PCNL in supine position. Diagnosis was established by angiotomography with a 3-D reconstruction. Treatment was successfully achieved by endovascular occlusion using N-butyl-2-cyanoacrylate.

  13. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)


    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  14. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang


    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  15. Predicting Respiratory Motion for Active Canceling During Percutaneous Needle Insertion (United States)


    Lecture Notes in Computer Science , Springer...robotic system for image guided percutaneous procedures,� Lecture Notes in Computer Science , Springer-Verlag, vol. 1496, pp. 404-410, 1998. [5] A...L.L. Whitcomb, and L.R. Kavoussi, �A passive positioning and supporting device for surgical robots and instrumentation,� Lecture Notes in Computer Science ,

  16. Clinical Application of Percutaneous Nephrostomy in Some Urologic Diseases

    Institute of Scientific and Technical Information of China (English)

    Hongbo LUO; Xiuheng LIU; Tianpeng WU; Xiaobin ZHANG


    Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy (PNL) was performed in patients with various renal, perinephric and bladder diseases (n=79). The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4-20 min. 12F-16F single tract was established in nephrohydrop patients and 16F-20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2-12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

  17. QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

    Directory of Open Access Journals (Sweden)

    Mahsa Asadi Moghaddam


    Full Text Available Background: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina.Methods: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values.Results: There were significant differences between the mean QRS interval (0.086 ± 0.01sec vs. 0.082 ± 0.01 second; p value = 0.01, mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001, and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001 before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters.Conclusion: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent.

  18. Early rethrombosis in femoropopliteal occlusions treated with percutaneous transluminal angioplasty

    DEFF Research Database (Denmark)

    Jørgensen, B; Meisner, S; Holstein, P;


    One hundred and thirty-seven consecutive percutaneous transluminal angioplasties (PTA) were performed for femoropopliteal vascular disease including 58 stenoses and 79 total occlusions. Nine occlusions could not be crossed with the guidewire, but in the remaining 128 the haemodynamic and clinical...

  19. Segmentally enclosed thrombolysis in percutaneous transluminal angioplasty for femoropopliteal occlusions

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Nielsen, J D;


    Segmentally enclosed thrombolysis (SET) was performed immediately following 34 percutaneous transluminal angioplasties (PTAs) for femoropopliteal occlusions. The dilated segment was sealed off with a double balloon catheter, and recombinant tissue plasminogen activator (rt-PA) 1 mg/ml and heparin...

  20. Future of Percutaneous Coronary Intervention From an Asian Perspective

    Institute of Scientific and Technical Information of China (English)

    Yean-Leng LIM


    @@ We have come a long-way since Andreas Gruentzig performed the first percutaneous transluminal coronary angioplasty (PTCA) in man in 1977. It is timely to assess what we have actually achieved for patients with coronary heart disease with the advent of this treatment modality and where we are heading from now.

  1. Systematic review comparing endoscopic, percutaneous and surgical pancreatic pseudocyst drainage

    Institute of Scientific and Technical Information of China (English)

    Anthony Yuen Bun Teoh; Vinay Dhir; Zhen-Dong Jin; Mitsuhiro Kida; Dong Wan Seo; Khek Yu Ho


    AIM: To perform a systematic review comparing the outcomes of endoscopic, percutaneous and surgical pancreatic pseudocyst drainage.METHODS: Comparative studies published between January 1980 and May 2014 were identified on Pub Med, Embase and the Cochrane controlled trials register and assessed for suitability of inclusion. The primary outcome was the treatment success rate. Secondary outcomes included were the recurrence rates, re-interventions, length of hospital stay, adverse events and mortalities.RESULTS: Ten comparative studies were identified and 3 were randomized controlled trials. Four studies reported on the outcomes of percutaneous and surgical drainage. Based on a large-scale national study, surgical drainage appeared to reduce mortality and adverse events rate as compared to the percutaneous approach. Three studies reported on the outcomes of endoscopic ultrasound(EUS) and surgical drainage. Clinical success and adverse events rates appeared to be comparable but the EUS approach reduced hospital stay, cost and improved quality of life. Three other studies comparedEUS and esophagogastroduodenoscopy-guided drainage. Both approaches were feasible for pseudocyst drainage but the success rate of the EUS approach was better for non-bulging cyst and the approach conferred additional safety benefits.CONCLUSION: In patients with unfavorable anatomy, surgical cystojejunostomy or percutaneous drainage could be considered. Large randomized studies with current definitions of pseudocysts and longer-term follow-up are needed to assess the efficacy of the various modalities.

  2. Effects of percutaneous needle liver biopsy on dairy cow behaviour

    DEFF Research Database (Denmark)

    Mølgaard, Lene; Damgaard, Birthe Marie; Bjerre-Harpøth, Vibeke;


    behavioural changes for up to 19 h – and particularly for behaviour previously associated with pain. Even though the exact welfare impact of percutaneous needle liver biopsies in cows is not known, and the magnitude of the behavioural changes was limited, pain always has negative effects on animal welfare...

  3. Percutaneous cholecystostomy at the community hospital: value evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Lee, Mi Suk; Lee, Jin Hee; Ym, Seong Hee; Yoon, Young Gun [Namwon Medical Center, Namwon (Korea, Republic of); Sohn, Myung Hee; Kim, Chong Soo; Han, Young Min; Choi, Ki Chul [Chonbuk National Univ., Chonju (Korea, Republic of)


    To assess the role of percutaneous cholecystostomy as a therapeutic maneuver in patients critically ill with acute cholecystitis in community hospitals. Eighteen patients, 11 with suspected acute calculous cholecystits and seven with acute acalulous cholecystitis underwent emergency percutaneous cholecystostomy. All demonstrated a variety of high risk factors for cholecystectomy:liver cirrhosis(n=3D2), diabetes mellitus(n=3D3), cardiac disease(n=3D3), underlying malignancy(n=3D2), pulmonary dysfunction(n=3D1), septic cholangitis(n=3D5), and old age(n=3D2). All percutaneous cholecystostomies were performed with ultrasound guidance and preferably using the transhepatic route. All procedures but one were successful, and most cholecystostomies were performed within 5-20 minutes. Technical problems were as follows: guide-wire buckling during catheter insertion(n=3D2) and procedure failure(n=3D1). The only major problem was a case of localized bile peritonitis due to procedural failure, but a few minor complications were encountered:catheter dislodgment(n=3D3), and significant abdominal pain during the procedure(2). After successful cholecystostomy, a dramatic improvement in clinical condition was observed in 16 of 17 patients(94%) within 48 hours. Ten of 16 patients who responded to percutaneous cholecystostomy underwent elective cholecystectomy after the improvement of clinical symptoms, and the remaining six patients improved without other gallbladder interventions. Percutaneous cholecystostomy is not only an effective procedure for acute cholecystitis, but also has a definite role in the management of these high-risk patients in community hospitals.=20.

  4. Percutaneous endoscopic lumbar discectomy: Results of first 100 cases

    Directory of Open Access Journals (Sweden)

    Kanthila Mahesha


    Full Text Available Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. Materials and Methods: One hundred patients with lumbar disc prolapse who were treated with percutaneous endoscopic discectomy from May 2012 to January 2014 were included in this retrospective study. Clinical followup was done at 1 month, 3 months, 6 months, 1 year, and at yearly interval thereafter. The outcome was assessed using modified Macnab′s criteria, visual analog scale, and Oswestry Disability Index. Results: The mean followup period was 2 years (range 18 months - 3 years. Transforaminal approach was used in 84 patients, interlaminar approach in seven patients, and combined approach in nine patients. An excellent outcome was noted in ninety patients, good outcome in six patients, fair result in two patients, and poor result in two patients. Minor complications were seen in three patients, and two patients had recurrent disc prolapse. Mean hospital stay was 1.6 days. Conclusions: Percutaneous endoscopic lumbar discectomy is a safe and effective procedure in lumbar disc prolapse. It has the advantage that it can be performed on a day care basis under local anesthesia with shorter length of hospitalization and early return to work thus improving the quality of life earlier. The low complication rate makes it the future of disc surgery. Transforaminal approach alone is sufficient in majority of cases, although 16% of cases required either percutaneous interlaminar approach or combined approach. The procedure definitely has a learning curve, but it is acceptable with adequate preparations.

  5. The efficiency and stability of bubble formation by acoustic vaporization of submicron perfluorocarbon droplets. (United States)

    Reznik, Nikita; Shpak, Oleksandr; Gelderblom, Erik C; Williams, Ross; de Jong, Nico; Versluis, Michel; Burns, Peter N


    Submicron droplets of liquid perfluorocarbon converted into microbubbles with applied ultrasound have been studied, for a number of years, as potential next generation extravascular ultrasound contrast agents. In this work, we conduct an initial ultra-high-speed optical imaging study to examine the vaporization of submicron droplets and observe the newly created microbubbles in the first microseconds after vaporization. It was estimated that single pulses of ultrasound at 10 MHz with pressures within the diagnostic range are able to vaporize on the order of at least 10% of the exposed droplets. However, only part of the newly created microbubbles survives immediately following vaporization - the bubbles may recondense back into the liquid droplet state within microseconds of nucleation. The probability of bubble survival within the first microseconds of vaporization was shown to depend on ultrasound excitation pressure as well as on bubble coalescence during vaporization, a behavior influenced by the presence of coating material on the newly created bubbles. The results of this study show for the first time that although initial vaporization of droplets is necessary to create echogenic bubbles, additional factors, such as coalescence and bubble shell properties, are important and should be carefully considered for the production of microbubbles for use in medical imaging.

  6. A copper vapor laser by using a copper-vapor-complex reaction at a low temperature


    Kano, Toshiyuki; Taniguchi, Hiroshi; Saito, Hiroshi


    A copper vapor laser performance by using ametal-vapor-complex reaction (Cu+AlBr3) is reported. The laser operation is obtained at a low temperature without externalheating because of the AlBr3 vapors evaporating at a room temperature. The copper vapor laser using this metal-vapor-complex reaction has an advantage of deposition-free of a metallic copper to the laser tube wall, which is different from the copper halide and the organometallic copper lasers.

  7. What Good is Raman Water Vapor Lidar? (United States)

    Whitman, David


    Raman lidar has been used to quantify water vapor in the atmosphere for various scientific studies including mesoscale meteorology and satellite validation. Now the international networks of NDACC and GRUAN have interest in using Raman water vapor lidar for detecting trends in atmospheric water vapor concentrations. What are the data needs for addressing these very different measurement challenges. We will review briefly the scientific needs for water vapor accuracy for each of these three applications and attempt to translate that into performance specifications for Raman lidar in an effort to address the question in the title of "What good is Raman water vapor Iidar."

  8. High temperature vapors science and technology

    CERN Document Server

    Hastie, John


    High Temperature Vapors: Science and Technology focuses on the relationship of the basic science of high-temperature vapors to some areas of discernible practical importance in modern science and technology. The major high-temperature problem areas selected for discussion include chemical vapor transport and deposition; the vapor phase aspects of corrosion, combustion, and energy systems; and extraterrestrial high-temperature species. This book is comprised of seven chapters and begins with an introduction to the nature of the high-temperature vapor state, the scope and literature of high-temp

  9. Target vessel revascularization following percutaneous coronary intervention. A 10-year report from the Danish Percutaneous Transluminal Coronary Angioplasty Registry

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Kassis, Eli;


    OBJECTIVE: To present the rate of target vessel revascularization (TVR) in a consecutive and unselected national population over 10 years. DESIGN: From 1989 to 1998 all percutaneous coronary interventions (PCIs) performed in Denmark were recorded in the Danish PTCA Registry. RESULTS: From 1989 to...

  10. Vapor stabilizing surfaces for superhydrophobicity (United States)

    Patankar, Neelesh


    The success of rough substrates designed for superhydrophobicity relies crucially on the presence of air pockets in the roughness grooves. This air is supplied by the surrounding environment. However, if the rough substrates are used in enclosed configurations, such as in fluidic networks, the air pockets may not be sustained in the roughness grooves. In this work a design approach based on sustaining a vapor phase of the liquid in the roughness grooves, instead of relying on the presence of air, is explored. The resulting surfaces, referred to as vapor stabilizing substrates, are deemed to be robust against wetting transition even if no air is present. Applications of this approach include low drag surfaces, nucleate boiling, and dropwise condensation heat transfer, among others.

  11. Active Hydrazine Vapor Sampler (AHVS) (United States)

    Young, Rebecca C.; Mcbrearty, Charles F.; Curran, Daniel J.


    The Active Hydrazine Vapor Sampler (AHVS) was developed to detect vapors of hydrazine (HZ) and monomethylhydrazine (MMH) in air at parts-per-billion (ppb) concentration levels. The sampler consists of a commercial personal pump that draws ambient air through paper tape treated with vanillin (4-hydroxy-3-methoxybenzaldehyde). The paper tape is sandwiched in a thin cardboard housing inserted in one of the two specially designed holders to facilitate sampling. Contaminated air reacts with vanillin to develop a yellow color. The density of the color is proportional to the concentration of HZ or MMH. The AHVS can detect 10 ppb in less than 5 minutes. The sampler is easy to use, low cost, and intrinsically safe and contains no toxic material. It is most beneficial for use in locations with no laboratory capabilities for instrumentation calibration. This paper reviews the development, laboratory test, and field test of the device.

  12. Vaporization chambers and associated methods

    Energy Technology Data Exchange (ETDEWEB)

    Turner, Terry D.; Wilding, Bruce M.; McKellar, Michael G.; Shunn, Lee P.


    A vaporization chamber may include at least one conduit and a shell. The at least one conduit may have an inlet at a first end, an outlet at a second end and a flow path therebetween. The shell may surround a portion of each conduit and define a chamber surrounding the portion of each conduit. Additionally, a plurality of discrete apertures may be positioned at longitudinal intervals in a wall of each conduit, each discrete aperture of the plurality of discrete apertures sized and configured to direct a jet of fluid into each conduit from the chamber. A liquid may be vaporized by directing a first fluid comprising a liquid into the inlet at the first end of each conduit, directing jets of a second fluid into each conduit from the chamber through discrete apertures in a wall of each conduit and transferring heat from the second fluid to the first fluid.

  13. Internal Water Vapor Photoacoustic Calibration (United States)

    Pilgrim, Jeffrey S.


    Water vapor absorption is ubiquitous in the infrared wavelength range where photoacoustic trace gas detectors operate. This technique allows for discontinuous wavelength tuning by temperature-jumping a laser diode from one range to another within a time span suitable for photoacoustic calibration. The use of an internal calibration eliminates the need for external calibrated reference gases. Commercial applications include an improvement of photoacoustic spectrometers in all fields of use.

  14. Critical points of metal vapors

    Energy Technology Data Exchange (ETDEWEB)

    Khomkin, A. L., E-mail:; Shumikhin, A. S. [Russian Academy of Sciences, Joint Institute for High Temperatures (Russian Federation)


    A new method is proposed for calculating the parameters of critical points and binodals for the vapor–liquid (insulator–metal) phase transition in vapors of metals with multielectron valence shells. The method is based on a model developed earlier for the vapors of alkali metals, atomic hydrogen, and exciton gas, proceeding from the assumption that the cohesion determining the basic characteristics of metals under normal conditions is also responsible for their properties in the vicinity of the critical point. It is proposed to calculate the cohesion of multielectron atoms using well-known scaling relations for the binding energy, which are constructed for most metals in the periodic table by processing the results of many numerical calculations. The adopted model allows the parameters of critical points and binodals for the vapor–liquid phase transition in metal vapors to be calculated using published data on the properties of metals under normal conditions. The parameters of critical points have been calculated for a large number of metals and show satisfactory agreement with experimental data for alkali metals and with available estimates for all other metals. Binodals of metals have been calculated for the first time.

  15. Water vapor diffusion membrane development (United States)

    Tan, M. K.


    An application of the water vapor diffusion technique is examined whereby the permeated water vapor is vented to space vacuum to alleviate on-board waste storage and provide supplemental cooling. The work reported herein deals primarily with the vapor diffusion-heat rejection (VD-HR) as it applies to the Space Shuttle. A stack configuration was selected, designed and fabricated. An asymmetric cellulose acetate membrane, used in reverse osmosis application was selected and a special spacer was designed to enhance mixing and promote mass transfer. A skid-mount unit was assembled from components used in the bench unit although no attempt was made to render it flight-suitable. The operating conditions of the VD-HR were examined and defined and a 60-day continuous test was carried out. The membranes performed very well throughout the test; no membrane rupture and no unusual flux decay was observed. In addition, a tentative design for a flight-suitable VD-HR unit was made.

  16. A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)



    A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction!050000$河北医科大学第二医院河北医科大学心脏介入中心@傅向华

  17. Liquid chromatography tandem mass spectrometry applied to quantitation of the organophosphorus nerve agent VX in microdialysates from blood probes. (United States)

    Stubbs, S J; Read, R W


    VX (O-ethyl-S-[2(di-isopropylamino)ethyl] methylphosphonothiolate) is a low volatility organophosphorus (OP) nerve agent and therefore the most likely route of exposure is via percutaneous absorption. Microdialysis has been used as a tool to study percutaneous poisoning by VX in the anesthetised guinea pig. A liquid chromatography tandem mass spectrometry (LC-MS-MS) method using positive electrospray ionisation (ESI) was used to quantitate VX in microdialysate samples collected from microdialysis probes, implanted into a blood vessel of anesthetised guinea pigs. The method resulted from modification of a LC-MS-MS method previously developed for the analysis of dermal microdialysates. Modification increased the sensitivity of the method, allowing quantitation of the trace levels of VX in blood microdialysates, over the range 0.002-1 ng/ml, with linear calibration. Quantitative results have been used to determine the time course of VX concentrations in the blood of guinea pigs following percutaneous poisoning.

  18. Toxicity and medical countermeasure studies on the organophosphorus nerve agents VM and VX. (United States)

    Rice, Helen; Dalton, Christopher H; Price, Matthew E; Graham, Stuart J; Green, A Christopher; Jenner, John; Groombridge, Helen J; Timperley, Christopher M


    To support the effort to eliminate the Syrian Arab Republic chemical weapons stockpile safely, there was a requirement to provide scientific advice based on experimentally derived information on both toxicity and medical countermeasures (MedCM) in the event of exposure to VM, VX or VM-VX mixtures. Complementary in vitro and in vivo studies were undertaken to inform that advice. The penetration rate of neat VM was not significantly different from that of neat VX, through either guinea pig or pig skin in vitro. The presence of VX did not affect the penetration rate of VM in mixtures of various proportions. A lethal dose of VM was approximately twice that of VX in guinea pigs poisoned via the percutaneous route. There was no interaction in mixed agent solutions which altered the in vivo toxicity of the agents. Percutaneous poisoning by VM responded to treatment with standard MedCM, although complete protection was not achieved.

  19. Performances of electrically heated microgroove vaporizers

    Institute of Scientific and Technical Information of China (English)


    An electrically heated microgroove vaporizer was proposed. The vaporizer mainly comprised an outer tube, an inner tube and an electrical heater cartridge. Microgrooves were fabricated on the external surface of the inner tube by micro-cutting method,which formed the flow passage for fluid between the external surface of the inner tube and the internal surface of the outer tube.Experiments related to the temperature rise response of water and the thermal conversion efficiency of vaporizer were done to estimate the influences of microgroove's direction, feed flow rate and input voltage on the performances of the vaporizer. The results indicate that the microgroove's direction dominates the vaporizer performance at a lower input voltage. The longitudina lmicrogroove vaporizer exhibits the best performances for the temperature rise response of water and thermal conversion efficiency of vaporizer. For a moderate input voltage, the microgroove's direction and the feed flow rate of water together govern the vaporizer performances. The input voltage becomes the key influencing factor when the vaporizer works at a high input voltage, resulting in the similar performances of longitudinal, oblique and latitudinal microgroove vaporizers.

  20. Fine-needle percutaneous transhepatic parenchymal portal venography by using carbon dioxide: a pilot study in pigs

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei; Hernandez, Javier; Crisostomo, Veronica; Pineda, Luis-Fernando; Lima, Juan Rafael; Uson, Jesus [Minimally Invasive Surgery Centre, Campus Universitario, Avenida de la Universidad, s/n, 10071 Caceres (Spain); Maynar, Manuel [Department of Radiology, Faculty of Medicine, Las Palmas University, 35016 Las Palmas de Gran Canaria (Spain)


    Our purpose was to evaluate the feasibility and safety of carbon dioxide (CO{sub 2}) in fine-needle percutaneous transhepatic parenchymal portal venography and its potential clinical applications. Three Belgian landrace pigs received fine-needle percutaneous transhepatic parenchymal portal venography by using CO{sub 2} as a contrast agent. Under fluoroscopic and B-mode ultrasonic guidance, right or left lobe of liver was punctured with a 22-G Chiba needle, through which CO{sub 2} was injected with a dedicated CO{sub 2} injector at injection rate of 20 ml/s for 20 ml, 40 ml/s for 40 ml, 40 ml/s for 60 ml, and 40 ml/s for 80 ml, respectively. The portal venograms were obtained by use of digital subtraction angiography (DSA) system with animal in supine position. In one pig transarterial portal venography was performed, in addition, using iodinated contrast agent. The portal vein was visualized in each run of venography. Optimal images of portal tree structure up to four-order branches were obtained in all those with CO{sub 2} injection rate of 40 ml/s, which appeared much better in quality than those obtained by cranial mesenteric arteriography with iodinated contrast agent. No extravasation of CO{sub 2}, liver laceration, or any other complication occurred during the procedures. The technique we proposed demonstrated optimal portography, which appeared to be safe, minimally invasive, less time-consuming, cost-effective, and easy to perform, with great potential in clinical applications. (orig.)

  1. Percutaneous Endovascular Treatment for Hepatic Artery Stenosis after Liver Transplantation: The Role of Percutaneous Endovascular Treatment (United States)

    Vidjak, Vinko; Novačić, Karlo; Matijević, Filip; Kavur, Lovro; Slavica, Marko; Mrzljak, Anna; Filipec-Kanižaj, Tajana; Leder, Nikola Ivan; Škegro, Dinko


    Summary Background To retrospectively analyze the outcomes of interventional radiology treatment of patients with hepatic artery stenosis (HAS) after liver transplantation at our Institution. Material/Methods Hepatic artery stenosis was diagnosed and treated by endovascular technique in 8 (2.8%) patients, who underwent liver transplantation between July 2007 and July 2011. Patients entered the follow-up period, during which we analyzed hepatic artery patency with Doppler ultrasound at 1, 3, 6, and 12 months after percutaneous endovascular treatment (PTA), and every six months thereafter. Results During the 12-month follow-up period, 6 out of 8 patients (75%) were asymptomatic with patent hepatic artery, which was confirmed by multislice computed tomography (MSCT) angiography, or color Doppler (CD) ultrasound. One patient had a fatal outcome of unknown cause, and one patient underwent orthotopic liver retransplantation (re-OLT) procedure due to graft failure. Conclusions Our results suggest that HAS angioplasty and stenting are minimally invasive and safe endovascular procedures that represent a good alternative to open surgery, with good 12-month follow-up patency results comparable to surgery. PMID:26150902





    Mobile agent technology has been promoted as an emerging technology that makes it much easier to design, implement, and maintain distributed systems, introduction to basic concepts of mobile agents like agent mobility, agent types and places and agent communication. Then benefits of the usage of mobile agents are summarized and illustrated by selected applications. The next section lists requirements and desirable properties for mobile agent languages and systems. We study the main features, ...

  3. Percutaneous treatment of patients with heart diseases: selection, guidance and follow-up. A review

    Directory of Open Access Journals (Sweden)

    Contaldi Carla


    Full Text Available Abstract Aortic stenosis and mitral regurgitation, patent foramen ovale, interatrial septal defect, atrial fibrillation and perivalvular leak, are now amenable to percutaneous treatment. These percutaneous procedures require the use of Transthoracic (TTE, Transesophageal (TEE and/or Intracardiac echocardiography (ICE. This paper provides an overview of the different percutaneous interventions, trying to provide a systematic and comprehensive approach for selection, guidance and follow-up of patients undergoing these procedures, illustrating the key role of 2D echocardiography.

  4. Four Cases of a Cerebral Air Embolism Complicating a Percutaneous Transthoracic Needle Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Um, Soo Jung; Lee, Soo Keol; Yang, Doo Kyung; Son, Choon Hee; Kim, Ki Nam; Lee, Ki Nam [Dong-A University College of Medicine, Busan (Korea, Republic of); Kim, Yun Seong [Busan National University College of Medicine, Busan (Korea, Republic of)


    A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.

  5. Treatment of Spinal Osseous Metastasis with Combined Percutaneous Radiofrequency Ablation and Vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Sik; Hong, Suk Joo; Kim, Ye Lim; Bae, Hyoung Ju; Kang, Eun young [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Joo Han [Dept. of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)


    Recent introduction of image-guided percutaneous methods to treat unresectable bone tumors including metastases that do not respond to conventional radiotherapy or chemotherapy has proven to be effective. Here we present three successfully treated cases of metastatic bone lesions: two cases of malignant bone metastases in the lumbar spine and one in the sacral bone, using combined percutaneous radiofrequency ablation and percutaneous vertebroplasty/compassionately. A brief review of literature is also included.

  6. Development of the 5-cm Agent Fate Wind Tunnel (United States)


    Generators Several approaches were evaluated to assure homogenous mixing of the agent vapor and air at the sampling port. One was a non- intrusive air mixer...9 pL) Multiple drops (30) in 2 lateral rows Vapour sampling of plume (no artificial mixing) 50 x 100 - cm Wind Tunnel On-line GC-MS Can test grass

  7. Photoelectron spectroscopy of phthalocyanine vapors

    Energy Technology Data Exchange (ETDEWEB)

    Berkowitz, J.


    The He(I) photoelectron spectra of several metal phthalocyanines and metal-free phthalocyanine vapor shows that: a sharp peak at 4.99 eV is an artifact due to ionization of atomic He by He(II) radiation; the first phthalocyanine peak (metal-containing or metal-free) occurs at 6.4 eV; and the metal-like d orbitals lie at least 1 to 2 eV deeper, except in the case of Fe. (DLC)

  8. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Robert Marcovich


    Full Text Available Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

  9. [Percutaneous transluminal angioplasty in vascular by-passes]. (United States)

    Rodríguez, J E; Fernández Guinea, O; López, V; Suárez Pereiro, M J; Reimunde, E; Cosío, J M; Barreiro, A


    Results from 21 cases of percutaneous transluminal angioplasties as a treatment of stenosed vascular by-pass from 16 patients, are presented. The technique took place in 10 cases at the aorto-femoral area, in others 10 cases at the popliteal-femoral area and, in the last one, at the carotid-subclavian area. Preliminary results were successful in all cases (100%). Follow-up showed a better long-term results at the aorto-femoral level. Considering the satisfactory results and also considering that, in case of negative results or re-stenosis, other surgical techniques could be performed, we conclude that the percutaneous transluminal angioplasty should be the first treatment for such of injuries.

  10. Subcutaneous Transitional Cell Cancer After Percutaneous Nephrolithotomy: A Case Report

    Directory of Open Access Journals (Sweden)

    Lokman Ižrkilata


    Full Text Available Transitional cell carcinomas of the upper urinary tract are rare but, highly predisposing to tumoral seeding. Percutaneous lithotripsy (PNL recently has expanded the therapeutic choices for patients with kidney stones and gained popularity by urologic surgeons. Although unusual, renal collecting system tumours may be encountered during PNL. We present and discuss the clinical course of a 48 years old male patient who underwent PNL surgery for kidney stone in whom transitional cell carcinoma in the renal collecting system obscured by stone left undiagnosed. Three months later following PNL he admitted with a bulge on lumbar region. Excisional biopsy revealed carcinoma and therefore, he was directed to chemoradiotherapy and died 21 months later. Renal collecting system tumors undiagnosed during surgery may progress and demonstrate local invasion in a short period of time. Therefore, we recommend to take more caution during any percutaneous access and to exclude the possible existence of tumor.

  11. High-density percutaneous chronic connector for neural prosthetics (United States)

    Shah, Kedar G.; Bennett, William J.; Pannu, Satinderpall S.


    A high density percutaneous chronic connector, having first and second connector structures each having an array of magnets surrounding a mounting cavity. A first electrical feedthrough array is seated in the mounting cavity of the first connector structure and a second electrical feedthrough array is seated in the mounting cavity of the second connector structure, with a feedthrough interconnect matrix positioned between a top side of the first electrical feedthrough array and a bottom side of the second electrical feedthrough array to electrically connect the first electrical feedthrough array to the second electrical feedthrough array. The two arrays of magnets are arranged to attract in a first angular position which connects the first and second connector structures together and electrically connects the percutaneously connected device to the external electronics, and to repel in a second angular position to facilitate removal of the second connector structure from the first connector structure.

  12. Percutaneous transluminal coronary angioplasty. A review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Przybojewski, J.Z.; Weich, H.F.H. (Tygerberg Hospital, Stellenbosch (South Africa). Dept. of Internal Medicine)


    The purpose of this article is to review PTCA, percutaneous transluminal coronary angioplasty, which can be considered to be a truly revolutionary and fairly simple invasive form of intervention to atherosclerotic obstruction. The 'epidemic' of IHD, ischaemic heart disease, in the Republic of South Africa calls for the employment of this technique, which has already been carried out in a few teaching hospitals in this country. Very recently, modified balloon dilatation catheters have been used percutaneously in the non-operative transluminal correction of congenital coarctation of the aorta in infants and children, congenital pulmonary value stenosis, and hypoplasia and stenosis of the pulmonary arteries. It has also been employed for PTCA and for the simultaneous occlusion of coronary-bronchial artery anastomosis using a detachable balloon. The isotopes thallium 201 and technetium 99 were also used in scintiscanning.

  13. Percutaneous left atrial appendage closure for stroke prevention

    DEFF Research Database (Denmark)

    De Backer, Ole; Loupis, Anastasia M; Ihlemann, Nikolaj;


    INTRODUCTION: In atrial fibrillation (AF) patients with an increased stroke risk, oral anticoagulation (OAC) is the standard treatment for stroke prevention. However, this therapy carries a high risk of major bleeding. Percutaneous closure of the left atrial appendage (LAA) is suggested...... as an alternative option for stroke prevention in AF patients with contraindication(s) for OAC treatment. MATERIAL AND METHODS: A total of 42 patients underwent percutaneous LAA closure. In this report, we describe our experience with this procedure. RESULTS: The patients treated were AF patients with a high stroke...... gastrointestinal bleeding immediately after the procedure. The mean duration of follow-up was 12.6 months. Both ischaemic stroke and bleeding occurred in one patient, resulting in an observed annual stroke and bleeding rate of 2.3%. This rate was lower than expected based on the CHADS-VASc (5.6%/year) and HAS...


    Directory of Open Access Journals (Sweden)

    Gil-Carcedo García, LM


    Full Text Available INTRODUCTION: Gastrostomy is a very useful technique to maintain an adequate nutritional status in patients with head and neck cancer. It presents very good acceptability and complete adherence of treatments.DISCUSSION: PEG is a good nutritional option for our oncological patients. It is a minimally invasive method with low morbility and mortality rates, low economical cost and very good social acceptability.We summarize the main ENT indications of this technique. CONCLUSION: Our department indicate the percutaneous endoscopic gastrostomy in patients with head and neck cancer who are unable to maintain an adequate nutritional status and need enteral nutrition for more than 8 weeks. Its acceptability is very good and complications are generally minor ones.Percutaneous endoscopic gastrostomy should replace to nasogastric feeding tubes and to open gastrostomy in patients with short life expectancy.

  15. Percutaneous antegrade ureteric stent removal using a rigid alligator forceps.

    LENUS (Irish Health Repository)

    Given, M F


    To evaluate the safety and efficacy of percutaneous antegrade ureteric stent removal using a rigid alligator forceps. Twenty patients were included in our study. Indications for ureteric stent insertion included stone disease (n = 7), malignancy (n = 8) and transplant anastomotic strictures (n = 5). Stent retrieval was carried out for proximal stent placement\\/migration in seven patients and encrustation in the remaining 13. Twenty-two stents were successfully retrieved in 20 patients. There was one technical failure (5%). There were no major complications. We had four minor complications, which included nephrostomy site pain (n = 2), periprocedural sepsis (n = 1) and a small urinoma (n = 1). All patients settled with conservative management. Percutaneous radiologically guided antegrade ureteric stent removal with an alligator forceps is safe and effective, particularly when initial surgical removal has failed.

  16. Immediate complications of percutaneous central venous cannulation in children (United States)

    Dheer, Geetika; Chaudhry, Gurmeet Kaur; Singh, Tejinder


    Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands. PMID:22121313

  17. Immediate complications of percutaneous central venous cannulation in children

    Directory of Open Access Journals (Sweden)

    Geetika Dheer


    Full Text Available Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands.

  18. Distal protection devices during percutaneous coronary and carotid interventions



    Abstract Distal embolization of particulate matter complicates percutaneous coronary and peripheral interventions more often than had been recognized until recently. A number of distal protection devices are under development. The PercuSurge GuardWire™ is a balloon occlusion thrombectomy device approved by the United States Food and Drug Administration for saphenous vein graft intervention. A number of filter devices utilize an expandable filter mounted on the angioplasty guidewire to facilit...

  19. Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts

    Energy Technology Data Exchange (ETDEWEB)

    Sane, S.S.; Towbin, A.; Bergey, E.A.; Kaye, R.D.; Fitz, C.R.; Albright, L.; Towbin, R.B. [Department of Radiology, Children`s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 (United States)


    Objective. The purpose of this study is to determine the risk of CNS and/or peritoneal infection in children with ventriculoperitoneal shunts in whom a percutaneous gastrostomy tube is placed. Materials and methods. We placed 205 gastrostomy or gastrojejunostomy tubes from January of 1991 to December 1996. Twenty-three patients (10 boys, 13 girls) had ventriculoperitoneal shunts at the time of placement. All shunts were placed at least 1 month prior to placement of the gastrostomy tube. The patients ranged in age from 8 months to 16 years with a mean age of 6 years, 9 months. Patient weight ranged from 2 kg to 60 kg. All 23 children required long-term nutritional support due to severe neurologic impairment. No prophylactic antibiotics were given prior to the procedure. Of the patients, 21/23 had a 14-F Sacks-Vine gastrostomy tube with a fixed terminal retention device inserted, using percutaneous fluoroscopic antegrade technique. Two of the 23 patients had a Ross 14-F Flexi-flo gastrostomy tube which required a retrograde technique due to a small caliber esophagus in these children. Results. All 23 children had technically successful placements of percutaneous gastrostomy (7) or gastrojejunostomy (16) tubes. Of the children, 21/23 (91 %) had no complications from the procedure. Two of 23 (9 %) patients demonstrated signs of peritonitis after placement of their gastrostomy tubes and subsequently had shunt infections. In both, children CSF culture grew gram-positive cocci. The antegrade technique was used in both children who developed peritonitis. Conclusion. Our study indicates children with ventriculoperitoneal shunts who undergo percutaneous gastrostomy are at greater risk for infection and subsequent shunt malfunction. Therefore, we recommend prophylactic antibiotic therapy to cover for skin and oral flora. (orig.) With 1 fig., 7 refs.

  20. Percutaneous aspiration of fluid for management of peritonitis in space (United States)

    Kirkpatrick, A. W.; Nicolaou, S.; Campbell, M. R.; Sargsyan, A. E.; Dulchavsky, S. A.; Melton, S.; Beck, G.; Dawson, D. L.; Billica, R. D.; Johnston, S. L.; Hamilton, D. R.


    BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

  1. Modular training for percutaneous nephrolithotripsy: The safe way to go



    Objectives should be describe a modular training scheme (MTS) which aims to provide training in percutaneous nephrolithotripsy (PCNL) and ensure the safety of the patients. Subjects and methods Two trainees with no experience in PCNL attended the MTS under the supervision of an experienced mentor. The MTS included five modules, comprising an initial animal laboratory course (using pigs), to acquire basic skills (Module 1), and Modules 2–5 included making the puncture, tract dilatation, single...

  2. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

    Madsen, M.A.; Frevert, S.; Madsen, P.L.;


    Splenic arteriovenous fistula is a rare complication following splenectomy. We report a case of a large splenic arteriovenous fistula 23 years after splenectomy in a 50-year old male with abdominal pain, gastro-intestinal bleeding, ascites, diarrhoea, dyspnoea, portal hypertension and heart failure....... The arteriovenous fistula was successfully treated with percutaneous transarterial embolization and the patient gained almost complete recovery. This case demonstrates the usefulness of embolization of an otherwise surgical demanding arteriovenous fistula Udgivelsesdato: 2008/11...

  3. Comparative Study between Standard and Totally Tubeless Percutaneous Nephrolithotomy


    Yun, Sung Il; Lee, Yoon Hyung; Kim, Jae Soo; Cho, Sung Ryong; Kim, Bum Soo; Kwon, Joon Beom


    Purpose Several recent studies have reported the benefits of tubeless percutaneous nephrolithotomy (PNL). Postoperatively, tubeless PNL patients have an indwelling ureteral stent placed, which is often associated with stent-related morbidity. We have performed totally tubeless (tubeless and stentless) PNL in which no nephrostomy tube or ureteral stent is placed postoperatively. We evaluated the safety, effectiveness, and feasibility of totally tubeless PNL. Materials and Methods From March 20...

  4. Echocardiographic assessment and percutaneous closure of multiple atrial septal defects

    Directory of Open Access Journals (Sweden)

    Timperley Jonathan


    Full Text Available Abstract Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is considerable morphological variation in size and location of the defects. A small proportion of atrial septal defects may have multiple fenestrations and these are often considered unsuitable for device closure. We report three cases of multiple atrial septal defects successfully closed with two Amplatzer septal occluders.

  5. Percutaneous Ablation for Small Renal Masses—Complications


    Kurup, A. Nicholas


    Although percutaneous ablation of small renal masses is generally safe, interventional radiologists should be aware of the various complications that may arise from the procedure. Renal hemorrhage is the most common significant complication. Additional less common but serious complications include injury to or stenosis of the ureter or ureteropelvic junction, infection/abscess, sensory or motor nerve injury, pneumothorax, needle tract seeding, and skin burn. Most complications may be treated ...

  6. Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan

    Institute of Scientific and Technical Information of China (English)

    Yutaka; Suzuki; Seryna; Tamez; Akihiko; Murakami; Akihiko; Taira; Akihiro; Mizuhara; Akira; Horiuchi; Chie; Mihara; Eiji; Ako; Hirohito; Muramatsu; Hitoshi; Okano; Hitoshi; Suenaga; Kazuaki; Jomoto; Junya; Kobayashi; Katsunari; Takifuji; Kazuhiro; Akiyama; Koh; Tahara; Koji; Onishi; Makoto; Shimazaki; Masami; Matsumoto; Masashi; Ijima; Masato; Murakami; Masato; Nakahori; Michiaki; Kudo; Michio; Maruyama; Mikako; Takahashi; Naohiro; Washizawa; Shigeru; Onozawa; Satoshi; Goshi; Satoyoshi; Yamashita; Shigeki; Ono; Shin; Imazato; Shinji; Nishiwaki; Shuichirou; Kitahara; Takao...


    AIM: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan. METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient’s characteristics at PEG using log-rank tests and Cox proportional hazard m...

  7. Manually controlled steerable needle for MRI-guided percutaneous interventions


    Henken, Kirsten R.; Seevinck, Peter R.; Dankelman, Jenny; van den Dobbelsteen, John J.


    This study aims to develop and evaluate a manually controlled steerable needle that is compatible with and visible on MRI to facilitate full intra-procedural control and accurate navigation in percutaneous interventions. The steerable needle has a working channel that provides a lumen to a cutting stylet or a therapeutic instrument. A steering mechanism based on cable-operated compliant elements is integrated in the working channel. The needle can be steered by adjusting the orientation of th...

  8. Biliary peritonitis following percutaneous nephrolithotomy: Minimally invasive management


    Yadav, Siddharth; Singh, Animesh; Singh, Prabhjot


    Percutaneous nephrolithotomy (PCNL) is a standard procedure for large renal calculi but has potential for complications. Rarely, biliary tract injury can occur during PCNL that can lead to biliary peritonitis with sepsis. Such cases are usually managed by emergent cholecystectomy. We present a case of biliary peritonitis resulting from gall bladder injury during PCNL, managed minimally invasively with an abdominal drain and endoscopic retrograde cholangiography with common bile duct stenting.

  9. Biliary peritonitis following percutaneous nephrolithotomy: Minimally invasive management. (United States)

    Yadav, Siddharth; Singh, Animesh; Singh, Prabhjot


    Percutaneous nephrolithotomy (PCNL) is a standard procedure for large renal calculi but has potential for complications. Rarely, biliary tract injury can occur during PCNL that can lead to biliary peritonitis with sepsis. Such cases are usually managed by emergent cholecystectomy. We present a case of biliary peritonitis resulting from gall bladder injury during PCNL, managed minimally invasively with an abdominal drain and endoscopic retrograde cholangiography with common bile duct stenting.

  10. Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis : A Case Report


    種田, 建史; 金光, 俊行; 林, 哲也; 藤本, 宜正; 小出, 卓生


    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0....

  11. Percutaneous ultrasonic lithotripsy of symptomatic renal calculi in children

    Energy Technology Data Exchange (ETDEWEB)

    Papanicolaou, N.; Pfister, R.C.; Yoder, I.C.; Young, H.H. II; Herrin, J.T.


    Percutaneous ultrasonic lithotripsy of upper urinary tract lithiasis is a well-established procedure in adults. We successfully applied this technique to completely remove symptomatic renal calculi in two children with idiopathic hypercalciuria. The procedure was well tolerated and no complications occurred. Both patients were discharged within 4 days of the lithotripsy. This method is an alternative to surgery for the removal of large or impacted calculi from the upper urinary tracts of pediatric patients. (orig.).

  12. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy


    Robert Marcovich; Smith, Arthur D.


    Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial...

  13. Percutaneous approach for sialolith removal in a donkey. (United States)

    Rodrigues, João B; Mora, Sara; Bastos, Estela; Viegas, Carlos; San Roman, Fidel


    Salivary duct lithiasis is a condition characterized by the partial or total obstruction ofa salivary gland or its excretory duct due to the formation of sialoliths. A 9-year-old female donkey, belonging to the unique and endangered indigenous breed of donkey in Portugal, was diagnosed with a sialolith in the rostral portion of the right parotid duct based on clinical, oral, dental, and radiographic examination results. Surgical removal of the sialolith was done through a percutaneous approach.

  14. Vapor Pressure Data Analysis and Statistics (United States)


    Army Edgewood Chemical Biological Center P vapor pressure (Pa) p vapor pressure (Torr) R ideal gas constant RVX O-isobutyl-S-[2(diethylamino...Respondents should be aware that notwithstanding any other provision of law , no person shall be subject to any penalty for failing to comply with a...1-Hexadecanol Vapor Pressure Data from Kemme and Kreps11 .......................................10 2. Antoine Constants (Equation 3), Standard

  15. Posterior Ischemic Optic Neuropathy Following Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Mohammad Pakravan


    Full Text Available

    PURPOSE: To report a case of posterior ischemic optic neuropathy (PION following percutaneous nephrolithotomy (PCNL. CASE REPORT: A 57-year-old man with history of diabetes mellitus, hyperlipidemia and mild anemia underwent PCNL for treatment of nephrolithiasis. He noticed painless visual loss in both eyes immediately after the procedure. Visual acuity was light perception, however ophthalmologic examinations were unremarkable and the optic discs were pink with no swelling. Visual fields were severely affected, but neuro-imaging was normal. Within three months, visual acuity and visual fields improved dramatically but the optic discs became slightly pale. CONCLUSION: This is the first report of PION following PCNL. PION is a rare cause of severe visual loss following surgery. Severe blood loss, hypotension, anemia and body position during surgery are the most important risk factors. Ophthalmologists, urologists and anesthesiologists should be aware of this condition and this rare possibility should be considered prior to surgery.

  1. Percutaneous treatment of complications occurring during hemodialysis graft recanalization

    Energy Technology Data Exchange (ETDEWEB)

    Sofocleous, Constantinos T. E-mail:; Schur, Israel; Koh, Elsie; Hinrichs, Clay; Cooper, Stanley G.; Welber, Adam; Brountzos, Elias; Kelekis, Dimitris


    Introduction/objective: To describe and evaluate percutaneous treatment methods of complications occurring during recanalization of thrombosed hemodialysis access grafts. Methods and materials: A retrospective review of 579 thrombosed hemodialysis access grafts revealed 48 complications occurring during urokinase thrombolysis (512) or mechanical thrombectomy (67). These include 12 venous or venous anastomotic ruptures not controlled by balloon tamponade, eight arterial emboli, 12 graft extravasations, seven small hematomas, four intragraft pseudointimal 'dissections', two incidents of pulmonary edema, one episode of intestinal angina, one procedural death, and one distant hematoma. Results: Twelve cases of post angioplasty ruptures were treated with uncovered stents of which 10 resulted in graft salvage allowing successful hemodialysis. All arterial emboli were retrieved by Fogarty or embolectomy balloons. The 10/12 graft extravasations were successfully treated by digital compression while the procedure was completed and the graft flow was restored. Dissections were treated with prolonged Percutaneous Trasluminal Angioplasty (PTA) balloon inflation. Overall technical success was 39/48 (81%). Kaplan-Meier Primary and secondary patency rates were 72 and 78% at 30, 62 and 73% at 90 and 36 and 67% at 180 days, respectively. Secondary patency rates remained over 50% at 1 year. There were no additional complications caused by these maneuvers. Discussions and conclusion: The majority of complications occurring during percutaneous thrombolysis/thrombectomy of thrombosed access grafts, can be treated at the same sitting allowing completion of the recanalization procedure and usage of the same access for hemodialysis.

  2. Current perspectives in percutaneous atrial septal defect closure devices

    Directory of Open Access Journals (Sweden)

    Bissessor N


    Full Text Available N Bissessor1–4 1Department of Cardiology, The Epworth Hospital, Melbourne, VIC, Australia; 2Division of Interventional Cardiology, The Alfred Hospital, Melbourne, VIC, Australia; 3Department of Clinical Science, Charles Sturt University Albury Campus, NSW, Australia; 4Heart Foundation, Griffith University, QLD, Australia Abstract: In the last decade, percutaneous atrial septal defect (ASD closure has become the treatment of choice in most clinical presentations of ASD. Percutaneous ASD closure has established procedural safety through operator experience and improved device structure and deliverability. There have also been advances in diagnostic capabilities. Devices have evolved from large bulky meshes to repositionable, minimal residual mesh content that easily endothelializes and conforms well to surrounding structures. Biodegradable technology has been introduced and will be closely watched as a future option. The evolution of ASD closure device usage in the last four decades incorporates development that minimizes a wide range of serious side effects that have been reported over the years. Complications reported in the literature include thrombus formation, air embolization, device embolization, erosions, residual shunts, and nickel hypersensitivity. Modern devices have intermediate to long term data with outcomes that have been favorable. Devices are available in multiple sizes with improved delivery mechanisms to recapture, reposition, and safely close simple and complex ASDs amenable to percutaneous closure. In this review, commonly used devices and deployment procedures are discussed together with a look at devices that show promise for the future. Keywords: ASD, congenital, Amplatzer, Gore Helex, Biostar, Figulla

  3. Percutaneous liver biopsy complicated by hemobilia-associated acute cholecystitis

    Institute of Scientific and Technical Information of China (English)

    Yair Edden; Hugo St Hilaire; Keith Benkov; Michael T Harris


    Liver biopsy is generally considered a safe and highly useful procedure. It is frequently performed in an outpatient setting for diagnosis and follow-up in numerous liver disorders. Since its introduction at the end of the 19th century, broad experience, new imaging techniques and special needles have significantly reduced the rate of complications associated with liver biopsy. Known complications of percutaneous biopsy of the liver include hemoperitoneum, subcapsular hematoma, hypotension, pneumothorax and sepsis.Other intra-abdominal complications are less common.Hemobilia due to arterio-biliary duct fistula has been described, which has only rarely been clinically expressed as cholecystitis or pancreatitis. We report a case of a fifteen year-old boy who developed severe acute cholecystitis twelve days after a percutaneous liver biopsy performed in an outpatient setting. The etiology was clearly demonstrated to be hemobilia-associated,and the clinical course required the performance of a laparoscopic cholecystectomy. The post operative course was uneventful and the patient was discharged home. Percutaneous liver biopsy is a safe and commonly performed procedure. However, severe complications can occasionally occur. Both medical and surgical options should be evaluated while dealing with these rare incidents.

  4. Percutaneous drainage of abscess in the treatment of emphysematous pyelonephritis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Yong; Jeong, Yong Yeon; Kim, Jae Kyu; Park, Seung Jei; Park, Jin Gyoon; Kang, Heoung Keun [Chonnam Univ. School of Medicine, Kwangju (Korea, Republic of); Roh, Byung Suk [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)


    To assess the usefulness of percutaneous drainage of abscess in the treatment of emphysematous pyelonephritis. Ten cases of nine patients with emphysematous pyelonephritis were percutaneously drained. All were suffering from diabetes mellitus. The procedure was performed under fluoroscopic guidance in nine cases and US guidance in one case in which bilateral multiloculated abscesses were present in the perirenal space. The results were classified as cure, partial success, recurrence, or failure. The mean drainage period and complication were analyzed. Eight cases were cured, and there was one case success. In one case, who had diffuse renal parenchymal destruction without perirenal fluid collection, the treatment failed. The longest drainage period was 45 days, in a case of re-insertion due to incidental catheter removal; the mean was 23 days. Bacteremia in one case was cured with antibiotic therapy which lasted two days. In diabetic patients, percutaneous drainage of obscess is thought to be a safe and effective method for the treatment of emphysematous pyelonephritis, and is one that does not involve diffuse destruction of renal parenchyma.

  5. Percutaneous gastrostomy -a report of twenty-seven cases-

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Ho; Lee, Ho Suk; Kim, Yong Joo; Kim, Tae Hun; Suh, Kyung Jin; Kang, Duk Sik [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of)


    Nutritional support by gastrostomy feeding is an important treatment adjunct when major swallowing difficulty or debilitating diseases is present. This technique for percutaneous placement of a gastric feeding tube now provides many patients with a simple, safe, and well-tolerated alternative to surgical feeding gastrostomy. We experienced 27 cases of percutaneous gastrostomy from January 1989 to February 1991 at Kyungpook National University Hospital. The underlying diseases of the patients were esophageal cancer (11), pyriform sinus cancer (4), laryngeal cancer (3), tongue cancer (2), lye stricture (1), lung cancer (1), chordoma (1), lethal midline granuloma (1), malignant lymphoma (1), maxillary cancer (1), and tonsil cancer (1). Selding method was used in all cases. In five patients it was difficult to insert the nasogastric tube for air insufflation, and one patient had subtotal gastrectomy with gastrojejunostomy, but gastrostomy was performed in all cases. The general condition improved in all patients. We experienced one case of mild peritonitis, but no other significant complications were observed. Gastrostomy tubes were patient in all patients during their survival period, except two patients who experienced obstruction 2 and 6 months after the procedure. Percutaneous gastrostomy can be used safely and effectively in such patients who have pharyngoesophageal or CNS lesions precluding oral intake.

  6. Optical studies of vaporization and stability of fluorescently labelled perfluorocarbon droplets (United States)

    Reznik, Nikita; Seo, Minseok; Williams, Ross; Bolewska-Pedyczak, Eleonora; Lee, Mike; Matsuura, Naomi; Gariepy, Jean; Foster, F. Stuart; Burns, Peter N.


    Droplets of liquid perfluorocarbon (PFC) are under study as the next generation of contrast agents for ultrasound (US). These droplets can be selectively vaporized into echogenic gas bubbles in situ by externally applied US, with numerous applications to diagnosis and therapy. However, little is known about the mechanisms of droplet vaporization and the stability of the bubbles so produced. Here we observe optically the vaporization of fluorescent PFC droplets and the stability of the newly created bubbles. Fluorescent markers were used to label selectively either the liquid PFC core or the shell of the droplets. It was found that, following vaporization, the fluorescent marker is quickly expelled from the core of the newly created bubble and is retained on the gas-liquid interface. At the same time, it was shown that bubbles retain the original shells encapsulating their droplet precursors. The efficiency of encapsulation was found to depend strongly on the nature of the stabilizing material itself. These results provide direct evidence of droplet encapsulation post-vaporization, and suggest that the behaviour of the vaporized droplets is strongly dependent on the choice of the stabilizing material for the emulsion.

  7. Percutaneous transvenous mitral commissurotomy (PTMC) and percutaneous coronary intervention (PCI) successfully applied in one patient in same sitting. (United States)

    Sial, Jawaid Akbar; Farman, Muhammad Tariq; Saghir, Tahir; Zaman, Khan Shah


    Sixty years old male with severe rheumatic mitral stenosis (MS), presented with dyspnoea New York Heart Association (NHYA) class III to IV. Coronary angiogram revealed severe occlusive coronary artery disease in left anterior coronary artery (LAD). Percutaneous Transvenous Mitral Commissurotomy (PTMC) and Percutaneous Coronary Intervention (PCI) of Left Anterior Descurery (LAD) were done in same sitting. Both procedures were successful and ended without complication. After, half an hour while shifting to coronary care unit (CCU) patient developed cardiac tamponade, which was managed successfully. Patient was followed up for three month, he is doing well and recent echocardiogram showed mild mitral stenosis with normal left ventricular function. This case demonstrates the feasibility of the combined appliance on interventional techniques in selected patients as an alternative to cardiac surgery.

  8. Influence of Soil Moisture on Soil Gas Vapor Concentration for Vapor Intrusion


    Shen, Rui; Pennell, Kelly G.; Suuberg, Eric M.


    Mathematical models have been widely used in analyzing the effects of various environmental factors in the vapor intrusion process. Soil moisture content is one of the key factors determining the subsurface vapor concentration profile. This manuscript considers the effects of soil moisture profiles on the soil gas vapor concentration away from any surface capping by buildings or pavement. The “open field” soil gas vapor concentration profile is observed to be sensitive to the soil moisture di...

  9. Preparation and in vitro evaluation of chitosan matrices cross-linked by formaldehyde vapors. (United States)

    Rao, B S; Murthy, K V


    Rifampicin-chitosan matrices were prepared by a chemical cross-linking method to develop a sustained-release form. The effects of cross-linking agent (formaldehyde) on the drug release rate and release kinetics were investigated in this study. Moreover, the kinetics of rifampicin released from chitosan matrices exposed to formaldehyde vapors for predetermined time intervals were analyzed using Ritger and Peppas exponential equation. The in vitro release kinetics exhibited a non-Fickian transport model. Increasing the exposure time to formaldehyde vapors decreased the release rate of rifampicin from chitosan matrices as a result of formation of greater structural strength and tighter texture.

  10. Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy. (United States)

    Ozgor, Faruk; Kucuktopcu, Onur; Sarılar, Omer; Toptas, Mehmet; Simsek, Abdulmuttalip; Gurbuz, Zafer Gokhan; Akbulut, Mehmet Fatih; Muslumanoglu, Ahmet Yaser; Binbay, Murat


    In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success.

  11. Interacting agents in finance

    NARCIS (Netherlands)

    C. Hommes


    Interacting agents in finance represent a behavioural, agent-based approach in which financial markets are viewed as complex adaptive systems consisting of many boundedly rational agents interacting through simple heterogeneous investment strategies, constantly adapting their behaviour in response t

  12. Riot Control Agents (United States)

    ... Submit What's this? Submit Button Facts About Riot Control Agents Interim document Recommend on Facebook Tweet Share Compartir FACT SHEET What riot control agents are Riot control agents (sometimes referred to ...

  13. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation. (United States)

    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng


    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P PCN procedure. There was no significant difference in stability either preoperatively or

  14. Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access (United States)

    Rodrigues, Pedro L.; Moreira, António H. J.; Rodrigues, Nuno F.; Pinho, A. C. M.; Fonseca, Jaime C.; Lima, Estevão.; Vilaça, João. L.


    Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.


    Nagy, S M; Golumbic, C; Stein, W H; Fruton, J S; Bergmann, M


    Analytical methods which are accurate to about 1 per cent have been developed for the determination of small amounts (ca. 500 gamma) of bis(beta-chloroethyl)-sulfide (H), ethyl-bis(beta-chloroethyl)amine (EBA), tris(beta-chloroethyl)amine (TBA), beta-chloroethyl-benzylsulfide (benzyl-H), and beta-chloroethyl-ethylsulfide (ethyl-H). The determinations are made by micro titration of the HCl liberated upon complete hydrolysis of the vesicants. A description is given of an apparatus suitable for applying vapors of vesicants to unit areas of skin. A very precise and reproducible micropipetting technique is described for the introduction of the vesicants into the penetration apparatus. By means of this penetration apparatus studies have been made of several factors which may influence the rate at which vesicant vapors penetrate into skin. Model experiments have been performed in which H was allowed to vaporize and the vapor was absorbed on a surface such as that of diethylene glycol or vaseline. It has been found that if the surface of liquid H is increased by spreading the agent on filter paper, the rate of evaporation is markedly increased. Furthermore, if the vapor is agitated by means of a magnetically driven fan, the rate of absorption by diethylene glycol is greatly accelerated. With vaseline as the absorbing surface it has been found that the area of the absorbing surface has an effect on the rate of absorption of H vapor. More H is absorbed by vaseline spread on filter paper to give a rough surface than is absorbed by a smooth film of vaseline. Measurements of the rate of penetration into human skin of H, EBA, TBA, benzyl-H, and ethyl-H vapors have been performed at 21-23 degrees C. and 30-31 degrees C. by means of the penetration apparatus described in this paper. The measurements were carred out on human volunteers under conditions of controlled temperature and humidity. When human skin is exposed to air saturated with H vapor, the H penetrates the skin of the

  16. Optical Sensor for Diverse Organic Vapors at ppm Concentration Ranges

    Directory of Open Access Journals (Sweden)

    Dora M. Paolucci


    Full Text Available A broadly responsive optical organic vapor sensor is described that responds to low concentrations of organic vapors without significant interference from water vapor. Responses to several classes of organic vapors are highlighted, and trends within classes are presented. The relationship between molecular properties (vapor pressure, boiling point, polarizability, and refractive index and sensor response are discussed.

  17. Soil vapor extraction with dewatering

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, N.R. [Univ. of Waterloo, Ontario (Canada)


    The physical treatment technology of soil vapor extraction (SVE) is reliable, safe, robust, and able to remove significant amounts of mass at a relatively low cost. SVE combined with a pump-and-treat system to create a dewatered zone has the opportunity to remove more mass with the added cost of treating the extracted groundwater. Various limiting processes result in a significant reduction in the overall mass removal rates from a SVE system in porous media. Only pilot scale, limited duration SVE tests conducted in low permeability media have been reported in the literature. It is expected that the presence of a fracture network in low permeability media will add another complexity to the limiting conditions surrounding the SVE technology. 20 refs., 4 figs.

  18. Tungsten chemical vapor deposition method

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Kiichi; Takeda, Nobuo.


    A tungsten chemical vapor deposition method is described, comprising: a first step of selectively growing a first thin tungsten film of a predetermined thickness in a desired region on the surface of a silicon substrate by reduction of a WF[sub 6] gas introduced into an atmosphere of a predetermined temperature containing said silicon substrate; and a second step of selectively growing a second tungsten film of a predetermined thickness on said first thin tungsten film by reduction of said WF[sub 6] with a silane gas further introduced into said atmosphere, wherein the surface state of said substrate is monitored by a pyrometer and the switching from said first step to said second step is performed when the emissivity of infrared light from the substrate surfaces reaches a predetermined value.

  19. Can a drawover vaporizer be a pushover? (United States)

    Taylor, J C; Restall, J


    Bench testing was carried out to establish whether the vapour output from an OMV50 vaporizer, as used in the Triservice apparatus, differs according to whether the carrier gas is either drawn or pushed through the vaporizer. Results show that the differences in output concentration between the two modes were clinically insignificant.

  20. Boron carbide whiskers produced by vapor deposition (United States)


    Boron carbide whiskers have an excellent combination of properties for use as a reinforcement material. They are produced by vaporizing boron carbide powder and condensing the vapors on a substrate. Certain catalysts promote the growth rate and size of the whiskers.

  1. Vapor Pressures of Several Commercially Used Alkanolamines

    NARCIS (Netherlands)

    Klepacova, Katarina; Huttenhuis, Patrick J. G.; Derks, Peter W. J.; Versteeg, Geert F.; Klepáčová, Katarína


    For the design of acid gas treating processes, vapor-liquid equilibrium (VLE) data must be available of the solvents to be applied. In this study the vapor pressures of seven frequently industrially used alkanolamines (diethanolamine, N-methylethanolamine, N,N-dimethylethanolamine, N,N-diethylethano

  2. Engineering vapor-deposited polyimides (United States)

    Tsai, Feng-Yu

    The vapor deposition polymerization (VDP) of PMDA-ODA polyimide was studied parametrically to produce microcapsules and thin films with desirable properties and quality for the Inertial Confinement Fusion (ICF) experiments. The mechanical properties and gas permeability were determined at temperatures from 10 to 573 K. The VDP polyimide possessed distinct properties including lower gas permeability and stronger tensile properties from those of solution-cast Kapton, which were attributed to the presence of cross-linking. Processing parameters determining the properties of the VDP polyimide were identified: (1) utilizing air instead of nitrogen as the atmosphere of imidization increased the permeability by 140%, lowered the activation energy for permeation, and reduced the tensile strength by 30% without affecting the Young's modulus; (2) imidizing at faster heating rates increased the permeability by up to 50% and reduced the activation energy for permeation with 50% lowered tensile strength and impervious Young's modulus; (3) bi-axial stretching increased the permeability by up to three orders of magnitude. Analyses via IR spectroscopy, X-ray diffraction, and density measurement revealed that the effects of the processing parameters were results of the modifications in the crystallinity and molecular weight. The VDP polyimide underwent minor degradation in the tensile strength and elongation at break with unaffected Young's modulus and permeability upon absorbing 120 MGy of beta-radiation. Substituting a fluorinated dianhydride monomer, 6FDA, for PMDA in the optimized VDP process yielded 6FDA-ODA polyimide microcapsules and films with 50-fold increased permeability and comparable mechanical properties. The results of this study enable the production of polyimide microcapsules that will greatly facilitate the ICF experiments, and will broaden the applications of vapor-deposited polyimides in other technology fields.

  3. Case report: percutaneous cryoablation of a small renal lesion necessitating modified lateral decubitus position. (United States)

    McClung, Chris; Wright, Andrew; Pierce, Ken; Posniak, Harold; Perry, Kent


    When performing percutaneous cryoablation for renal masses, the standard patient positioning has been the prone position. We present a case in which placing the patient in a modified lateral decubitus position aided in the access of probe placement for percutaneous cryoablation.

  4. Health-related quality of life in the elderly three years after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Panasewicz, Anna; Pedersen, Susanne S.; Veenhuis, Stefanie J G;


    Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (......Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (...

  5. Clinical study of percutaneous transhepatic balloon dilation: a novel procedure for common bileduct stone

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the safety and efficacy of percutaneous transhepatic balloon dilation for the removal of common bile duct stone.Methods Sixty-eight cases with common bile duct stone treated with percutaneous transhepatic balloon dilation in our department from July2008 to April 20l1 were analyzed retrospectively.Record CA19-9,total bilirubin,

  6. Percutaneous vertebroplasty in the treatment of vertebral body compression fracture secondary to osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Rami, Parag M.; Heatwole, Eric V.; Boorstein, Jeffrey M. [Center for Vascular and Interventional Radiology, St. Vincent Mercy Medical Center, Toledo, OH (United States); McGraw, Kevin J. [Riverside Methodist Hospital, Columbus, OH (United States)


    Percutaneous vertebroplasty, a minimally invasive interventional radiological procedure, has recently been used effectively for the treatment of symptomatic vertebral body compression fractures. Primary indications for vertebroplasty include osteoporotic compression fracture, osteolytic vertebral metastasis and myeloma, and vertebral hemangioma. We present a case and extend the indication of percutaneous vertebroplasty in a patient with a vertebral body compression fracture secondary to osteogenesis imperfecta. (orig.)

  7. Interactions of skin thickness and physicochemical properties of test compounds in percutaneous penetration studies

    NARCIS (Netherlands)

    Wilkinson, S.C.; Maas, W.J.M.; Nielsen, J.B.; Greaves, L.C.; Sandt, J.J.M. van de; Williams, F.M.


    Objectives: To determine the effect of skin thickness on the percutaneous penetration and distribution of test compounds with varying physicochemical properties using in vitro systems. Studies were carried out in accordance with OECD guidelines on skin absorption tests. Methods: Percutaneous penetra

  8. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention


    Ruygrok, Peter; Webster, Mark; de Valk, Vincent; Es, Gerrit Anne; Ormiston, John; Morel, Marie-Angèle; Serruys, Patrick


    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND RESULTS: All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariat...



    S. V. Kostritsky; D. V. Semenov; V. I. Shirokorad; B. K. Komyakov; D. A. Ptashnikov; S. A. Zamyatnin; P. A. Karlov


    Data on 19 patients with kidney cancer with metastatic involvement of the vertebral column, who had undergone percutaneous vertebroplasty, were retrospectively analyzed. The role of percutaneous vertebroplasty was assessed in patients with bony metastases from kidney cancer to the vertebral column and this surgical treatment was found to achieve satisfactory results in improving the quality of life in patients.

  10. Bile peritonitis after inadvertant puncture of the gallbladder as a rare complication of percutaneous transhepatic cholangiography

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, I.; Marik, J.


    A report is given about a rare complication after percutaneous transhepatic cholangiography: after inadvertant puncture of the gallbladder, bile peritonitis developed. Surgery was done immediately and the gallbladder, which was filled with stones, as well as stones from the choledochus were removed. The literature dealing with complications of percutaneous cholangiography is reviewed.

  11. Percutaneous Catheter Drainage of Periappendiceal abscess due to Appendicolith : A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Dae Sik; Kim, Heung Chueol; Han, Tae Kyun; Hur, Hun; Yum, Kung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chueol [Hallym University College of Medicine, Chuncheon (Korea, Republic of)


    Percutaneous catheter drainage of periappendiceal abscess is an effective and safe method of treatment. It is known that CT guided approach is the first choice of method. We experienced a successful percutaneous catheter drainage under ultrasound guidance for periappendiceal abscess with appendicolith

  12. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hryhorczuk, Anastasia L. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Harvard University School of Medicine, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Strouse, Peter J. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Biermann, J.S. [University of Michigan, Department of Orthopaedic Surgery, Ann Arbor, MI (United States)


    CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies. To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign. From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed. Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies. Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. (orig.)

  13. [Studies on percutaneous absorption of ruyi jinhuang san patcher with radioisotope tracer]. (United States)

    Zhao, H W; Shen, Z; Zhou, B; Lin, X; Ye, M


    Berberine is one of the active ingredients in Ruyi Jinhuang San Patcher. With 3H-berberine as the tracer, a radio-labelled method was used for determining percutaneous rate and drug concentration of berberine in plasma in vivo and in vitro. A study on the percutaneous rate of different technological plasters and various animal skins was also carried out.

  14. Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience)

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas E-mail:; Mylona, Sophia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos


    Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, which are a useful diagnostic and therapeutic tool. In this study we present our experience in CT-guided percutaneous musculoskeletal biopsies, drainages of musculoskeletal abscesses, facet and sacroiliac joint injection and radiofrequency thermal ablation of painful metastases or osteoid osteomas.

  15. Microbial growth with vapor-phase substrate

    Energy Technology Data Exchange (ETDEWEB)

    Hanzel, Joanna; Thullner, Martin; Harms, Hauke [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Microbiology, Permoserstrasse 15, 04318 Leipzig (Germany); Wick, Lukas Y., E-mail: [UFZ - Helmholtz Centre for Environmental Research, Department of Environmental Microbiology, Permoserstrasse 15, 04318 Leipzig (Germany)


    Limited information exists on influences of the diffusive transport of volatile organic contaminants (VOC) on bacterial activity in the unsaturated zone of the terrestrial subsurface. Diffusion of VOC in the vapor-phase is much more efficient than in water and results in effective VOC transport and high bioavailability despite restricted mobility of bacteria in the vadose zone. Since many bacteria tend to accumulate at solid-water, solid-air and air-water interfaces, such phase boundaries are of a special interest for VOC-biodegradation. In an attempt to evaluate microbial activity toward air-borne substrates, this study investigated the spatio-temporal interplay between growth of Pseudomonas putida (NAH7) on vapor-phase naphthalene (NAPH) and its repercussion on vapor-phase NAPH concentrations. Our data demonstrate that growth rates of strain PpG7 were inversely correlated to the distance from the source of vapor-phase NAPH. Despite the high gas phase diffusivity of NAPH, microbial growth was absent at distances above 5 cm from the source when sufficient biomass was located in between. This indicates a high efficiency of suspended bacteria to acquire vapor-phase compounds and influence headspace concentration gradients at the centimeter-scale. It further suggests a crucial role of microorganisms as biofilters for gas-phase VOC emanating from contaminated groundwater or soil. - Research highlights: > Suspended bacteria have a high efficiency to degrade vapor-phase naphthalene. > Bacteria influence NAPH vapor-phase concentration gradients at centimeter-scale. > Microbial growth on vapor-phase naphthalene is inversely correlated to its source. > Bacteria are good biofilters for gas-phase NAPH emanating from contaminated sites. - Suspended bacteria have a high efficiency to degrade vapor-phase naphthalene and effectively influence vapor-phase naphthalene concentration gradients at the centimeter scale.


    Energy Technology Data Exchange (ETDEWEB)



    Chemical vapor emissions from underground hazardous waste storage tanks on the Hanford site in eastern Washington State are a potential concern because workers enter the tank farms on a regular basis for waste retrievals, equipment maintenance, and surveillance. Tank farm contractors are in the process of retrieving all remaining waste from aging single-shell tanks, some of which date to World War II, and transferring it to newer double-shell tanks. During the waste retrieval process, tank farm workers are potentially exposed to fugitive chemical vapors that can escape from tank headspaces and other emission points. The tanks are known to hold more than 1,500 different species of chemicals, in addition to radionuclides. Exposure assessments have fully characterized the hazards from chemical vapors in half of the tank farms. Extensive sampling and analysis has been done to characterize the chemical properties of hazardous waste and to evaluate potential health hazards of vapors at the ground surface, where workers perform maintenance and waste transfer activities. Worker concerns. risk communication, and exposure assessment are discussed, including evaluation of the potential hazards of complex mixtures of chemical vapors. Concentrations of vapors above occupational exposure limits-(OEL) were detected only at exhaust stacks and passive breather filter outlets. Beyond five feet from the sources, vapors disperse rapidly. No vapors have been measured above 50% of their OELs more than five feet from the source. Vapor controls are focused on limited hazard zones around sources. Further evaluations of vapors include analysis of routes of exposure and thorough analysis of nuisance odors.

  17. Supine Versus Prone Position During Percutaneous Nephrolithotomy: A Report from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    G. Vadivia, José; M. Scarpa, Roberto; Duvdevani, Mordechai


    To determine differences in patients' characteristics, operative time and procedures, and perioperative outcomes between prone and supine positioning in percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  18. Percutaneous left atrial appendage closure devices: safety, efficacy, and clinical utility

    Directory of Open Access Journals (Sweden)

    Swaans MJ


    Full Text Available Martin J Swaans, Lisette IS Wintgens, Arash Alipour,  Benno JWM Rensing, Lucas VA Boersma Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands Abstract: Atrial fibrillation (AF is the most common arrhythmia treated in the clinical practice. One of the major complications of AF is a thromboembolic cerebral ischemic event. Up to 20% of all strokes are caused by AF. Thromboembolic cerebral ischemic event in patients with AF occurs due to atrial thrombi, mainly from the left atrial appendage (LAA. Prevention of clot formation with antiplatelet agents and especially oral anticoagulants (­vitamin K antagonists or newer oral anticoagulants has been shown to be effective in reducing the stroke risk in patients with AF but has several drawbacks with (major bleedings as the most important disadvantage. Therefore, physical elimination of the LAA, which excludes the site of clot formation by surgical or percutaneous techniques, might be a good alternative. In this review, we discuss the safety, efficacy, and clinical utility of the Watchman™ LAA closure device. Keywords: stroke, left atrial appendage, prevention, atrial fibrillation

  19. [In vitro percutaneous absorption of chromium powder and the effect of skin cleanser]. (United States)

    D'Agostin, F; Crosera, M; Adami, G; Malvestio, A; Rosani, R; Bovenzi, M; Maina, G; Filon, F Larese


    Occupational chromium dermatitis occurs frequently among cement and metal workers, workers dealing with leather tanning and employees in the ceramic industry. The present study, using an in-vitro system, evaluated percutaneous absorption of chromium powder and the effect of rapid skin decontamination with a common detergent. Experiments were performed using the Franz diffusion cell method with human skin. Physiological solution was used as receiving phase and a suspension of chromium powder in synthetic sweat was used as donor phase. The tests were performed without or with decontamination using the cleanser 30 minutes after the start of exposure. The amount of chromium permeated through the skin was analysed by Inductively Coupled Plasma Atomic Emission Spectroscopy and Electro Thermal Atomic Absorption Spectroscopy. Speciation analysis and measurements of chromium skin content were also performed. We calculated a permeation flux of 0.843 +/- 0.25 ng cm(-2) h(-1) and a lag time of 1.1 +/- 0.7 h. The cleaning procedure significantly increased chromium skin content, whereas skin passage was not increased. These results showed that chromium powder can pass through the skin and that skin decontamination did not decrease skin absorption. Therefore, it is necessary to prevent skin contamination when using toxic agents.

  20. Vaporous Hydrogen Peroxide (VHP) Decontamination of a C-141B Starlifter Aircraft: Validation of VHP and Modified VHP (mVHP) Fumigation Decontamination Process via VHP-Sensor, Biological Indicator, and HD Simulant in a Large-Scale Environment (United States)


    21 18. G. stearothermophilus ATCC 7953VHP Exposure Test Results ..................... 33 19. Vapor Cup ...provided forced air circulation. An anemometer , located downstream of the main blower, measured and recorded the airflow generated by the mVHP system...Station) Height (inches) 1 670 8 2 890 48 3 1230 72 3.4.2 Chemical Warfare Agent Simulant Vapor Analysis Vapor cups were prepared for residual chemical

  1. Vaporization and recondensation dynamics of indocyanine green-loaded perfluoropentane droplets irradiated by a short pulse laser (United States)

    Yu, Jaesok; Chen, Xucai; Villanueva, Flordeliza S.; Kim, Kang


    Phase-transition droplets have been proposed as promising contrast agents for ultrasound and photoacoustic imaging. Short pulse laser activated perfluorocarbon-based droplets, especially when in a medium with a temperature below their boiling point, undergo phase changes of vaporization and recondensation in response to pulsed laser irradiation. Here, we report and discuss the vaporization and recondensation dynamics of perfluoropentane droplets containing indocyanine green in response to a short pulsed laser with optical and acoustic measurements. To investigate the effect of temperature on the vaporization process, an imaging chamber was mounted on a temperature-controlled water reservoir and then the vaporization event was recorded at 5 million frames per second via a high-speed camera. The high-speed movies show that most of the droplets within the laser beam area expanded rapidly as soon as they were exposed to the laser pulse and immediately recondensed within 1-2 μs. The vaporization/recondensation process was consistently reproduced in six consecutive laser pulses to the same area. As the temperature of the media was increased above the boiling point of the perfluoropentane, the droplets were less likely to recondense and remained in a gas phase after the first vaporization. These observations will help to clarify the underlying processes and eventually guide the design of repeatable phase-transition droplets as a photoacoustic imaging contrast agent.

  2. Biological warfare agents. (United States)

    Pohanka, Miroslav; Kuca, Kamil


    Biological warfare agents are a group of pathogens and toxins of biological origin that can be potentially misused for military or criminal purposes. The present review attempts to summarize necessary knowledge about biological warfare agents. The historical aspects, examples of applications of these agents such as anthrax letters, biological weapons impact, a summary of biological warfare agents and epidemiology of infections are described. The last section tries to estimate future trends in research on biological warfare agents.

  3. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Huwart, Laurent, E-mail: [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Foti, Pauline, E-mail: [Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Andreani, Olivier, E-mail: [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Hauger, Olivier, E-mail: [Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux (France); Cervantes, Elodie, E-mail: [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Brunner, Philippe, E-mail: [Department of Radiology, Hôpital Princesse Grasse de Monaco (Monaco); Boileau, Pascal, E-mail: [Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Amoretti, Nicolas, E-mail: [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France)


    Objective: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P < 0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P < 0.001). Conclusion: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.

  4. The comparison of standard and tubeless percutaneous nephrolithotomy procedures

    Directory of Open Access Journals (Sweden)

    Ismail Nalbant


    Full Text Available Purpose To compare totally tubeless and standard percutaneous nephrolitotomy procedures on many parameters. Materials and Methods Percutaneous nephrolitotomy was performed on 195 patients between June 2009 and May 2012. The data of those patients were evaluated retrospectively. Totally tubeless cases were enrolled to Group 1, and Group 2 consisted of non-tubeless cases (re-entry or Foley catheter. Results Group 1 included 85 cases and group 2 a total of 110 patients. Paper tracing values for the kidney stones were 321.25 ± 102.4 mm2 and 324.10 ± 169.5 mm2 respectively. Mean fluoroscopy time was 4.9 ± 1.9 min and 5.08 ± 2.7 min, mean operation time was 78.8 ± 27.9 min and 81.9 ± 28.77 min and mean decrease in hematocrit was 2.6 ± 1.6 and 3.74 ± 1.9 respectively. All these comparisons were statistically significant. Length of hospitalization was 1.6 ± 1.1 and 3.5 ± 1.5 days for Groups 1 and 2 respectively. Mean superficial pain score was 5.8 ± 1.6 and 6.7 ± 1.2 respectively for both groups after 1 hour. At 6 hours, the scores changed to 3.87 ± 1.22 and 4.84 ± 1.3 respectively. The analgesic dose was 1.00 ± 0.7 and 1.53 ± 0.6 for the groups respectively at 6 hours. All the statistical differences were significant for these three parameters. Conclusions We believe that, because of their post operative patient comfort and decreased length of hospital stay, totally tubeless procedures should be considered as an alternative to standard percutaneous nephrolitotomy.

  5. Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children

    Energy Technology Data Exchange (ETDEWEB)

    Donkol, Ragab H. [Cairo University, Department of Radiology, Faculty of Medicine, Cairo (Egypt); Assir Central Hospital, Department of Radiology, P.O. Box 34, Abha (Saudi Arabia); Al-Nammi, Ahmed [Assir Central Hospital, Department of Radiology, P.O. Box 34, Abha (Saudi Arabia); Moghazi, Khaled [Alexandria University, Faculty of Medicine, Alexandria (Egypt)


    Percutaneous radiofrequency (RF) ablation of osteoid osteoma has high technical and clinical success rates. However, there are limited data on its use in the treatment of osteoid osteoma in children. To assess the safety and efficacy of CT-guided percutaneous RF ablation of osteoid osteoma in children and compare the outcomes with published data on its use in patients unselected for age. From January 2003 to July 2006, 23 children with osteoid osteoma were treated with CT-guided RF ablation using a straight rigid electrode. Their mean age was 11 years (range 3.5-16 years) and there were 15 boys and 8 girls. The procedures were carried out under general anaesthesia. Follow-up was performed to assess technical and clinical outcome. The mean follow-up period was 2.5 years (range 13-49 months). Technical success was achieved in 21 children (91.3%). Failure occurred in two children, in one due to failure to adequately localize the nidus within the dense sclerosis and in the other because of a short ablation time (2 min) because he developed hyperthermia. Clinical success was achieved in 18 patients within 2-5 days (primary clinical success rate 78.2%).These patients were allowed to fully weight-bear and function without limitation 1 week after the procedure. Pain recurrence was observed in two patients; one was treated successfully with a second ablation after 6 months (secondary clinical success rate 82.6%). Hyperthermia was observed in two patients during the procedure. Three other minor complications were observed: wound infection in one child and skin burn in two children. No major immediate or delayed complications were observed. Percutaneous CT-guided RF ablation is an effective and safe minimally invasive procedure for the treatment of osteoid osteoma in children. It has high technical and clinical success rates that are slightly lower than those of patients with a wider range of ages. (orig.)

  6. Results of percutaneous nephrolithotomy performed in a regional state hospital

    Directory of Open Access Journals (Sweden)

    Taner Çiftçi


    Full Text Available Aim: The aim of this study was to evaluate the results of percutaneous stone surgery that performe in a regional state hospital.Materials and methods: We retrospectively analyzed 183 percutaneous nephrolithotomy (PNL performed cases that treated at our clinic between June 2010 and July 2011. After necessary laboratory and radiological investigations, we performed PNL for the patients those diagnosed as having stones needed surgery. After surgery, we investigated radiologically whether residual stone fragments remained or not. When there were residual stone fragments (bigger than 4 mm, we performed ESWL, repeated percutaneous interventions and surveillance protocols. In six patients, open surgery was needed during PNL.Results: Of the totally 183 patients underwent PNL at our clinic, 102 were male and 81 were female. The mean age was 37.6 and mean stone burden was 35.5 mm2. Stone-free rate was 75.4% and the rate of the patients who have residual stones (bigger than 4mm was 25.7%. Stone free rates were 95% and 86% for stone burden lesser and more than 2 cm2, respectively. The mean blood loss was 186ml for per operational case. Totally four patients (8.5% underwent blood tranfusion.Conclusion: As a result, because of its high stone-free rates, the shorter hospital stay, minimal surgical scar and absence of wound infection, PNL is preserving its place for the treatment of stones bigger than 2 cm2. J Clin Exp Invest 2011; 2 (4: 371-374

  7. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children. (United States)

    Feng, Yongzeng; Yu, Yang; Shui, Xiaolong; Ying, Xiaozhou; Cai, Leyi; Hong, Jianjun


    Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed. Preoperative radiographs and computed tomography scans were used to evaluate and classify the fractures. Clinical outcomes and radiographic findings were assessed at postoperative follow-up. The study included 14 displaced intra-articular calcaneal fractures in 11 patients (7 boys and 4 girls). Mean patient age was 11.18 years (range, 6-16 years), and average follow-up time was 42.8 months postoperatively (range, 12-72 months). There were 6 tongue-type fractures and 8 joint depression-type fractures, based on the Essex-Lopresti classification, and there were 11 type II and 3 type III fractures, based on the Sanders classification. Average Böhler angle was 8.00° (range, -5° to 18°) preoperatively and 30.79° (range, 26° to 40°) postoperatively (P<.001). Average subjective American Orthopaedic Foot and Ankle Society hindfoot score was 65.7 (range, 52-68). No patients had wound breakdown or infection. In the treatment of displaced intra-articular calcaneal fractures in pediatric patients, closed reduction and percutaneous fixation achieved good outcomes, with few complications. [Orthopedics. 2016; 39(4):e744-e748.].

  8. Permeation Testing of Materials With Chemical Agents or Simulants (Swatch Testing) (United States)


    chemical warfare agent (CWA) and simulant challenges through swatches of materials. Such agents include the blister agent, distilled mustard (HD) and the...2) general and specialized chemical analysis, (3) emergency response provisions, and (4) hazardous waste storage and disposal. Swatch test...moni- tor. The effluent from the vapor generator will be routed to the waste air until the challenge con- centration for the trial has stabilized

  9. Distal protection devices during percutaneous coronary and carotid interventions. (United States)

    Fasseas, Panayotis; Orford, James L; Denktas, Ali E; Berger, Peter B


    Distal embolization of particulate matter complicates percutaneous coronary and peripheral interventions more often than had been recognized until recently. A number of distal protection devices are under development. The PercuSurge GuardWiretrade mark is a balloon occlusion thrombectomy device approved by the United States Food and Drug Administration for saphenous vein graft intervention. A number of filter devices utilize an expandable filter mounted on the angioplasty guidewire to facilitate entrapment of particles and safe removal. The Parodi Anti-Emboli Systemtrade mark is an example of a catheter occlusion device that establishes protection by reversing blood flow in the target vessel.

  10. Distal protection devices during percutaneous coronary and carotid interventions

    Directory of Open Access Journals (Sweden)

    Berger Peter B


    Full Text Available Abstract Distal embolization of particulate matter complicates percutaneous coronary and peripheral interventions more often than had been recognized until recently. A number of distal protection devices are under development. The PercuSurge GuardWire™ is a balloon occlusion thrombectomy device approved by the United States Food and Drug Administration for saphenous vein graft intervention. A number of filter devices utilize an expandable filter mounted on the angioplasty guidewire to facilitate entrapment of particles and safe removal. The Parodi Anti-Emboli System™ is an example of a catheter occlusion device that establishes protection by reversing blood flow in the target vessel.

  11. Percutaneous endoscopic gastrostomy for postoperative rehabilitation after maxillofacial tumor surgery. (United States)

    Koehler, J; Buhl, K


    Despite the progress made in tumor and reconstructive surgery of the maxillofacial region, postoperative problems, such as malnutrition and dysfunction of the oral-oesophageal tract are still encountered. Nutrition via a nasogastric tube often complicates the rehabilitation process of these patients. Percutaneous endoscopic gastronomy (PEG), as opposed to nasogastral feeding, is presented. The technique, possible long-term complications, and the easy usage of the mechanical pump system, are presented. In our study of 40 patients, PEG, objectively, proved useful for functional, esthetic, practical, economical, and psychological reasons.

  12. Resistant tennis elbow: shock-wave therapy versus percutaneous tenotomy



    Fifty-six patients who suffered from chronic persistent tennis elbow of more than six months duration were randomly assigned to two active treatment groups. Group 1 (n = 29) received high-energy extracorporeal shock wave treatment (ESWT; 1,500 shocks) at 18 kV (0.22 mJ/mm2) without local anaesthesia; group 2 (n = 27) underwent percutaneous tenotomy of the common extensor origin. Both groups achieved improvement from the base line at three weeks, six weeks, 12 weeks and 12 months post-interven...

  13. Adaptive support ventilation with percutaneous dilatational tracheotomy: a clinical study. (United States)

    Veelo, Denise P; Dongelmans, Dave A; Middelhoek, Pauline; Korevaar, Johanna C; Schultz, Marcus J


    We determined the need for changes in minute ventilation with adaptive support ventilation after percutaneous dilatational tracheotomy under endoscopic guidance in 34 intensive care unit patients. During the procedure, minute ventilation was not changed; only maximum pressure limits were adjusted, if necessary. After insertion of the tracheotomy, cannula minute ventilation was adjusted only if Paco(2)-values changed >or=0.5 kPa from baseline. In 74% of patients, adaptive support ventilation was unable to maintain minute ventilation during the use of the endoscope, mandating pressure limitation adjustments. In a minority of patients (26%), minute ventilation had to be adjusted to achieve similar Paco(2) values.

  14. [Immediate complications of feeding percutaneous gastrostomy: a 10-year experience]. (United States)

    Chicharro, L; Puiggrós, C; Cots, I; Pérez-Portabella, C; Planas, M


    Percutaneous gastrostomy feeding tube (PG) may be beneficial in some patients, in others such as advanced dementia or rapidly progressive diseases its value is being questioned. Patient selection is important to identify those who will benefit from PG. This study aims to identify patients factors that may help in patient selection for PG. To analyse the characteristics of this patient's cohort and to describe the immediate complications of the procedure that we have defined as the ones happened in the first 30 days. To compare the two patient's group -with and without- immediate complications, non-parametric tests were used.

  15. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia


    Full Text Available OBJECTIVE: To assess the evolution of the cases treated with percutaneous facet fusion with bone allograft in lumbar facet disease. METHOD: Between 2010 and 2014, 100 patients (59 women and 41 men diagnosed with lumbar facet disease underwent surgery. RESULTS: The lumbar facet fusion with bone allograft shows good clinical results, is performed on an outpatient basis, and presents minimal complications and rapid incorporation of the patient to the activities of daily living. CONCLUSIONS: The lumbar facet fusion with bone allograft appears to be an effective treatment for lumbar facet disease.

  16. Lumbar percutaneous discectomy. Initial experience in 28 cases

    Energy Technology Data Exchange (ETDEWEB)

    Faubert, C. (Saarland Univ., Homburg/Saar (Germany). Neuroradiological Inst.); Caspar, W. (Saarland Univ., Homburg/Saar (Germany). Dept. of Neurosurgery)


    Since November 88, 28 patients with lumbar L5 radiculopathy refractory to conservative care and with a radiologically verified central or mediolateral disc herniation at the level of L4/L5 had had a percutaneous discectomy. A short-term follow-up analysis of at least 2 months taking the clinical and functional status as well as the professional reintegration into account revealed a 64.3% (18/28 patients) satisfactory outcome and a 32.1% (10/28 patients) failure rate. Of the latter 28.6% (8/28 patients) required further open surgery. (orig./GDG).

  17. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Nikhil Ranjan


    Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

  18. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Tonino, Pim A L; De Bruyne, Bernard; Pijls, Nico H J


    BACKGROUND: In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio......-eluting stents guided by angiography alone or guided by FFR measurements in addition to angiography. Before randomization, lesions requiring PCI were identified on the basis of their angiographic appearance. Patients assigned to angiography-guided PCI underwent stenting of all indicated lesions, whereas those...

  19. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy. (United States)

    Ranjan, Nikhil; Singh, Rana Pratap; Tiwary, Rajesh


    A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL) for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB) and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

  20. Systemic arterial air embolism after percutaneous lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Hare, S.S., E-mail: [Ottawa Hospital, Ontario (Canada); Gupta, A.; Goncalves, A.T.C.; Souza, C.A.; Matzinger, F.; Seely, J.M. [Ottawa Hospital, Ontario (Canada)


    Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often suboptimally managed. This review was inspired by our own institutional experience and we use this to demonstrate that excellent outcomes from this complication can be seen with prompt treatment using hyperbaric oxygen chamber therapy, after initial patient stabilization has been achieved. Pathophysiology, clinical features, and risk factors are reviewed and misconceptions regards venous versus arterial air embolism are examined. An algorithm is provided for radiologists to ensure suspected patients are appropriately managed with more favourable outcomes.

  1. Percutaneous drug-eluting stent implantation in dextrocardia: case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi; ZHANG Rui-yan; HU Jian; SHEN Wei-feng


    @@ Although situs inversus with dextrocardia is a rare clinical phenomenon, the association with coronary artery disease(CAD) is at the same frequency as in the general population.1,2 Few cases of dextrocardia complicated with CAD was reported before. The feasibility and prognosis of percutaneous coronary intervention (PCI) in such case still remains unclear because of the uncommon anatomical abnormality,especially in the drug-eluting stent (DES) era. Here we report a female case with dextrocardia and CAD was successfully treated by DES implantation.

  2. Primary percutaneous coronary intervention in a patient with dextrocardia. (United States)

    Khan, Naveed-Ullah; Farman, Muhammad Tariq; Ashraf, Tariq


    The case of a 40-year-old male with dextrocardia who presented with ST Elevated Myocardial Infarction (STEMI) is reported. Coronary angiogram was performed after due manipulation and then successful primary percutaneous coronary intervention (PCI) of Left anterior descending (LAD) coronary artery was done. His 9 months follow up primary PCI in a patient with angiogram revealed patent stent in proximal LAD. There are very few published case reports of this rare congenital anomaly addressing technical details of successful primary PCI with dextrocardia.

  3. Palmar hyperhidrosis - CT guided chemical percutaneous thoracic sympathectomy

    Energy Technology Data Exchange (ETDEWEB)

    Adler, O.B.; Engel, A.; Rosenberger, A. (Technion-Israel Inst. of Tech., Haifa (Israel). Dept. of Diagnostic Radiology); Dondelinger, R. (Centre Hospitalier, Luxembourg (Luxembourg). Dept. of Diagnostic Radiology)


    Palmar hyperhidrosis or excessive sweating of the hands causes, to those affected, emotional and physical disturbance and impediment in professional and social life. The cause is unknown. Sweat glands are innervated by the sympathic chain of the autonomous nervous system. The center of sympathic regulation of the upper extremities is located between the segments of D.2-D.9 of the spinal cord. Accepted treatment consists of surgery aimed to excise the third thoracic sympathic ganglion. CT guided chemical percutaneous thoracic sympathectomy presents an alternative, which in the event of failure does not prevent ensuing surgery. The preliminary experience with this procedure in 50 patients is presented and discussed. (orig./GDG).

  4. [Percutaneous angioscopy of the iliac and femoral arteries]. (United States)

    Cécile, J P; Foucart, H; Carlier, C; Baudrillard, J C; Varloteaux, M C; Servais, B; Bourgois, L


    Very few papers about peripheral angioscopy are reported in literature. Percutaneous angioscopy (P.T.A.) of 25 peripheral arteries (21 iliac and 4 femoral arteries) have been performed by the authors without surgery and without anesthesia. Three observations are selected. The first one demonstrates an eccentric stenosis altering its diameter during pulsations; an irregular ulcerated atheroma is observed. The second case shows the signs of a centric atheroma with an intimal fragment. The last one is an intimal dissection due to PTA. The prospective aspects of this new technique are discussed.

  5. Overview of the transradial approach in percutaneous coronary intervention. (United States)

    Amoroso, Giovanni; Laarman, Gert-Jan; Kiemeneij, Ferdinand


    Thirteen years have passed since the first percutaneous coronary intervention was performed at Onze Lieve Vrouwe Gasthuis in Amsterdam using the transradial approach (TRA). Since then TRA has spread through the interventional community and many centres have now adopted TRA as the arterial access of choice. This review is focused on the hot issues and the latest developments in this field. The following subjects will be addressed and discussed: drawbacks and learning curve, procedural technique, indications (with particular attention to acute coronary patients), complications, contraindications, nurse workload, patient management, and economics.

  6. El vapor de ruedas "Cid": de pionero de la navegación comercial a vapor a primer vapor hospital

    Directory of Open Access Journals (Sweden)

    O. González García

    Full Text Available La aparición de la máquina de vapor había hecho realidad el sueño de navegar sin depender de las fuerzas de la naturaleza. La carrera por lograr un vapor comercial eficiente había comenzado. Con retraso por la Guerra de la Independencia, España se incorporó a la carrera. Entre los primeros vapores comerciales estaba el vapor "Cid". En 1859, en la Guerra de África, ante la necesidad de una evacuación regular de bajas se designa al "Cid" como buque hospital, fue la primera vez en el mundo que se usó un vapor hospital. El Dr. Nicasio Landa fue el responsable de realizar la misión con una organización moderna, eficaz y ejemplar. Pronto los vapores de ruedas perdieron su batalla con los de hélice y el "Cid" quedó obsoleto. Sin embargo, a pesar de su corta vida operativa, poco más de quince años, escribió una importante página en la historia de la navegación en España.

  7. Percutaneous dilatational tracheostomy for ICU patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Guo Dongyuan


    Full Text Available 【Abstract】Objective: To sum up our experience in percutaneous dilatational tracheostomy (PDT in ICU patient with severe brain injury. Methods: Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, effi cacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results: The operations took 4-15 minutes (mean 9.1 minutes±4.2 minutes. Totally 4 cases suffered from complications in the operations: 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, or clinically signifi cant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion: Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in diffi cult airway management. Key words: Brain injuries; Percutaneous dilatational tracheostomy; ICU

  8. Angioscopic assessment of various percutaneous treatments for arteriosclerosis obliterance (United States)

    Kusaba, Hiroyasu; Watanabe, Kazuo; Shiraishi, Shohzo; Sato, Takashi; Koga, Nobuhiko


    We have evaluated the angioscopic findings before and after various percutaneous techniques to treat 39 lesions in 32 cases of arteriosclerosis obliterans (ASO). We applied a laser (CL50: SLT, Japan), percutaneous transluminal angioplasty (PTA), and atherectomy -- either singly or in combination, with angioscopic luminal observation (angioscope: PF14L & PF18L Olympus, Japan) recorded before and after the treatments. In the case of a complete obstruction, we employed PTA as the first choice. We used a laser prior to PTA when the PTA guide-wire failed to penetrate the lumen. For eccentric and calcified lesions atherectomy was applied. A sufficient enlargement was obtained initially in 37 of the 39 lesions. The angioscopic observations after treatment revealed carbonization (3/5) and attachment of small thrombi (3/5) after using the laser, intimal rupture (3/8), dissection (2/8), flap formation (2/8), and attachment of small thrombi (4/8) after PTA, and attachment of small thrombi (9/19), flap formation (6/19), and dissection (2/19) after atherectomy. We established the efficacy of angioscopic assessment demonstrating beneficial clinical results. The angioscopic findings suggest that attachment of small thrombi may be responsible for a poor prognosis. Additional angioscopic observations with angiography are recommended for improved understanding of the luminal changes.

  9. Percutaneous Renal Biopsy : A Report of 200 Caces

    Directory of Open Access Journals (Sweden)

    M. Bahadori


    Full Text Available In the diffuse medical diseases of kidney, percutaneous renal biopsy is a valuable, safe and hazardless procedure. With the aid of this nearly new technique renal pathology, the natural history of renal diseases and the response of renal diseases to therapy, as well as the prognosis of renal disorders can be evaluated."nWe have analysed 210 percutaneous biopsies in Tehran. Complications were observed in 13% of cases, there is no mortality and no patient required drastic therapeutic intervention. Anuria, peri-renal colic and peri-renal hematoma were the only serious complications, which were seen in 4 patients, and were. readily controled with simple measures We obtained renal tissue in 95% cases of our patients and in 9 I% of them the tissue was adequate for c'ear diagnosis."nLike other authors, we believe that the procedure, when properly performed, can give a far more valuable informations about the patients without any realy dangerous risk.

  10. Percutaneous coaxial transpedicular biopsy of vertebral body lesions during vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Minart, D.; Vallee, J.N.; Cormier, E.; Chiras, J. [Service de Neuroradiologie Diagnostique et Interventionnelle Charcot, Groupe Hospitalo-Universitaire Pitie-Salpetriere, Paris (France)


    We evaluated the safety and histological results of percutaneous transpedicular biopsy in patients undergoing vertebroplasty for vertebral collapse. Over a 6 year period, we carried out biopsies in 46 patients who underwent percutaneous injection of acrylic surgical cement for 57 collapsed vertebrae, because the diagnosis was not clearly established on clinical or imaging grounds. All procedures were performed under fluoroscopic guidance via a coaxial bitranspedicular approach used for vertebroplasty. We performed a clinical examination and CT after every procedure and approximately 6 months thereafter. Biopsies contributed to in 55 (96.5 %) of the 57 vertebral lesions. Biopsy material was inadequate in one case (1.7 %) and one biopsy was a false-negative (1.7 %). The accuracy of the histological results was 98.2 %, allowing a correct diagnosis in 55 of the 56 procedures. Of the 37 lesions in 28 patients with a history of a tumour, the final diagnosis was osteoporotic collapse in 25 (67.6 %), metastasis in nine (24.3 %), and myeloma in three (8.1 %). The final diagnosis in the 19 lesions in 17 patients without a known tumour was osteoporotic collapse in 12 (63.2 %), metastasis in five (26.3 %), and amyloidosis in two (10.5 %), the latter in one patient. No complications were observed. (orig.)

  11. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Martinez Montes, Jose Luis [Department of Traumatology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain)


    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean ({+-}SD) reduction in visual analogue scale (VAS) pain score from 9.0 {+-} 0.4 before the procedure to <4 during the follow-up period.

  12. Percutaneous osteosynthesis in the pelvis in cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Deschamps, Frederic; Baere, Thierry de; Tselikas, Lambros [Gustave Roussy, Interventional Radiology Department, Villejuif (France); Univeristy Paris-Sud, Le Kremlin Bicetre (France); Hakime, Antoine; Pearson, Ernesto; Farouil, Geoffroy; Teriitehau, Christophe [Gustave Roussy, Interventional Radiology Department, Villejuif (France)


    Screw fixation (osteosynthesis) can be performed percutaneously by interventional radiologists. We report our experience in cancer patients. We retrospectively reviewed all cases of percutaneous osteosynthesis (PO) of the pelvic ring and proximal femur performed in our hospital. PO were performed for fracture palliation or for osteolytic metastases consolidation. Screws were inserted under CT- or cone-beam CT- guidance and general anaesthesia. Patients were followed-up with pelvic-CT and medical consultation at 1 month, then every 3 months. For fractures, the goal was pain palliation and for osteolytic metastases, pathologic fracture prevention. Between February 2010 and August 2014, 64 cancer patients were treated with PO. Twenty-one patients had PO alone for 33 painful fractures (13 bone-insufficiency, 20 pathologic fractures). The pain was significantly improved at 1 month (VAS score = 20/100 vs. 80/100). In addition, 43 cancer patients were preventively consolidated using PO plus cementoplasty for 45 impending pathologic fractures (10 iliac crests, 35 proximal femurs). For the iliac crests, no fracture occurred (median-FU = 75 days). For the proximal femurs, 2 pathological fractures occurred (fracture rate = 5.7 %, median-FU = 205 days). PO is a new tool in the therapeutic arsenal of interventional radiologists for bone pain management. (orig.)

  13. Urologist Directed Percutaneous Nephrostomy Tube Placement: 6 Years Experience

    Directory of Open Access Journals (Sweden)

    Tarik Yonguc


    Full Text Available Aim: To report our results on percutaneous nephrostomy (PCN and classify our complications with the modified Clavien Classification System (CCS in 6 years. Material and Method: Eight hundred fourteen PCN insertions were performed in 722 patients (538 men and 184 women at our institution. PCN insertion was performed under ultrasound for dilated pelvicalyceal system and ultrasound/fluoroscopy for nondilated system. PCN was considered successful if the catheter was drained urine spontaneously. Number of complications was registered. Results: Primary successful PCN insertion was achieved in 770 of the 814 procedures (94.5%. The success rates for nondilated and dilated systems were 71.1% and 97.7%, respectively. Our overall complication rate was 17.3%. According to the modified CCS grades I, II, III, IV, and V were 9%, 1.2%, 6.2%, 0.3%, 0.3%, 0.4% and 0.1%, respectively. Age, grade of the hydronephrosis, serum creatinine levels, and mean hemoglobin levels were statistically significant parameters for the occurrence of complications. The nondilated system has statistically significant parameter affecting the complication rates. Discussion: Percutaneous nephrostomy is a well-known procedure in the treatment of temporary or permanent drainage of an obstructed system. It is very important to define the complications related to interventions for interpretation of clinical comparisons more accurately. Modified CCS is a reproducible system to evaluate the complications of PCN.

  14. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail:; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)


    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

  15. Percutaneous Method of Management of Simple Bone Cyst

    Directory of Open Access Journals (Sweden)

    O. P. Lakhwani


    Full Text Available Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V.

  16. Percutaneous sclerotherapy for venous malformations using polidocanol under fluoroscopy.

    Directory of Open Access Journals (Sweden)

    Mimura H


    Full Text Available This retrospective study evaluated the safety and efficacy of using polidocanol with X-ray fluoroscopy for percutaneous sclerotherapy of venous malformations of the limbs, head, and neck. The subjects were 16 of 18 patients who presented to our department with venous malformations. Two patients were excluded because they were unlikely to benefit from the treatment. Of the 16 included in the study, 1 could not be treated because of inaccessibility, and another was lost to follow-up. Among the 14 cases that we were able to follow-up, 11 cases had had pain as their primary symptom. Following treatment, this symptom remained unchanged in 1 patient, was improved in 4, and had disappeared in 6; however, there was a recurrence of pain for 3 of these patients. Two patients had sought treatment for cosmetic purposes; following treatment, the lesion disappeared in one and showed a significant reduction in the other. The remaining patient presented with a primary symptom of mouth bleeding, which disappeared following treatment. There were no critical complications. Percutaneous sclerotherapy of venous malformations using polidocanol is safe and effective, and permits repeat treatments. The efficacy is especially good for resolving pain, and complications are minor. It is desirable to use fluoroscopy for these procedures

  17. Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy. (United States)

    Yanbin, Xu; Haikun, Chu; Xiaofeng, Ji; Wanshan, Yang; Shuangping, Liu


    Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who had undergone this treatment within a follow-up period of ≥13 months. All procedures were performed in the clinic with the patient under local anesthesia. No wound infections or blood vessel or nerve damage occurred. At a mean follow-up period of 16.0 ± 2.29 (range 13 to 21) months, significant improvement was seen in the preoperative mean Mayo score (from 12.06 ± 2.54 to 89.76 ± 4.28, p plantar fasciitis with percutaneous latticed plantar fasciotomy could be a promising treatment option for patients with recalcitrant chronic plantar fasciitis.

  18. Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

    Institute of Scientific and Technical Information of China (English)

    Mert Krolu; Okan Akhan; Bekir Erol; Cemil Grses; Bar Trkbey; Cem Yunus Ba; Ahmetkr Alparslan; Banu Kale Krolu; clal Erdem Toslak; Blenteki


    Objective:To demonstrate utility and safety of the puncture aspiration injection and reaspiration (PAIR) technique for outpatients.Methods:Percutaneous treatment withUS guidance was applied to33 patients for44 cysts.Patients treated with thePAIR technique, were outpatients. PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of44 cysts were treated with thePAIR and9 of44 were treated with the catheterization technique.The success rate of the cystsGharbi type1(CE1) and type2(CE3a) treated with thePAIR technique was100%.In the follow up of9 cysts treated with the catheterization technique,2 of them(22%) developed cyst infection and1(11%) developed a biliary fistula.Conclusions:ThePAIR technique was found to be an effective and safe approach in order to treatGharbi type1 and type2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be made to finish the treatment withPAIR technique.

  19. Cannulation strategies for percutaneous extracorporeal membrane oxygenation in adults. (United States)

    Napp, L Christian; Kühn, Christian; Hoeper, Marius M; Vogel-Claussen, Jens; Haverich, Axel; Schäfer, Andreas; Bauersachs, Johann


    Extracorporeal membrane oxygenation (ECMO) has revolutionized treatment of severe isolated or combined failure of lung and heart. Due to remarkable technical development the frequency of use is growing fast, with increasing adoption by interventional cardiologists independent of cardiac surgery. Nevertheless, ECMO support harbors substantial risk such as bleeding, thromboembolic events and infection. Percutaneous ECMO circuits usually comprise cannulation of two large vessels ('dual' cannulation), either veno-venous for respiratory and veno-arterial for circulatory support. Recently experienced centers apply more advanced strategies by cannulation of three large vessels ('triple' cannulation), resulting in veno-veno-arterial or veno-arterio-venous cannulation. While the former intends to improve drainage and unloading, the latter represents a very potent method to provide circulatory and respiratory support at the same time. As such triple cannulation expands the field of application at the expense of increased complexity of ECMO systems. Here, we review percutaneous dual and triple cannulation strategies for different clinical scenarios of the critically ill. As there is no unifying terminology to date, we propose a nomenclature which uses "A" and all following letters for supplying cannulas and all letters before "A" for draining cannulas. This general and unequivocal code covers both dual and triple ECMO cannulation strategies (VV, VA, VVA, VAV). Notwithstanding the technical evolution, current knowledge of ECMO support is mainly based on observational experience and mostly retrospective studies. Prospective controlled trials are urgently needed to generate evidence on safety and efficacy of ECMO support in different clinical settings.

  20. Percutaneous vertebroplasty in osteoporosis, myeloma and Langerhans' cell histiocytosis.

    LENUS (Irish Health Repository)

    Kevane, B


    This review aims to assess the effectiveness of percutaneous vertebroplasty as a treatment for the severe refractory pain associated with vertebral fracture, in a group of patients with fractures secondary to either osteoporotic or neoplastic disease. A retrospective review of 20 patients treated with percutaneous vertebroplasty in Cork University Hospital up until March 2007 was carried out and a questionnaire was prepared and distributed. Prior to vertebroplasty, patients had been symptomatic with severe pain for a mean of 20.9 weeks. Of those thirteen whom replied to a postal questionnaire, 12 (92.3%) reported pain relief and this improvement occurred within 7 days in 9 (81.8%). This was associated with decreased analgesic requirements, as determined on chart review. Prior to the procedure only 5 (38.4%) were independently mobile and this figure rose to 10 (76.9%) afterwards, occurring within one week in the majority. Subjective outcomes were better in the group of patients with neoplasm-induced fractures.

  1. CT-guided percutaneous radiofrequency denervation of the sacroiliac joint

    Energy Technology Data Exchange (ETDEWEB)

    Gevargez, A.; Schirp, S.; Braun, M. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); Groenemeyer, D. [Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum (Germany); EFMT Development and Research Center for Microtherapy, Bochum (Germany)


    Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks. (orig.)

  2. Fabrication of Rare Earth-Doped Transparent Glass Ceramic Optical Fibers by Modified Chemical Vapor Deposition



    International audience; Rare earth (RE) doped silica-based optical fibers with transparent glass ceramic (TGC) core was fabricated through the well-known modified chemical vapor deposition (MCVD) process without going through the commonly used stage of post-ceramming. The main characteristics of the RE-doped oxyde nanoparticles namely, their density and mean diameter in the fibers are dictated by the concentration of alkaline earth element used as phase separating agent. Magnesium and erbium ...

  3. Analytical modeling of the subsurface volatile organic vapor concentration in vapor intrusion. (United States)

    Shen, Rui; Pennell, Kelly G; Suuberg, Eric M


    The inhalation of volatile and semi-volatile organic compounds that intrude from a subsurface contaminant source into indoor air has become the subject of health and safety concerns over the last twenty years. Building subslab and soil gas contaminant vapor concentration sampling have become integral parts of vapor intrusion field investigations. While numerical models can be of use in analyzing field data and in helping understand the subslab and soil gas vapor concentrations, they are not widely used due to the perceived effort in setting them up. In this manuscript, we present a new closed-form analytical expression describing subsurface contaminant vapor concentrations, including subslab vapor concentrations. The expression was derived using Schwarz-Christoffel mapping. Results from this analytical model match well the numerical modeling results. This manuscript also explores the relationship between subslab and exterior soil gas vapor concentrations, and offers insights on what parameters need to receive greater focus in field studies.

  4. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    Energy Technology Data Exchange (ETDEWEB)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer [GATA Medical Faculty, Ankara (Turkmenistan)


    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  5. Acute oral and percutaneous toxicity of pesticides to mallards: Correlations with mammalian toxicity data (United States)

    Hudson, R.H.; Haegele, M.A.; Tucker, R.K.


    Acute oral (po) and 24-hr percutaneous (perc) LD50 values for 21 common pesticides (19 anticholinesterases, of which 18 were organophosphates, and one was a carbamate; one was an organochlorine central nervous system stimulant; and one was an organonitrogen pneumotoxicant) were determined in mallards (Anas platyrhynchos). Three of the pesticides tested were more toxic percutaneously than orally. An index to the percutaneous hazard of a pesticide, the dermal toxicity index (DTI = po LD50/perc LD50 ? 100), was also calculated for each pesticide. These toxicity values in mallards were compared with toxicity data for rats from the literature. Significant positive correlations were found between log po and log percutaneous LD50 values in mallards (r = 0.65, p 0.10). Variations in percutaneous methodologies are discussed with reference to interspecies variation in toxicity values. It is recommended that a mammalian DTI value approaching 30 be used as a guideline for the initiation of percutaneous toxicity studies in birds, when the po LD50 and/or projected percutaneous LD50 are less than expected field exposure levels.

  6. Leidenfrost Vapor Layer Stabilization on Superhydrophobic Surfaces (United States)

    Vakarelski, Ivan; Patankar, Neelesh; Marston, Jeremy; Chan, Derek; Thoroddsen, Sigurdur


    We have performed experiments to investigate the influence of the wettability of a superheated metallic sphere on the stability of a thin vapor layer during the cooling of a sphere immersed in water. For high enough sphere temperatures, a continuous vapor layer (Leidenfrost regime) is observed on the surface of non-superhydrophobic spheres, but below a critical sphere temperature the layer becomes unstable and explosively switches to nuclear boiling regime. In contrast, when the sphere surface is textured and superhydrophobic, the vapor layer is stable and gradually relaxes to the sphere surface until the complete cooling of the sphere, thus avoiding the nuclear boiling transition altogether. This finding could help in the development of heat exchange devices and of vapor layer based drag reducing technologies.

  7. Static Water Vapor Feed Electrolyzer Project (United States)

    National Aeronautics and Space Administration — Development of a static vapor feed electrolyzer utilizing an advanced bipolar plate that produces sub-saturated H2 and O2 is proposed. This novel bipolar design can...

  8. DMSP SSMT/2 - Atmospheric Water Vapor Profiler (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The SSM/T-2 sensor is a five channel, total power microwave radiometer with three channels situated symmetrically about the 183.31 GHz water vapor resonance line and...

  9. Vapor Growth of Alloy-Type Semiconductor Crystals (United States)

    Wiedemeier, H.


    The present effort is part of a continuing research program directed towards the investigation of basic vapor transport phenomena and of crystal growth properties of electronic materials. The primary purpose of ground-based studies is the development and definition of optimum experimental parameters for flight experiments. The ground-based effort includes the investigation of gravity-driven convection effects on mass transport rates and on crystal morphology for different orientations of the density gradient with respect to the gravity vector, and as a function of pressure and of temperature. In addition to the experimental tasks, theoretical efforts involve the quantitative thermodynamic analysis of the systems under investigation, the computation of fluid dynamic parameters, and the consideration of other possible effects on fluid flow under vertical, stabilizing and microgravity conditions. The specific experiments to be performed in a microgravity environment include the investigation of vapor transport and crystal growth phenomena of the GeSe-Xenon system and of the mass flux and growth of bulk and layer-type crystals of Hg sub (1-x) Cd sub x Te using HgI as a transport agent.

  10. Nanometer bismuth oxide produced by resistance heating vapor oxidation

    Institute of Scientific and Technical Information of China (English)

    HU Han-xiang; QIU Ke-qiang


    Bismuth oxide has wide applications in superconductive material, photoelectric material, electronic ceramic, electrolyte, and catalysts. To produce ultrafine bismuth oxide powders, some costly heating sources, such as plasma, high frequency induction, electron beam or laser, have to be used in the conventional vapor oxidation methods. The vapor oxidation method was improved by adding a reducing agent in the reaction system, where heating source was resistance tubular oven, instead of special heat source requirement. Nanometer bismuth oxide was prepared at 1 000-1 140 ℃, and the particle characteristics were investigated by XRD, SEM, DTA, laser sedimentograph. With low oxygen concentration (less than 20%) in the carrier gas, the bismuth oxide particle was near-sphere β-Bi2O3 with uniform and fine particle size (d0.5=65 nm, GSD=1.42); while with higher oxygen content (more than 50%), the powders were mixture of Bi2O2CO3 and β-Bi2O3.

  11. Organophosphate vapor detection on gold electrodes using peptide nanotubes. (United States)

    Baker, Peter A; Goltz, Mark N; Schrand, Amanda M; Yoon, Do Young; Kim, Dong-Shik


    Peptide nanotubes (PNTs) encapsulating horseradish peroxidase and surface coated with acetylcholinesterase (AChE) were attached to gold screen printed electrodes to construct a novel gas phase organophosphate (OP) biosensor. When the sensor with the AChE enzyme is put in contact with acetylthiocholine (ATCh), the ATCh is hydrolyzed to produce thiocholine, which is then oxidized by horseradish peroxidase (HRP). Direct electron transfer between HRP and electrode is achieved through PNTs. The signal produced by the electron transfer is measured with cyclic voltammetry (CV). The presence of an OP compound inhibits this signal by binding with the AChE enzyme. In this study, gas phase malathion was used as a model OP due to the fact that it displays the identical binding mechanism with acetylcholinesterase (AChE) as its more potent counterparts such as sarin and VX, but has low toxicity, making it more practical and safer to handle. The CV signal was proportionally inhibited by malathion vapor concentrations as low as 12 ppbv. Depending on the method used in their preparation, the electrodes maintained their activity for up to 45 days. This research demonstrates the potential of applying nano-modified biosensors for the detection of low levels of OP vapor, an important development in countering weaponized organophosphate nerve agents and detecting commercially-used OP pesticides.

  12. Analytical modeling of the subsurface volatile organic vapor concentration in vapor intrusion


    Shen, Rui; Pennell, Kelly G.; Suuberg, Eric M.


    The inhalation of volatile and semi-volatile organic compounds that intrude from a subsurface contaminant source into indoor air has become the subject of health and safety concerns over the last twenty years. Building subslab and soil gas contaminant vapor concentration sampling have become integral parts of vapor intrusion field investigations. While numerical models can be of use in analyzing field data and in helping understand the subslab and soil gas vapor concentrations, they are not w...

  13. Vapor Pressure of 2-Chlorovinyl Dichloroarsine (Lewisite) (United States)


    Streams of Compounds for Determining Vapor Pressure 11 3. Vapor Pressure of Lewisite I from Multiple Sources: Conant, Sumner, Lewis, Keyes, Price ...number of publications in the open literature by Green and Price ,4 Lewis and Perkins,5 Mann and Pope, Mohler and Polya7 and Gibson and Johnson.8...point. (2) Banks et al.,14 reported that during the fractional distillation of the reaction products of phenyl dichloroarsine and acetylene , 2

  14. Binary Schemes of Vapor Bubble Growth (United States)

    Zudin, Yu. B.


    A problem on spherically symmetric growth of a vapor bubble in an infi nite volume of a uniformly superheated liquid is considered. A description of the limiting schemes of bubble growth is presented. A binary inertial-thermal bubble growth scheme characterized by such specifi c features as the "three quarters" growth law and the effect of "pressure blocking" in a vapor phase is considered.

  15. A heated vapor cell unit for dichroic atomic vapor laser lock in atomic rubidium. (United States)

    McCarron, Daniel J; Hughes, Ifan G; Tierney, Patrick; Cornish, Simon L


    The design and performance of a compact heated vapor cell unit for realizing a dichroic atomic vapor laser lock (DAVLL) for the D(2) transitions in atomic rubidium is described. A 5 cm long vapor cell is placed in a double-solenoid arrangement to produce the required magnetic field; the heat from the solenoid is used to increase the vapor pressure and correspondingly the DAVLL signal. We have characterized experimentally the dependence of important features of the DAVLL signal on magnetic field and cell temperature. For the weaker transitions both the amplitude and gradient of the signal are increased by an order of magnitude.

  16. Vapor Hydrogen Peroxide Sterilization Certification (United States)

    Chen, Fei; Chung, Shirley; Barengoltz, Jack

    For interplanetary missions landing on a planet of potential biological interest, United States NASA planetary protection currently requires that the flight system must be assembled, tested and ultimately launched with the intent of minimizing the bioload taken to and deposited on the planet. Currently the only NASA approved microbial reduction method is dry heat sterilization process. However, with utilization of such elements as highly sophisticated electronics and sensors in modern spacecraft, this process presents significant materials challenges and is thus an undesirable bioburden reduction method to design engineers. The objective of this work is to introduce vapor hydrogen peroxide (VHP) as an alternative to dry heat microbial reduction to meet planetary protection requirements. The VHP sterilization technology is widely used by the medical industry, but high doses of VHP may degrade the performance of flight hardware, or compromise material compatibility. The goal of our study is determine the minimum VHP process conditions for PP acceptable microbial reduction levels. A series of experiments were conducted using Geobacillus stearothermophilus to determine VHP process parameters that provided significant reductions in spore viability while allowing survival of sufficient spores for statistically significant enumeration. In addition to the obvious process parameters -hydrogen peroxide concentration, number of pulses, and exposure duration -the investigation also considered the possible effect of environmental pa-rameters. Temperature, relative humidity, and material substrate effects on lethality were also studied. Based on the results, a most conservative D value was recommended. This recom-mended D value was also validated using VHP "hardy" strains that were isolated from clean-rooms and environmental populations collected from spacecraft relevant areas. The efficiency of VHP at ambient condition as well as VHP material compatibility will also be

  17. Bioeffects due to acoustic droplet vaporization (United States)

    Bull, Joseph


    Encapsulated micro- and nano-droplets can be vaporized via ultrasound, a process termed acoustic droplet vaporization. Our interest is primarily motivated by a developmental gas embolotherapy technique for cancer treatment. In this methodology, infarction of tumors is induced by selectively formed vascular gas bubbles that arise from the acoustic vaporization of vascular microdroplets. Additionally, the microdroplets may be used as vehicles for localized drug delivery, with or without flow occlusion. In this talk, we examine the dynamics of acoustic droplet vaporization through experiments and theoretical/computational fluid mechanics models, and investigate the bioeffects of acoustic droplet vaporization on endothelial cells and in vivo. Early timescale vaporization events, including phase change, are directly visualized using ultra-high speed imaging, and the influence of acoustic parameters on droplet/bubble dynamics is discussed. Acoustic and fluid mechanics parameters affecting the severity of endothelial cell bioeffects are explored. These findings suggest parameter spaces for which bioeffects may be reduced or enhanced, depending on the objective of the therapy. This work was supported by NIH grant R01EB006476.

  18. Percutaneous Revision of a Testicular Prosthesis is Safe, Cost-effective, and Provides Good Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Eugene B. Cone


    Full Text Available Office-based percutaneous revision of a testicular prosthesis has never been reported. A patient received a testicular prosthesis but was dissatisfied with the firmness of the implant. In an office setting, the prosthesis was inflated with additional fluid via a percutaneous approach. Evaluated outcomes included patient satisfaction, prosthesis size, recovery time, and cost savings. The patient was satisfied, with no infection, leak, or complication after more than 1 year of follow-up, at significantly less cost than revision surgery. Percutaneous adjustment of testicular prosthesis fill-volume can be safe, inexpensive, and result in good patient satisfaction.

  19. A case of percutaneous high dose rate brachytherapy for superior pulmonary sulcus tumor

    Energy Technology Data Exchange (ETDEWEB)

    Asakura, Tamaki; Imamura, Masahiro; Murata, Takashi [Kansai Medical Univ., Moriguchi, Osaka (Japan)] [and others


    A 64-year-old man with advanced superior pulmonary sulcus tumor suffered severe unrelieved pain even after chemotherapy, external irradiation and hyperthermia. So we planned to introduce a percutaneous high dose rate brachytherapy using the microselectron HDR {sup 192}Ir. With the estimation using the Pain Score, satisfying pain relief was attainable with a combination of the percutaneous high dose rate brachytherapy and conventional treatment. So the percutaneous high dose rate brachytherapy had the possibility to contribute to the alleviation of the pain. (author)

  20. Percutaneous retrieval of a biliary stent after migration and ileal perforation

    Directory of Open Access Journals (Sweden)

    Cherry Robert A


    Full Text Available Abstract We present a case of a migrated biliary stent that resulted in a distal small bowel perforation, abscess formation and high grade partial small bowel obstruction in a medically stable patient without signs of sepsis or diffuse peritonitis. We performed a percutaneous drainage of the abscess followed by percutaneous retrieval of the stent. The entero-peritoneal fistula closed spontaneously with a drain in place. We conclude, migrated biliary stents associated with perforation distal to the Ligament of Trietz (LOT, may be treated by percutaneous drainage of the abscess and retrieval of the stent from the peritoneal cavity, even when associated with a large intra-abdominal abscess.

  1. Animal Capture Agents (United States)


    agents and delivery systems reviewed . Questionnaires were sent to 137 Air Force bases to obtain information about the chemical agents and delivery systems...used by animal control personnel. A literature review included chemical agents, delivery methods, toxicity information and emergency procedures from...34-like agent. Users should familiarize themselves with catatonia in general and particularly that its successful use as an immobilizer doesn’t necessarily

  2. 33 CFR 154.808 - Vapor control system, general. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Vapor control system, general... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Vapor Control Systems § 154.808 Vapor control system, general. (a) A vapor control system design and installation must...

  3. Intelligent Agents: A Primer. (United States)

    Yu, Edmund; Feldman, Susan


    Provides an in-depth introduction to the various technologies that are bringing intelligent agents into the forefront of information technology, explaining how such agents work, the standards involved, and how agent-based applications can be developed. (Author/AEF)

  4. Reasoning about emotional agents

    NARCIS (Netherlands)

    Meyer, J.-J.


    In this paper we discuss the role of emotions in artificial agent design, and the use of logic in reasoning about the emotional or affective states an agent can reside in. We do so by extending the KARO framework for reasoning about rational agents appropriately. In particular we formalize in this f

  5. Users, Bystanders and Agents

    DEFF Research Database (Denmark)

    Krummheuer, Antonia Lina


    Human-agent interaction (HAI), especially in the field of embodied conversational agents (ECA), is mainly construed as dyadic communication between a human user and a virtual agent. This is despite the fact that many application scenarios for future ECAs involve the presence of others. This paper...

  6. A Kinect™ camera based navigation system for percutaneous abdominal puncture (United States)

    Xiao, Deqiang; Luo, Huoling; Jia, Fucang; Zhang, Yanfang; Li, Yong; Guo, Xuejun; Cai, Wei; Fang, Chihua; Fan, Yingfang; Zheng, Huimin; Hu, Qingmao


    Percutaneous abdominal puncture is a popular interventional method for the management of abdominal tumors. Image-guided puncture can help interventional radiologists improve targeting accuracy. The second generation of Kinect™ was released recently, we developed an optical navigation system to investigate its feasibility for guiding percutaneous abdominal puncture, and compare its performance on needle insertion guidance with that of the first-generation Kinect™. For physical-to-image registration in this system, two surfaces extracted from preoperative CT and intraoperative Kinect™ depth images were matched using an iterative closest point (ICP) algorithm. A 2D shape image-based correspondence searching algorithm was proposed for generating a close initial position before ICP matching. Evaluation experiments were conducted on an abdominal phantom and six beagles in vivo. For phantom study, a two-factor experiment was designed to evaluate the effect of the operator’s skill and trajectory on target positioning error (TPE). A total of 36 needle punctures were tested on a Kinect™ for Windows version 2 (Kinect™ V2). The target registration error (TRE), user error, and TPE are 4.26  ±  1.94 mm, 2.92  ±  1.67 mm, and 5.23  ±  2.29 mm, respectively. No statistically significant differences in TPE regarding operator’s skill and trajectory are observed. Additionally, a Kinect™ for Windows version 1 (Kinect™ V1) was tested with 12 insertions, and the TRE evaluated with the Kinect™ V1 is statistically significantly larger than that with the Kinect™ V2. For the animal experiment, fifteen artificial liver tumors were inserted guided by the navigation system. The TPE was evaluated as 6.40  ±  2.72 mm, and its lateral and longitudinal component were 4.30  ±  2.51 mm and 3.80  ±  3.11 mm, respectively. This study demonstrates that the navigation accuracy of the proposed system is acceptable

  7. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report. (United States)

    Lei, Mingxing; Liu, Yaosheng; Yang, Shaoxing; Jiang, Weigang; Cao, Yuncen; Liu, Shubin


    Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted.

  8. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis

    NARCIS (Netherlands)

    Baal, M.C. van; Santvoort, H.C. van; Bollen, T.L.; Bakker, O.J.; Besselink, M.G.; Gooszen, H.G.


    BACKGROUND: The role of percutaneous catheter drainage (PCD) in patients with (infected) necrotizing pancreatitis was evaluated. METHODS: A systematic literature search was performed. Inclusion criteria were: consecutive cohort of patients with necrotizing pancreatitis undergoing PCD as primary trea

  9. Effect of occlusion on the percutaneous penetration of linoleic acid and glycerol. (United States)

    Taylor, Louise J; Lee, Robert S; Long, Mark; Rawlings, Anthony V; Tubek, Joseph; Whitehead, Lynne; Moss, Gary P


    The effect of occlusion on the in vitro percutaneous absorption of linoleic acid was investigated. A greater skin concentration of linoleic acid from an ethanolic vehicle was observed in non-occluded experiments compared with occluded experiments (Pcyclomethicone). These observations were attributed to the increase in the concentration gradient due to the unimpeded evaporation of volatile solvents, which provided a greater driving force and enhanced non-occluded delivery in these systems, compared with occluded systems. Conversely, the percutaneous absorption of a polar material (glycerol) from an aqueous solution did not yield any such differences. While more conclusive comparisons between volatile and non-volatile solvents and penetrants would be required to substantiate fully these comparisons, it is apparent that non-occlusion of volatile solvents may enhance percutaneous absorption. The physicochemical properties of the penetrant, for example its natural state at skin temperature (i.e. solid or liquid) may further determine the degree of enhanced percutaneous absorption compared with occluded environments.

  10. Successful disintegration, dissolution and drainage of intracholedochal hematoma by percutaneous transhepatic intervention

    Institute of Scientific and Technical Information of China (English)

    Jian-Jie Qin; Yong-Xiang Xia; Ling Lv; Zhao-Jing Wang; Feng Zhang; Xue-Hao Wang; Bei-Cheng Sun


    Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopic retrograde cholangiopancreatography,cholecystectomy,biliary tract surgery,and liver transplantation.Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients.Hemobilia may also be caused by coagulation defects.It can form intracholedochal hematomas,causing obstructive jaundice.Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure.Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation,but in our case,percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot,with a good outcome.

  11. Image-guided percutaneous drainage of an emphysematous bulla with a fluid level

    Directory of Open Access Journals (Sweden)

    Kalra Naveen


    Full Text Available We report here a case of a large emphysematous bulla with a fluid level that was managed successfully by percutaneous catheter drainage in a 50 year-old man with chronic obstructive airway disease.

  12. Pre-treatment with clopidogrel and postprocedure troponin elevation after elective percutaneous coronary intervention

    NARCIS (Netherlands)

    Nienhuis, MB; Ottervanger, JP; Miedema, K; Suryapranata, H; de Boer, MJ; Hoorntje, JCA; van 't Hof, AWJ; Gosselink, M; Zijlstra, F; Dambrink, Jan Hendrik Everwijn


    Elevated troponin after elective percutaneous coronary intervention (PCl) has been associated with a worse prognosis. Pretreatment with clopidogrel may be beneficial in patients undergoing PCl. Therefore, a prospective observational study was conducted to address the potential role of clopidogrel in

  13. Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the effects of trimetazidine therapy on left ventricular(LV)function after percutaneous coronary intervention(PCI).Methods A total of 106 patients with unstable angina pectoris undergoing successful

  14. Percutaneous tracheostomy with the guide wire dilating forceps technique : presentation of 171 consecutive patients

    NARCIS (Netherlands)

    Fikkers, Bernard G; van Heerbeek, Niels; Krabbe, Paul F M; Marres, Henri A M; van den Hoogen, Frank J A


    BACKGROUND: Evaluation of percutaneous tracheostomy (PT) with the guide wire dilating forceps (GWDF) technique. METHODS: Prospective study of perioperative complications, retrospective analysis of early and late complications in an ICU in a teaching university hospital. RESULTS: The success rate of


    Institute of Scientific and Technical Information of China (English)

    ZHAOSheng-Cai; etal.


    A non-incision method of vss occlusion based on the percutaneous injection of polyurethane elastomer solution to form a plug is described. The procedure was conducted under aseptic procedure and local fidocaine anaesthesia. Two different kinds of

  16. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)


    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.

  17. Danish Guidelines 2015 for percutaneous Dilatational Tracheostomy in the Intensive Care Unit

    DEFF Research Database (Denmark)

    Madsen, Kristian Rørbæk; Guldager, Henrik; Rewers, Mikael;


    Percutaneous dilatational tracheostomy is a common procedure in intensive care. This updated Danish national guideline describes indications, contraindications and complications, and gives recommendations for timing, anaesthesia, and technique, use of fibre bronchoscopy and ultrasound guidance...

  18. Targeting reperfusion injury in the era of primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen


    Introduction of reperfusion therapy by primary percutaneous coronary intervention (PCI) has resulted in improved outcomes for patients presenting with ST-segment elevation myocardial infarction. Despite the obvious advantages of primary PCI, acute restoration of blood flow paradoxically also...

  19. Does Imaging Modality Used For Percutaneous Renal Access Make a Difference?

    DEFF Research Database (Denmark)

    Andonian, Sero; Scoffone, Cesare; Louie, Michael K;


    OBJECTIVE To assess peri-operative outcomes of percutaneous nephrolithotomy (PCNL) using ultrasound or fluoroscopic guidance for percutaneous access. METHODS A prospectively collected international CROES database containing 5806 patients treated with PCNL was used for the study. Patients were...... divided into two groups based on the methods of percutaneous access: ultrasound vs. fluoroscopy. Patient characteristics, operative data and post-operative outcomes were compared. RESULTS Percutaneous access was obtained using ultrasound guidance only in 453 patients (13.7%) and fluoroscopic guidance only...... in 2853 patients (86.3%). Comparisons were performed on a matched sample with 453 patients in each group. Frequency and pattern of Clavien complications did not differ between groups (P =.333). However, post-operative hemorrhage and transfusions were significantly higher in the fluoroscopy group: 6.0 vs...

  20. Distal Embolization of Hydrophilic-Coating Material From Coronary Guidewires After Percutaneous Coronary Interventions

    NARCIS (Netherlands)

    Grundeken, Maik J.; Li, Xiaofei; Kurpershoek, C. Eline; Kramer, Miranda C.; Vink, Aryan; Piek, Jan J.; Tijssen, Jan G. P.; Koch, Karel T.; Wykrzykowska, Joanna J.; de Winter, Robbert J.; van der Wal, Allard C.


    Background-Coronary guidewires are indispensable during percutaneous coronary interventions. Nowadays, most guidewires have hydrophilic coatings to improve their trackability, allowing easy lesion passage and facilitating balloon and stent positioning. Recent reports, however, have raised concerns a

  1. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    Bucuras, Viorel; Gopalakrishnam, Ganesh; Wolf, J Stuart;


    The study compared characteristics and outcomes in patients with solitary and bilateral kidneys who were treated with percutaneous nephrolithotomy (PCNL) in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study....

  2. Percutaneous drainage of hydatid cyst in the liver as a primary treatment: Review of 52 consecutive cases with long-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Bosanac, Zeljko B.; Lisanin, Ljubomir


    AIM: To evaluate the suitability of percutaneous drainage as a primary and definitive treatment of hydatid disease of the liver. MATERIALS AND METHODS: Between October 1989 and April 1992, percutaneous drainage was performed on 52 consecutive patients (27 women and 25 men aged 13 to 84 years) with 55 hydatid cysts in the liver. Twenty-five (45%) cysts were type I, 10 (18%) were type II, 14 (25%) were type III, 5 (10%) were type IV and 1 (2%) was type V. All procedures were performed under light sedation and local anaesthetic at the puncture site. The standard Seldinger technique was used. Initial puncture was performed under ultrasound (US) guidance through the liver parenchyma. The rest of the procedure was conducted under fluoroscopic control. Pigtail drainage catheters (size 12-20 Fr) were used, with Betadine (10% povidone iodine; 1% free iodine) being allowed to act within the cyst for 30 min, as a scolicidal agent. RESULTS: All the patients were successfully treated and 6-9 year follow-up involving US, computed tomography (CT) and serology tests showed no local recurrence or spread of the disease. No major (death, cyst rupture, anaphylactic shock) and very few minor complications arose. Two patients had mild skin reaction with nausea requiring no treatment and three patients developed a secondary infection of the cyst, due to prolonged drainage time. These liver abscesses responded successfully to further catheter drainage. Subsequent patients were treated with large bore (18-20 Fr) catheters and none developed secondary infection. Overall drainage time varied from 7-118 days (7-28 days, if we exclude three initial cases who had prolonged drainage). CONCLUSION: It is our strong belief that percutaneous drainage using the above method should be considered a first-line treatment for hydatid disease of the liver. Bosanac, Z.B., Lisanin, L. (2000)

  3. Interventional radiology robot for CT and MRI guided percutaneous interventions. (United States)

    Hungr, Nikolai; Fouard, Céline; Robert, Adeline; Bricault, Ivan; Cinquin, Philippe


    This paper introduces a new patient-mounted CT and MRI guided interventional radiology robot for percutaneous needle interventions. The 5 DOF robot uses ultrasonic motors and pneumatics to position the needle and then insert it progressively. The needle position and inclination can be registered in the images using two strategically placed fiducials visible in both imaging modalities. A first prototype is presented and described in terms of its sterilization, CT and MRI compatibility, and precision. Tests showed that 1) it is entirely sterilizable with hydrogen peroxide gas, 2) no image artifacts or deformations are noticeable in the CT and MRI images, 3) does not affect the SNR of MR images, and 4) its mechanical error is less than 5mm.

  4. A Novel Technique to Prevent Effluent Spillage During Percutaneous Cystolithotripsy

    Directory of Open Access Journals (Sweden)

    Shenoy SP


    Full Text Available Our objective was to design an efficient system for collection of refluxing irrigant during performance of percutaneous cystolithotripsy (PCL to avoid the messy spillage and its undesirable consequences on the patient, the operating team and the operating room environment. A closed drainage system using a long sleeve surgical glove, 10 millimeter laparoscopic trocar, 30 french Amplatz sheath, Y-tubing and linen thread was designed for performing PCL without disconnection during the procedure. While the refluxing effluent was efficiently drained, minimizing spillage, the calculus fragments were collected in a distensible receptacle adjacent to the Amplatz sheath. Three procedures were performed over a year on males with large bladder calculi. The system designed by us was easy to set up, lent itself to easy unhindered performance of the procedure, and spillage of effluent was minimized.

  5. Late Life-Threatening Hemorrhage after Percutaneous Tracheostomy

    Directory of Open Access Journals (Sweden)

    Torsten Richter


    Full Text Available Purpose. Formation of a tracheoinnominate artery fistula (TIF and consecutive hemorrhage is a rare and life-threatening complication with high mortality. Warning symptoms can be absent. The current literature contains only few considerations for misleading signs, especially in cases where the contact between the tissue and the cannula is tight. Method and Results. We report two cases of life-threatening hemorrhages that appeared six days and two months after percutaneous dilatational tracheostomy (PDT in two patients, respectively. In these cases, diagnosis of tracheoinnominate artery fistula (TIF was difficult. Tracheal ring fracture after PDT and pressure ulceration caused by cannula were implicated in TIF formation. The cannula was overblocked to buy time before surgical closure. Both patients survived without any additional neurological deficiency. Conclusion. Massive hemorrhage in patients after tracheostomy is likely due to TIF. Ultrasound scanning before PDT and careful periodical followup of the trachea are required.

  6. Percutaneous laser photocoagulation of osteoid osteomas under CT guidance

    Energy Technology Data Exchange (ETDEWEB)

    Friend, D.E. de; Smith, S.P.; Hughes, P.M


    AIM: The aim was to evaluate laser photocoagulation and the use of the Bonopty needle system in the treatment of osteoid osteoma. MATERIALS AND METHODS: Five patients with osteoid osteomas were treated with computed tomography (CT)-guided, percutaneous laser photocoagulation using the Bonopty biopsy system. RESULTS: Complete pain relief was obtained in four patients. In one patient, pain persisted until the 6 weeks follow-up but resolved within 24 h of repeating the procedure. There were no complications, and patients remained symptom free at follow-up of 4-23 months (mean, 14 months). CONCLUSION: CT-guided laser photocoagulation of osteoid osteoma is a minimally invasive technique that represents a cost-effective alternative to surgical excision. The Bonopty needle system allows successful penetration of the sclerotic bone surrounding the nidus with manual pressure alone.

  7. Impact of stone density on outcomes in percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Anastasiadis, Anastasios; Onal, Bulent; Modi, Pranjal


    Abstract Objective. This study aimed to explore the relationship between stone density and outcomes of percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. Material and methods. Patients undergoing PCNL treatment...... success, particularly at very low HU values. With increasing radiological stone density, operating time decreased to a minimum at approximately 1000 HU, then increased with further increase in stone density. Multivariate non-linear regression analysis showed a similar relationship between the probability...... of a stone-free outcome and stone density. Higher treatment success rates were found with low stone burden, pelvic stone location and use of pneumatic lithotripsy. Conclusions. Very low and high stone densities are associated with lower rates of treatment success and longer operating time in PCNL...

  8. [Nursing care for children undergoing percutaneous endoscopic gastrostomy]. (United States)

    Huang, Mei-Jung; Lin, Chieh-Chung; Cheng, Shue-Lin


    Ever since percutaneous endoscopic gastronomy (PEG) was used for the first time in 1980 by Gauderer, Ponsky, Izant et al., It has been widely used in patients incapable of oral feeding. It is a safe and effective technique for long-term nutritional support in children, and easy to perform, as only local anesthesia or heavy sedation is required PEG can prevent children from suffering from nasopharyngeal and esophageal erosions due to repeated insertion of nasogastric tubes and the complication of aspiration pneumonia. It is therefore an alternative for children who need long-term feeding. In this article we review the literature on PEG and give a full description of its indications, complications, as well as advice on when to change gastrostomy tubes, and on nursing care, in the hope that this will be useful reference material for medical staff.

  9. Percutaneously injectable fetal pacemaker: electronics, pacing thresholds, and power budget. (United States)

    Nicholson, Adriana; Chmait, Ramen; Bar-Cohen, Yaniv; Zheng, Kaihui; Loeb, Gerald E


    We are developing a cardiac pacemaker that is designed to be implanted percutaneously into a fetus to treat complete heart block and consequent hydrops fetalis, which is otherwise fatal. One of the most significant considerations for this device is the technical challenges presented by the battery and charging system. The size of the device is limited to about 3 mm in diameter; batteries on this scale have very small charge capacities. The smaller capacity means that the device needs to be designed so that it uses as little current as possible and so that its battery can be recharged wirelessly. We determined the pacing thresholds for a simple relaxation oscillator that can be assembled from discrete, surface mount components and analyzed the power consumption of the device given different electrode configurations and stimulus parameters. An inductive recharging system will be required for some patients; it is feasible within the package constraints and under development.

  10. Resistant tennis elbow: shock-wave therapy versus percutaneous tenotomy. (United States)

    Radwan, Yasser A; ElSobhi, Gamal; Badawy, Walid S; Reda, Ali; Khalid, Sherif


    Fifty-six patients who suffered from chronic persistent tennis elbow of more than six months duration were randomly assigned to two active treatment groups. Group 1 (n = 29) received high-energy extracorporeal shock wave treatment (ESWT; 1,500 shocks) at 18 kV (0.22 mJ/mm(2)) without local anaesthesia; group 2 (n = 27) underwent percutaneous tenotomy of the common extensor origin. Both groups achieved improvement from the base line at three weeks, six weeks, 12 weeks and 12 months post-intervention. The success rate (Roles and Maudsley score: excellent and good) at three months in the ESWT group was 65.5% and in the tenotomy group was 74.1%. ESWT appeared to be a useful noninvasive treatment method that reduced the necessity for surgical procedures.

  11. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah


    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  12. Mammary tuberculosis: percutaneous treatment of a mammary tuberculous abscess

    Energy Technology Data Exchange (ETDEWEB)

    Romero, C.; Carreira, C.; Cereceda, C.; Pinto, J. [Servicio de Radiologia, Hospital Virgen de la Salud, Toledo (Spain); Lopez, R.; Bolanos, F. [Servicio de Cirugia, Hospital Virgen de la Salud, Toledo (Spain)


    It is currently very rare to find mammary involvement in cases of tuberculosis, in either primary or secondary form. Diagnosis is classically clinical and microbiological, and the basic techniques used in imaging diagnosis are mammography and ultrasound. Computed tomography may define the involvement of the thoracic wall in those cases which present as mammary masses adhering to deep levels, and is also able to evaluate accompanying pulmonary disease, if it is present. Traditionally, treatment has consisted of quadrantectomy and specific antibiotic therapy. We present a case of tuberculous mammary abscess secondary to pulmonary disease, which was treated by percutaneous drainage controlled by CT and specific antibiotic therapy. We revise the diagnosis, differential diagnosis and treatment of mammary tuberculosis. (orig.)

  13. Conservative management of migrated percutaneous endoscopic colostomy tube (United States)

    Chase, Thomas J.G.; Luck, Joshua; Harris, Lauren S.; Bashir, Gareth


    A 68-year-old male nursing home resident presented following dislodgement of a percutaneous endoscopic colostomy (PEC) tube originally sited to prevent recurrent sigmoid volvulus. Computed tomography demonstrated tube migration into the lumen of the recto-sigmoid junction, where it remained for 12 days before passing spontaneously. During this period, the patient remained asymptomatic; the residual colocutaneous fistula functioned as a decompressive valve. Originally, the patient was due to be discharged with early flexible sigmoidoscopy follow-up. However, complex social issues delayed discharge. During his admission, a second PEC tube was successfully inserted next to the previous colostomy site without complication. This is an unusual case and no similar episodes of asymptomatic PEC migration have been reported. We demonstrate that such cases may be offered an appropriate trial of conservative management. Here, we describe our experience and critically appraise the literature. PMID:28064245

  14. Implantation of the CoreValve percutaneous aortic valve. (United States)

    Lamarche, Yoan; Cartier, Raymond; Denault, André Y; Basmadjian, Arsène; Berry, Colin; Laborde, Jean-Claude; Bonan, Raoul


    Surgical aortic valve replacement is the only recommended treatment for significant aortic valve stenosis. Percutaneous aortic valve replacement appears to be a novel option for high-risk patients. We report the implantation of the ReValving system (CoreValve, Paris, France) in a 64-year-old woman who was refused aortic valve replacement surgery for critical aortic stenosis and left ventricular dysfunction because of severe pulmonary fibrosis. After anesthesia, the patient was put on femorofemoral cardiopulmonary bypass, and underwent a balloon valvuloplasty with subsequent retrograde aortic valve replacement by the ReValving system. Transesophageal echocardiographic monitoring of the patient's hemodynamics showed immediate improvements of the valvular area and left ventricular ejection fraction and only traces of paravalvular leaks. The patient was easily weaned from ventilation and resumed activity soon after the surgery. A multidisciplinary approach is presently necessary to offer a reliable and safe procedure.

  15. [Percutaneous alcoholization of simple serous cysts of the kidney]. (United States)

    Aboutaieb, R; Joual, A; Ousehal, A; el Mrini, M; Benjelloun, S


    Benign renal cysts are usually asymptomatic: They require a minimally invasive treatment if they cause complaints such as flank pain or other compressive complications. During a 6 month period, 14 patients were treated for benign renal cyst using an ultrasound guided puncture. Presenting complaints were flank pain (12 cases), hypertension (1 case), polycythaemia (1 case). Only cyst of 5 centimeters diameter or more were assigned to this treatment. After needle puncture, the cyst was evacuated and then filled with sterile 95% alcohol. Clinical and anatomical results, after 6 months, were good in 9 cases, 2 cases showed good anatomical results with persistence of initial symptoms, and there were 3 failures corresponding to large cysts of 10 cm diameter or more. Percutaneous alcoholization of moderate benign cysts is a safe, simple and reliable method.

  16. Percutaneous transhepatic biliary drainage using large needle: Complications and usefulness

    Energy Technology Data Exchange (ETDEWEB)

    Park, Noh Kyoung; Lim, Hyun Yang; Lee, Ji Yeon; Lee, Kil Jun; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)


    To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). 46 patients underwent PTBD in 52 occasions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general condition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. We PTBD using large needle is a simple and safe procedure for prompt bile decompression.

  17. Percutaneous vertebroplasty and kyphoplasty; Perkutane Vertebroplastie und Kyphoplastie

    Energy Technology Data Exchange (ETDEWEB)

    Wetzel, S.G. [Basel Univ. (Switzerland). Abt. fuer Neuroradiologie; Wilhelm, K.E. [Radiologische Universitaetsklinik Bonn (Germany)


    With percutaneous vertebroplasty, a minimal invasive method, bone cement is injected under radiological control into a vertebra. The technique was first applied for treatment of aggressive hemangiomas. Today, osteoporotic compression fractures and other vertebral pathologies that cause pain - foremost metastasis - are the main indications for PVP. Kyphoplasty (KP) is closely related to PVP; with this technique expandable balloons are introduced into a vertebra and the cavity is then filled with bone cement. Apart from pain treatment and stabilisation of the vertebra, the aim of the method is to restore and correct a local kyphosis. In this article the indications for both PVP and KP are discussed and the value of an interdisciplinary discussion that takes alternative therapeutic methods into account is stressed. Additionally, the technical aspects and the potential complications of the methods are explained. Finally, the therapeutic results of PVP and KP are reviewed in light of published results and our own experiences. (orig.)

  18. [Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis: A Case Report]. (United States)

    Oida, Takeshi; Kanemitsu, Toshiyuki; Hayashi, Tetsuya; Fujimoto, Nobumasa; Koide, Takuo


    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0.17-1.8%, for which PNL and TUL are frequently used. Although considered to be accompanied with risks of bleeding, bowel injury, and renal dysfunction, PNL is effective for urinary lithiasis after renal transplantation. TUL is less invasive, but access may be difficult when the ureter has an unusual course or ureteral stricture exists, as in our patient.

  19. Triple-Vessel Percutaneous Coronary Revascularization In Situs Inversus Dextrocardia

    Directory of Open Access Journals (Sweden)

    Nikolaos Kakouros


    Full Text Available Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population.

  20. Percutaneous CT-guided treatment of recurrent spinal cyst hydatid. (United States)

    Ozdemir, Ozgur; Calisaneller, Tarkan; Yildirim, Erkan; Altinors, Nur


    The involvement of spinal column in cyst hydatid disease is rare and hard to treat. The gold standard treatment is total removal of the cysts without rupture. However, recurrence after surgery is almost inevitable and reoperations carries technical difficulties and higher morbidity. We present a 69-year-old woman with two cystic masses at the T12 level, which compress the spinal cord causing severe paresis in her left leg. Under local anestesia, the cysts were aspirated and irrigated with 20% hypertonic saline solution via bilateral T12 transpedicular route. We aimed to report that percutaneous CT guided treatment should be considered as an alternative therapeutic option in case of recurrent spinal cyst hydatid.

  1. Percutaneous cardioscopy of the left ventricle in patients with myocarditis (United States)

    Uchida, Yasumi; Tomaru, Takanobu; Nakamura, Fumitaka; Oshima, Tomomitsu; Fujimori, Yoshiharu; Hirose, Junichi


    The morphology and function of the cardiac chambers have been evaluated clinically using cineventriculography, computed tomography, magnetic resonance imaging, and endomyocardial biopsy. Excluding the invasive technique of biopsy where tissue is actually removed, these other non-invasive techniques reveal only indirect evidence of endocardial and subendocardial pathology and, therefore, allow the potential for misdiagnosis from insufficient data. Fiberoptic examinations, as recently demonstrated in coronary, pulmonary, and peripheral vessels, allow direct observation of pathology otherwise unobtainable. Recently, similar techniques have been applied to examine the cardiac chambers of dogs and the right heart of humans. In this study, we examine the feasibility and safety of percutaneous fiberoptic cardioscopy of the left ventricle in patients with myocarditis.

  2. On the use of abciximab in percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Iversen, Allan


    ) with intravenous (IV) abciximab in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), and one section concerning results from 3 registry studies on the effect of abciximab in distinct subgroups of patients with acute coronary syndrome......PCI. Recommendations on the use of abciximab in this setting are based on trials showing clinical benefit of IV bolus of abciximab compared to placebo. However, it has been speculated, that by administering the initial bolus of abciximab IC, a higher local concentration of the drug could be obtained, and this might...... might benefit more than others, and that abciximab might even be harmful in yet others. Although data are not consistent, suggestions have been made, that risk factors, such as diabetes, age and complexity of the coronary lesions might influence the efficacy of abciximab. Objectives and methods...

  3. Quality of life after percutaneous coronary intervention: part 1. (United States)

    Cassar, Stephen; R Baldacchino, Donia

    Quality of life (QOL) is a complex concept comprised of biopsychosocial, spiritual and environmental dimensions. However, the majority of research addresses only its physical function perspectives. This two-part series examines the holistic perspective of QOL of patients after percutaneous coronary intervention (PCI). Part 1 explains the research process of a cross-sectional descriptive study and its limitations. Data were collected by a mailed WHOQOL-BREF questionnaire in Maltese from a systematic sample of patients who had undergone PCI; the response rate was 64% (n=228; males n=169, females n=59, age 40-89 years). Part 1 also considers limitations, such as its cross-sectional design and retrospective data collection. The hierarchy of human needs theory (Maslow, 1999) guided the study. Part 2 gives the findings on the holistic view of QOL. Having social and family support, as a characteristic of Maltese culture appeared to contribute towards a better QOL.

  4. Assessment of a percutaneous iliosacral screw insertion simulator

    CERN Document Server

    Tonetti, J; Girard, P; Dubois, M; Merloz, P; Troccaz, Jocelyne; 10.1016/j.otsr.2009.07.005


    BACKGROUND: Navigational simulator use for specialized training purposes is rather uncommon in orthopaedic and trauma surgery. However, it reveals providing a valuable tool to train orthopaedic surgeons and help them to plan complex surgical procedures. PURPOSE: This work's objective was to assess educational efficiency of a path simulator under fluoroscopic guidance applied to sacroiliac joint percutaneous screw fixation. MATERIALS AND METHODS: We evaluated 23 surgeons' accuracy inserting a guide-wire in a human cadaver experiment, following a pre-established procedure. These medical trainees were defined in three prospective respects: novice or skilled; with or without theoretical knowledge; with or without surgical procedure familiarity. Analysed criteria for each tested surgeon included the number of intraoperative X-rays taken in order to achieve the surgical procedure as well as an iatrogenic index reflecting the surgeon's ability to detect any hazardous trajectory at the time of performing said procedu...

  5. Influence of Soil Moisture on Soil Gas Vapor Concentration for Vapor Intrusion. (United States)

    Shen, Rui; Pennell, Kelly G; Suuberg, Eric M


    Mathematical models have been widely used in analyzing the effects of various environmental factors in the vapor intrusion process. Soil moisture content is one of the key factors determining the subsurface vapor concentration profile. This manuscript considers the effects of soil moisture profiles on the soil gas vapor concentration away from any surface capping by buildings or pavement. The "open field" soil gas vapor concentration profile is observed to be sensitive to the soil moisture distribution. The van Genuchten relations can be used for describing the soil moisture retention curve, and give results consistent with the results from a previous experimental study. Other modeling methods that account for soil moisture are evaluated. These modeling results are also compared with the measured subsurface concentration profiles in the U.S. EPA vapor intrusion database.

  6. Acute Obstructive Cholangitis after Transarterial Chemoembolization: the Effect of Percutaneous Transhepatic Removal of Tumor Fragment

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyu Ho; Cho, Young Kwon; An, Jin Kyung; Woo, Jeong Joo; Kim, Hyun Sook; Choi, Yun Sun [Eulji Medical Center, Eulji University College of Medicine, Seoul (Korea, Republic of)


    Acute obstructive cholangitis due to the migration of necrotized tumor fragment is a rare complication occurring after a transarterial chemoembolization. The percutaneous tumor removal procedure following percutaneous transhepatic biliary drainage is an appropriate treatment over endoscopic removal for the relief of acute cholangitis in this case. Following this serial management, no invasive hepatocellular carcinoma of the bile duct recurred after two years of follow-up.

  7. Percutaneous puncture of spinal cysts in the diagnosis and therapy of syringomyelia and cystic tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Babin, E.; Wackenheim, A.; Maitrot, D.; Bonneville, J.F.


    The experience with percutaneous puncture of intraspinal cystic lesions is reported in cases: an extradural cyst demonstrated with air, a spinal cord tumor with lipiodol and two cases of syringomyelia with metrizamide. Percutaneous puncture of cystic lesions makes possible an accurate delineation of the lesion and a histological approach through biochemical and cytological analysis of the aspirated cystic fluid, while aspiration of the fluid of cystic tumors decompresses the spinal cord and thus plays a therapeutic role.

  8. A Rare And Life Threatening Complication Of Percutaneously Inserted Central Venous Catheters: Cardiac Tamponade.

    Directory of Open Access Journals (Sweden)

    seyma Kayali


    Full Text Available Percutaneously inserted central venous catheters are commonly used to provide parenteral nutrition for premature neonates. This study presents report of two preterm neonates who developed pericardial effusion resulting from osmotic damage of parenteral nutrition. When a neonate with percutaneously inserted central venous catheter clinical status worsens a high index of clinical suspicion for diagnosing pericardial effusion and immediate treatment might be life saving. [J Contemp Med 2016; 6(3.000: 226-230

  9. AB095. Five concerns need to be pay attention to in percutaneous nephrolithotomy


    Zhang, Xiaochun


    Objective To recommend our clinical experiences in five important concerns which common to be met in percutaneous nephrolithotomy (PCNL), helping the beginners easy to handle this kind of procedures. Methods Review PCNL in ten years in our hospital, we analyzed five important aspects which could influence the results of operations. Include selection of access site, loss of percutaneous access while dilation, different methods of stone fragmentation, controlling pressure of irrigation in PCNL,...

  10. Prevention of contrast-induced nephropathy in STEMI patients undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Busch, Sarah Victoria Ekeløf; Jensen, Svend Eggert; Rosenberg, Jacob;


    Objective: To evaluate the current prophylactic strategies against CIN in patients with STEMI treated by primary percutaneous coronary intervention. Background: Contrast-induced nephropathy (CIN) is the third leading course of acute renal failure and a recognized complication to cardiac catheteri......Objective: To evaluate the current prophylactic strategies against CIN in patients with STEMI treated by primary percutaneous coronary intervention. Background: Contrast-induced nephropathy (CIN) is the third leading course of acute renal failure and a recognized complication to cardiac...

  11. Diagnostic and therapeutical aspects of antegrade uretero-pyelography in percutaneous nephro-pyelostomy in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Helmig, F.J.; Wisser, J.; Fendel, H.


    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  12. [Diagnostic and therapeutic aspects of antegrade ureteropyelography and percutaneous nephropyelostomy in childhood]. (United States)

    Schneider, K; Helmig, F J; Wisser, J; Fendel, H


    In a sample of 18 children aging one day to eighteen years 21 percutaneous nephrostomies and 27 antegrade pyelographies were performed using sonography and fluoroscopy. Thirteen patients had both nephrostomy and pyelography and 5 had only pyelography. Three of 13 patients needed bilateral nephrostomies. The results indicate that the combination of percutaneous nephrostomy and antegrade pyelography is helpful in diagnosis and treatment of various obstructive disorders of the urinary tract especially in the newborn period.

  13. Percutaneous pancreatic stent placement for postoperative pancreaticojejunostomy stenosis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Koo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)


    Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach.

  14. [Percutaneous treatment of calculosis in caliceal diverticulosis: 13-year experience]. (United States)

    Lancini, V; Liatsikos, E N; Bernardo, N O; Dinlenc, C Z; Kapoor, R; Smith, A D


    We report our experience with the composition and management of caliceal diverticular stones for the past 13 years at our institution. Fourty patients with caliceal diverticular stones were treated percutaneously at Long Island Jewish Medical Center. The size of the diverticula ranged from 1 to 4.8 cm, with a mean size of 2.27 cm. The stone size ranged from 0.2 to 4.5 cm in diameter with an average of 1.7 cm. Twenty patients underwent a metabolic evaluation. Follow-up ranged from 8 months to 140 months with a mean of 72.5 months. We achieved a stone free rate of 95%. All 40 patients were free of pain and infection. The chemical composition of stones was identified in 38 patients. Twelve patients were found to have mainly calcium phosphate stones, 16 mainly calcium oxalate stones, 7 mainly uric acid stones and 3 were found with milk of calcium in their diverticulum. Thirty-five patients had complete resolution of their diverticula with normal urograms. The remaining 5 patients had at least 50% diminution of the diverticulum size. No one of the latter patients was found to have stone recurrence. Metabolic evaluation of the 40 patients showed in the 75% of the cases any metabolic abnormality, an absorptive hypercalciuria type II in two patients (10%), hyperuricosuric hypercalciuria in two cases (10%) and hyperoxaluria in one (5%). Percutaneous management of caliceal diverticular stones is a safe and effective modality compared to the existing alternative procedures reported in the literature.

  15. Percutaneous thermal ablation of renal neoplasms; Perkutane Thermoablation von Nierentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J. [Inst. fuer Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau (Germany); Mahnken, A.H.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)


    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  16. Vapor scavenging by atmospheric aerosol particles

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, E.


    Particle growth due to vapor scavenging was studied using both experimental and computational techniques. Vapor scavenging by particles is an important physical process in the atmosphere because it can result in changes to particle properties (e.g., size, shape, composition, and activity) and, thus, influence atmospheric phenomena in which particles play a role, such as cloud formation and long range transport. The influence of organic vapor on the evolution of a particle mass size distribution was investigated using a modified version of MAEROS (a multicomponent aerosol dynamics code). The modeling study attempted to identify the sources of organic aerosol observed by Novakov and Penner (1993) in a field study in Puerto Rico. Experimentally, vapor scavenging and particle growth were investigated using two techniques. The influence of the presence of organic vapor on the particle`s hydroscopicity was investigated using an electrodynamic balance. The charge on a particle was investigated theoretically and experimentally. A prototype apparatus--the refractive index thermal diffusion chamber (RITDC)--was developed to study multiple particles in the same environment at the same time.

  17. Explosive vapor detection payload for small robots (United States)

    Stimac, Phil J.; Pettit, Michael; Wetzel, John P.; Haas, John W.


    Detection of explosive hazards is a critical component of enabling and improving operational mobility and protection of US Forces. The Autonomous Mine Detection System (AMDS) developed by the US Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD) is addressing this challenge for dismounted soldiers. Under the AMDS program, ARA has developed a vapor sampling system that enhances the detection of explosive residues using commercial-off-the-shelf (COTS) sensors. The Explosives Hazard Trace Detection (EHTD) payload is designed for plug-and-play installation and operation on small robotic platforms, addressing critical Army needs for more safely detecting concealed or exposed explosives in areas such as culverts, walls and vehicles. In this paper, we describe the development, robotic integration and performance of the explosive vapor sampling system, which consists of a sampling "head," a vapor transport tube and an extendable "boom." The sampling head and transport tube are integrated with the boom, allowing samples to be collected from targeted surfaces up to 7-ft away from the robotic platform. During sample collection, an IR lamp in the sampling head is used to heat a suspected object/surface and the vapors are drawn through the heated vapor transport tube to an ion mobility spectrometer (IMS) for detection. The EHTD payload is capable of quickly (less than 30 seconds) detecting explosives such as TNT, PETN, and RDX at nanogram levels on common surfaces (brick, concrete, wood, glass, etc.).

  18. A Numerical Investigation of Vapor Intrusion — the Dynamic Response of Contaminant Vapors to Rainfall Events (United States)

    Shen, Rui; Pennell, Kelly G.; Suuberg, Eric M.


    The U.S. government and various agencies have published guidelines for field investigation of vapor intrusion, most of which suggest soil gas sampling as an integral part of the investigation. Contaminant soil gas data are often relatively more stable than indoor air vapor concentration measurements, but meteorological conditions might influence soil gas values. Although a few field and numerical studies have considered some temporal effects on soil gas vapor transport, a full explanation of the contaminant vapor concentration response to rainfall events is not available. This manuscript seeks to demonstrate the effects on soil vapor transport during and after different rainfall events, by applying a coupled numerical model of fluid flow and vapor transport. Both a single rainfall event and seasonal rainfall events were modeled. For the single rainfall event models, the vapor response process could be divided into three steps: namely, infiltration, water redistribution, and establishment of a water lens atop the groundwater source. In the infiltration step, rainfall intensity was found to determine the speed of the wetting front and wash-out effect on the vapor. The passage of the wetting front led to an increase of the vapor concentration in both the infiltration and water redistribution steps and this effect is noted at soil probes located 1 m below the ground surface. When the mixing of groundwater with infiltrated water was not allowed, a clean water lens accumulated above the groundwater source and led to a capping effect which can reduce diffusion rates of contaminant from the source. Seasonal rainfall with short time intervals involved superposition of the individual rainfall events. This modeling results indicated that for relatively deeper soil that the infiltration wetting front could not flood, the effects were damped out in less than a month after rain; while in the long term (years), possible formation of a water lens played a larger role in

  19. A numerical investigation of vapor intrusion--the dynamic response of contaminant vapors to rainfall events. (United States)

    Shen, Rui; Pennell, Kelly G; Suuberg, Eric M


    The U.S. government and various agencies have published guidelines for field investigation of vapor intrusion, most of which suggest soil gas sampling as an integral part of the investigation. Contaminant soil gas data are often relatively more stable than indoor air vapor concentration measurements, but meteorological conditions might influence soil gas values. Although a few field and numerical studies have considered some temporal effects on soil gas vapor transport, a full explanation of the contaminant vapor concentration response to rainfall events is not available. This manuscript seeks to demonstrate the effects on soil vapor transport during and after different rainfall events, by applying a coupled numerical model of fluid flow and vapor transport. Both a single rainfall event and seasonal rainfall events were modeled. For the single rainfall event models, the vapor response process could be divided into three steps: namely, infiltration, water redistribution, and establishment of a water lens atop the groundwater source. In the infiltration step, rainfall intensity was found to determine the speed of the wetting front and wash-out effect on the vapor. The passage of the wetting front led to an increase of the vapor concentration in both the infiltration and water redistribution steps and this effect is noted at soil probes located 1m below the ground surface. When the mixing of groundwater with infiltrated water was not allowed, a clean water lens accumulated above the groundwater source and led to a capping effect which can reduce diffusion rates of contaminant from the source. Seasonal rainfall with short time intervals involved superposition of the individual rainfall events. This modeling results indicated that for relatively deeper soil that the infiltration wetting front could not flood, the effects were damped out in less than a month after rain; while in the long term (years), possible formation of a water lens played a larger role in determining

  20. Moral actor, selfish agent. (United States)

    Frimer, Jeremy A; Schaefer, Nicola K; Oakes, Harrison


    People are motivated to behave selfishly while appearing moral. This tension gives rise to 2 divergently motivated selves. The actor-the watched self-tends to be moral; the agent-the self as executor-tends to be selfish. Three studies present direct evidence of the actor's and agent's distinct motives. To recruit the self-as-actor, we asked people to rate the importance of various goals. To recruit the self-as-agent, we asked people to describe their goals verbally. In Study 1, actors claimed their goals were equally about helping the self and others (viz., moral); agents claimed their goals were primarily about helping the self (viz., selfish). This disparity was evident in both individualist and collectivist cultures, attesting to the universality of the selfish agent. Study 2 compared actors' and agents' motives to those of people role-playing highly prosocial or selfish exemplars. In content (Study 2a) and in the impressions they made on an outside observer (Study 2b), actors' motives were similar to those of the prosocial role-players, whereas agents' motives were similar to those of the selfish role-players. Study 3 accounted for the difference between the actor and agent: Participants claimed that their agent's motives were the more realistic and that their actor's motives were the more idealistic. The selfish agent/moral actor duality may account for why implicit and explicit measures of the same construct diverge, and why feeling watched brings out the better angels of human nature.

  1. CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Jae; Choi, A. Lam; Yie, Mi-Yeon; Yoon, Ji Young; Jeon, Eui Yong; Koh, Sung Hye; Yoon, Dae Young; Lim, Kyung Ja (Dept. of Radiology, Hallym Univ. Sacred Heart Hospital, Seoul (Korea)), e-mail:; Im, Hyoung June (Dept. of Occupational Medicine, Hallym Univ. College of Medicine, Seoul (Korea))


    Background: Percutaneous injection of bone cement (acrylic cement) during percutaneous kyphoplasty and vertebroplasty can cause symptomatic or asymptomatic complications due to leakage, extravasation or vascular migration of cement. Purpose: To investigate and to compare the incidence and site of local leakage or complications of bone cement after percutaneous kyphoplasty and vertebroplasty using bone cement. Material and Methods: We retrospectively reviewed 473 cases of percutaneous kyphoplasty or vertebroplasty performed under fluoroscopic guidance. Of the 473 cases, follow-up CT scans that covered the treated bones were available for 83 cases (59 kyphoplasty and 24 vertebroplasty). Results: The rate of local leakage of bone cement was 87.5% (21/24) for percutaneous vertebroplasty and 49.2% (29/59) for kyphoplasty. The most common site of local leakage was perivertebral soft tissue (n=8, 38.1%) for vertebroplasty. The most common site of local leakage was a perivertebral vein (n=7, 24.1%) for kyphoplasty. Two cases of pulmonary cement embolism developed: one case after kyphoplasty and one case after vertebroplasty. Conclusion: Local leakage of bone cement was more common for percutaneous vertebroplasty compared with kyphoplasty (P<0.005). The most common sites of local leakage were perivertebral soft tissue and perivertebral vein.

  2. Ilio-psoas abscess in the paediatric population: treatment by US-guided percutaneous drainage

    Energy Technology Data Exchange (ETDEWEB)

    Kang, M.; Gupta, S.; Gulati, M.; Suri, S. [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh 160012 (India)


    Background. Image-guided percutaneous drainage has been shown to be a safe and effective alternative to surgery in the management of psoas abscess in adults and adolescents. There is little information on its use in children. Objective. To evaluate the safety and efficacy of US-guided percutaneous needle aspiration and catheter drainage of ilio-psoas abscesses. Materials and methods. A retrospective review of 14 children with 16 ilio-psoas abscesses (10 pyogenic and 4 tuberculous) who were treated by US-guided percutaneous needle aspiration (n = 5) or catheter drainage (n = 9) along with appropriate antimicrobial therapy. Results. Percutaneous treatment was successful in 10 of the 14 patients; all showed clinical improvement within 24-48 h of drainage and subsequent imaging demonstrated resolution of the abscess cavities. Surgery was avoided in all of these ten patients except one, who underwent open surgical drainage of ipsilateral hip joint pus. Of the other four patients, two had to undergo surgical drainage of the ilio-psoas abscesses after failure of percutaneous treatment, one improved with antibiotics after needle aspiration failed to yield any pus, and one died of continuing staphylococcal septicaemia within 24 h of the procedure. There were no procedural complications. Conclusions. Percutaneous drainage represents an effective alternative to surgical drainage as a supplement to medical therapy in the management of children with ilio-psoas abscesses. (orig.) With 2 figs., 11 refs.

  3. Mobile agent security using proxy-agents and trusted domains


    Mitrovic, Nikola; Arronategui Arribalzaga, Unai


    Commercial or wide-network deployment of Mobile Agent Systems is not possible without satisfying security architecture. In this paper we propose architecture for secure Mobile Agent Systems, using Trusted Domains and Proxy agents. Existing approaches are based on security services at the level of an agent system, library or specific objects. Our concept uses proxy agents to enable transparent security services both to security-aware mobile agents and legacy agents. Per-agent and domain-level...



    Maleković, Mirko; Čubrilo, Mirko


    [n this paper, we characterize the integrated agent in multi-agent systems. The following result is proved: if a multi-agent system is reflexive (symmetric, transitive, Euclidean) then the integrated agent of the multi-agent system is reflexive (symmetric, transitive, Euclidean), respectively. We also prove that the analogous result does not hold for multi-agent system's serial ness. A knowledge relationship between the integrated agent and agents in a multiagent system is presented.

  5. Serum biomarkers and source of inflammation in acute coronary syndromes and percutaneous coronary interventions. (United States)

    Centurión, Osmar Antonio


    There is robust information that confirms the enormous contribution of inflammation to plaque development, progression and vulnerability. The presence of plaques with inflammatory components associates with a greater likelihood of future cardiovascular events. The inflammatory cascade has been implicated during the entire plaque formation, from the early stages of endothelial dysfunction to the development of acute coronary syndromes (ACS). The presence of macrophages, T lymphocytes, dendritic cells, and mast cells in atherosclerotic lesions; the detection of HLA class II antigen expression; and the finding of secretion of several cytokines point to the involvement of immune inflammatory mechanisms in the pathogenesis of atherosclerosis. Serum biomarkers reflecting the activity of biological processes involved in plaque growth or destabilization may provide great help in establishing the appropriate clinical management, and therapeutic interventions. Evidence for a role of inflammation in plaque rupture has been demonstrated by localization of inflammation at plaque rupture sites. However, the focus of inflammation may not precisely reside within the coronary vessel itself but rather in the injured myocardium distal to the disrupted plaque. These observations outline the potential benefits of therapies targeting inflammation in the arterial wall and cardiovascular system. Emerging anti-inflammatory approaches to vascular protection have the potential to benefit patients by marked reductions in serum biomarkers of inflammation and reduce vascular events. With ongoing technical advances, percutaneous coronary interventions (PCI) will continue to play a critical role in the evaluation of novel compounds designed to modulate inflammation. The constant refinements in the different therapeutic strategies, the combination of scientific understanding in the adequate utilization of novel inflammatory markers, the new pharmacologic agents, and the new techniques in PCI will

  6. Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver. (United States)

    de Leede, Eleonora M; Burgmans, Mark C; Martini, Christian H; Tijl, Fred G J; van Erkel, Arian R; Vuyk, Jaap; Kapiteijn, Ellen; Verhoef, Cornelis; van de Velde, Cornelis J H; Vahrmeijer, Alexander L


    Unresectable liver metastases of colorectal cancer can be treated with systemic chemotherapy, aiming to limit the disease, extend survival or turn unresectable metastases into resectable ones. Some patients however, suffer from side effects or progression under systemic treatment. For patients with metastasized uveal melanoma there are no standard systemic therapy options. For patients without extrahepatic disease, isolated liver perfusion (IHP) may enable local disease control with limited systemic side effects. Previously, this was performed during open surgery with satisfying results, but morbidity and mortality related to the open procedure, prohibited a widespread application. Therefore, percutaneous hepatic perfusion (PHP) with simultaneous chemofiltration was developed. Besides decreasing morbidity and mortality, this procedure can be repeated, hopefully leading to a higher response rate and improved survival (by local control of disease). During PHP, catheters are placed in the proper hepatic artery, to infuse the chemotherapeutic agent, and in the inferior caval vein to aspirate the chemosaturated blood returning through the hepatic veins. The caval vein catheter is a double balloon catheter that prohibits leakage into the systemic circulation. The blood returning from the hepatic veins is aspirated through the catheter fenestrations and then perfused through an extra-corporeal filtration system. After filtration, the blood is returned to the patient by a third catheter in the right internal jugular vein. During PHP a high dose of melphalan is infused into the liver, which is toxic and would lead to life threatening complications when administered systemically. Because of the significant hemodynamic instability resulting from the combination of caval vein occlusion and chemofiltration, hemodynamic monitoring and hemodynamic support is of paramount importance during this complex procedure.

  7. Water vapor release from biofuel combustion (United States)

    Parmar, R. S.; Welling, M.; Andreae, M. O.; Helas, G.


    We report on the emission of water vapor from biofuel combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are compared to carbon in the biofuel. Fuel types included hardwood (oak and African musasa), softwood (pine and spruce, partly with green needles), and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the emissions from 16 combustion experiments ranged from 1.2 to 3.7 on average, indicating the presence of water that is not chemically bound. This biofuel moisture content ranged from 33% in the dry African hardwood, musasa, to 220% in fresh pine branches with needles. The moisture content from fresh biofuel contributes distinctly to the water vapor in biomass burning emissions, and its influence on meteorology needs to be evaluated.

  8. Water vapor release from biomass combustion (United States)

    Parmar, R. S.; Welling, M.; Andreae, M. O.; Helas, G.


    We report on the emission of water vapor from biomass combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are referenced to carbon in the biomass. The investigated fuel types include hardwood (oak and African musasa), softwood (pine and spruce, partly with green needles), and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the emissions from 16 combustion experiments ranged from 1.2 to 3.7, indicating the presence of water that is not chemically bound. This non-bound biomass moisture content ranged from 33% in the dry African hardwood, musasa, to 220% in fresh pine branches with needles. The moisture content from fresh biomass contributes significantly to the water vapor in biomass burning emissions, and its influence on the behavior of fire plumes and pyro-cumulus clouds needs to be evaluated.

  9. Water vapor release from biofuel combustion

    Directory of Open Access Journals (Sweden)

    R. S. Parmar


    Full Text Available We report on the emission of water vapor from biofuel combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are compared to carbon in the biofuel. Fuel types included hardwood (oak and African musasa, softwood (pine and spruce, partly with green needles, and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the emissions from 16 combustion experiments ranged from 1.2 to 3.7 on average, indicating the presence of water that is not chemically bound. This biofuel moisture content ranged from 33% in the dry African hardwood, musasa, to 220% in fresh pine branches with needles. The moisture content from fresh biofuel contributes distinctly to the water vapor in biomass burning emissions, and its influence on meteorology needs to be evaluated.

  10. Possible seasonal variability of mesospheric water vapor (United States)

    Bevilacqua, R. M.; Schwartz, P. R.; Wilson, W. J.; Ricketts, W. B.; Howard, R. J.


    Ground-based spectral line measurements of the 22.2 GHz water vapor line in atmospheric emission were made at the Jet Propulsion Laboratory, which have been used to deduce the mesospheric water vapor profile. The measurements were made nearly continuously in the spring and early summer of 1984. The results indicate a temporal increase in the water vapor mixing ratio in the upper mesosphere from April through June. At 75 km, this increase is nearly by a factor of 2. Comparison of the present results with the results of a similar series of measurements made at the Haystack (radio astronomy) Observatory indicate that this temporal increase is part of a seasonal variation.

  11. The use of percutaneous left ventricular assist device in high-risk percutaneous coronary intervention and cardiogenic shock. (United States)

    Akhondi, Andre Babak; Lee, Michael S


    Patients with high-risk coronary lesions may be denied coronary artery bypass grafting due to excessive comorbidities. Percutaneous coronary intervention (PCI) may be a feasible revascularization strategy in high-risk patients who present with ST-elevation myocardial infarction and cardiogenic shock. Historically, the use if intra-aortic balloon pump (IABP) has been used in high-risk PCI and cardiogenic shock. However, recent data has shown that elective IABP insertion did not reduce the incidence of major cardiovascular events following PCI. The use of a left ventricular assist device is a reasonable and safe alternative compared with IABP counterpulsation, giving greater cardiac output and hemodynamic support in patients undergoing high-risk PCI and in those with severe cardiogenic shock. This review outlines a case of severe cardiogenic shock and hemodynamic instability where high-risk PCI is a reasonable option.

  12. Agent Architectures for Compliance (United States)

    Burgemeestre, Brigitte; Hulstijn, Joris; Tan, Yao-Hua

    A Normative Multi-Agent System consists of autonomous agents who must comply with social norms. Different kinds of norms make different assumptions about the cognitive architecture of the agents. For example, a principle-based norm assumes that agents can reflect upon the consequences of their actions; a rule-based formulation only assumes that agents can avoid violations. In this paper we present several cognitive agent architectures for self-monitoring and compliance. We show how different assumptions about the cognitive architecture lead to different information needs when assessing compliance. The approach is validated with a case study of horizontal monitoring, an approach to corporate tax auditing recently introduced by the Dutch Customs and Tax Authority.

  13. Value of percutaneous radiofrequency ablation with or without percutaneous vertebroplasty for pain relief and functional recovery in painful bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Clarencon, Frederic; Jean, Betty; Cormier, Evelyne; Chiras, Jacques [Pitie-Salpetriere Hospital, Department of Neuroradiology, Paris (France); Pham, Hang-Phuong; Bensimon, Gilbert [Pitie-Salpetriere Hospital, Department of Clinical Pharmacology, Paris (France); Rose, Michele [Pitie-Salpetriere Hospital, Department of Critical Care, Paris (France); Maksud, Philippe [Pitie-Salpetriere Hospital, Assistance Publique des, Hopitaux de Paris, Department of Nuclear Medicine, Paris (France)


    To evaluate the effectiveness of percutaneous radiofrequency (RF) ablation with or without percutaneous vertebroplasty (PV) on pain relief, functional recovery and local recurrence at 6 months' follow-up (FU), in patients with painful osseous metastases. Thirty RF ablations were performed in 24 patients (mean age: 61 years) with bone metastases. Half of the patients had an additional PV. The primary end point was pain relief evaluated by a visual analogue scale (VAS) before treatment, and at 1 and 6 months' FU. Functional outcome was assessed according to the evolution of their ability to walk at 6 months' FU. Imaging FU was available in 20 out of 24 patients with a mean delay of 4.7 months. Reduction of pain was obtained at 6 months FU in 81% of cases (15 out of 18). Mean pretreatment VAS was 6.4 ({+-}2.7). Mean VAS was 1.9 ({+-}2.4) at 1 month FU, and 2.3 ({+-}2.9) at 6 months' FU. Pain was significantly reduced at 6 months FU (mean VAS reduction = 4.1; P < 0.00001). Functional improvement was obtained in 74% of the cases. Major complications rate was 12.5 % (3 out of 24) with 2 skin burns, and 1 case of myelopathy. Local tumour recurrence or progression was recorded in 5 cases. Radiofrequency ablation is an effective technique in terms of pain relief and functional recovery for the treatment of bone metastases, which provides a relatively low rate of local recurrence. (orig.)

  14. Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell's disease: A retrospective study

    Directory of Open Access Journals (Sweden)

    Guang-Quan Zhang


    Full Text Available Background: Post traumatic osteonecrosis of a vertebral body occurring in a delayed fashion was first described by the German doctor Kümmell in 1895. Several studies have reported percutaneous vertebroplasty (PVP, or percutaneous kyphoplasty (PKP for Kümmell's disease achieves good outcomes. However, it is unknown whether a technique is superior for the treatment of this disease. The objective of the study is to compare the efficacy of PVP and PKP for the treatment of Kümmell's disease. Materials and Methods: A retrospective review was conducted for 73 patients with Kümmell's disease. PVP was performed in 38 patients and PKP in 35 patients. Visual analogue score (VAS was used to evaluate pain. The anterior vertebral height was measured. The operative time, the incidence of cement leakage and the costs were recorded. Results: In both PVP group and PKP group, the VAS and anterior vertebral height significantly improved at 1-day postoperatively (P 0.05. Between the PVP and PKP groups, there were no significant differences in VAS and the anterior vertebral height at 1-day postoperatively and at the final followup (P > 0.05. The operating time and expense in the PKP group were higher than the PVP group (P < 0.001. Cement leakages in the PKP group were fewer than PVP group (P < 0.05. Conclusions: PVP is a faster, less expensive option that still provides a comparable pain relief and restoration of vertebral height to PKP for the treatment of Kümmell's disease. PKP has a significant advantage over PVP in term of the fewer cement leakages.

  15. Drag Reduction by Leidenfrost Vapor Layers

    KAUST Repository

    Vakarelski, Ivan Uriev


    We demonstrate and quantify a highly effective drag reduction technique that exploits the Leidenfrost effect to create a continuous and robust lubricating vapor layer on the surface of a heated solid sphere moving in a liquid. Using high-speed video, we show that such vapor layers can reduce the hydrodynamic drag by over 85%. These results appear to approach the ultimate limit of drag reduction possible by different methods based on gas-layer lubrication and can stimulate the development of related energy saving technologies.

  16. Drag Reduction by Leidenfrost Vapor Layers (United States)

    Vakarelski, Ivan U.; Marston, Jeremy O.; Chan, Derek Y. C.; Thoroddsen, Sigurdur T.


    We demonstrate and quantify a highly effective drag reduction technique that exploits the Leidenfrost effect to create a continuous and robust lubricating vapor layer on the surface of a heated solid sphere moving in a liquid. Using high-speed video, we show that such vapor layers can reduce the hydrodynamic drag by over 85%. These results appear to approach the ultimate limit of drag reduction possible by different methods based on gas-layer lubrication and can stimulate the development of related energy saving technologies.

  17. Water vapor release from biomass combustion


    Parmar, R. S.; Welling, M.; Andreae, M. O.; G. Helas


    We report on the emission of water vapor from biomass combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are referenced to carbon in the biomass. The investigated fuel types include hardwood (oak and African musasa), softwood (pine and spruce, partly with green needles), and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the ...

  18. Water vapor release from biofuel combustion


    Parmar, R. S.; Welling, M.; Andreae, M. O.; G. Helas


    We report on the emission of water vapor from biofuel combustion. Concurrent measurements of carbon monoxide and carbon dioxide are used to scale the concentrations of water vapor found, and are compared to carbon in the biofuel. Fuel types included hardwood (oak and African musasa), softwood (pine and spruce, partly with green needles), and African savanna grass. The session-averaged ratio of H2O to the sum of CO and CO2 in the emissions from 16 ...

  19. Guidance on Soil Vapor Extraction Optimization (United States)


    343 Table LNAPL DNAPL Source: after USEPA 1991 draw\\$vehandbk3.cdr aee p1 4/5/01 M~ssive Clay ) . ’C. ~AA_··’’’· --V,V~ . >:’ .’ ’·Sand...for removing orgamc contaminants with a vapor pressure greater than 0.5 mm mercury (Hg) at 200 Celsius (C). This includes common chlorinated solvents...liquids ( DNAPLs ), solvent vapors, or dissolved contaminants. • Depth to groundwater, seasonal variations, recharge and discharge information including

  20. Decontamination Data - Blister Agents (United States)

    U.S. Environmental Protection Agency — Decontamination efficacy data for blister agents on various building materials using various decontamination solutions. This dataset is associated with the following...

  1. Optimization of penetrating agents in Gushang Gel Paste%骨伤凝胶膏剂中促渗剂的优选研究

    Institute of Scientific and Technical Information of China (English)

    李学敏; 吴清; 范峥; 杨银花; 杜守颖; 龚卫红


    Objective To optimize the penetrating agents for Gushang Gel Paste, and study their percutaneous absorption behavior and release rate in vitro. Methods Franzs diffusion cell test and HPLC were applied to optimize the penetrating agents for Gushang Gel Paste and their percutaneous absorption and release rate were detected taken normal saline water as reception liquid, and 24-hour accumulative osmosis dose and anatonosis times of naringin as indexes. Results When taking azone and propylene glycol as penetrating agents the percutaneous absorption was good, and finally the ratio of azone to propylene glycol was set at 1: 1 with a dose of 5%. The accumulative release rate of naringin was 83.48% and accumulative percutaneous absorption was 46.59%. The release in vitro and percutaneous absorption all accorded with Weibull distribution equation. Conclusion When azone and propylene glycol are added into Gushang Gel Paste, the percutaneous absorption of which is increased significantly, and the percutaneous absorption and release rate are favorable.%目的 优选骨伤凝胶膏剂的促渗剂,研究其透皮吸收行为和体外释放度.方法 采用改良Franzs扩散池法,生理盐水为接受液,用高效液相色谱法测定,以柚皮苷24 h累积透过量和增渗倍数为指标,优选骨伤凝胶膏剂的促渗剂并测定其释放度和透皮吸收情况.结果 选用氮酮和丙二醇为促渗剂时,透皮吸收较好,最后确定氮酮和丙二醇的比例为(1∶ 1),用量为5%;柚皮苷24 h累积释放率为83.48%,累积透皮吸收率为46.59%,体外释药和透皮吸收均符合威布尔分布方程.结论 骨伤凝胶膏剂加入氮酮和丙二醇后,透皮吸收明显增加,透皮吸收和释药均良好.

  2. Optical droplet vaporization of micron-sized perfluorocarbon droplets and their photoacoustic detection (United States)

    Strohm, Eric; Rui, Min; Gorelikov, Ivan; Matsuura, Naomi; Kolios, Michael


    An acoustic and photoacoustic characterization of micron-sized perfluorocarbon (PFC) droplets is presented. PFC droplets are currently being investigated as acoustic and photoacoustic contrast agents and as cancer therapy agents. Pulse echo measurements at 375 MHz were used to determine the diameter, ranging from 3.2 to 6.5 μm, and the sound velocity, ranging from 311 to 406 m/s of nine droplets. An average sound velocity of 379 +/- 18 m/s was calculated for droplets larger than the ultrasound beam width of 4.0 μm. Optical droplet vaporization, where vaporization of a single droplet occurred upon laser irradiation of sufficient intensity, was verified using pulse echo acoustic methods. The ultrasonic backscatter amplitude, acoustic impedance and attenuation increased after vaporization, consistent with a phase change from a liquid to gas core. Photoacoustic measurements were used to compare the spectra of three droplets ranging in diameter from 3.0 to 6.2 μm to a theoretical model. Good agreement in the spectral features was observed over the bandwidth of the 375 MHz transducer.

  3. Change Agent Survival Guide (United States)

    Dunbar, Folwell L.


    Consulting is a rough racket. Only a tarantula hair above IRS agents, meter maids and used car sales people, the profession is a prickly burr for slings and arrows. Throw in education, focus on dysfunctional schools and call oneself a "change agent," and this bad rap all but disappears. Unfortunately, though, consulting/coaching/mentoring in…

  4. Agents in domestic environments

    NARCIS (Netherlands)

    Moergestel, Leo van; Langerak, Wouter; Meerstra, Glenn; Nieuwenburg, Niels van; Pape, Franc; Telgen, Daniël; Puik, Erik; Meyer, John-Jules


    Athor supplied : "This paper describes an agent-based architecture for domotics. This architecture is based on requirements about expandability and hardware independence. The heart of the system is a multi-agent system. This system is distributed over several platforms to open the possibility to ti

  5. Microbial growth with vapor-phase substrate

    NARCIS (Netherlands)

    Hanzel, J.; Thullner, M.; Harms, H.; Wick, L.Y.


    Limited information exists on influences of the diffusive transport of volatile organic contaminants (VOC) on bacterial activity in the unsaturated zone of the terrestrial subsurface. Diffusion of VOC in the vapor-phase is much more efficient than in water and results in effective VOC transport and

  6. Vaporization of atherosclerotic plaques by spark erosion

    NARCIS (Netherlands)

    C.J. Slager (Cornelis); C.E. Essed; J.C.H. Schuurbiers (Johan); N. Bom (Klaas); P.W.J.C. Serruys (Patrick); G.T. Meester (Geert)


    textabstractAn alternative to the laser irradiation of atherosclerotic lesions has been developed. A pulsed electrocardiogram R wave-triggered electrical spark erosion technique is described. Controlled vaporization of fibrous and lipid plaques with minimal thermal side effects was achieved and docu

  7. Chemical vapor deposition of mullite coatings (United States)

    Sarin, Vinod; Mulpuri, Rao


    This invention is directed to the creation of crystalline mullite coatings having uniform microstructure by chemical vapor deposition (CVD). The process comprises the steps of establishing a flow of reactants which will yield mullite in a CVD reactor, and depositing a crystalline coating from the reactant flow. The process will yield crystalline coatings which are dense and of uniform thickness.

  8. Thermodynamics of incongruently vaporizing tungsten diselenide

    Energy Technology Data Exchange (ETDEWEB)

    Schiffman, R.A.; Franzen, H.F.; Ziegler, R.J.


    The incongruent vaporization of WSe/sub 2/ was investigated by a simultaneous weight-loss-mass-spectrometric Knudsen effusion technique in the temperature range 1290-1720 K. For the reaction (1/2)WSe/sub 2/(s) ..-->.. (1/2)W(s) + Se(g), 298//sup 0/ = 311 +/- 3 kJ/mol.

  9. Atomic lithium vapor laser isotope separation

    CERN Document Server

    Olivares, I E


    An atomic vapor laser isotope separation in lithium was performed using tunable diode lasers. The method permits also the separation of the isotopes between the sup 6 LiD sub 2 and the sup 7 LiD sub 1 lines using a self-made mass separator which includes a magnetic sector and an ion beam designed for lithium. (Author)

  10. Vaporization of synthetic fuels. Final report. [Thesis

    Energy Technology Data Exchange (ETDEWEB)

    Sirignano, W.A.; Yao, S.C.; Tong, A.Y.; Talley, D.


    The problem of transient droplet vaporization in a hot convective environment is examined. The main objective of the present study is to develop an algorithm for the droplet vaporization which is simple enough to be feasibly incorporated into a complete spray combustion analysis and yet will also account for the important physics such as liquid-phase internal circulation, unsteady droplet heating and axisymmetric gas-phase convection. A simplified liquid-phase model has been obtained based on the assumption of the existence of a Hill's spherical vortex inside the droplet together with some approximations made in the governing diffusion equation. The use of the simplified model in a spray situation has also been examined. It has been found that droplet heating and vaporization are essentially unsteady and droplet temperature is nonuniform for a significant portion of its lifetime. It has also been found that the droplet vaporization characteristic can be quite sensitive to the particular liquid-phase and gas-phase models. The results of the various models are compared with the existing experimental data. Due to large scattering in the experimental measurements, particularly the droplet diameter, no definite conclusion can be drawn based on the experimental data. Finally, certain research problems which are related to the present study are suggested for future studies.

  11. Percutaneous Release of the First Dorsal Extensor Compartment: A Cadaver Study (United States)

    Güleç, Ali; Türkmen, Faik; Toker, Serdar


    Background: To evaluate the efficiency of the percutaneous 18-G needle technique in releasing the fibro-osseous sheath over the first dorsal extensor compartment of the hand. Methods: Using anatomic landmarks, percutaneous release was performed with an 18-G needle on 48 wrists of 24 cadavers. The specimens were then dissected and examined for the completeness of the first dorsal extensor compartment release and any tendon or neurovascular injuries. The tunnel length, number of abductor pollicis longus and extensor pollicis brevis tendons, presence of an intertendinous septum, and the effects of these parameters on percutaneous release were evaluated. Results: Percutaneous release was performed on all of the wrists, and the evaluation of the adequacy of release revealed 25 complete releases, 21 partial releases, and 2 missed releases. There were 19 cases of tendon complications. No neurovascular injuries were noted. The mean tunnel length was 2.66 ± 30 cm, and the mean number of tendons was 2.75 ± 0.86. A septum was present in 33.3% of cases. Tunnel length and tendon number had no statistically significant effect on release, whereas the presence of a septum was significantly associated with inadequate tunnel release and the development of tendon complications. Conclusions: Percutaneous release of the first dorsal extensor compartment using an 18-G needle was associated with high rates of incomplete release and tendon damage in the presence of an intertendinous septum. Further study is required under ultrasound guidance to determine the usefulness of percutaneous release in the first dorsal extensor compartment. Clinical Relevance: Release with a percutaneous needle tip in De Quervain’s syndrome may provide the advantages of better cosmetic results with less scar formation and an early return to work. PMID:27826460

  12. Asimovian Adaptive Agents

    CERN Document Server

    Gordon, D F


    The goal of this research is to develop agents that are adaptive and predictable and timely. At first blush, these three requirements seem contradictory. For example, adaptation risks introducing undesirable side effects, thereby making agents' behavior less predictable. Furthermore, although formal verification can assist in ensuring behavioral predictability, it is known to be time-consuming. Our solution to the challenge of satisfying all three requirements is the following. Agents have finite-state automaton plans, which are adapted online via evolutionary learning (perturbation) operators. To ensure that critical behavioral constraints are always satisfied, agents' plans are first formally verified. They are then reverified after every adaptation. If reverification concludes that constraints are violated, the plans are repaired. The main objective of this paper is to improve the efficiency of reverification after learning, so that agents have a sufficiently rapid response time. We present two solutions: ...

  13. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; Design of a prospective randomized controlled trial

    NARCIS (Netherlands)

    P.A. Brouwer (Patrick); W.C. Peul (Wilco); R. Brand (René); M.P. Arts (Mark); B.W. Koes (Bart); A.A. van den Berg (Annette); M.A. van Buchem (Mark)


    textabstractBackground. The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser

  14. Percutaneous Anterior Column Fixation for Acetabulum Fractures, Does It Have to Be Difficult?-The New Axial Pedicle View of the Anterior Column for Percutaneous Fixation. (United States)

    Zhang, Lihai; Zhang, Wei; Mullis, Brian; Liu, Daohong; Xiong, Qi; Lv, Houchen; Ji, Xinran; Peng, Ye; Tang, Peifu


    Anterior column percutaneous screw fixation can be challenging. The purpose of this new technique is to offer a rapid, simple, and safe method to place an anterior screw. The authors used a 3-dimensional reconstruction simulation, cadaver study, and a clinical case series to demonstrate this new alternative to standard previously described techniques.

  15. Assisted circulation using the Tandemheart®, percutaneous transseptal left ventricular assist device, during percutaneous aortic valve implantation: The Rotterdam experience

    NARCIS (Netherlands)

    P. Vranckx (Pascal); A. Otten (Amber); C.J. Schultz (Carl); R.T. van Domburg (Ron); P.P.T. de Jaegere (Peter); P.W.J.C. Serruys (Patrick)


    textabstractAims: The morbidity and mortality of surgical aortic valve replacement are increased in elderly patients with multiple high risk comorbid conditions. Percutaneous prosthetic aortic valve replacement (PAVR) via the femoral arterial approach is feasible in selected patients, who are poor o

  16. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    Directory of Open Access Journals (Sweden)

    Mohinder Kaushal


    Full Text Available Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive “Arthrospine assisted percutaneous technique for lumbar discectomy” is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30° arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods: 150 patients suffering from lumbar disc herniations were operated between January 2004 and December 2012 by indiginously designed Arthrospine system and were evaluated retrospectively. In lumbar discectomy group, there were 85 males and 65 females aged between 18 and 72 years (mean, 38.4 years. The delay between onset of symptoms to surgery was between 3 months to 7 years. Levels operated upon included L1-L2 (n = 3, L2-L3 (n = 2, L3-L4 (n = 8, L4-L5 (n = 90, and L5-S1 (n = 47. Ninety patients had radiculopathy on right side and 60 on left side. There were 22 central, 88 paracentral, 12 contained, 3 extraforaminal, and 25 sequestrated herniations. Standard protocol of preoperative blood tests, x-ray LS Spine and pre operative MRI and pre anaesthetic evaluation for anaesthesia was done in all cases. Technique comprised localization of symptomatic level followed by percutaneous dilatation and insertion of a newly devised arthrospine system devise over a dilator through a 15 mm skin and fascial incision. Arthro/endoscopic discectomy was then carried out by 30° arthroscope and conventional disc surgery instruments. Results: Based on modified Macnab's criteria, of 150 patients operated for lumbar discectomy, 136 (90% patients had excellent to good, 12 (8% had fair, and 2 patients (1.3% had poor results. The complications observed were discitis in 3 patients (2%, dural tear in 4 patients (2.6%, and nerve root injury in 2 patients (1.3%. About 90% patients

  17. A two-dimensional mathematical model of percutaneous drug absorption

    Directory of Open Access Journals (Sweden)

    Kubota K


    Full Text Available Abstract Background When a drug is applied on the skin surface, the concentration of the drug accumulated in the skin and the amount of the drug eliminated into the blood vessel depend on the value of a parameter, r. The values of r depend on the amount of diffusion and the normalized skin-capillary clearence. It is defined as the ratio of the steady-state drug concentration at the skin-capillary boundary to that at the skin-surface in one-dimensional models. The present paper studies the effect of the parameter values, when the region of contact of the skin with the drug, is a line segment on the skin surface. Methods Though a simple one-dimensional model is often useful to describe percutaneous drug absorption, it may be better represented by multi-dimensional models. A two-dimensional mathematical model is developed for percutaneous absorption of a drug, which may be used when the diffusion of the drug in the direction parallel to the skin surface must be examined, as well as in the direction into the skin, examined in one-dimensional models. This model consists of a linear second-order parabolic equation with appropriate initial conditions and boundary conditions. These boundary conditions are of Dirichlet type, Neumann type or Robin type. A finite-difference method which maintains second-order accuracy in space along the boundary, is developed to solve the parabolic equation. Extrapolation in time is applied to improve the accuracy in time. Solution of the parabolic equation gives the concentration of the drug in the skin at a given time. Results Simulation of the numerical methods described is carried out with various values of the parameter r. The illustrations are given in the form of figures. Conclusion Based on the values of r, conclusions are drawn about (1 the flow rate of the drug, (2 the flux and the cumulative amount of drug eliminated into the receptor cell, (3 the steady-state value of the flux, (4 the time to reach the steady

  18. Employment of vapor pressure data in the description of vapor-liquid equilibrium with direct method

    Energy Technology Data Exchange (ETDEWEB)

    Morbidelli, M.; Carra, S.


    A general procedure for inserting vapor-pressure data of pure components into equations of state provides a straightforward scheme for the extension of direct methods to the study of phase equilibria of polar mixtures and of solutions containing nonvolatile electrolytes. It makes the equation of state applicable to all compounds and to the shole temperature range and more accurate in the prediction of both multicomponent and pure vapor-liquid equilibria.

  19. Biological warfare agents

    Directory of Open Access Journals (Sweden)

    Duraipandian Thavaselvam


    Full Text Available The recent bioterrorist attacks using anthrax spores have emphasized the need to detect and decontaminate critical facilities in the shortest possible time. There has been a remarkable progress in the detection, protection and decontamination of biological warfare agents as many instrumentation platforms and detection methodologies are developed and commissioned. Even then the threat of biological warfare agents and their use in bioterrorist attacks still remain a leading cause of global concern. Furthermore in the past decade there have been threats due to the emerging new diseases and also the re-emergence of old diseases and development of antimicrobial resistance and spread to new geographical regions. The preparedness against these agents need complete knowledge about the disease, better research and training facilities, diagnostic facilities and improved public health system. This review on the biological warfare agents will provide information on the biological warfare agents, their mode of transmission and spread and also the detection systems available to detect them. In addition the current information on the availability of commercially available and developing technologies against biological warfare agents has also been discussed. The risk that arise due to the use of these agents in warfare or bioterrorism related scenario can be mitigated with the availability of improved detection technologies.

  20. 33 CFR 154.826 - Vapor compressors and blowers. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Vapor compressors and blowers....826 Vapor compressors and blowers. (a) Each inlet and outlet to a compressor or blower which handles...) Excessive shaft bearing temperature. (d) If a centrifugal compressor, fan, or lobe blower handles vapor...