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Sample records for balloon enteroscopy-assisted ercp

  1. Single- and double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y plus hepaticojejunostomy anastomosis and Whipple resection.

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    Itokawa, Fumihide; Itoi, Takao; Ishii, Kentaro; Sofuni, Atsushi; Moriyasu, Fuminori

    2014-04-01

    In patients with Roux-en-Y hepaticojejunostomy (HJ with R-Y) and Whipple resection, endoscopic retrograde cholangiopancreatography (ERCP) can be challenging. We report our experience with ERCP using balloon-assisted enteroscopy (BAE) (BAE-ERCP) in patients with HJ with R-Y, and Whipple resection. BAE-ERCP procedures were carried out in 62 patients (HJ with R-Y:Whipple resection=34:28). Overall, the rates of reaching the anastomosis were 85.3% (29/34) in HJ with R-Y and 96.4% (27/28) in Whipple resection. In terms of HJ with R-Y, insertion success rate by standard single-balloon enteroscopy (SBE) was 89.3% (25/28). Insertion success rate by short BAE, including SBE and double-balloon enteroscopy (DBE), was 50% (3/6). There was a statistically significant difference of insertion success rate between standard long BE and short BE (P=0.021). However, in the Whipple patients, insertion success rate by standard and short SBE was 93.8% (15/16) and 91.7% (11/12), respectively. Initial insertion success rate by short BAE in Whipple patients was significantly higher than in HJ with R-Y (91.7% vs 50%, P=0.045). Therapeutic interventions included dilation of anastomosis stricture, stone extraction, endoscopic mechanical lithotripsy, biliary stent placement, stent extraction, endoscopic nasobiliary drainage, direct cholangioscopy, and electrohydraulic lithotripsy. Our HJ with R-Y series and Whipple series treatment success rate was 90% (18/20) and 95.0% (19/20), respectively. BAE-ERCP enabled ERCP to be carried out in patients with HJ. It is considered safe and feasible. Further experience and device improvement are needed. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  2. ERCP with the Balloon-Assisted Enteroscopy Technique : A Systematic Review

    NARCIS (Netherlands)

    Koornstra, Jan J.; Fry, Lucia; Moenkemueller, Klaus

    2008-01-01

    Background: Endoscopic retrograde cholangiopancreatography (ERCP) is generally difficult with conventional instruments in patients with surgically altered gastrointestinal anatomy. Balloon-assisted enteroscopy is a relatively new technique that allows for access to the papilla of Vater or a

  3. Nonradiation ERCP with endoscopic biliary sphincterotomy plus papillary balloon dilation for the treatment of choledocholithiasis during pregnancy.

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    Ersoz, Galip; Turan, Ilker; Tekin, Fatih; Ozutemiz, Omer; Tekesin, Oktay

    2016-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is currently the treatment of choice for symptomatic choledocholithiasis in pregnant patients. We aimed to present our experience with pregnant patients who underwent nonradiation ERCP and to evaluate the safety and efficacy of a new technique. A retrospective analysis of nonradiation ERCP in 22 pregnant patients with symptomatic choledocholithiasis between January 2002 and December 2013 was performed. The bile aspiration technique with wire-guided sphincterotome was used to confirm selective biliary cannulation. Transpapillary pancreatic septotomy was performed in cases with difficult biliary cannulation (n = 3). After endoscopic biliary sphincterotomy, endoscopic papillary balloon dilation was performed with a 6- or 8-mm dilation balloon in all patients to reduce the risk of recurrent cholangitis because of residual or additional stones. Stones were extracted by balloon sweeping after dilation. All patients were followed for 6 months after the ERCP procedure. Biliary cannulation was achieved in all patients. Endoscopic papillary balloon dilation was performed with a 6-mm balloon in 17 patients and an 8-mm balloon in five patients. The stones were extracted in 18 of the 22 patients by balloon sweeping, but no stones were extracted in the remaining four patients. There were two cases of mild post-ERCP pancreatitis. All patients delivered at term, and none experienced recurrence of choledocholithiasis and/or cholangitis during the 6-month follow-up. Endoscopic biliary sphincterotomy plus endoscopic papillary balloon dilation in nonradiation ERCP is a safe and effective treatment method for symptomatic choledocholithiasis during pregnancy.

  4. ERCP via gastrostomy vs. double balloon enteroscopy in patients with prior bariatric Roux-en-Y gastric bypass surgery.

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    Choi, Eun Kwang; Chiorean, Michael V; Coté, Gregory A; El Hajj, Ihab I; El Hajj, Ihab; Ballard, Darren; Fogel, Evan L; Watkins, James L; McHenry, Lee; Sherman, Stuart; Lehman, Glen A

    2013-08-01

    Roux-en-Y gastric bypass (RYGB) is the most common bariatric surgery. The performance of ERCP in bariatric RYGB is challenging due to the long Roux limb. We herein compared the indications and technical outcomes of ERCP via percutaneous gastrostomy (GERCP) and double balloon enteroscopy (DBERCP) for patients with prior bariatric RYGB anatomy. Between December 2005 and November 2011, consecutive ERCP patients who had undergone RYGB were identified using a prospectively maintained electronic ERCP database. Medical records were abstracted for ERCP indications and outcomes. In most cases, the gastrostomy was done by either laparoscopic or open surgery and allowed to mature at least 1 month before performing ERCP. The choice of route for ERCP was at discretion of managing physician. Forty-four patients (F = 42) with GERCP and 28 patients (F = 26) with DBERCP were identified. The mean age was younger in GERCP than DBERCP (44.8 vs. 56.1, p successful in all but two (97 %), whereas duct cannulation and interventions were successful in all. In DBERCP, the success rate of accessing major papilla, cannulation and therapeutic intervention was 78, 63, 56 %, respectively. There was one (3.1 %) post-ERCP pancreatitis in DBERCP. Complications occurred in 11 GERCP procedures (14.5 %) and 10 were related to the gastrostomy. This was significantly higher than that of DBERCP (p = 0.022). GERCP is more effective than DBERCP in gaining access to the pancreatobiliary tree in patients with RYGB, but it is hindered by the gastrostomy maturation delay and a higher morbidity. Technical improvements in each method are needed.

  5. ERCP atlas

    International Nuclear Information System (INIS)

    Pott, G.; Schrameyer, B.

    1989-01-01

    Endoscopic-retrograde cholangio-pancreatography is a diagnostic tool that has become a routine method also in medical centres other than those specializing in the field of gastroenterology. It is estimated that there are about 1000 hospitals in the Federal Republic of Germany applying cholangio-pancreatography as a diagnostic method. Frequently, data interpretation is difficult, because imaging of subsequently detected lesions is found to have been insufficiently differential, or incomplete. The experienced examiner, who knows the pathological processes involved and hence to be expected, will perform the ERCP examination in a specific manner, i.e. purposefully. The ERCP atlas now presents a selection of typical, frequently found conditions, and of rarely encountered lesions. The material has been chosen from a total of 15 000 retrograde cholangio-pancreatographies. The introductory text is relatively short, as it is not so much intended to enhance experienced readers' skill in endoscopic diagnostics, - there is other literature for this purpose -, but rather as a brief survey for less experienced readers. (orig./MG) With 280 figs [de

  6. Complications of ERCP.

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    Talukdar, Rupjyoti

    2016-10-01

    Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP. However, head to head RCTs comparing PD stents with NSAIDs would be required to confirm this. Other complications include ERCP induced bleeding, perforation, and cholangitis. Bleeding is related to morphological, procedural, and patient related factors. Early identification and correction of the risk factors are of paramount importance in preventing bleeding. Risk of infection is particularly high during ERCP. It is important to ensure complete drainage of obstructed biliary system in order to reduce the risk of post-ERCP cholangitis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Feasibility of nonradiation EUS-based ERCP in patients with uncomplicated choledocholithiasis (with video).

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    Shah, Janak N; Bhat, Yasser M; Hamerski, Chris M; Kane, Steve D; Binmoeller, Kenneth F

    2016-11-01

    ERCP inherently involves radiation exposure. Nonradiation ERCP has been described in pregnancy. Theoretically, the same techniques could be applied to the general population. We prospectively assessed the feasibility of nonradiation, EUS-based ERCP in nonpregnant patients with choledocholithiasis. Consecutive patients referred for ERCP for choledocholithiasis were recruited over a 1-year period. Patients providing study consent underwent the following procedural protocol. First, EUS was performed to verify the presence, size, and number of stones. Second, biliary cannulation was attempted without fluoroscopy for a maximum of 10 minutes. Selective cannulation was based on deep insertion with visible bile in the catheter on aspiration. Third, for stone removal, sphincterotomy was performed and stones were removed using a basket or balloon. The number of stones exiting the papilla was matched to the number seen on EUS. Finally, once the duct was deemed clear by the endoscopist, a final occlusion cholangiogram and ductal sweep served as the reference standard for confirmation of stone clearance. Nonradiation ERCP was attempted in 31 patients. Cannulation without fluoroscopy was successful in 26 patients (84%). Complete stone removal without fluoroscopy was achieved in all 26 of these cases. The 5 patients with failed nonfluoroscopic cannulation required double guidewire (n = 2) or precut papillotomy (n = 3) for deep biliary access and subsequent stone clearance. One patient who required precut papillotomy for access developed moderate post-ERCP pancreatitis (3%). Nonradiation, EUS-based ERCP for uncomplicated choledocholithiasis appears to be successful and safe. (Clinical trial registration number: NCT01678391.). Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  8. Liver parenchumography following endoscopic retrograde cholangiopancreatography (ERCP)

    International Nuclear Information System (INIS)

    Revert, A.; Arana, E.; Pertejo, V.; Berenguer, M.; Masip, M.J.

    1998-01-01

    Focal liver opacification during endoscopic retrograde cholangiography (ERCP) is an uncommon complication caused by excessive pressure during contrast injection. In this situation, ERCP must be interrupted and the position of the cannula checked. We recommend that these images be excluded from the diagnosis of tumor or cystic cavities. 4 refs

  9. ERCP as an outpatient treatment : a review

    NARCIS (Netherlands)

    Jeurnink, Suzanne M.; Poley, Jan Werner; Steyerberg, Ewout W.; Kuipers, Ernst J.; Siersema, Peter D.

    Background: ERCP on an outpatient basis could be as safe as on an inpatient basis and may also reduce medical costs. Objective: To review the available literature to determine the safety of an ERCP performed on an outpatient basis. Design: A review of the published literature was performed by

  10. Application of computed radiography to ERCP

    International Nuclear Information System (INIS)

    Lee, Shigeki; Mochizuki, Fukuji; Fujita, Naotaka; Itoh, Shoichiro; Ikeda, Takashi; Toyohara, Tokiaki; Matsumoto, Kyoichi

    1984-01-01

    Computed radiography technic was applied to ERCP. Fuji Computed Radiography System was used. The pancreatogram obtained by this method was compared with that of conventional screen-film radiograph. The much finer changes of the pancreatogram can be delineated by the new method. The diagnostic ability of ERCP is thus enhanced by the introduction of FCR. (author)

  11. ERCP

    Science.gov (United States)

    ... through the mouth. It goes through the esophagus (food pipe) and stomach until it reaches the duodenum (the part of the small intestine that is closest to the stomach). You should not feel discomfort, and may have little memory of the test. You may gag as the ...

  12. Cerebral air embolism after ERCP.

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    Trabanco, Sonia; Pardo, Sara; Williams, Mónica; Diaz, Javier; Ruiz, Cristina

    2017-02-01

    Digestive endoscopic procedures have become increasingly common diagnostic and therapeutic procedures in hospitals. Generally they are safe procedures and complications, though infrequent, can occur and are potentially lethal. As the number of procedures performed increases, the complications arising are likely to become more frequent, so it is advisable to bear this in mind when establishing early diagnosis and treatment. Cerebral air embolism is a rare complication after a digestive endoscopic procedure, although in the case of endoscopic retrograde cholangiopancreatography (ERCP), may be as high as 10%. In such cases there are usually local circumstances exist favoring the entry of air into the bloodstream, and in some cases it is the presence of a patent foramen ovale that favors the passage of air into the arterial system. The clinical signs and symptoms will depend on the speed and volume of the air infused and on the territory affected, and in some cases the consequences may be fatal. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Frequency and risk factors in the post-ercp pancreatitis in a tertiary care centre

    International Nuclear Information System (INIS)

    Leghari, A.; Ghazanfar, S.; Qureshi, S.; Taj, M.A.; Niaz, S.K.; Quraishy, M.S.

    2013-01-01

    Objective: To evaluate the frequency and associated factors in the post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Endoscopy Suite of Surgical Unit IV, Civil Hospital, Karachi, from December 2009 to November 2010. Methodology: Patients undergoing ERCP were included. Patients who had presented with pancreatitis or raised amylase levels before procedure or patients who had previous history of surgery on the biliary or pancreatic systems were excluded from the study. Pearson chi-square and Fisher's exact test were used for qualitative data and t-test for quantitative data. Significance was taken as p=0.05. Odds ratio was calculated for the qualitative data using 95% confidence interval. Results: Age of the study population ranged from 9 to 90 years (mean age 46.5 A+- 14.94 years, median 45 years). Male to female ratio was 1:1.87. Pancreatitis was seen in 18 patients (3.6%), mild in 15 (3%), moderate in one (0.2%) and severe in 2 (0.4%). Mean amylase level at 4 hours and 24 hours was 280.93 A+- 539.13 and 168.83 A+- 338.34 respectively. Pancreatitis was seen in 15/326 (4.6%) females and 3/174 (1.72%) males. Statistically significant increased risk for pancreatitis was seen in difficult cannulation (9.8%, p = 0.006), prolonged cannulation time (7.6 minute, p = 0.002), pancreatic duct cannulation (13.7%, p = 0.001) and pancreatic duct contrast injection (13.4%, p < 0.001). Conclusion: The frequency of post-ERCP pancreatitis was 3.6%. Difficult cannulation, pancreatic duct cannulation, pancreatic duct contrast injection and balloon sphincteroplasty were associated with higher frequency of post-ERCP pancreatitis. Reuse of ERCP accessories poses no additional risk to the frequency of pancreatitis. (author)

  14. Are Patients Informed When They Consent to ERCP?

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    Sinead O’Sullivan

    2002-01-01

    Full Text Available BACKGROUD: Only the British Society of Gastroenterology has published consent guidelines that are inclusive for endoscopic retrograde cholangiopancreatography (ERCP. Previous research has shown that there are variations in the information discussed with patients who are undergoing ERCP.

  15. Early Management Experience of Perforation after ERCP

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    Guohua Li

    2012-01-01

    Full Text Available Background and Aim. Perforation after endoscopic retrograde cholangiopancreatography (ERCP is a rare complication, but it is associated with significant mortality. This study evaluated the early management experience of these perforations. Patients and Methods. Between November 2003 and December 2011, a total of 8504 ERCPs were performed at our regional endoscopy center. Sixteen perforations (0.45% were identified and retrospectively reviewed. Results. Nine of these 16 patients with perforations were periampullary, 3 duodenal, 1 gastric fundus, and 3 patients had a perforation of an afferent limb of a Billroth II anastomosis. All patients with perforations were recognized during ERCP by X-ray and managed immediately. One patient with duodenal perforation and three patients with afferent limb perforation received surgery, others received medical conservative treatment which included suturing lesion, endoscopic nasobiliary drainage (ENBD, endoscopic retrograde pancreatic duct drainage (ERPD, gastrointestinal decompression, fasting, broad-spectrum antibiotics, and so on. All patients with perforation recovered successfully. Conclusions. We found that: (1 the diagnosis of perforation during ERCP may be easy, but you must pay attention to it. (2 Most retroperitoneal perforations can recover with only medical conservative treatment in early phase. (3 Most peritoneal perforations need surgery unless you can close the lesion up under endoscopy in early phase.

  16. Difference of CBD width on US vs. ERCP.

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    Brook, Olga R; Suissa, Alain; Khamaysi, Iyad; Koren, Dorit; Gaitini, Diana

    2007-01-01

    To investigate the relationship between US and ERCP in the measurement of common bile duct (CBD) width after application of Compound and Harmonic imaging on ultrasound. We prospectively evaluated the CBD width as measured on endoscopic retrograde cholangiopancreatography (ERCP) and ultrasonography (US), applying Compound and Harmonic US techniques, on 100 patients. Furthermore, we retrospectively re-examined US and ERCP images of 48 patients who underwent ERCP and US during the same hospitalization period. The average difference in measurements by US compared to ERCP was 2.3 mm (P CBD width. There was a good correlation between ERCP and US measurements of CBD width (r = 0.73 for all patients and r = 0.88 for patients with intact gallbladder, P CBD width on US and ERCP of about 2 mm. The application of Compound and Harmonic techniques in the prospective study probably enabled a more accurate sonographic measurement.

  17. Ultrasonography, CT, and ERCP in the diagnosis of choledochal stones

    International Nuclear Information System (INIS)

    Pasanen, P.; Partanen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E.

    1992-01-01

    A prospective study of jaundiced (n = 187) and nonjaundiced (n = 33) cholestatic patients was carried out to evaluate the sensitivity of ultrasonography (US), CT and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of choledochal stone disease. Altogether 83 patients had the final diagnosis of choledocholithiasis. In the jaundiced patients, the sensitivity of US, CT, and ERCP was 22,5%, 23,2%, and 80,6%, respectively. In cases of cholestasis without jaundice, the values were 20%, 37,5%, and 66,7%. In patients in whom all 3 imaging studies were done (n = 64), the differences between US and ERCP and between CT and ERCP were statistically significant (p < 0.0001). In most false-negative ERCP studies (10/15), the clinical course of the disease strongly suggested a passed choledochal stone. On the basis of this study, we recommend prompt ERCP to be performed if choledochal stone disease is suspected on clinical grounds. (orig.)

  18. Ultrasonography, CT, and ERCP in the diagnosis of choledochal stones

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    Pasanen, P.; Partanen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E. (Kuopio Univ. Hospital (Finland). Depts. of Surgery, Clinical Radiology, and Medicine)

    1992-01-01

    A prospective study of jaundiced (n = 187) and nonjaundiced (n = 33) cholestatic patients was carried out to evaluate the sensitivity of ultrasonography (US), CT and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of choledochal stone disease. Altogether 83 patients had the final diagnosis of choledocholithiasis. In the jaundiced patients, the sensitivity of US, CT, and ERCP was 22,5%, 23,2%, and 80,6%, respectively. In cases of cholestasis without jaundice, the values were 20%, 37,5%, and 66,7%. In patients in whom all 3 imaging studies were done (n = 64), the differences between US and ERCP and between CT and ERCP were statistically significant (p < 0.0001). In most false-negative ERCP studies (10/15), the clinical course of the disease strongly suggested a passed choledochal stone. On the basis of this study, we recommend prompt ERCP to be performed if choledochal stone disease is suspected on clinical grounds. (orig.).

  19. Endoscopic large balloon sphincteroplasty is a useful, safe adjunct for difficult to treat choledocholithiasis.

    Science.gov (United States)

    Turner, Greg A; Ing, Andrew J; Connor, Saxon J

    2016-05-01

    The aim of this study was to assess the safety and efficacy of large balloon sphincteroplasty when used in conjunction with endoscopic biliary sphincterotomy during endoscopic retrograde cholangiopancreatography (ERCP) for therapy of choledocholithiasis. A retrospective audit of all ERCP's performed for choledocholithiasis between January 2012 and October 2013 at one institution was performed. Procedures that utilized large balloon sphincteroplasty were compared with those underwent standard endoscopic stone extraction. Outcomes including stone clearance rate for the individual procedure type, post-ERCP complications and need for surgical exploration of the bile duct were documented. A total of 346 procedures on 306 patients that met the inclusion criteria were identified. Fifty-four (15.6%) procedures included large balloon sphincteroplasty and were compared with 292 (84.4%) procedures that used standard balloon extraction techniques. Despite those patients in the large balloon sphincteroplasty group having a higher rate of previous ERCP (33.3% versus 19.5%, P = 0.031) and a larger proportion of patients with stones greater than 10 mm (40.3% versus 11.3%, P choledocholithiasis. The current study demonstrated large balloon sphincteroplasty did not result in more complications despite a tendency to being used for larger stones. © 2014 Royal Australasian College of Surgeons.

  20. Biliary stones: Comparative study with sonography and ERCP

    International Nuclear Information System (INIS)

    Kang, In Young; Kim, Jong Chae; Park, Jung Suk; Kim, Se Jong; Park, Byung Lan; Kim, Byong Geun

    1990-01-01

    We analyzed findings of sonography and ERCP retrospectively to compare the diagnostic accuracy of sonography with ERCP in patients suspected with biliary stones. 88 patients underwent surgery who had studied with sonography and ERCP were evaluated in order of intrahepatic duct, extrahepatic duct and gall bladder. Of these patients, 80 cases were proved biliary stones. Sonography correctly diagnosed 19 of 19 patients with intrahepatic duct stones, 32 of 40 patients with extrahepatic duct stones and 35 of 41 patients with gall stones with sensitivities of 100%, 80% and 85% respectively. ERCP correctly identified 14 of 18 patients with intrahepatic duct stones, 26 of 37 patients with extrahepatic duct stones and 15 of 33 patients with gall stones with sensitivities of 78%, 70% and 45% respectively. Our results shows sonography is more sensitive to detect stones of biliary system than ERCP

  1. ERCP during pregnancy CPRE durante el embarazo

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    Jesús García-Cano

    2012-02-01

    Full Text Available Background and aims: ERCP during pregnancy is always challenging for the entire team performing the endoscopic intervention. In this study techniques and different interventional aspects used at several centres about the clinical experience on ERCP in pregnant women are analyzed. Patients and methods: the practice on ERCP in pregnant women in six centers during a period of ten years is reported. Results: eleven patients were included in the study. Mean age was 30.6 years. Indication for ERCP was always symptomatic common bile duct stone (CBDS disease. Before the procedure abdominal ultrasound was performed at all times and magnetic resonance cholangiopancreatography in four occasions. Conscious sedation by means of midazolam and fentanyl or meperidine was applied. Sphincterotomes and guidewires were used for bilary cannulation. Sometimes, rapid exchange platforms with short-length guidewires controlled by the same endoscopist were employed. Biliary cannulation was confirmed in 9 occasions by bile aspiration. In five procedures, a mean of 30 seconds of fluoroscopy was used, both to verify cannulation and to corroborate complete CBDS clearance. These patients had the pelvic zone protected with a lead shield and radiation dose was measured. Ten biliary sphincterotomies were performed followed by CBDS extraction. Two plastic stents were inserted. Relief of biliary obstruction was attained in all circumstances. Only one patient had hyperamylasemia after ERCP. All pregnant women had healthy foetuses with normal deliveries. Conclusions: with experience, ERCP appears to be a safe technique during pregnancy. With simple measures fluoroscopic time can be diminished or even abolished. It seems that ERCP during pregnancy is underused in our working areas, although it has shown to be a useful technique for relieving biliary obstruction.Antecedentes y objetivos: la CPRE realizada durante el embarazo constituye siempre un reto para todo el equipo que participa

  2. Ultrasonic evaluation of biliary stones: retrospective comparison with ERCP

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    Park, Jeong Kook; Lim, Jin Woo; Jeon, Hae Jeong; Cha, In Ho; Suh, Won Hyuck [College of Medicine, Korean University, Seoul (Korea, Republic of); Chung, Woun Kyun [Inha General Hospital, Incheon (Korea, Republic of)

    1987-06-15

    Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra-and extra hepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We retrospectively examined 127 patients who had undergone ERCP by performing right upper quadrant sonography immediately prior to ERCP and undergone surgery due to biliary stone. We assessed the size of the intra-and extrahepatic ducts and presence or absence of calculi, and compared the detection rate of ultrasound with that of ERCP in the patient with biliary stone in order of gall bladder, extrahepatic duct, and intrahepatic duct. The results are as follows : 1. Of all 127 patients with biliary stone, female were 75 (59%). 6th decades were most common. 2. Each numbers of patients in the order of biliary location are 43 in gall bladder, 17 in intrahepatic ducts, 23 in extrahepatic ducts, 44 in multiple locations. 3. Gall bladder stones were 81 in total and ultrasound detected stones in 75 patients (Sensitivity;93%). ERCP-in 35 patients (Sensitivity;43%). 4. Extrahepatic duct stones were 54 in total and ultrasound detected stones in 31 patients (Sensitivity;57%). ERCP-in 49 patients (Sensitivity;91%). 5. Intrahepatic duct stones were 45 in total and ultrasound detected stones in 38 patients (Sensitivity;84%). ERCP-in 41 patients (Sensitivity;91%). In summary, Ultrasound is much more sensitive to detect GB stones than ERCP (93%;43%). ERCP is much more sensitive to detect extrahepatic duct stones than ultrasound (91%;57%). Sensitivity of ultrasound and ERCP were almost equal in the intrahepatic duct stones (84%;91%)

  3. Ultrasonic evaluation of biliary stones: retrospective comparison with ERCP

    International Nuclear Information System (INIS)

    Park, Jeong Kook; Lim, Jin Woo; Jeon, Hae Jeong; Cha, In Ho; Suh, Won Hyuck; Chung, Woun Kyun

    1987-01-01

    Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra-and extra hepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We retrospectively examined 127 patients who had undergone ERCP by performing right upper quadrant sonography immediately prior to ERCP and undergone surgery due to biliary stone. We assessed the size of the intra-and extrahepatic ducts and presence or absence of calculi, and compared the detection rate of ultrasound with that of ERCP in the patient with biliary stone in order of gall bladder, extrahepatic duct, and intrahepatic duct. The results are as follows : 1. Of all 127 patients with biliary stone, female were 75 (59%). 6th decades were most common. 2. Each numbers of patients in the order of biliary location are 43 in gall bladder, 17 in intrahepatic ducts, 23 in extrahepatic ducts, 44 in multiple locations. 3. Gall bladder stones were 81 in total and ultrasound detected stones in 75 patients (Sensitivity;93%). ERCP-in 35 patients (Sensitivity;43%). 4. Extrahepatic duct stones were 54 in total and ultrasound detected stones in 31 patients (Sensitivity;57%). ERCP-in 49 patients (Sensitivity;91%). 5. Intrahepatic duct stones were 45 in total and ultrasound detected stones in 38 patients (Sensitivity;84%). ERCP-in 41 patients (Sensitivity;91%). In summary, Ultrasound is much more sensitive to detect GB stones than ERCP (93%;43%). ERCP is much more sensitive to detect extrahepatic duct stones than ultrasound (91%;57%). Sensitivity of ultrasound and ERCP were almost equal in the intrahepatic duct stones (84%;91%)

  4. Laparoscopy-assisted ERCP (LA-ERCP) following bariatric gastric bypass surgery: initial experience of a single UK centre.

    Science.gov (United States)

    Paranandi, Bharat; Joshi, Deepak; Mohammadi, Borzoueh; Jenkinson, Andrew; Adamo, Marco; Read, Samantha; Johnson, Gavin J; Chapman, Michael H; Pereira, Stephen P; Webster, George J

    2016-01-01

    Bariatric gastric bypass surgery is being increasingly performed, but endoscopic retrograde cholangiopancreatography (ERCP) in these patients poses a unique challenge because of a lack of per-oral access to the stomach. Small series suggest a higher technical success rate using laparoscopy-assisted ERCP (LA-ERCP) than with an enteroscopic approach via the Roux-en-Y anastomosis. We present initial experience of LA-ERCP in our unit. Retrospective case series of consecutive patients undergoing LA-ERCP in our unit between September 2011 and July 2014. Data was retrieved from electronic, clinical and endoscopy records. Seven LA-ERCPs were performed. All seven patients were female, with median age 44 years (range 36-71). Indications included symptomatic bile duct stones (5/7), benign papillary fibrosis (1/7) and retained biliary stent (1/7). 5/7 (71%) patients had had a prior cholecystectomy. To facilitate LA-ERCP, laparoscopic gastrostomy ports were created in all patients. Duodenal access, biliary cannulation and completion of therapeutic aim were achieved in all patients. 6/7 (86%) patients required endoscopic sphincterotomy. The median duration of procedures was 94 min (range 70-135). Median postoperative length of stay was 2 days (range 1-9). One patient developed mild postprocedural acute pancreatitis, and another patient developed a mild port-site infection. Otherwise, no procedure-related complications were seen. All patients remained well on follow-up (median 14 months (range 1-35) from date of ERCP), with no evidence of further biliary symptoms. Our early experience of LA-ERCP is that it is safe and effective. The technique may require particular consideration, as bariatric surgery is increasingly performed, in a patient group at significant risk of bile duct stones.

  5. Diagnostic and therapeutic double-balloon enteroscopy after small bowel Roux-en-Y reconstructive surgery.

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    Moreels, Tom G; Hubens, Guy J; Ysebaert, Dirk K; Op de Beeck, Bart; Pelckmans, Paul A

    2009-01-01

    Roux-en-Y reconstruction excludes the afferent limb and the biliopancreatic system from conventional endoscopic access. Postoperative problems in these excluded gastrointestinal systems are therefore often dealt with surgically. We investigated the usefulness of the therapeutic double-balloon enteroscope to perform interventional endoscopic procedures in the excluded segment of the gastrointestinal tract after Roux-en-Y reconstruction. 30 procedures were performed in 22 patients with Roux-en-Y reconstruction after enterobiliary anastomosis, gastrectomy or bariatric gastric bypass. All procedures were performed with the therapeutic double-balloon enteroscope, under general anesthesia and with fluoroscopic control. ERCP at the enterobiliary anastomosis was successful in 90% (n = 10) of the procedures. ERCP at the intact papilla was successful in 60% (n = 5). Enterocutaneous fistula closure after (sub)total gastrectomy was performed in 2 procedures. Successful diagnostic procedures encompassed intubation of the excluded stomach after bariatric gastric bypass (89%, n = 9) or the afferent limb after Roux-en-Y reconstruction (75%, n = 4). The overall success rate in accessing the aimed excluded segment with the double-balloon enteroscope was 87%. Interventional procedures were able to avoid surgery in 65%. One retroperitoneal perforation occurred during ERCP which was conservatively treated. Excluded gastrointestinal segments after Roux-en-Y reconstruction can be accessed with a substantial success rate using double-balloon enteroscopy. Therapeutic interventions like ERCP can prevent surgery in the majority of patients. Copyright 2009 S. Karger AG, Basel.

  6. Recent progress in ERCP for biliary and pancreatic diseases

    Directory of Open Access Journals (Sweden)

    MIAO Lin

    2014-12-01

    Full Text Available In recent years, with the continuous development of endoscopic and interventional techniques, many new devices and methods have been used in clinical practice, and the application of endoscopic retrograde cholangiopancreatography (ERCP in biliary and pancreatic diseases has developed rapidly. This paper reviews and summarizes the recent progress in ERCP among patients with biliary and pancreatic diseases, including those with altered gastrointestinal anatomy, pregnant patients, patients with benign and malignant biliary strictures, and patients with pancreatic pseudocysts, as well as the application of SpyGlass, photodynamic therapy, and radiofrequency ablation, the management of ERCP-related duodenal perforation, and the prevention of post-ERCP pancreatitis. All the progress has made a great contribution to the diagnosis and treatment of biliary and pancreatic diseases.

  7. Laparoscopic transgastric ERCP in bariatric surgery patients: our experience

    Directory of Open Access Journals (Sweden)

    Jesús Espinel

    Full Text Available Laparoscopic Roux-en-Y gastric bypass (LRYGB is the surgical treatment of choice for morbid obesity. Several therapeutic options to remove common bile duct (CBD stones have been proposed in these patients. Laparoscopy-assisted transgastric ERCP (LATERCP has a high success rate. However, the procedure is not fully standardized and some technical variations have been proposed. We introduce two cases in which laparoscopic transgastric ERCP has been used to treat choledocholithiasis after LRYGB.

  8. Laparoscopic transgastric ERCP in bariatric surgery patients: our experience.

    Science.gov (United States)

    Espinel, Jesús; Pinedo, María Eugenia; Ojeda, Vanesa; Guerra Del Río, María

    2017-07-01

    Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the surgical treatment of choice for morbid obesity. Several therapeutic options to remove common bile duct (CBD) stones have been proposed in these patients. Laparoscopy-assisted transgastric ERCP (LATERCP) has a high success rate. However, the procedure is not fully standardized and some technical variations have been proposed. We introduce two cases in which laparoscopic transgastric ERCP has been used to treat choledocholithiasis after LRYGB.

  9. Endoscopic Papillary Balloon Dilation with Large Balloon after Limited Sphincterotomy for Retrieval of Choledocholithiasis

    Science.gov (United States)

    Bang, Seungmin; Kim, Myoung Hwan; Park, Jeong Youp; Park, Seung Woo; Song, Si Young

    2006-01-01

    Endoscopic papillary balloon dilation (EBD) for choledocholithiasis is known to be comparable to endoscopic sphincterotomy (EST) especially in cases of small stones. With larger stones, EBD with conventional balloon, which have a diameter of 6-8 mm, was reported as less effective for extraction of stones. We evaluated the efficacy and complications of EBD with large balloons (10-15 mm) after limited EST for retrieval of choledocholithiasis. From February 2005, we have performed EBD with limited EST for retrieval of common bile duct (CBD) stones. The patients who admitted with hyperamylasemia and gallstone pancreatitis were excluded. In cases without CBD dilation, EPBD with 12 mm for 40 seconds was performed. And in cases with CBD dilation, we dilated the sphincters with 15 mm sized balloon for 40 seconds. Total 22 patients (11 of male) were performed EBD with limited EST for retrieval of CBD stones. The median diameter of the stones was 10 mm (5-25 mm). Ten cases had multiple stones and 6 cases periampullary diverticuli. Successful stone removal in the initial session of ERCP with EBD was accomplished in 16 patients (72.7%). And complete retrieval of bile duct stones was achieved in all patients with repeated ERCP. In the aspect of complications, any episodes of perforation, bleeding was not developed. Only one case of mild grade of post-procedural pancreatitis was noted. However, post-procedural hyperamylasemia was developed in 16 cases (68.2%). EBD with larger balloon seems to be a feasible and safe alternative technique for conventional EST in CBD stone extraction. PMID:17191309

  10. ERCP after bariatric surgery - literature review and case report

    Science.gov (United States)

    Iorgulescu, A; Turcu, F; Iordache, N

    2014-01-01

    Abstract Obesity is a disease which has become more prevalent in Romania. Bariatric surgical procedures are among the treatment options for obese patients. Obesity and the metabolic disorders induced by it are risk factors for gallstones formation and their complications. ERCP is a minimally invasive therapeutic procedure indicated in the treatment of choledochal lithiasis and its complications. ERCP is generally considered the most difficult endoscopic procedure from the technical point of view. The authors have proposed to consider the possibility of performing therapeutic ERCP in patients who have undergone bariatric procedures. Literature data are reviewed and the case of a patient treated in a minimally invasive (laparoendoscopic) way for cholecyst and choledocholithiasis after longitudinal gastrectomy is presented PMID:25408751

  11. Systematic review: periprocedural hydration in the prevention of post-ERCP pancreatitis

    NARCIS (Netherlands)

    Smeets, X. J. N. M.; da Costa, D. W.; Besselink, M. G.; Bruno, M. J.; Fockens, P.; Mulder, C. J. J.; van der Hulst, R. W.; Vleggaar, F. P.; Timmer, R.; Drenth, J. P. H.; van Geenen, E. J. M.

    2016-01-01

    With an overall incidence of 3.5%, pancreatitis is the most frequent complication of endoscopic retrograde cholangiopancreatography (ERCP). Periprocedural hydration may prevent post-ERCP pancreatitis by maintaining pancreatic microperfusion, thereby inhibiting the pancreatic inflammatory response.

  12. Difficult cannulation as defined by a prospective study of the Scandinavian Association for Digestive Endoscopy (SADE) in 907 ERCPs

    DEFF Research Database (Denmark)

    Halttunen, Jorma; Meisner, Søren; Aabakken, Lars

    2014-01-01

    BACKGROUND: The definition of a "difficult" cannulation varies considerably in reports of endoscopic retrograde cholangiopancreatography (ERCP). AIMS: To define a difficult cannulation, which translates into higher risk of post-ERCP pancreatitis. PATIENTS AND METHODS: Prospective consecutive...

  13. Pre-ERCP infusion of semapimod, a mitogen-activated protein kinases inhibitor, lowers post-ERCP hyperamylasemia but not pancreatitis incidence

    NARCIS (Netherlands)

    van Westerloo, David J.; Rauws, Erik A.; Hommes, Daan; de Vos, Alex F.; van der Poll, Tom; Powers, Barbara L.; Fockens, Paul; Dijkgraaf, Marcel G. W.; Bruno, Marco J.

    2008-01-01

    BACKGROUND: Acute pancreatitis and hyperamylasemia are frequent complications of an ERCP. Semapimod is a synthetic guanylhydrazone that inhibits the mitogen-activated protein kinase (MAPK) pathway, macrophage activation, and the production of several inflammatory cytokines. OBJECTIVE: This study

  14. Severity of post-ERCP pancreatitis directly proportional to the invasiveness of endoscopic intervention: a pilot study in a canine model.

    Science.gov (United States)

    Buscaglia, J M; Simons, B W; Prosser, B J; Ruben, D S; Giday, S A; Magno, P; Clarke, J O; Shin, E J; Kalloo, A N; Kantsevoy, S V; Gabrielson, K L; Jagannath, S B

    2008-06-01

    Pancreatitis complicates 1% - 22% of endoscopic retrograde cholangiopancreatography procedures. The study aims were to develop a reproducible animal model of post-ERCP pancreatitis (PEP), and investigate the impact of endoscopic technique on severity of PEP. ERCP was carried out in six male hound dogs. Pancreatitis was induced by one of three escalating methods: 1) pancreatic acinarization with 20 - 30 mL of contrast; 2) acinarization + ductal balloon occlusion + sphincterotomy; 3) acinarization + intraductal synthetic bile injection + ductal balloon occlusion + sphincterotomy. Dogs 5 and 6 received a pancreatic stent. Necropsy was performed on postoperative day 5. All pancreatic specimens were graded by two blinded pathologists according to a validated scoring system. All dogs were compared with three control dogs. Dogs 1 - 4 developed clinical pancreatitis and hyperamylasemia (11 736 vs. 722 U/L, P = 0.02). Total injury scores were significantly elevated compared with controls (6.85 vs. 1.06, P = 0.004). There was significant increase in acinar cell necrosis (0.86 vs. 0.06, P = Dogs 5 and 6 developed clinical pancreatitis without significant hyperamylasemia; total injury scores were elevated compared with controls (4.83 vs. 1.06, P = 0.01), but lower than in Dogs 1 - 4 (4.83 vs. 6.85, P = 0.25). There was escalating severity of pancreatic injury from Dogs 1 to 4 correlating with the method of endoscopic injury used. Severity of PEP is directly proportional to invasiveness of endoscopic intervention. Pancreatic acinarization, even without balloon occlusion and sphincterotomy, can be used as a reliable animal model for future studies investigating therapy and prevention of disease.

  15. ERCP at a UK Hospital: A Cue for Developing Countries | Ola ...

    African Journals Online (AJOL)

    The study aimed to determine the pattern of the patients who had ERCP at the Gastroenterology Department of Trafford General Hospital (TGH), Manchester UK as a cue for developing countries where the procedure is uncommon. A retrospective study of 240 adult patients who had ERCP was carried out between October ...

  16. Comparison between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP)

    International Nuclear Information System (INIS)

    Pulpeiro, J. R.; Armesto, V.; Lopez-Roses, L.; Lancho, A.; Gonzalez, A.

    2000-01-01

    To assess the correlation between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). The authors carried out a prospective study of 71 patients suspected of having biliary diseases. MRCP was performed, followed by ERCP.MRCP was done with a 1.5-T system using hypergradients, abdominal phase array coil and single-shot fast spin-echo (SSFSE) sequences with maximum signal intensity in T2-weighted images. This sequence only provides images of the fluids, similar to those obtained with ERCP. The results of ERCP were employed as a reference standard. Thirty patients were found to have stenosis (19 malignant and 11 benign). 25 had choledocholithiasis and 16 showed no abnormal findings. The correlation was complete in patients with stenosis. MRCP detected 23 cases of choledocholithiasis (ERCP was normal in the remaining two patients, but calculi were discovered on shpincterotomy). MRCP confirmed the normal condition of the bile duct in 12 of the 16 patients free of biliary disease (2 patients in whom ERCP had been normal had been diagnosed as having bile duct dilatation due to choledocholithiasis 24 hours and 10 days earlier, respectively, and two cases of presented ectasia due to fibrosis of the sphincter of Oddi showed good emptying during ERCP). MRCP using SSFSE is highly correlated with ERCP, which should be reserved for cases in which the diagnosis is in doubt or endoscopic management is necessary. (Author) 25 refs

  17. CT and ERCP findings of chronic focal pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Soo; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Eun Kyeong [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the major radiologic features of chronic focal pancreatitis in various imaging studies, with special emphasis on CT and ERCP findings. From 1991 to 1995, twelve patients were pathologically proved to be suffering from focal chronic pancreatitis after pancreatico-duodenectomy;for retrospective evaluation, imaging studies were available for eight(seven men, one woman;mean age 58.9{+-}6.6, range 47 to 67). Clinical, surgical, and radiological findings, including CT(n=8), ultrasound(n=7), ERCP(n=8) and UGI(n=3) were analysed. Seven male patients had suffered from chronic alcoholism for between 20 and 50 years. Serum bilirubin levels were normal in eight patients and alkaline phosphatase levels were normal in seven patients. Serum CA 19-9 levels were normal in all five patients who had undergone preoperative evaluation. Seven patients(87.5%) showed focal enlargement without definable margin on CT, and five of the six lesions detectable on ultrasound(83.3%) were ill defined hypoechoic nodules. Dilated side branches within lesions were seen in five of eight patients(83.3%) on CT and ERCP. Double duct signs were observed in siven(87.5%) patients, and dilated intrahepatic ducts in six(75%), with diameters ranging from 5 to 8mm(average:5.42{+-}1.96mm). The average ratio of pancreatic duct caliber to gland width was 0.33{+-}0.19. None of the patients had calcification within the lesion and one case showed intraductal calcification. None showed perivascular fat obliteration around the superior mesenteric artery or celiac axis. The average biductal distance between abnormal common bile duct and the immediately adjacent pancreatic duct was 4.0{+-}1.15mm. One of three cases who under went a UGI examination showed severe luminal narrowing and mucosal thickening in the second protion of the duodenum, another showed double contour, and the other merely showed widening of the C-loop of the duodenum. Chronic focal pancreatitis mostly demonstrated ill defined focal

  18. CT and ERCP findings of chronic focal pancreatitis

    International Nuclear Information System (INIS)

    Kim, Hee Soo; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Eun Kyeong

    1996-01-01

    To evaluate the major radiologic features of chronic focal pancreatitis in various imaging studies, with special emphasis on CT and ERCP findings. From 1991 to 1995, twelve patients were pathologically proved to be suffering from focal chronic pancreatitis after pancreatico-duodenectomy;for retrospective evaluation, imaging studies were available for eight(seven men, one woman;mean age 58.9±6.6, range 47 to 67). Clinical, surgical, and radiological findings, including CT(n=8), ultrasound(n=7), ERCP(n=8) and UGI(n=3) were analysed. Seven male patients had suffered from chronic alcoholism for between 20 and 50 years. Serum bilirubin levels were normal in eight patients and alkaline phosphatase levels were normal in seven patients. Serum CA 19-9 levels were normal in all five patients who had undergone preoperative evaluation. Seven patients(87.5%) showed focal enlargement without definable margin on CT, and five of the six lesions detectable on ultrasound(83.3%) were ill defined hypoechoic nodules. Dilated side branches within lesions were seen in five of eight patients(83.3%) on CT and ERCP. Double duct signs were observed in siven(87.5%) patients, and dilated intrahepatic ducts in six(75%), with diameters ranging from 5 to 8mm(average:5.42±1.96mm). The average ratio of pancreatic duct caliber to gland width was 0.33±0.19. None of the patients had calcification within the lesion and one case showed intraductal calcification. None showed perivascular fat obliteration around the superior mesenteric artery or celiac axis. The average biductal distance between abnormal common bile duct and the immediately adjacent pancreatic duct was 4.0±1.15mm. One of three cases who under went a UGI examination showed severe luminal narrowing and mucosal thickening in the second protion of the duodenum, another showed double contour, and the other merely showed widening of the C-loop of the duodenum. Chronic focal pancreatitis mostly demonstrated ill defined focal enlargement and

  19. Artificial neural network predicts the need for therapeutic ERCP in patients with suspected choledocholithiasis.

    Science.gov (United States)

    Jovanovic, Predrag; Salkic, Nermin N; Zerem, Enver

    2014-08-01

    Selection of patients with the highest probability for therapeutic ERCP remains an important task in a clinical workup of patients with suspected choledocholithiasis (CDL). To determine whether an artificial neural network (ANN) model can improve the accuracy of selecting patients with a high probability of undergoing therapeutic ERCP among those with strong clinical suspicion of CDL and to compare it with our previously reported prediction model. Prospective, observational study. Single, tertiary-care endoscopy center. Between January 2010 and September 2012, we prospectively recruited 291 consecutive patients who underwent ERCP after being referred to our center with firm suspicion for CDL. Predictive scores for CDL based on a multivariate logistic regression model and ANN model. The presence of common bile duct stones confirmed by ERCP. There were 80.4% of patients with positive findings on ERCP. The area under the receiver-operating characteristic curve for our previously established multivariate logistic regression model was 0.787 (95% CI, 0.720-0.854; P < .001), whereas area under the curve for the ANN model was 0.884 (95% CI, 0.831-0.938; P < .001). The ANN model correctly classified 92.3% of patients with positive findings on ERCP and 69.6% patients with negative findings on ERCP. Only those variables believed to be related to the outcome of interest were included. The majority of patients in our sample had positive findings on ERCP. An ANN model has better discriminant ability and accuracy than a multivariate logistic regression model in selecting patients for therapeutic ERCP. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  20. The safety and efficacy of therapeutic ERCP in the pediatric population performed by adult gastroenterologists.

    Science.gov (United States)

    Halvorson, Lauren; Halsey, Kevin; Darwin, Peter; Goldberg, Eric

    2013-12-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is much less commonly performed in the pediatric population compared to adults. As a result, few pediatric gastroenterologists receive adequate training in ERCP. At many institutions, pediatric ERCP is performed by adult gastroenterologists not formally trained in pediatric gastroenterology. The purpose of this study was to assess the efficacy and safety of ERCP performed in pediatric patients by adult gastroenterologists in a single tertiary care center. We performed a retrospective analysis of pooled endoscopic procedures in pediatric patients (age<18 years) at the University of Maryland Medical Center, between 2003 and 2011, by two adult therapeutic endoscopists. Neither endoscopist had formal training in pediatric ERCP prior to 2003. Outcome measures included the procedure indications, cannulation success rates, procedure success rates, type of anesthesia, therapeutic interventions, frequency and type of procedure related complications, and technical complexity. Forty-five patients were included with a mean age of 12 years (range 6-17). There were a total of 70 ERCP procedures. Choledocholithiasis was the most common indication. Modes of anesthesia included monitored anesthesia care (31, 44.3%), general anesthesia (22, 31.4%) and moderate conscious sedation (17, 24.3%). The papilla cannulation success rate was 98.6% (69/70). Therapeutic maneuvers included 31 biliary sphincterotomies, ten pancreatic sphincterotomies, 17 pancreatic duct stents, 16 bile duct stents, two cystgastrostomy stents, four biliary stricture dilations, one minor papillotomy site dilation, one mechanical lithotripsy and one ampullectomy. The procedural success rate was 97.1% (68/70). The overall complication rate was 7.1% (5/70) with a post-ERCP pancreatitis rate of 4.3% (3/70). Complications included infection (moderate-1), bleeding (moderate-1), and post-ERCP pancreatitis (mild-1, moderate-2). ERCP procedures in pediatric patients can

  1. Post-ERCP Emphysematous Cholecystitis in a Young Woman: A Rare and Potentially Fatal Complication

    Directory of Open Access Journals (Sweden)

    Roisin Stack

    2017-01-01

    Full Text Available A 45-year-old woman with suspected Functional Biliary Sphincter Disorder (FBSD developed Clostridium perfringens related emphysematous cholecystitis after ERCP. A low index of suspicion for emphysematous cholecystitis in this young, otherwise healthy woman led to a significant delay in making the correct diagnosis, and air in the gallbladder was wrongly attributed to a possible gallbladder perforation. ERCP is associated with significant risks, particularly in patients with FBSD, where diagnostic uncertainty renders the balance of risk versus benefit even more critical. Post-ERCP emphysematous cholecystitis secondary to Clostridium perfringens is a rare but potentially fatal complication.

  2. Accuracy of MRCP compared to ERCP in the diagnosis of bile duct ...

    African Journals Online (AJOL)

    Aim. To determine the accuracy of magnetic resonance cholangiopancreatography (MRCP) compared with the gold standard endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of bile duct disorders at Universitas Hospital, University of the. Free State (UFS), Bloemfontein. Patients and methods.

  3. Utility and Safety of ERCP in the Elderly: A Comparative Study in Iran

    Directory of Open Access Journals (Sweden)

    Amir Houshang Mohammad Alizadeh

    2012-01-01

    Full Text Available Background. The present study sought and compared the utility and safety of endoscopic retrograde cholangiopancreatography (ERCP in the elderly and younger people in a great sample of Iranian population. Methods. Our study involved 780 patients undergoing diagnostic and therapeutic ERCP at the Taleghani hospital in Tehran between 2010 and 2011; among them, 558 patients were less than 70 years old and others were 70 years old or older. The patients were prospectively identified and data including clinical and biochemical features, ERCP procedures, ERCP diagnosis, and ERCP complications were gathered on them prospectively. Results. Clinical manifestations were comparable in young and older groups except for hepatosplenomegaly and constipation that were more prevalent in the elderly. Laboratory findings were similar in both groups other than mean levels of alkaline phosphatase, hemoglobin and albumin levels, which were higher in the elderly group. Selective biliary cannulation was technically more successful in the younger than in others (89.0% versus 81.8%. Common bile duct stone was the most frequent diagnosis in both young and older groups (36.6% and 45.9%, resp., whereas ERCP was reported to be normal in 13.4% of the younger and 5.0% of the elderly patients. Post-ERCP complications were observed in 4.8% of patients aged less than 70 years in comparison with 2.3% of patients aged over 70 years. The most frequent complication was pancreatitis that was significantly more developed in young than older patients (3.6% versus 1.5%; OR: 8.216, P=0.015. Conclusion. Diagnostic ERCP is safe and well tolerated in the elderly and even associated with significantly less risk than the younger.

  4. Balloon Command-Control

    Science.gov (United States)

    1977-01-07

    Continuo on reverse side Ii nocosom7’ and identify by block numnber) P cientific Balloons; Balloon flights; Telemetry; Balloon Control; plight Termination... improvements in the ground station which should result in a truly simplified operation. The final modification to the decoder board which appears... improve the sweep range nnd sweep rate, however, the wave shape is still not as good as achieved using an exter..al sine wave oscillator manually

  5. The Diagnostic Value of Endoscopic Balloon Catheter Usage for Detecting Early-Stage Primary Sclerosing Cholangitis in Endoscopic Retrograde Cholangiopancreatography: A Case Report

    Science.gov (United States)

    Ozdil, Burhan; Cosar, Arif; Kece, Can; Sandikci, Macit; Akkiz, Hikmet

    2010-01-01

    A 34-year-old woman was admitted to our clinic with abdominal pain, jaundice and pruritus. Endoscopic retrograde cholangiopancreatography was performed for cholestasis. Endoscopic retrograde cholangiopancreatography (ERCP) was judged as normal, after a standard ERCP cannula was used for the cholangiogram. However, marked canalicular irregularities were identified in cholangiography when pressurized contrast agent was administrated via balloon catheter. This cholangiographic view was thought to reveal an early-stage alteration of sclerosing cholangitis. Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by destruction and fibrosis of the bile ducts. The diagnosis of PSC is based on typical cholangiographic findings, supported by nonspecific clinical signs and symptoms, cholestatic liver biochemical tests, and liver biopsy. Cholangiography is considered to be the gold standard for the diagnosis of PSC. The diagnosis is easy when diffuse multifocal biliary strictures, the hallmarks of the disease, resulting in a ‘beaded’ appearance on ERCP is detected. However, it may reveal a normal image in an early stage of the disease when bile duct changings are not prominent. We think that balloon catheter ERCP appears to facilitate the diagnosis of early-stage primary sclerosing cholangitis. PMID:21103219

  6. The Diagnostic Value of Endoscopic Balloon Catheter Usage for Detecting Early-Stage Primary Sclerosing Cholangitis in Endoscopic Retrograde Cholangiopancreatography:A Case Report

    Directory of Open Access Journals (Sweden)

    Burhan Ozdil

    2010-02-01

    Full Text Available A 34-year-old woman was admitted to our clinic with abdominal pain, jaundice and pruritus. Endoscopic retrograde cholangiopancreatography was performed for cholestasis. Endoscopic retrograde cholangiopancreatography (ERCP was judged as normal, after a standard ERCP cannula was used for the cholangiogram. However, marked canalicular irregularities were identified in cholangiography when pressurized contrast agent was administrated via balloon catheter. This cholangiographic view was thought to reveal an early-stage alteration of sclerosing cholangitis. Primary sclerosing cholangitis (PSC is a chronic cholestatic liver disease characterized by destruction and fibrosis of the bile ducts. The diagnosis of PSC is based on typical cholangiographic findings, supported by nonspecific clinical signs and symptoms, cholestatic liver biochemical tests, and liver biopsy. Cholangiography is considered to be the gold standard for the diagnosis of PSC. The diagnosis is easy when diffuse multifocal biliary strictures, the hallmarks of the disease, resulting in a ‘beaded’ appearance on ERCP is detected. However, it may reveal a normal image in an early stage of the disease when bile duct changings are not prominent. We think that balloon catheter ERCP appears to facilitate the diagnosis of early-stage primary sclerosing cholangitis.

  7. Weather Balloon Ascent Rate

    Science.gov (United States)

    Denny, Mark

    2016-05-01

    The physics of a weather balloon is analyzed. The surprising aspect of the motion of these balloons is that they ascend to great altitudes (typically 35 km) at a more or less constant rate. Such behavior is not surprising near the ground—say for a helium-filled party balloon rising from street level to the top of the Empire State building—but it is unexpected for a balloon that rises to altitudes where the air is rarefied. We show from elementary physical laws why the ascent rate is approximately constant.

  8. Factors and Outcomes Associated with MRCP Use prior to ERCP in Patients at High Risk for Choledocholithiasis.

    Science.gov (United States)

    Anand, Gobind; Patel, Yuval A; Yeh, Hsin-Chieh; Khashab, Mouen A; Lennon, Anne Marie; Shin, Eun Ji; Canto, Marcia I; Okolo, Patrick I; Kalloo, Anthony N; Singh, Vikesh K

    2016-01-01

    Background. Consensus guidelines recommend that patients at high risk for choledocholithiasis undergo endoscopic retrograde cholangiopancreatography (ERCP) without additional imaging. This study evaluates factors and outcomes associated with performing magnetic resonance cholangiopancreatography (MRCP) prior to ERCP among patients at high risk for choledocholithiasis. Methods. An institutional administrative database was searched using diagnosis codes for choledocholithiasis, cholangitis, and acute pancreatitis and procedure codes for MRCP and ERCP. Patients categorized as high risk for choledocholithiasis were evaluated. Results. 224 patients classified as high risk, of whom 176 (79%) underwent ERCP only, while 48 (21%) underwent MRCP prior to ERCP. Patients undergoing MRCP experienced longer time to ERCP (72 hours versus 35 hours, p choledocholithiasis is common and associated with greater length of hospital stay, higher radiology charges, and a trend towards higher hospital charges.

  9. The Japanese Balloon Program

    Science.gov (United States)

    Nishimura, J.

    The Japanese scientific ballooning program has been organized by ISAS since the institute was founded in mid 1960s. Since then, the balloon group of ISAS has been engaged in the development of the balloon technologies and scientific observations in collaboration with scientists and engineers in other universities and organizations. Here, I describe several subjects of recent activities, the details of some items will also be reported in the separate papers in this meeting.Preparation of a new mobile receiving station.Balloons of made of the EVAL (Ethylene-Vinyl-Alcohol) films. EVAL film has specific Infra-red absorption bands, and is expected to be useful for saving the ballast for a long duration flight.A high altitude balloon with thin polyethylene films achieving at an altitude of above 50km. Further improvement of this type of balloons is continued by inventing how to extrude thin films less than 5 microns of thickness.Recent achievement of Antarctica Flights under the collaboration of ISAS and National Polar Institute.Other new efforts to long duration flights such as satellite link boomerang balloon systems and others.New balloon borne scientific instrumentation for observations of high energy electrons and Anti-protons in cosmic-rays.

  10. Clefting in pumpkin balloons

    Science.gov (United States)

    Baginski, F.; Schur, W.

    NASA's effort to develop a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, focuses on a pumpkin shape super-pressure design. It has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired stable state instead. Hoop stress considerations in the pumpkin design leads to choosing the lowest possible bulge radius, while robust deployment is favored by a large bulge radius. Some qualitative understanding of design aspects on undesired equilibria in pumpkin balloons has been obtained via small-scale balloon testing. Poorly deploying balloons have clefts, but most gores away from the cleft deploy uniformly. In this paper, we present models for pumpkin balloons with clefts. Long term success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and means for quantitative assessment of measures that prevent their occurrence. This paper attempts to determine numerical thresholds of design parameters that distinguish between properly deploying designs and improperly deploying designs by analytically investigating designs in the vicinity of criticality. Design elements which may trigger the onset undesired equilibria and remedial measures that ensure deployment are discussed.

  11. Modified Hydrogen Balloon Explosion.

    Science.gov (United States)

    Lawrence, Stephen S.

    1995-01-01

    Describes the technique of exploding an oxygen-hydrogen balloon using two balloons and having students observe the formation of water droplets. Suggests that the Socratic Method can be used to start discussions related to stochiometry, states of matter, and gas laws. (DDR)

  12. MR cholangiopancreatography: prospective comparison of a breath-hold 2D projection technique with diagnostic ERCP

    International Nuclear Information System (INIS)

    Lomas, D.J.; Bearcroft, P.W.P.; Gimson, A.E.

    1999-01-01

    The aim of this study was to compare prospectively a breath-hold projection magnetic resonance cholangiopancreatography (MRCP) technique with diagnostic endoscopic retrograde cholangiopancreatography (ERCP). Seventy-six patients with suspected strictures or choledocholithiasis were referred for MRCP and subsequent ERCP examination, which were performed within 4 h of each other. The MRCP technique was performed using fat-suppressed rapid acquisition with relaxation enhancement (RARE) projection images obtained in standardised planes with additional targeted projections as required by the supervising radiologist. Two radiologists (in consensus) assessed the MRCP results prospectively and independently for the presence of bile duct calculi, strictures, non-specific biliary dilatation and pancreatic duct dilatation, and recorded a single primary diagnosis. The ERCP was assessed prospectively and independently by a single endoscopist and used as a gold standard for comparison with MRCP. Diagnostic agreement was assessed by the Kappa statistic. The MRCP technique failed in two patients and ERCP in five. In the remaining 69 referrals ERCP demonstrated normal findings in 23 cases, strictures in 19 cases, choledocholithiasis in 9 cases, non-specific biliary dilatation in 14 cases and chronic pancreatitis in 4 cases. The MRCP technique correctly demonstrated 22 of 23 normal cases, 19 strictures with one false positive (sensitivity 100 %, specificity 98 %), all 9 cases of choledocholithiasis with two false positives (sensitivity 100 %, specificity 97 %), 12 of 14 cases of non-specific biliary dilatation and only 1 of 4 cases of chronic pancreatitis. There was overall good agreement for diagnosis based on a kappa value of 0.88. Breath-hold projection MRCP can provide non-invasively comparable diagnostic information to diagnostic ERCP for suspected choledocholithiasis and biliary strictures and may allow more selective use of therapeutic ERCP. (orig.)

  13. MR cholangiopancreatography: prospective comparison of a breath-hold 2D projection technique with diagnostic ERCP

    Energy Technology Data Exchange (ETDEWEB)

    Lomas, D.J.; Bearcroft, P.W.P.; Gimson, A.E. [University Department of Radiology, Addenbrooke Hospital, Cambridge (United Kingdom)

    1999-09-01

    The aim of this study was to compare prospectively a breath-hold projection magnetic resonance cholangiopancreatography (MRCP) technique with diagnostic endoscopic retrograde cholangiopancreatography (ERCP). Seventy-six patients with suspected strictures or choledocholithiasis were referred for MRCP and subsequent ERCP examination, which were performed within 4 h of each other. The MRCP technique was performed using fat-suppressed rapid acquisition with relaxation enhancement (RARE) projection images obtained in standardised planes with additional targeted projections as required by the supervising radiologist. Two radiologists (in consensus) assessed the MRCP results prospectively and independently for the presence of bile duct calculi, strictures, non-specific biliary dilatation and pancreatic duct dilatation, and recorded a single primary diagnosis. The ERCP was assessed prospectively and independently by a single endoscopist and used as a gold standard for comparison with MRCP. Diagnostic agreement was assessed by the Kappa statistic. The MRCP technique failed in two patients and ERCP in five. In the remaining 69 referrals ERCP demonstrated normal findings in 23 cases, strictures in 19 cases, choledocholithiasis in 9 cases, non-specific biliary dilatation in 14 cases and chronic pancreatitis in 4 cases. The MRCP technique correctly demonstrated 22 of 23 normal cases, 19 strictures with one false positive (sensitivity 100 %, specificity 98 %), all 9 cases of choledocholithiasis with two false positives (sensitivity 100 %, specificity 97 %), 12 of 14 cases of non-specific biliary dilatation and only 1 of 4 cases of chronic pancreatitis. There was overall good agreement for diagnosis based on a kappa value of 0.88. Breath-hold projection MRCP can provide non-invasively comparable diagnostic information to diagnostic ERCP for suspected choledocholithiasis and biliary strictures and may allow more selective use of therapeutic ERCP. (orig.) With 6 figs., 1 tab., 20

  14. Safety and Yield of Diagnostic ERCP in Liver Transplant Patients with Abnormal Liver Function Tests

    Directory of Open Access Journals (Sweden)

    Jayapal Ramesh

    2014-01-01

    Full Text Available Background. Abnormal liver enzymes postorthotopic liver transplant (OLT may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patients presenting with abnormal liver function tests in the setting of OLT. Methods. A retrospective review of diagnostic ERCPs in patients with OLT from 2002 to 2013 from a prospectively maintained, IRB approved database. Results. Of the 474 ERCPs performed in OLT patients, 210 (44.3%; 95% CI 39.8–48.8 were performed for abnormal liver function tests during the study period. Majority of patients were Caucasian (83.8%, male (62.4% with median age of 55 years (IQR 48–62 years. Biliary cannulation was successful in 99.6% of cases and findings included stricture in 45 (21.4 %; biliary stones/sludge in 23 (11%; biliary dilation alone in 31 (14.8%; and normal in 91 (43.3%. Three (1.4% patients developed mild, self-limiting pancreatitis; one patient (0.5% developed cholangitis and two (1% had postsphincterotomy bleeding. Multivariate analyses showed significant association between dilated ducts on imaging with a therapeutic outcome. Conclusion. Diagnostic ERCP in OLT patients presenting with liver function test abnormalities is safe and frequently therapeutic.

  15. Minimizing Radiation Exposure During ERCP by Avoiding Live or Continuous Fluoroscopy.

    Science.gov (United States)

    Churrango, Gustavo; Deutsch, Jill K; Dinneen, Henry S; Churrango, Jose; Samiullah, Sami; Ahlawat, Sushil K

    2015-01-01

    The aim of this study was to assess the cumulative radiation exposure incurred by patients when using single-frame fluoroscopy. Single-frame fluoroscopy is a technique that can be used instead of pulsed fluoroscopy or continuous live fluoroscopy to minimize radiation exposure during endoscopic retrograde cholangiopancreatography (ERCP). We retrospectively reviewed ERCPs performed at our academic medical center. We recorded fluoroscopy time (FT, minutes), total radiation dose (mGy), dose area product (DAP, Gy cm²), and effective dose (ED, mSv). ERCP degree of difficulty was graded based on procedure complexity level. There were 400 ERCP procedures performed on 210 patients, 32 ERCPs were unsuccessful. The mean FT for all procedures was 1.57 minutes (median, 1.2 min); the mean FT for complexity score 1 procedures (0.78 min) was significantly shorter than for all other procedures (Pfluoroscopy only. Our results demonstrate lower radiation exposure using this technique than what is reported in the literature.

  16. Endoscopic papillary balloon dilatation versus endoscopic sphincterotomy in the treatment for choledocholithiasis: a meta-analysis.

    Science.gov (United States)

    Liu, Yangyang; Su, Peizhu; Lin, Siheng; Xiao, Kun; Chen, Pingyan; An, Shengli; Zhi, Fachao; Bai, Yang

    2012-03-01

    Endoscopic papillary balloon dilatation (EPBD) and endoscopic sphincterotomy (EST) are two common nonsurgical treatments endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. The aim of this study was to compare the efficacy and safety of EPBD and EST in the treatment for choledocholithiasis, confining the analysis to work reported in the last decade. The rate of overall postoperative complications was chosen as the primary outcome, and 10 other outcomes were secondary outcomes. Relative risk (RR) or Peto odds ratio (OR) were computed as the measures of pooled effects. We planned sensitivity analyses a priori for examining the change in robustness of the sensitivity to excluding studies with some inappropriate objects, technique defects or without full-text acquisition. For complete stone removal, EPBD was similar to EST (95% vs. 96%, P = 0.36) and overall postoperative complications (14.0% vs. 11.7%, P = 0.53). The incidence of post-ERCP cholangitis (2.5% vs. 1.8%, P = 0.40), basket impaction (0.9% vs. 0%, P = 0.16) and perforation (0.0% vs. 0.4%, P = 0.17) were equivalent between EPBD and EST. On the other hand, EPBD caused more post-ERCP pancreatitis (PEP) (9.4% vs. 3.3%, P stone extraction, though it requires more endoscopic mechanical lithotripsy (EML). EPBD may outweigh EST for patients with coagulopathy; however, it may cause more PEP. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

  17. Meta-analysis: Nitroglycerin for prevention of post-ERCP pancreatitis

    DEFF Research Database (Denmark)

    Nøjgaard, C; Matzen, P; Andersen, Per Kragh

    2009-01-01

    BACKGROUND: Acute pancreatitis after ERCP is a severe side effect. AIM: To evaluate the preventive effect of nitroglycerin on post-ERCP pancreatitis by a meta-analysis of randomized clinical studies. METHODS: We searched on Pubmed, Embase, Cochrane Library and all abstracts presented at Digestive......-ERCP pancreatitis after administration of nitroglycerin were identified. Meta-analysis including all five studies showed a relative risk (RR) of 0.61 (95% CI; 0.44, 0.86) with the number needed to treat (NNT) of 26 (95% CI: 16, 82). Three studies evaluated nitroglycerin administered by a dermal patch reaching...... together an RR of 0.66 (95% CI; 0.43, 1.01). The use of nitroglycerin is associated with a significantly increased risk of hypotension (RR 2.25) and headache (RR 3.64). No difference in mortality was observed. CONCLUSIONS: Overall, our meta-analysis supports the use of nitroglycerin in the prevention...

  18. Sudden death after endoscopic retrograde cholangiopancreatography (ERCP)--case report and literature review.

    Science.gov (United States)

    Hauser, Goran; Milosevic, Marko; Zelić, Marko; Stimac, Davor

    2014-12-01

    There are only a few cases found in literature regarding air embolism in endoscopic procedures, especially in connection to endoscopic retrograde cholangiopancreatography (ERCP). We are presenting a case of a 56-year-old female patient who suffered from non-Hodgkin lymphoma located in her right groin. She was also diagnosed with choledocholithiasis and underwent ERCP to remove the gallstones. Immediately after the procedure she went into sudden cardiac arrest and subsequently died, despite all of our efforts. We reviewed literature in order to identify possible causes of death because fatal outcome following an uneventful and successful procedure was not expected. It is important to bear in mind all possible complications of ERCP. Our focus during the literature search was on air embolism.

  19. Digitalised endoscopic retrograde pancreatography (D-ERP): A comparison with ERCP

    International Nuclear Information System (INIS)

    Soimakallio, S.; Pirinen, A.; Suhonen, M.

    1988-01-01

    Cannulation of the papilla of Vater was successful in 49 out of 65 cases (75.4%) and digital imaging of the pancreas in 38% of cases. Visualisation of the pancreatic duct with D-ERP was comparable to that of conventional ERCP. Absent or faint opacification of the parenchyma was seen in 39.5% of patients. Both methods were equally effective for the diagnosis of pancreatic tumours. D-ERP was better than ERCP for the diagnosis of chronic pancreatitis. Two patients (4.1%) had clinical evidence of mild acute pancreatitis following pancreatic duct injections. (orig.) [de

  20. Focal pancreatic enlargement: differentiation between pancreatic adenocarcinoma and focal pancreatitis on CT and ERCP

    International Nuclear Information System (INIS)

    Kim, Eun Kyung; Kim, Ki Whang; Lee, Jong Tae; Kim, Hee Soo; Yoo, Hyung Sik; Yu, Jeong Sik; Yoon, Sang Wook

    1995-01-01

    To differentiate the pancreatic adenocarcinoma from focal pancreatitis on CT and ERCP in cases of focal pancreatic enlargement. We analysed CT findings of 66 patients of pancreatic adenocarcinoma (n = 45) or focal pancreatitis (n = 21) with respect to size, density, calcification, pancreatic or biliary duct dilatation, fat plane obliteration around the vessels, direction of retroperitoneal extension, lymphadenopathy, pseudocyst formation and atrophy of pancreas. ERCP available in 48 patients were analysed in respect to morphologic appearance of CBD and pancreatic duct, and distance between the two ducts. The patients in focal pancreatitis were younger with more common history of alcohol drinking. There was no statistical difference in calcifications of the mass (18% in the adenocarcinoma, 33% in the focal pancreatitis), but a tendency of denser, larger number of calcifications was noted in focal pancreatitis. The finding of fat plane obliteration around the vessels were more common in pancreatic adenocarcinoma, and fascial thickenings were more prominent in focal pancreatitis, although not statistically significant. On ERCP, there were no differential points of CBD, pancreatic duct morphology, but distance between the two ducts at the lesion center was more wider in focal pancreatitis. Differentiating focal pancreatitis from pancreatic adenocarcinoma is difficult. However, we should consider the possibility of focal pancreatitis in cases of patients with young age, having alcoholic history in association with CT findings of large numbers of and dense calcifications, and ERCP findings of prominent separation of two duct at the lesion center

  1. Focal pancreatic enlargement: differentiation between pancreatic adenocarcinoma and focal pancreatitis on CT and ERCP

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Kim, Ki Whang; Lee, Jong Tae; Kim, Hee Soo; Yoo, Hyung Sik; Yu, Jeong Sik; Yoon, Sang Wook [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1995-10-15

    To differentiate the pancreatic adenocarcinoma from focal pancreatitis on CT and ERCP in cases of focal pancreatic enlargement. We analysed CT findings of 66 patients of pancreatic adenocarcinoma (n = 45) or focal pancreatitis (n = 21) with respect to size, density, calcification, pancreatic or biliary duct dilatation, fat plane obliteration around the vessels, direction of retroperitoneal extension, lymphadenopathy, pseudocyst formation and atrophy of pancreas. ERCP available in 48 patients were analysed in respect to morphologic appearance of CBD and pancreatic duct, and distance between the two ducts. The patients in focal pancreatitis were younger with more common history of alcohol drinking. There was no statistical difference in calcifications of the mass (18% in the adenocarcinoma, 33% in the focal pancreatitis), but a tendency of denser, larger number of calcifications was noted in focal pancreatitis. The finding of fat plane obliteration around the vessels were more common in pancreatic adenocarcinoma, and fascial thickenings were more prominent in focal pancreatitis, although not statistically significant. On ERCP, there were no differential points of CBD, pancreatic duct morphology, but distance between the two ducts at the lesion center was more wider in focal pancreatitis. Differentiating focal pancreatitis from pancreatic adenocarcinoma is difficult. However, we should consider the possibility of focal pancreatitis in cases of patients with young age, having alcoholic history in association with CT findings of large numbers of and dense calcifications, and ERCP findings of prominent separation of two duct at the lesion center.

  2. Launching Garbage-Bag Balloons.

    Science.gov (United States)

    Kim, Hy

    1997-01-01

    Presents a modification of a procedure for making and launching hot air balloons made out of garbage bags. Student instructions for balloon construction, launching instructions, and scale diagrams are included. (DDR)

  3. Venus Altitude Cycling Balloon Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The ISTAR Group ( IG) and team mate Thin Red Line Aerospace (TRLA) propose a Venus altitude cycling balloon (Venus ACB), an innovative superpressure balloon...

  4. Factors and Outcomes Associated with MRCP Use prior to ERCP in Patients at High Risk for Choledocholithiasis

    Directory of Open Access Journals (Sweden)

    Gobind Anand

    2016-01-01

    Full Text Available Background. Consensus guidelines recommend that patients at high risk for choledocholithiasis undergo endoscopic retrograde cholangiopancreatography (ERCP without additional imaging. This study evaluates factors and outcomes associated with performing magnetic resonance cholangiopancreatography (MRCP prior to ERCP among patients at high risk for choledocholithiasis. Methods. An institutional administrative database was searched using diagnosis codes for choledocholithiasis, cholangitis, and acute pancreatitis and procedure codes for MRCP and ERCP. Patients categorized as high risk for choledocholithiasis were evaluated. Results. 224 patients classified as high risk, of whom 176 (79% underwent ERCP only, while 48 (21% underwent MRCP prior to ERCP. Patients undergoing MRCP experienced longer time to ERCP (72 hours versus 35 hours, p<0.0001, longer length of stay (8 days versus 6 days, p=0.02, higher hospital charges ($23,488 versus $19,260, p=0.08, and higher radiology charges ($3,385 versus $1,711, p<0.0001. The presence of common bile duct stone(s on ultrasound was the only independent factor associated with less use of MRCP (OR 0.09, p<0.0001. Conclusions. MRCP use prior to ERCP in patients at high risk for choledocholithiasis is common and associated with greater length of hospital stay, higher radiology charges, and a trend towards higher hospital charges.

  5. ERCP can be safely and effectively performed by a pediatric gastroenterologist for choledocholithiasis in a pediatric facility.

    Science.gov (United States)

    Troendle, David M; Barth, Bradley A

    2013-11-01

    The aim of this study was to demonstrate that an appropriately trained pediatric gastroenterologist can perform endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis both safely and effectively. Retrospective analysis of ERCP experience from November 2006 to May 2012. Only ERCPs performed by a pediatric gastroenterologist on pediatric patients for the indication of suspected choledocholithiasis were included for formal chart review. Patient characteristics, procedural success, and adverse events were recorded, and subsequently compared with quality standards as defined by the American Society for Gastrointestinal Endoscopy Quality Task Force. A total of 154 ERCPs were performed, of which 65 (42%) were performed on unique patients for the indication of suspected choledocholithiasis. The median age was 15.2 years (range 1 month-18.4 years). The median weight was 65 kg (range 4-127 kg). Biliary cannulation was achieved in 65 (100%). All 65 patients underwent sphincterotomy. Ductal clearance was achieved in 64 (98%) patients during the initial ERCP session. Adverse events included 3 (5%) episodes of mild pancreatitis, 1 episode of moderate bleeding, and 1 episode of sphincterotomy clot causing obstruction and need for repeat ERCP within 1 week. Overall, 5 (8%) unique patients experienced a complication. Therapeutic ERCP for the indication of choledocholithiasis can be performed by an appropriately trained pediatric gastroenterologist at a pediatric facility with acceptable cannulation rates, stone extraction rates, and adverse event rates as defined by the American Society for Gastrointestinal Endoscopy Quality Task Force.

  6. Therapeutic balloon-assisted enteroscopy

    NARCIS (Netherlands)

    H. Aktas (Huseyin); P.B.F. Mensink (Peter)

    2009-01-01

    textabstractSince the introduction of the first balloon-based enteroscopic technique in 2001, therapeutic balloon-assisted enteroscopy (BAE) using either the single or double balloon enteroscopy technique (respectively SBE and DBE) has evolved rapidly. Argon plasma coagulation (APC), polypectomy,

  7. Comparative study of ultrasound and ERCP in the diagnosis of hepatic, biliary and pancreatic diseases: A prospective study based on a continuous series of 424 patients

    International Nuclear Information System (INIS)

    Frederic, N.; D'Hondt, M.; Hermanus, A.; Potvliege, R.; Deltenre, M.; Reuck, M. de

    1983-01-01

    A prospective study of the diagnostic yield of ultrasound (US) and ERCP was made on a continuous series of 424 patients. Technical failures were slightly more frequent with US (11%) than with ERCP (8%), while US proved more accurate than ERCP in the diagnosis of focal hepatic disease -94% of correct diagnoses versus 41% (n=17). In diffuse hepatic disease (n=63) the accuracy of both methods was the same -87% of correct diagnoses with US, 83% with ERCP. US had better performances (91%), while ERCP was more accurate in the diagnosis of common duct lithiasis or tumor (98% for ERCP, 36% for US). Although ERCP has a better diagnostic yield for pancreatic diseases (92% to 100% of correct diagnoses according to the lesions) associate complications, such as pseudo-cysts, abscess formation and extravasations are better demonstrated by US (95% of correct diagnoses versus 73%). The two methods thus prove to be complementary. (orig.)

  8. Comparative study of ultrasound and ERCP in the diagnosis of hepatic, biliary and pancreatic diseases: A prospective study based on a continuous series of 424 patients

    Energy Technology Data Exchange (ETDEWEB)

    Frederic, N.; D' Hondt, M.; Hermanus, A.; Potvliege, R.; Deltenre, M.; Reuck, M. de

    1983-08-01

    A prospective study of the diagnostic yield of ultrasound (US) and ERCP was made on a continuous series of 424 patients. Technical failures were slightly more frequent with US (11%) than with ERCP (8%), while US proved more accurate than ERCP in the diagnosis of focal hepatic disease -94% of correct diagnoses versus 41% (n=17). In diffuse hepatic disease (n=63) the accuracy of both methods was the same -87% of correct diagnoses with US, 83% with ERCP. US had better performances (91%), while ERCP was more accurate in the diagnosis of common duct lithiasis or tumor (98% for ERCP, 36% for US). Although ERCP has a better diagnostic yield for pancreatic diseases (92% to 100% of correct diagnoses according to the lesions) associate complications, such as pseudo-cysts, abscess formation and extravasations are better demonstrated by US (95% of correct diagnoses versus 73%). The two methods thus prove to be complementary.

  9. Routine vs "on demand" postoperative ERCP for small bile duct calculi detected at intraoperative cholangiography. Clinical evaluation and cost analysis.

    Science.gov (United States)

    Ammori, B J; Birbas, K; Davides, D; Vezakis, A; Larvin, M; McMahon, M J

    2000-12-01

    The detection of small and often asymptomatic gallbladder calculi within the bile duct at intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) frequently poses a management dilemma. Therefore, we set out to compare the outcomes and costs of two management strategies for small stones that remain in the bile duct after LC-routine postoperative endoscopic retrograde cholangiopancreatography (ERCP) vs observation alone with "on-demand" ERCP. We studied 70 patients with bile duct stones among 922 consecutive patients who underwent LC between 1990 and 1997. Data were collected prospectively. Bile duct calculi were detected in 70 of 705 patients (9.9%) with successful IOC. Of these, 44 patients had large calculi (> or =5 mm in diameter) and were subjected to a laparoscopic common bile duct exploration. The remaining 26 patients had small calculi (routine postoperative ERCP (group A, n = 8) or observation (group B, n = 14). ERCP was reserved for those who become symptomatic. The two groups were comparable for age and sex distribution. No complications developed during the follow-up period in patients assigned to observation, although four became symptomatic and underwent ERCP. In group A, ERCP demonstrated a clear biliary tree in four patients and bile duct calculi in three patients; it failed in one patient. In group B, ERCP demonstrated a clear bile duct in one patient and bile duct calculi in two patients; it also failed in one patient. Endoscopic sphincterotomy and duct clearance were achieved in all patients with demonstrable bile duct calculi at ERCP. There was no morbidity or mortality associated with ERCP. The overall hospital stay was significantly longer in group A than in group B (median 5 vs 1.5 days; p = 0.011); however, the number of outpatient clinic visits was significantly greater in group b (median 3 vs 5.5, p = 0.011). The mean hospital costs, including the costs of hospital stay, readmissions, ERCP, and follow-up, were

  10. Adjustable continence balloons

    DEFF Research Database (Denmark)

    Kjær, Line; Fode, Mikkel; Nørgaard, Nis

    2012-01-01

    . Fourteen patients (12%) ended up with an artificial sphincter or a urethral sling. Sixty patients (63%) experienced no discomfort and 58 (61%) reported being dry or markedly improved. Overall, 50 patients (53%) reported being very or predominantly satisfied. Conclusions. Adjustable continence balloons seem...

  11. Does glyceryl nitrate prevent post-ERCP pancreatitis? A prospective, randomized, double-blind, placebo-controlled multicenter trial

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Hornum, Mads; Elkjaer, Margarita

    2009-01-01

    OBJECTIVE: Acute pancreatitis is the most dreaded complication of ERCP. Two studies have shown a significant effect of glyceryl nitrate (GN) in preventing post-ERCP pancreatitis (PEP). We wanted to evaluate this promising effect in a larger study with a realistically precalculated incidence of PEP...... (PL) was an identical-looking patch applied before ERCP. A total of 401 patients received GN; 405 received PL. RESULTS: Forty-seven patients had PEP (5.8%), 18 (4.5%) in the GN group and 29 (7.1%) in the PL group. The relative risk reduction of PEP in the GN group of 36% (95% CI, 11%-65%) compared...... (P = .006) were more common in the GN group. Significant variables predictive of PEP were not having biliary stones extracted; hypotension after ERCP; morphine, propofol, glucagon, and general anesthesia during the procedure; or no sufentanil during the procedure. CONCLUSIONS: The trial showed...

  12. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis.

    Science.gov (United States)

    Lee, Hee Seung; Chung, Moon Jae; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2018-01-01

    Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial. We investigated the optimal timing for ERCP in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, and whether performing endoscopy within 24 h is superior to performing it after 24 h. We analyzed the clinical data of 505 patients with newly diagnosed acute pancreatitis, from January 1, 2005 to December 31, 2014. We divided the patients into two groups according to the timing of ERCP: pancreatitis and a bile duct obstruction without cholangitis. The mean age of the patients was 55 years (range: 26-90 years). Bile duct stones and biliary sludge were identified on endoscopy in 45 (61.6%) and 11 (15.0%) patients, respectively. The timing of ERCP within 72 h was not associated with ERCP-related complications (P = 0.113), and the total length of hospital stay was not different between urgent and early ERCP (5.9 vs. 5.7 days, P = 0.174). No significant differences were found in total length of hospitalization or procedural-related complications, in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, according to the timing of ERCP (< 24 h vs. 24-72 h).

  13. Post-ERCP bacteremia caused by Alcaligenes xylosoxidans in a patient with pancreas cancer

    Directory of Open Access Journals (Sweden)

    Akcay Korhan

    2006-09-01

    Full Text Available Abstract Alcaligenes xylosoxidans is an aerobic, motile, oxidase and catalase positive, nonfermentative Gram negative bacillus. This bacterium has been isolated from intestine of humans and from various hospital or environmental water sources. A.xylosoxidans is both waterborne and results from the poor-hygienic conditions healthcare workers are in. In this case report, the bacteremia which appeared in a patient with pancreas cancer after ERCP was described.

  14. MRCP compared to diagnostic ERCP for diagnosis when biliary obstruction is suspected: a systematic review

    International Nuclear Information System (INIS)

    Kaltenthaler, Eva C; Walters, Stephen J; Chilcott, Jim; Blakeborough, Anthony; Vergel, Yolanda Bravo; Thomas, Steven

    2006-01-01

    Magnetic resonance cholangiopancreatography (MRCP) is an alternative to diagnostic endoscopic retrograde cholangiopancreatography (ERCP) for investigating biliary obstruction. The use of MRCP, a non-invasive procedure, may prevent the use of unnecessary invasive procedures. The aim of the study was to compare the findings of MRCP with those of ERCP by the computation of accuracy statistics. Thirteen electronic bibliographic databases, covering biomedical, science, health economics and grey literature were searched. A systematic review of studies comparing MRCP to diagnostic ERCP in patients with suspected biliary obstruction was conducted. Sensitivity, specificity, likelihood ratios, acceptability and adverse events were reported. 25 studies were identified reporting several conditions including choledocholithiasis (18 studies), malignancy (four studies), obstruction (three studies), stricture (two studies) and dilatation (five studies). Three of the 18 studies reporting choledocholithiasis were excluded from the analysis due to lack of data, or differences in study design. The sensitivity for the 15 studies of choledocholithiasis ranged from 0.50 to 1.00 while specificity ranged from 0.83 to 1.00. The positive likelihood ratio ranged: from 5.44–47.72 and the negative likelihood ratio for the 15 studies ranged from 0.00–0.51. Significant heterogeneity was found across the 15 studies so the sensitivities and specificities were summarised by a Receiver Operating Characteristic (ROC) curve. For malignancy, sensitivity ranged from 0.81 to 0.94 and specificity from 0.92 to 1.00. Positive likelihood ratios ranged from 10.12 to 43 and negative likelihood ratios ranged from 0.15 to 0.21, although these estimates were less reliable. MRCP is a comparable diagnostic investigation in comparison to ERCP for diagnosing biliary obstruction

  15. Electronic and Microbiological Detection, Investigation, and Surveillance for Potential Hospital- Acquired Device Associated Infections at ERCP.

    OpenAIRE

    Ross, Jack

    2017-01-01

    Abstract Background Duodenoscopy, done 700,000 times annually, is potentially life saving in biliary and pancreatic disease. ERCP is prone to device associated infections due to a complex elevator mechanism and slim margin of safety in scope reprocessing with a high microbial burden. Nosocomial infections are difficult to detect without a marker organism or antibiotic phenotype. A cluster of ESBL infections was detected by electronic surveillance in 2014 in a large 865 bed facility. Methods U...

  16. ERCP-induced duodenal perforation successfully treated with endoscopic purse-string suture: a case report.

    Science.gov (United States)

    Li, Quanpeng; Ji, Jie; Wang, Fei; Ge, Xianxiu; Nie, Junjie; Xu, Boming; Zhang, Xiuhua; Jiang, Guobing; Miao, Lin

    2015-07-10

    Duodenal perforation is one of the most serious complications of endoscopic retrograde cholangiopancreatography (ERCP) and is difficult to manage. Recently, endoscopic purse-string suture, using endoloops with endoclips, is a relatively new technology and has provided good clinical results. However, the study and use of endoscopic purse-string suture on duodenal perforation is less and its feasibility and safety are unknown. Here, we report a case of ERCP-induced duodenal perforation successfully treated with endoscopic purse-string suture. During ERCP, fluoroscopy revealed abnormal perinephric gas shadowing after breaking and extracting the stones with a stone-removal basket. Then duodenal endoscopy showed an approximately 2.0 cm × 1.5 cm perforation on the lateral duodenal wall, with visible retroperitoneal loose connective tissue. Titanium clips were used to attempt closure of the perforation but failed because of the long diameter of the injury. Therefore, an endoscopic purse-string suture, using endoloops with endoclips, was employed with an Olympus double-lumen endoscope. The perforation was successfully closed. At the 2-month follow-up visit, the patient had no complaints or symptoms. Our case once again proved its feasibility and safety and provided a new perspective for surgeons.

  17. Application of remifentanil for conscious sedation and analgesia in short-term ERCP and EST surgery.

    Science.gov (United States)

    Sun, Guo-Qiang; Gao, Bao-Feng; Li, Guan-Jun; Lei, Yun-Long; Li, Jie

    2017-04-01

    This study aims to observe and evaluate the use of remifentanil in conscious sedation and analgesia for the safety and comfort of patients undergoing short-term endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST).Sixty-eight patients who underwent ERCP and EST were randomly divided into two groups: research group and control group. Patients in the research group were intravenously injected with remifentanil (80-2/3* age) for 1 to 2 minutes, combined with the intravenous injection of propofol (20-30 mg) during the course of treatment. ERCP surgery was performed when Ramsay sedation scale (RSS) score reached 2-3. During the surgery, patients were closely monitored for cough symptoms, aspiration, and respiratory and circulatory system performance, and timely treatment was performed. Sedative drugs were not given in patients in the control group.In research group, the circulatory and respiratory depression of patients was mild, only one patient needed to be treated, and there was no arrhythmia requiring treatment. Five patients had respiratory depression (blood oxygen saturation decreased to bear promise for a widespread use in future clinical practice.

  18. The ERCP quality network benchmarking project: a preliminary comparison of practice in UK and USA.

    Science.gov (United States)

    Oppong, Kofi W; Romagnuolo, Joseph; Cotton, Peter B

    2012-07-01

    The Endoscopic retrograde cholangiopancreatography (ERCP) Quality Network is a voluntary system for submission of data to generate individual report cards and benchmarking. The aim of this study was to compare aspects of ERCP practice between USA and UK participants. Analysis was limited to USA and UK based endoscopists who had each entered more than 30 cases. A number of practice and performance measures were studied including, rates of deep biliary cannulation, sedation use and success in bile duct stone removal. Patients attending for routine and emergency ERCP in participating tertiary and secondary care units in the UK and USA. 61 US endoscopists performed 18 182 procedures and 16 UK endoscopists 3172, respectively. The UK participants performed less complex procedures as judged by the accepted complexity grading system, 8% versus 35% at grade 3, psmall bile duct stones (success rate was 96% compared with 99%, psuccess in both cohorts, albeit significantly better in the USA. The inexorable drive to greater accountability and transparency of outcomes in endoscopic practice is likely to lead to increased participation in subsequent benchmarking projects.

  19. Propofol Sedation for ERCP Procedures: A Dilemna? Observations from an Anesthesia Perspective

    Directory of Open Access Journals (Sweden)

    Davinder Garewal

    2012-01-01

    Full Text Available Propofol sedation for endoscopic retrograde cholangiopancreatography (ERCP procedures is a popular current technique that has generated controversy in the medical field. Worldwide, both anesthetic and nonanesthetic personnel administer this form of sedation. Although the American and Canadian societies of gastroenterologists have endorsed the administration of propofol by nonanesthesia personnel, the US Food and Drug Administration (FDA has not licensed its use in this manner. There is some evidence for the safe use of propofol by nonanesthetic personnel in patients undergoing endoscopy procedures, but there are few randomized trials addressing the safety and efficacy of propofol in patients undergoing ERCP procedures. A serious possible consequence of propofol sedation in patients is that it may result in rapid and unpredictable progression from deep sedation to general anesthesia, and skilled airway support may be required as a rescue measure. Potential complications following deep propofol sedation include hypoxemia and hypotension. Propofol sedation for ERCP procedures is an area of clinical practice where discussion and mutual cooperation between anesthesia and nonanesthesia personnel may enhance patient safety.

  20. Cleft formation in pumpkin balloons

    Science.gov (United States)

    Baginski, Frank E.; Brakke, Kenneth A.; Schur, Willi W.

    NASA’s development of a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, centers on a pumpkin shape super-pressure design. Under certain circumstances, it has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired state instead. Success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and developing of means for the quantitative assessment of design measures that prevent the occurrence of undesired equilibrium. In this paper, we will use the concept of stability to classify cyclically symmetric equilibrium states at full inflation and pressurization. Our mathematical model for a strained equilibrium balloon, when applied to a shape that mimics the Phase IV-A balloon of Flight 517, predicts instability at float. Launched in Spring 2003, this pumpkin balloon failed to deploy properly. Observations on pumpkin shape type super-pressure balloons that date back to the 1980s suggest that within a narrowly defined design class of pumpkin shape super-pressure balloons where individual designs are fully described by the number of gores ng and by a single measure of the bulging gore shape, the designs tend to become more vulnerable with the growing number of gores and with the diminishing size of the bulge radius rB Weight efficiency considerations favor a small bulge radius, while robust deployment into the desired cyclically symmetrical configuration becomes more likely with an increased bulge radius. In an effort to quantify this dependency, we will explore the stability of a family of balloon shapes parametrized by (ng, rB) which includes a design that is very similar, but not identical, to the balloon of Flight 517. In addition, we carry out a number of simulations that demonstrate other aspects related to multiple equilibria of pumpkin balloons.

  1. The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study.

    Science.gov (United States)

    Zhang, Cheng; Yang, Yu-Long; Ma, Yue-Feng; Zhang, Hong-Wei; Li, Jing-Yi; Lin, Mei-Ju; Shi, Li-Jun; Qi, Chun-Chun

    2017-10-18

    Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups. In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication. The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent.

  2. Analysis of incidence and risk factors for ERCP-related adverse events in patients with primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    BI Rongxin

    2015-02-01

    Full Text Available ObjectiveTo investigate the incidence and risk factors for endoscopic retrograde cholangiopancreatography (ERCP-related adverse events in patients with primary sclerosing cholangitis (PSC. MethodsThis study included 72 patients who were diagnosed with PSC by magnetic resonance cholangiopancreatography and underwent ERCP in the Third Hospital of Xingtai City from December 2009 to December 2013. The incidence of postoperative adverse events within 30 d after ERCP was monitored and recorded. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ERCP-related adverse events in PSC patients. ResultsThe success rate of ERCP was 94.4% (68/72. Among all adverse events, the incidence of pancreatitis and biliary tract infection were highest (6.94% and 4.17%, while the incidence of perforation was lowest (1.38%. Univariate logistic regression analysis showed that the risk of adverse events was significantly higher in patients who underwent cholangiopancreatography and sphincterotomy than in those not undergoing these procedures (OR=13.642, P=0.017; OR=7.381, P=0.000; guide wire insertion and cholangiopancreatography also increased the incidence of adverse reactions (OR=8.042, P=0.000; OR=2.651, P=0.032. Multivariate logistic regression analysis showed that guide wire insertion (OR = 4.547, 95%CI: 1.076-12.543 and biliary sphincterotomy (OR=5.023, 95%CI: 2.643-18.321 are associated with the incidence of ERCP-related adverse events. ConclusionSphincterotomy and guide wire insertion can increase the risk of adverse events in PSC patients after ERCP.

  3. VVER ballooning experiments

    International Nuclear Information System (INIS)

    Gyoeri, Cs.; Hozer, Z.; Maroti, L.; Matus, L.

    1998-01-01

    A series of ballooning experiments was performed at the KFKI-AEKI in order to compare the mechanical behaviour and strength of Zircaloy-4 and Zr1%Nb claddings. The effects of temperature, oxidation and iodine absorption on deformation and burst pressure was investigated in almost 100 biaxial tests. Numerical post-test analyses have also been performed with the stand-alone fuel module of the French CATHARE code and the US fuel behaviour code FRAP-T6. Comparing the experimental and the analytical results, relevant differences of high temperature strength due to different α-β phase transition temperature were revealed between the investigated cladding materials. (author)

  4. Aerodynamics of a Party Balloon

    Science.gov (United States)

    Cross, Rod

    2007-01-01

    It is well-known that a party balloon can be made to fly erratically across a room, but it can also be used for quantitative measurements of other aspects of aerodynamics. Since a balloon is light and has a large surface area, even relatively weak aerodynamic forces can be readily demonstrated or measured in the classroom. Accurate measurements…

  5. Meta-Analysis of Early Endoscopic Retrograde Cholangiopancreatography (ERCP) ± Endoscopic Sphincterotomy (ES) Versus Conservative Management for Gallstone Pancreatitis (GSP).

    Science.gov (United States)

    Burstow, Matthew J; Yunus, Rossita M; Hossain, Md Belal; Khan, Shahjahan; Memon, Breda; Memon, Muhammed A

    2015-06-01

    The utility of early endoscopic retrograde cholangiopancreatography (ERCP) ± endoscopic sphincterotomy (ES) in the treatment of gallstone pancreatitis (GSP) is still contentious. The aim was to conduct a meta-analysis of randomized controlled trials (RCTs) investigating the treatment of GSP by early ERCP ± ES versus conservative management and analyzing the patient outcomes. A search of Medline, Embase, Science Citation Index, Current Contents, PubMed, and the Cochrane Database of Systematic Reviews identified all RCTs comparing early ERCP to conservative management in GSP published between January 1970 and January 2014. Search terms included "Endoscopic retrograde cholangiopancreatography (ERCP)"; "Endoscopic sphincterotomy"; "Gallstones"; "Bile duct stones"; "Gallstone pancreatitis"; "Biliary pancreatitis"; "Randomize/Randomised controlled trials"; "Conservative management/treatment"; "Human"; "English." Only prospective RCTs comparing early intervention (ie, between 24 and 72 h) with ERCP ± ES versus conservative management in GSP were included. Data extraction and critical appraisal was carried out independently by 2 authors (M.J.B. and M.A.M.) using predefined data fields. Variables analyzed included severity of pancreatitis (mild or severe), overall mortality, overall complications which included pseudocyst formation, organ failure (renal, respiratory, and cardiac), abnormal coagulation, biliary sepsis, and development of pancreatic abscess/phlegmon. The quality of RCTs was assessed using Jadad's scoring system. Random-effects model was used to calculate the outcomes of both binary and continuous data. Heterogeneity among the outcome variables of these trials was determined by the Cochran Q statistic and I2 index. The meta-analysis was prepared in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Eleven RCTs consisting of 1314 patients (conservative management=662, ERCP=652) were analyzed. There was a

  6. Success rate and complications of ERCP performed during hands-on training courses: a multicenter study in China.

    Science.gov (United States)

    Liao, Zhuan; Li, Zhao-Shen; Leung, Joseph W; Zou, Xiao-Ping; He, Li-Ping; Jia, Guo-Fa; Huang, Qiang; Ji, Ming; Huang, Liu-Ye; Chao, William S C

    2009-02-01

    Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP. We compared the success rates and complications between patients in the hands-on training courses and matched control patients. A retrospective, multicenter study. Seven endoscopy centers in mainland China. All patients who underwent ERCP during hands-on training courses at GI endoscopy conferences in China between January 2002 and December 2006 were included. Clinical and endoscopic characteristics, including age, sex, indication, therapeutic intervention, success rate, and complication, were collected. Differences in ERCP outcomes between domestic and foreign mentors were also compared. Conference, patient, and endoscopist-related variables were analyzed for potential risk factors associated with post-ERCP complications. Nine conferences with hands-on ERCP training, including 124 patients, were held at 7 endoscopy centers. There were no significant differences in the sex ratio, age, indication, and therapeutic intervention between patients for hands-on training (n = 124) and controls (n = 124). The success rates and overall complication rates were similar between the 2 groups (91.9% vs 92.7%, respectively, P = .811; 12.9% vs 9.7%, respectively, P = .422). Domestic mentors encountered more post-ERCP complications than foreign mentors (18.0% vs 0%, respectively, P = .001). Univariate analyses showed that a large-scale conference (P = .004), first-time mentorship (P = .015), and small case volume for the mentor (P = .015) were significantly associated with post-ERCP complications. Nominal significance in univariate testing was removed when analyzed in a comprehensive multivariate setting. A nonrandomized retrospective trial with only 7 centers (9 conferences). The success rate and overall complication rate were similar between patients in the

  7. Ocular Radiation Threshold Projection Based off of Fluoroscopy Time During ERCP.

    Science.gov (United States)

    Garg, Mrinal S; Patel, Pikul; Blackwood, Margaret; Munigala, Satish; Thakkar, Payal; Field, James; Wallace, Dustin; Agarwal, Satty; Aoun, Elie; Kulkarni, Abhijit; Dhawan, Manish; Farah, Katie; Thakkar, Shyam

    2017-05-01

    Current international guidelines for ocular radiation exposure suggest a threshold of 20 millisieverts (mSv)/year. Although endoscopists wear lead aprons, use of protective eye wear is optional. This study was conducted to analyze the lens radiation exposure during endoscopic retrograde cholangiopancreatography (ERCP) for endoscopists to determine the time of fluoroscopy needed to warrant using lens protection during ERCP. ERCP patients were prospectively enrolled. Indications, interventions, fluoroscopy time, dose, and attending ± fellow involvement were recorded. Radiation exposure was collected from body dosimeters and dosimeters placed between the eyes. Cumulative radiation doses were obtained at study completion and averaged over the total fluoroscopy time to determine the mSv/hour exposure. A total of 187 cases were included. Attendings and fellows wore lens dosimeters in 178 and 126 cases, respectively, and body dosimeters in 174 and 128 cases, respectively. Attendings and fellows wore lens dosimeters throughout 15.89 and 11.24 h of fluoroscopy, respectively. The cumulative radiation dose absorbed per lens dosimeters was 5.35 mSv for attendings and 2.55 mSv for fellows. The projected lens absorption by the body dosimeters was 19.03 mSv for attendings and 5.21 mSv for fellows. The hourly fluoroscopy lens exposure was 0.34 mSv/hour for attendings and 0.23 mSv/hour for fellows. The amount of fluoroscopy hours needed to reach the currently suggested lens threshold limit (20 mSv/year) was 59.41 h for attendings and 88.17 h for fellows. Radioprotective eye wear should be worn by physicians with yearly fluoroscopy times in similarly structured practices that meet or exceed these thresholds.

  8. Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP.

    Science.gov (United States)

    Chong, Charing Cn; Chiu, Philip Wy; Tan, Teresa; Teoh, Anthony Yb; Lee, Kit Fai; Ng, Enders Kwok Wai; Lai, Paul Bs; Lau, James Yw

    2016-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) for bile duct stone extraction has a major role in the treatment of cholangitis. It is well known that certain risk factors predispose to recurrence of such stones. The aims of this study were to evaluate the correlation between angulation of the common bile duct (CBD), right hepatic duct (RHD), and left hepatic duct (LHD) with recurrent cholangitic attacks and to elucidate other risk factors that may be associated with these attacks. This is retrospective study included 62 patients who had undergone therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stones. Their medical records were followed until May 1, 2009. The RHD, LHD, and CBD angulation and CBD diameter were measured on cholangiography prior to any endoscopic procedures. Among these 62 patients, 6 (9.7 %) had recurrence of cholangitis. Both angles of the RHD and the CBD were significantly smaller in the group with recurrence (P = 0.001, P = 0.004). A CBD angle ≤ 130(o) and RHD angle ≤ 125(o) were found to be significantly associated with an increased risk of recurrence (RR = 10.526, P = 0.033; RR = 24.97, P = 0.008) in multivariate analysis. Cholecystectomy was not a protective factor against recurrence of cholangitis (P = 0.615). Angulation of the CBD (≤ 130°) and RHD (≤ 125°) on ERCP are independent risk factors for recurrent cholangitis. Further prospective studies using these data may be warranted for a more accurate estimation and verification of the risk factors predisposing to recurrent cholangitis.

  9. Radio induced cancer risk during ERCP: Is it a real clinical problem? Riesgo de cáncer por irradiación durante ERCP: ¿Es un problema clínico real?

    Directory of Open Access Journals (Sweden)

    Manuel Luis Rodríguez-Perálvarez

    2011-04-01

    Full Text Available Background: in recent years many factors have been shown to influence dose received by the patient during ERCP. Therefore it is necessary to update radio induced cancer risk. Objectives: to calculate lifetime attributable risk of cancer during ERCP. To compare the risk with the most common X-ray examinations. Design: descriptive study with 393 consecutive ERCP performed at one center. Equipment used was Philips BV pulsera. In each exploration demographic and anthropometric variables of the patient were collected. Dosimetric quantities were calculated from exposure parameters. Effective dose was estimated using specific conversion factors. Organ doses and radio induced cancer incidence was estimated. Results: dose area product was 0.82 mGym² (IQR 0.4-1.5 with an average fluoroscopy time of 2 minutes and 45 seconds. Entrance surface dose was 30.7 mGy (IQR 15-60.8 and effective dose was 0.44 mSv (IQR 0.2-0.9. Multivariate analysis identified that difficult papillary cannulation (β0.4; p = 0.009, patient age (β-0.01; p = 0.001 and therapeutic applied (β= 0.89; p < 0.001 influenced dose-area product. The ERCP dose would be equivalent to the radiation received by twenty chest radiographs and would be about fourteen times smaller than a barium enema or twenty times less than that received during an abdominal CT. Lifetime attributable risk of cancer incidence was 4.08 and 16.81 per million procedures in diagnostic and therapeutic ERCP respectively. Conclusions: from the radiological point of view, ERCP is a safe technique that uses low exposure levels compared to other explorations commonly used in medicine. It implies a reasonably low risk of radio induced cancer.

  10. Air Force Cambridge Research Laboratories balloon operations

    Science.gov (United States)

    Danaher, T. J.

    1974-01-01

    The establishment and functions of the AFCRL balloon operations facility are discussed. The types of research work conducted by the facility are defined. The facilities which support the balloon programs are described. The free balloon and tethered balloon capabilities are analyzed.

  11. 21 CFR 874.4100 - Epistaxis balloon.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a) Identification. An epistaxis balloon is a device consisting of an inflatable balloon intended to control internal...

  12. The role of intraductal US in the management of idiopathic recurrent pancreatitis without a definite cause on ERCP.

    Science.gov (United States)

    Kim, Hyun Su; Moon, Jong Ho; Choi, Hyun Jong; Lee, Jong Chan; Han, Seung Hyo; Hong, Su Jin; Lee, Tae Hoon; Cheon, Young Koog; Cho, Young Deok; Park, Sang-Heum; Lee, Moon Sung

    2011-06-01

    The cause of pancreatitis is unknown in as many as 30% of cases of recurrent acute pancreatitis, even after ERCP. To investigate the role of intraductal US (IDUS) for managing idiopathic recurrent pancreatitis (IRP). Prospective study. Tertiary referral hospital. Thirty-one patients with suspicious IRP with negative findings on ERCP. IDUS during ERCP. IDUS findings showing any possible cause of pancreatitis. IDUS revealed small bile duct stones (≤3 mm) in 5 patients (16.1%) and sludge in 3 patients (9.7%). The detection rate for a bile duct stone and sludge was significantly higher in patients with a dilated CBD than a nondilated CBD on ERCP (71.4 vs 12.5%; P < .05). Recurrent pancreatitis did not develop in 7 of 8 patients with biliary stones or sludge after an endoscopic sphincterotomy (EST). Two patients (6.5%) demonstrated a small polypoid lesion on the distal end of the pancreatic duct. One patient underwent surgery for intra-ampullary cancer, and another one underwent EST without another attack of pancreatitis. Three patients (9.7%) showed evidence of chronic pancreatitis with small pancreatic stones and/or calcifications on IDUS. Small number of patients. IDUS results were not compared with those of conventional EUS. There was no reference standard for chronic pancreatitis as diagnosed by IDUS. IDUS identified a possible cause of idiopathic recurrent pancreatitis in 42% of patients with negative findings on ERCP. The IDUS-guided approach combined with ERCP and EST may be useful for decreasing recurring attacks of pancreatitis. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  13. Comparison between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP); Comparacion entre calongiografia por resonancia magnetica (CPRM) y colangiografia retrograda endoscopia (CPRE)

    Energy Technology Data Exchange (ETDEWEB)

    Pulpeiro, J. R.; Armesto, V. [Clinica Nosa Senora dos Ollos Grandes. Lugo (Spain); Lopez-Roses, L.; Lancho, A.; Gonzalez, A. [Hospital Xeral. Lugo (Spain)

    2000-07-01

    To assess the correlation between magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). The authors carried out a prospective study of 71 patients suspected of having biliary diseases. MRCP was performed, followed by ERCP.MRCP was done with a 1.5-T system using hypergradients, abdominal phase array coil and single-shot fast spin-echo (SSFSE) sequences with maximum signal intensity in T2-weighted images. This sequence only provides images of the fluids, similar to those obtained with ERCP. The results of ERCP were employed as a reference standard. Thirty patients were found to have stenosis (19 malignant and 11 benign). 25 had choledocholithiasis and 16 showed no abnormal findings. The correlation was complete in patients with stenosis. MRCP detected 23 cases of choledocholithiasis (ERCP was normal in the remaining two patients, but calculi were discovered on shpincterotomy). MRCP confirmed the normal condition of the bile duct in 12 of the 16 patients free of biliary disease (2 patients in whom ERCP had been normal had been diagnosed as having bile duct dilatation due to choledocholithiasis 24 hours and 10 days earlier, respectively, and two cases of presented ectasia due to fibrosis of the sphincter of Oddi showed good emptying during ERCP). MRCP using SSFSE is highly correlated with ERCP, which should be reserved for cases in which the diagnosis is in doubt or endoscopic management is necessary. (Author) 25 refs.

  14. US Air Force Balloon Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Worksheets containing pilot balloon data computed from releases at Air Force stations in the western United States. Elevation and azimuth angles are used to compute...

  15. US Daily Pilot Balloon Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Pilot Balloon observational forms for the United States. Taken by Weather Bureau and U.S. Army observers. Period of record 1918-1960. Records scanned from the NCDC...

  16. Retrieving Balloon Data in Flight

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's Ultra Long Duration Balloon (ULDB) program will soon make flights lasting up to 100 days. Some flights may generate high data rates and retrieving this data...

  17. US Monthly Pilot Balloon Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly winds aloft summary forms summarizing Pilot Balloon observational data for the United States. Generally labeled as Form 1114, and then transitioning to Form...

  18. Superpressure Tow Balloon for Extending Durations and Modifying Trajectories of High Altitude Balloon Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation involves the concept of using a Superpressure Tow Balloon (STB) with existing NASA high altitude balloon designs to form a tandem balloon...

  19. Pioneering Space Research with Balloons

    Science.gov (United States)

    Jones, W. V.

    NASA s Scientific Ballooning Planning Team has concluded that ballooning enables significant scientific discoveries while providing test beds for space instruments and training for young scientists Circumpolar flights around Antarctica have been spectacularly successful with fight durations up to 42 days Demand for participation in this Long-Duration Balloon LDB program a partnership with the U S National Science Foundation Office of Polar Programs is greater than the current capacity of two flights per campaign Given appropriate international agreements LDB flights in the Northern Hemisphere would be competitive with Antarctic flights and super-pressure balloons would allow comparable flights at any latitude The Balloon Planning Team made several recommendations for LDB flights provide a reliable funding source for sophisticated payloads extend the Antarctic capability to three flights per year and develop a comparable capability in the Arctic provide aircraft for intact-payload recovery develop a modest trajectory modification capability to enable longer flights and enhance super-pressure balloons to carry 1-ton payloads to 38 km Implementation of these recommendations would facilitate frequent access to near-space for cutting-edge research and technology development for a wide range of investigations

  20. Image-guided percutaneous management of duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP): assessment of efficacy and safety.

    Science.gov (United States)

    McCarthy, C J; Butros, S R; Dawson, S L; Arellano, R S

    2018-03-01

    To evaluate the efficacy and safety of image-guided percutaneous drain placement for duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP). A retrospective review of 7,249 ERCP examinations over a 10-year period was performed to identify cases of duodenal perforation. Indications for ERCP were documented, along with the clinical, laboratory, and imaging findings following perforation. Technical and clinical success of percutaneous drain placement was reviewed. Duodenal perforation occurred in 35 of 7,249 patients during the study period. Management included primary surgical debridement (n=2), conservative management consisting of bowel rest, nasogastric/nasojejunal tube placement (n=20), and percutaneous catheter drainage (n=13). Twenty-seven percutaneous drainage catheters were placed in 13 patients, with a mean duration of catheter drainage of 30.9 days (range 4-108 days). Ten patients were successfully treated with percutaneous management alone, and three required subsequent surgical intervention. Percutaneous management of duodenal perforation related to ERCP is associated with high technical and clinical success, and may obviate the need for surgical intervention. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Role of ERCP in the era of laparoscopic cholecystectomy for the evaluation of choledocholithiasis in sickle cell anemia

    Science.gov (United States)

    Issa, Hussain; Al-Salem, Ahmed H

    2011-01-01

    AIM: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis in patients with sickle cell anemia (SCA) in the era of laparoscopic cholecystectomy (LC). METHODS: Two hundred and twenty four patients (144 male, 80 female; mean age, 22.4 years; range, 5-70 years) with SCA underwent ERCP as part of their evaluation for cholestatic jaundice (CJ). The indications for ERCP were: CJ only in 97, CJ and dilated bile ducts on ultrasound in 103, and CJ and common bile duct (CBD) stones on ultrasound in 42. RESULTS: In total, CBD stones were found in 88 (39.3%) patients and there was evidence of recent stone passage in 16. Fifteen were post-LC patients. These had endoscopic sphincterotomy and stone extraction. The remaining 73 had endoscopic sphincterotomy and stone extraction followed by LC without an intraoperative cholangiogram. CONCLUSION: In patients with SCA and cholelithiasis, ERCP is valuable whether preoperative or postoperative, and in none was there a need to perform intraoperative cholangiography. Sequential endoscopic sphincterotomy and stone extraction followed by LC is beneficial in these patients. Endoscopic sphincterotomy may also prove to be useful in these patients as it may prevent the future development of biliary sludge and bile duct stones. PMID:21528058

  2. Etanercept, a TNF-alpha binding agent, is ineffective in the prevention of post-ERCP pancreatitis in canines.

    Science.gov (United States)

    Buscaglia, Jonathan M; Simons, Brian W; Prosser, Brent J; Ruben, Dawn S; Giday, Samuel A; Magno, Priscilla; Clarke, John O; Shin, Eun Ji; Kalloo, Anthony N; Kantsevoy, Sergey V; Gabrielson, Kathleen L; Jagannath, Sanjay B

    2008-07-10

    The incidence of post-ERCP pancreatitis is 1-22%. It continues to be a difficult problem for endoscopist and patient. Uncovering an agent that may be used to prevent its occurrence is critical. The aim of our study was to investigate the role of etanercept in the prevention of post-ERCP pancreatitis. Endoscopic retrograde pancreatography (ERP)-induced injury was performed in dogs using a previously established endoscopic model of post-ERCP pancreatitis. Eight study dogs underwent ERP: 4 were pre-treated with etanercept one day before the procedure and 4 were untreated. In addition, three control dogs not undergoing ERP were also studied. Serum levels of amylase, lipase, and TNF-alpha, as well as the ratio of urinary trypsinogen activation peptide (TAP) and urinary creatinine, were measured before and after ERP. Necropsy was performed on post-operative day 5. All pancreatic specimens were graded by two blinded pathologists according to a validated scoring system. Eight study dogs developed mild to moderate clinical pancreatitis with hyperamylasemia (11,538+/-4,065 U/L vs. 701+/-157 U/L; post-ERP peak levels vs. baseline values: Pdogs compared to control dogs (6.16+/-1.85 vs. 1.06+/-0.49; P=0.001). There were escalating total injury scores concordant with more elaborate methods of endoscopically-induced injury although the trend did not reach the statistical significance (P=0.223). When comparing untreated to etanercept-treated dogs, there were no significant differences in serum amylase levels (P=0.903), serum lipase levels (P=0.771), TAP/creatinine urinary ratio (P=0.912), and pancreatic injury score (P=0.324). Etanercept is ineffective in prevention of mild to moderate post-ERCP pancreatitis in canines. ERP-induced pancreatic injury can be used as a reliable animal model for studies investigating therapy and prevention of post-ERCP pancreatitis.

  3. Complications in endoscopic retrograde cholangiopancreatography (ERCP and endoscopic ultrasound (EUS: analysis of 7-year physician-reported adverse events

    Directory of Open Access Journals (Sweden)

    Niv Y

    2011-06-01

    Full Text Available Yaron Niv1, Yael Gershtansky2, Ron S Kenett3, Yossi Tal2, Shlomo Birkenfeld41Department of Gastroenterology, Rabin Medical Center, Petach Tikva, Israel; 2Medical Risk Management, The Madanes Group, Tel Aviv, Israel; 3The KPA Group, University of Torino, Turin, Italy; 4Clalit Health Services, Tel Aviv, IsraelIntroduction: The number of malpractice claims against physicians and health institutes is increasing continuously in Israel as in the rest of the Western world, and has become a serious financial burden.Aim: In this study we analyzed the reports of gastroenterologists on endoscopic retrograde cholangiopancreatography (ERCP and endoscopic ultrasound (EUS adverse events to the risk management authority between January 1, 2000 and December 31, 2006.Methods: All the reported adverse events associated with ERCP and EUS of health institutes and covered by Madanes Insurance Agency were summarized and analyzed. Clinical and epidemiological details about the patients, procedures, and adverse events were coded into an Excel worksheet, discussed, and evaluated.Results: Forty-two cases of ERCP and EUS adverse events were reported. There were nine cases of men (21.4% and the average age was 69.3 ± 14.3 years. During this period, 10,647 procedures were performed by the institutes concerned and the number of adverse events was 20.2 to 67.8 per year for 10,000 procedures. Perforation occurred in one out of 367 procedures, bleeding in one out of 5323 procedures, teeth trauma in one out of 5323 procedures, and respiratory complications in one out of 10,647 procedures.Conclusion: This is the first study in Israel about physicians' reports of ERCP and EUS adverse events. Physicians reported only about severe adverse events with high rate of mortality and morbidity.Keywords: ERCP, EUS, defensive medicine, perforation, bleeding, sedation, risk management, patient safety

  4. Sensor System for Super-Pressure Balloon Performance Modeling Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Long-duration balloon flights are an exciting new area of scientific ballooning, enabled by the development of large super-pressure balloons. As these balloons...

  5. Effect of diclofenac on the levels of lipoxin A4 and Resolvin D1 and E1 in the post-ERCP pancreatitis.

    Science.gov (United States)

    Zhao, Xiao-wen; Bao, Jun-jun; Hu, Cui; Ding, Hao; Liu, Xiao-chang; Mei, Qiao; Xu, Jian-ming

    2014-12-01

    Acute pancreatitis is one of the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Numerous studies have shown that administered nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the incidence of acute pancreatitis after ERCP. Little is known, however, about the mechanism of NSAIDs in preventing pancreatitis (PEP). In this study, we assigned patients to receive a single dose of intramuscular diclofenac 75 mg immediately after ERCP (diclofenac group) or without (control group). The primary outcome measure was the occurrence of PEP. The serum amylase levels were measured before ERCP and at 3 and 24 h post-procedure in all patients. The Lipoxin A4 (LXA4), Resolvin D1 (Rvd1), and Resolvin E1 (RvE1) levels were measured before ERCP, and 3 and 24 h after the procedure in 30 patients from the diclofenac group and 30 patients from the control group. A total of 120 patients were enrolled and completed the follow-up. The overall incidence of PEP was 13.3% (16/120). It occurred in four of 60 patients (6.67%) in the diclofenac group and in 12 of 60 patients (20.00%) in the control group (p = 0.032). The LxA4, RvD1, and RvE1 levels in the diclofenac group at 3 h after ERCP were significantly increased compared with before ERCP (p diclofenac group at 3 and 24 h after ERCP were significantly increased (p diclofenac after ERCP can reduce the incidence of PEP. This may be related to the fact that diclofenac can increase the levels of LxA4, RvD1, and RvE1.

  6. Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study

    Directory of Open Access Journals (Sweden)

    Mingmei Du

    2017-12-01

    Full Text Available Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP is widely performed as a treatment for biliary and pancreatic illness in China; however, there are few data available regarding post-ERCP infections. This study aimed to describe the overall incidence of post-ERCP infections and the epidemiological characteristics of infected patients in a large tertiary-care hospital in China. Methods Real-time surveillance was performed from 2012 through 2015 to identify all healthcare-associated infections (HAIs that occurred after ERCP, using an automatic system. All HAIs (e.g., cholangtitis, bacteremia were identified by infection control practitioners and doctors. Inpatient data were automatically collected by the surveillance system. Results A total of 1743 ERCP operations were included in the study, among these, 132 (7.57% HAIs were identified. ERCP postoperative infections occurred following different surgical procedures, with infection rates ranging from 3.58 to 13.51%. The most prevalent HAI was biliary tract infection (4.02%, followed by transient bacteremia (1.14%. Overall, 62 cases of bacteremia occurred following ERCP surgery and 34 (54.84% cases occurred on the day of the operation or 1-day post-surgery. The most prevalent isolates detected during bacteremia were Enterococcus faecium (12/58 and Escherichia coli (11/58. A large proportion (72.73% of the E. coli isolates and all of the E. faecium isolates were resistant to ciprofloxacin. In addition, only 37.50% of the E. coli isolates were susceptible to ceftriaxone. Conclusions The high incidence of post-ERCP infection and the prevalence of drug resistance suggests that employing second generation cephalosporin or ceftriaxone as the antibiotic of choice for prophylaxis before ERCP, as recommended by the Chinese clinical application of antibacterial drugs guidelines, may not be effective.

  7. Radiation exposure to examiners and patients during therapeutic ERCP: Dose optimisation and risk estimation

    International Nuclear Information System (INIS)

    Sulieman, A.; Kappas, K.; Theodorou, K.; Paroutoglou, G.; Kapatenakis, A.; Kapsoritakis, A.; Potamianos, S.; Vlychou, M.; Fezoulidis, I.

    2008-01-01

    Aim: This study intended to optimise the radiation dose during therapeutic ERCP, and to estimate the risk for examiners and patients, to compare the doses based on available data obtained by other researchers and reference levels recommended by international organizations, and to evaluate the technique applied in order to reduce patient and examiners doses. Materials and Methods: 153 patients were studied in two Gastroenterology Departments, (group A, 111; group B, 42). Thermoluminescent dosimeters (TLD) were used to measure the staff and patients entrance surface dose (ESD) at different body sites. Results: The mean ESD, exit and thyroid surface dose per procedure was estimated to be 68.75 mGy, 3.45 mGy and 0.67 mGy, respectively. The mean patient effective dose was 3.44 mSv, and the cancer risk per procedure was estimated to be 190 x10 -6 . The effective dose for the first, second and third examiner was 0.4 μSv, 0.2 μSv and 5.0 μSv, respectively. Conclusion: The patient dose can be optimized by the presence of two experienced examiners and reduction of radiographic images. The examiners should use a wrap around lead apron since the highest dose originating from the X-ray tube, is incident on their side and back. The current formulae, which exist, underestimate the effective dose to the examiners, when they are applied for ERCP procedures. For both patients and examiners, our results were up to 60% lower compared to the lowest values found in previous studies. (authors)

  8. Status of the NASA Balloon Program

    Science.gov (United States)

    Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

    1993-01-01

    The NASA Balloon Program (BP) is examined in an overview of design philosophy, R&D activities, flight testing, and the development of a long-duration balloon for Antarctic use. The Balloon Recovery Program was developed to qualify the use of existing films and to design improved materials and seals. Balloon flights are described for studying the supernova SN1987a, and systems were developed to enhance balloon campaigns including mobile launch vehicles and tracking/data-acquisition systems. The technical approach to long-duration ballooning is reviewed which allows the use of payloads of up to 1350 kg for two to three weeks. The BP is responsible for the development of several candidate polyethylene balloon films as well as design/performance standards for candidate balloons. Specific progress is noted in reliability and in R&D with respect to optimization of structural design, resin blending, and extrusion.

  9. Acoustic Detection from Aerial Balloon Platform

    National Research Council Canada - National Science Library

    Reiff, C; Pham, T; Scanlon, M; Noble, J; Van Landuyt, A; Petek, J; Ratches, J

    2004-01-01

    ... such as unmanned aerial vehicles (UAVs) and balloons. Our most immediate collaboration focuses on the use of acoustic sensors on small balloons and/or aerostats at several elevations and on the ground with the primary goals...

  10. Mars Solar Balloon Lander, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The Mars Solar Balloon Lander (MSBL) is a novel concept which utilizes the capability of solar-heated hot air balloons to perform soft landings of scientific...

  11. Structure variations of pumpkin balloon

    Science.gov (United States)

    Yajima, N.; Izutsu, N.; Honda, H.

    2004-01-01

    A lobed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super-pressure balloon. This paper deals with extensions of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes, belts or a strut. When the original pumpkin shape is modified by these systems, the superior characteristics of the 3-D gore design, incorporating large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail. Application for ground structures are also mentioned.

  12. Complications of balloon packing in epistaxis

    NARCIS (Netherlands)

    Vermeeren, Lenka; Derks, Wynia; Fokkens, Wytske; Menger, Dirk Jan

    2015-01-01

    Although balloon packing appears to be efficient to control epistaxis, severe local complications can occur. We describe four patients with local lesions after balloon packing. Prolonged balloon packing can cause damage to nasal mucosa, septum and alar skin (nasal mucosa, the cartilaginous skeleton

  13. Magnetic resonance cholangiopancreaticography as a diagnostic tool for common bile duct stones - A comparison with ERCP and clinical follow-up

    NARCIS (Netherlands)

    Kats, J; Kraai, M; Dijkstra, AJ; Koster, K; ter Borg, F; Hazenberg, HJA; Schattenkerk, ME; des Plantes, BGZ; Eddes, EH

    2003-01-01

    Background/Aims: The diagnostic potential of magnetic resonance cholangiopancreaticography (MRCP) has improved as a result of evolving technique. MRCP has the advantage of negligible morbidity and mortality in contrast to endoscopic retrograde cholangiopancreatography (ERCP). This study was

  14. Routine endoscopic ultrasound in moderate and indeterminate risk patients of suspected choledocholithiasis to avoid unwarranted ERCP: A prospective randomized blinded study.

    Science.gov (United States)

    Sharma, Rajesh; Menachery, John; Choudhary, Narendra S; Kumar, Mandhir; Puri, Rajesh; Sud, Randhir

    2015-07-01

    Endoscopic ultrasound (EUS) is the most sensitive test for diagnosis of common bile duct stones and it may avoid unnecessary endoscopic retrograde cholangiopancreatography (ERCP). The purpose of this study was to evaluate whether EUS done initially would avoid unnecessary ERCP in patients with moderate or indeterminate risk for occurrence of choledocholithiasis. Patients with biliary colic or acute biliary pancreatitis, who were referred for suspected choledocholithiasis on the basis of alterations in liver function tests were prospectively included over 12 months period in blinded randomized fashion. Endoscopic ultrasonography was performed for all patients. Patients were randomized to two groups. ERCP was done in all patients in group A irrespective of the EUS findings, while in the group B, ERCP was done only in those patients in whom EUS was suggested the presence of common bile duct stone or sludge. A total of 50 patients were randomized into each group. EUS diagnosed common bile duct stones in 24 out of 50 patients (48 %) in group A, and ERCP identified common bile duct stones in 23 of those 24 patients. Twenty-eight out of 50 patients had common bile duct stones/sludge in group B, which were removed by subsequent ERCP. However, ERCP could be avoided in 22 cases (44 %) of group B and none of these patients had biliary symptoms up to 6 months of follow up. In patients with moderate or indeterminate risk for choledocholithiasis, prior EUS done for confirmation of choledocholithiasis avoids unnecessary ERCP in almost half of the cases.

  15. Fluid hydration to prevent post-ERCP pancreatitis in average- to high-risk patients receiving prophylactic rectal NSAIDs (FLUYT trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Smeets, Xavier J N M; da Costa, David W; Fockens, Paul; Mulder, Chris J J; Timmer, Robin; Kievit, Wietske; Zegers, Marieke; Bruno, Marco J; Besselink, Marc G H; Vleggaar, Frank P; van der Hulst, Rene W M; Poen, Alexander C; Heine, Gerbrand D N; Venneman, Niels G; Kolkman, Jeroen J; Baak, Lubbertus C; Römkens, Tessa E H; van Dijk, Sven M; Hallensleben, Nora D L; van de Vrie, Wim; Seerden, Tom C J; Tan, Adriaan C I T L; Voorburg, Annet M C J; Poley, Jan-Werner; Witteman, Ben J; Bhalla, Abha; Hadithi, Muhammed; Thijs, Willem J; Schwartz, Matthijs P; Vrolijk, Jan Maarten; Verdonk, Robert C; van Delft, Foke; Keulemans, Yolande; van Goor, Harry; Drenth, Joost P H; van Geenen, Erwin J M

    2018-04-02

    Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of ERCP and may run a severe course. Evidence suggests that vigorous periprocedural hydration can prevent PEP, but studies to date have significant methodological drawbacks. Importantly, evidence for its added value in patients already receiving prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) is lacking and the cost-effectiveness of the approach has not been investigated. We hypothesize that combination therapy of rectal NSAIDs and periprocedural hydration would significantly lower the incidence of post-ERCP pancreatitis compared to rectal NSAIDs alone in moderate- to high-risk patients undergoing ERCP. The FLUYT trial is a multicenter, parallel group, open label, superiority randomized controlled trial. A total of 826 moderate- to high-risk patients undergoing ERCP that receive prophylactic rectal NSAIDs will be randomized to a control group (no fluids or normal saline with a maximum of 1.5 mL/kg/h and 3 L/24 h) or intervention group (lactated Ringer's solution with 20 mL/kg over 60 min at start of ERCP, followed by 3 mL/kg/h for 8 h thereafter). The primary endpoint is the incidence of post-ERCP pancreatitis. Secondary endpoints include PEP severity, hydration-related complications, and cost-effectiveness. The FLUYT trial design, including hydration schedule, fluid type, and sample size, maximize its power of identifying a potential difference in post-ERCP pancreatitis incidence in patients receiving prophylactic rectal NSAIDs. EudraCT: 2015-000829-37 . Registered on 18 February 2015. 13659155 . Registered on 18 May 2015.

  16. Simulating clefts in pumpkin balloons

    Science.gov (United States)

    Baginski, Frank; Brakke, Kenneth

    2010-02-01

    The geometry of a large axisymmetric balloon with positive differential pressure, such as a sphere, leads to very high film stresses. These stresses can be significantly reduced by using a tendon re-enforced lobed pumpkin-like shape. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin shape, including the constant bulge angle (CBA) design, the constant bulge radius (CBR) design, CBA/CBR hybrids, and NASA’s recent constant stress (CS) design. Utilizing a hybrid CBA/CBR pumpkin design, Flight 555-NT in June 2006 formed an S-cleft and was unable to fully deploy. In order to better understand the S-cleft phenomenon, a series of inflation tests involving four 27-m diameter 200-gore pumpkin balloons were conducted in 2007. One of the test vehicles was a 1/3-scale mockup of the Flight 555-NT balloon. Using an inflation procedure intended to mimic ascent, the 1/3-scale mockup developed an S-cleft feature strikingly similar to the one observed in Flight 555-NT. Our analysis of the 1/3-scale mockup found it to be unstable. We compute asymmetric equilibrium configurations of this balloon, including shapes with an S-cleft feature.

  17. Stability of the pumpkin balloon

    Science.gov (United States)

    Baginski, Frank

    A large axisymmetric balloon with positive differential pressure, e.g., a sphere, leads to high film stresses. These can be significantly reduced by using a lobed pumpkin-like shape re-enforced with tendons. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin-shape at full inflation, including the constant bulge angle (CBA) design and the constant bulge radius (CBR) design. The authors and others have carried out stability studies of CBA and CBR designs and found instabilities under various conditions. While stability seems to be a good indicator of deployment problems for large balloons under normal ascent conditions, one cannot conclude that a stable design will deploy reliably. Nevertheless, stability analysis allows one to quantify certain deployment characteristics. Ongoing research by NASA's Balloon Program Office utilizes a new design approach developed by Rodger Farley, NASA/GSFC, that takes into account film and tendon strain. We refer to such a balloon as a constant stress (CS) pumpkin design. In June 2006, the Flight 555-NT balloon (based on a hybrid CBR/CBA design) developed an S-cleft and did not deploy. In order to understand the S-cleft phenomena and study a number of aspects related to the CS-design, a series of inflation tests were conducted at TCOM, Elizabeth City, NC in 2007. The test vehicles were 27 meter diameter pumpkins distinguished by their respective equatorial bulge angles (BA). For example, BA98 indicates an equatorial bulge angle of 98° . BA90, BA55, and BA00 are similarly defined. BA98 was essentially a one-third scale version of of the Flight 555 balloon (i.e., 12 micron film instead of 38.1 micron, mini-tendons, etc.). BA90 and BA55 were Farley CS-designs. BA00 was derived from the BA55 design so that a flat chord spanned adjacent tendons. In this paper, we will carry out stability studies of BA98, BA90, BA55, and BA00. We discuss the deployment problem of pumpkin balloons in light of 2007 inflation

  18. Scientific ballooning: Past, present and future

    Science.gov (United States)

    Jones, W. Vernon

    2013-02-01

    Balloons have been used for scientific research since they were invented in France more than 200 years ago. Cosmic rays were discovered 100 years ago with an experiment flown on a manned balloon. A major change in balloon design occurred in 1950 with the introduction of the socalled natural shape balloon with integral load tapes. This basic design has been used with more or less continuously improved materials for scientific balloon flights for the past half century, including long-duration balloon (LDB) flights around Antarctica for the past two decades. The U.S. National Aeronautics and Space Administration (NASA) is currently developing a super-pressure balloon that would enable extended duration missions above 99.5% of the Earth's atmosphere at any latitude. Ultra-long-duration balloon (ULDB) flights enabled by constant-volume balloons should result in an even greater sea change in scientific ballooning than the inauguration of long-duration balloon (LDB) flights in Antarctica during the 1990-91 austral summer.

  19. A systematic review of the management and outcome of ERCP related duodenal perforations using a standardized classification system.

    Science.gov (United States)

    Cirocchi, Roberto; Kelly, Michael Denis; Griffiths, Ewen A; Tabola, Renata; Sartelli, Massimo; Carlini, Luigi; Ghersi, Stefania; Di Saverio, Salomone

    2017-12-01

    The incidence of duodenal perforation after ERCP ranges from 0.09% to 1.67% and mortality up to 8%. This systematic review was registered in Prospective Register of Systematic Reviews, PROSPERO. Stapfer classification of ERCP-related duodenal perforations was used. The systematic search yielded 259 articles. Most frequent post-ERCP perforation was Stapfer type II (58.4%), type I second most frequent perforation (17.8%) followed by Stapfer type III in 13.2% and type IV in 10.6%. Rate of NOM was lowest in Stapfer type I perforations (13%), moderate in type III lesions (58.1%) and high in other types of perforations (84.2% in type II and 84.6% in IV). In patients underwent early surgical treatment (24 h from ERCP) interventions performed were more complex. In type I lesions post-operative mortality rate was higher in patients underwent late operation (>24 h). In type I lesions, failure of NOM occurred in 42.8% of patients. In type II failure of NOM occurred in 28.9% of patients and in type III there was failure of NOM in only 11.1%, none in type IV. Postoperative mortality after NOM failure was 75% in type I, 22.5% in type II and none died after surgical treatment for failure of NOM in type III perforations. This systematic review showed that in patients with Stapfer type I lesions, early surgical treatment gives better results, however the opposite seems true in Stapfer III and IV lesions. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  20. Clinical effect of endoscopic nasobiliary drainage in prevention of post-ERCP pancreatitis in patients with choledocholithiasis

    Directory of Open Access Journals (Sweden)

    ZHAO Xiaowen

    2014-08-01

    Full Text Available ObjectiveTo investigate the clinical effect of endoscopic nasobiliary drainage (ENBD in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP pancreatitis (PEP and hyperamylasemia in patients with choledocholithiasis. MethodsA total of 560 patients with choledocholithiasis who underwent ERCP from October 2010 to December 2013 were included in the study. ENBD was performed in 371 patients (test group, and the other 189 patients were designated as control group. Serum amylase level was measured at 3 and 24 h after ERCP, and the incidence of PEP and hyperamylasemia was determined. Comparison of continuous data between the two groups was made by t test, while comparison of rates was made by chi-square test. ResultsThe incidence rates of PEP and hyperamylasemia in the test group were 8.1% (30/371 and 13.7% (51/371, respectively, significantly lower than those in the control group (13.8%, 26/189; 21.2%, 40/189, (χ2 = 4.47, P=0.034; χ2=5.06, P=0.024. The serum amylase levels at 3 and 24 h after ERCP in the test group were 215.34±304.00 U/L and 199.38±273.32 U/L, respectively, significantly lower those in the control group (283.28±261.76 U/L and 257.05±199.25 U/L (t=2.61, P=0.01; t=2.57, P=0.01. ConclusionENBD can effectively reduce the incidence of PEP and hyperamylasemia in patients with choledocholithiasis.

  1. Initial Cholecystectomy with Cholangiography Decreases Length of Stay Compared to Preoperative MRCP or ERCP in the Management of Choledocholithiasis.

    Science.gov (United States)

    Lin, Christine; Collins, Jay N; Britt, Rebecca C; Britt, Lunzy D

    2015-07-01

    There are several treatments available for choledocholithiasis, but the optimal treatment is highly debated. Some advocate preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) with cholangiography (IOC). Others advocate initial LC + IOC followed by common bile duct exploration or ERCP. The purpose of this study was to determine whether initial LC + IOC had a shorter length of stay (LOS) compared with preoperative magnetic resonance cholangiopancreatography (MRCP) or ERCP. Patients who underwent cholecystectomy between 2012 and 2013 at two institutions were reviewed. Patients were selected if they had suspected choledocholithiasis, indicated by dilated CBD and/or elevated bilirubin, or confirmed choledocholithiasis. They were excluded if they had pancreatitis or cholangitis. There were 126 patients with suspected choledocholithiasis in this study. Of these, 97 patients underwent initial LC ± IOC with an average LOS of 3.9 days. IOC was negative in 47.4 per cent patients, and they had a shorter LOS compared with positive IOC patients (2.93 vs 4.82, P choledocholithiasis.

  2. Development of scientific ballooning in Japan

    Science.gov (United States)

    Nishimura, Jun

    On the occasion of the 50th Anniversary Celebration of COSPAR of this year of 2008, it is worthwhile to summarize the results of the Scientific ballooning in early days in connection with the recent developments in various countries. Nishina Laboratories, Riken, had started the observations of cosmic rays with rubber balloons as early as 1942. However it was interrupted soon by the war II. After the war, new research group started in collaboration with several universities with nuclear emulsions put on the rubber balloons in 1950, and then soon after the group manufactured by themselves and launched the first plastic balloon in 1953. Based on additional technologies during a few years developed by these group, the Institute of Nuclear Study, INS, the University of Tokyo, organized the large campaign of 14 emulsion chambers and a pellicle stack with 8 plastic balloons in 1956. It is to be noted that the project was one of the largest in the world standard in those days. By the experience of this campaign, the importance of the balloon technologies was more recognized, and INS organized the group to study the balloon technologies, and had established some developments. The systematic study of scientific ballooning has started, when the scientific ballooning laboratory was founded in 1965, in the new Institute of ISAS, the University of Tokyo. The permanent balloon base of "Sanriku Balloon Center" was founded in 1971. This group has expended all efforts for the scientific ballooning, launching 10-20 balloons in each year with new inventions such as the studies of; Technologies to manufacture the reliable plastic balloons, New Balloon materials, New instrumentations for scientific ballooning, Systems of long duration flights including Antarctica flights, International collaboratiom, etc. Up to now almost 600 plastic balloons were launched during past 50 years. Then the scientific balloonings have played important and indispensable roles for the development of space

  3. MELD Scores and Child–Pugh Classifications Predict the Outcomes of ERCP in Cirrhotic Patients With Choledocholithiasis

    Science.gov (United States)

    Zhang, Jinshun; Ye, Liping; Zhang, Jinlan; Lin, Minhua; He, Saiqin; Mao, Xinlin; Zhou, Xianbin; Zhi, Fachao

    2015-01-01

    Abstract Endoscopic retrograde cholangiopancreatography (ERCP) is challenging in cirrhotic patients with choledocholithiasis. We evaluated the safety and efficacy of ERCP in cirrhotic patients with choledocholithiasis and accessed the model for end-stage liver disease (MELD) scores and Child–Pugh classifications for prediction of morbidity and mortality. From January 2000 to June 2014, 77 ERCP operations were performed in cirrhotic patients with choledocholithiasis. The data on operative complications were analyzed. MELD scores and Child–Pugh classifications were calculated and associated with operative outcomes and survival. Telephone follow-up was performed to determine survival situations. No death, perforation, or hemorrhage caused by gastroesophageal varices occurred as a result of the procedure. The rate of intraoperative hemorrhage was 13.0%, and the rate of postoperative morbidity was 27.3% including hemorrhage (18.2%), post-ERCP pancreatitis (6.1%), aggravated infection of the biliary tract (1.3%), hepatic encephalopathy (1.3%), and respiratory failure (1.3%). Four (5.2%) patients had both intraoperative and postoperative hemorrhage. Receiver operating characteristic analysis identified MELD scores higher than 11.5 as the best cutoff value for predicting complication incidence (95% confidence interval = 0.63–0.87). Twenty-one (44.7%) patients with a MELD score above 11.5 developed a complication, and 3 (10%) patients who had a lower MELD score developed a complication (P = 0.001). Both MELD score and Child–Pugh classification had prognostic value in patients without jaundice, although sex may result in different prognostic values based on the 2 scores. The rate of complications was not significantly different among patients with different Child–Pugh classifications. No significant difference was observed in patients with different MELD scores or Child–Pugh classifications in terms of median survival times. ERCP is an effective and safe

  4. Trainee involvement increases precut rates and delays access to the common bile duct without an increase in procedure-related adverse events: a brave new world of ERCP training?

    Directory of Open Access Journals (Sweden)

    Voiosu Theodor

    2018-03-01

    Full Text Available Background and aims. Selective cannulation of the desired duct is a key element in ERCP procedures and an important step in the training of fellows. However, there is limited data about technical success and patient safety for ERCPs conducted in a training setting.We aimed to evaluate the impact of trainee involvement on the cannulation technique and procedure related outcomes at ERCP.

  5. PEBS - Positron Electron Balloon Spectrometer

    CERN Document Server

    von Doetinchem, P.; Kirn, T.; Yearwood, G.Roper; Schael, S.

    2007-01-01

    The best measurement of the cosmic ray positron flux available today was performed by the HEAT balloon experiment more than 10 years ago. Given the limitations in weight and power consumption for balloon experiments, a novel approach was needed to design a detector which could increase the existing data by more than a factor of 100. Using silicon photomultipliers for the readout of a scintillating fiber tracker and of an imaging electromagnetic calorimeter, the PEBS detector features a large geometrical acceptance of 2500 cm^2 sr for positrons, a total weight of 1500 kg and a power consumption of 600 W. The experiment is intended to measure cosmic ray particle spectra for a period of up to 20 days at an altitude of 40 km circulating the North or South Pole. A full Geant 4 simulation of the detector concept has been developed and key elements have been verified in a testbeam in October 2006 at CERN.

  6. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  7. Viscoelastic behaviour of pumpkin balloons

    Science.gov (United States)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    2008-11-01

    The lobes of the NASA ULDB pumpkin-shaped super-pressure balloons are made of a thin polymeric film that shows considerable time-dependent behaviour. A nonlinear viscoelastic model based on experimental measurements has been recently established for this film. This paper presents a simulation of the viscoelastic behaviour of ULDB balloons with the finite element software ABAQUS. First, the standard viscoelastic modelling capabilities available in ABAQUS are examined, but are found of limited accuracy even for the case of simple uniaxial creep tests on ULDB films. Then, a nonlinear viscoelastic constitutive model is implemented by means of a user-defined subroutine. This approach is verified by means of biaxial creep experiments on pressurized cylinders and is found to be accurate provided that the film anisotropy is also included in the model. A preliminary set of predictions for a single lobe of a ULDB is presented at the end of the paper. It indicates that time-dependent effects in a balloon structure can lead to significant stress redistribution and large increases in the transverse strains in the lobes.

  8. Ballooning stability of JET discharges

    International Nuclear Information System (INIS)

    Huysmans, G.T.A.; Goedbloed, J.P.; Galvao, R.M.O.; Lazzaro, E.; Smeulders, P.

    1989-01-01

    Conditions under which ballooning modes are expected to be excited have recently been obtained in two different types of discharges in JET. In the first type, extremely large pressure gradients have been produced in the plasma core through pellet injections in the current rise phase followed by strong additional heating. In the second type, the total pressure of the discharge is approaching the Troyon limit. The stability of these discharges with respect to the ideal MHD ballooning modes has been studied with the stability code HBT. The equilibria are reconstructed with the IDENTC code using the external magnetic measurements and the experimental pressure profile. The results show that the evaluated high beta discharge is unstable in the central region of the plasma. This instability is related to the low shear and not to a large pressure gradient, as expected at the Troyon limit. In the pellet discharges the regions with the large pressure gradients are unstable to ballooning modes at the time of the beta decay, which ends the period of enhanced performance. The maximum pressure gradient in these discharges is limited by the boundary of the first region of stability. The observed phenomena at the beta decay are similar to those observed at the beta limit in DIII-D and TFTR. (author)

  9. Titan Balloon Convection Model, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This innovative research effort is directed at determining, quantitatively, the convective heat transfer coefficients applicable to a Montgolfiere balloon operating...

  10. Current trends of balloon laryngoplasty in Thailand.

    Science.gov (United States)

    Moungthong, Greetha; Bunbanjerdsuk, Sacarin; Wright, Nida; Sathavornmanee, Thanakrit; Setabutr, Dhave

    2017-06-01

    To describe the current trend in balloon laryngoplasty usage and experience by practicing otolaryngologists in Thailand. Anonymous 11 question online and paper survey of otolaryngologists on their current balloon laryngoplasty practices. Current practices and experience in balloon laryngoplasty were queried with multiple choice and open-ended questions. Laser use is the most commonly utilized instrument to treat airway stenosis in Thailand. 86% of respondents do not have experience with balloon dilatation; yet, almost half (47.6%) report they perform a minimum of five airway surgeries per year. Most respondents had been in practice for less than 6 years (41%) and reported that they did not have exposure to balloon use during residency training. The largest barrier reported for the use of balloon instrumentation in the airway is inexperience (44.4%) followed by cost (38.3%), yet most feel that treatment in airway stenosis could benefit by usage of balloons (95.5%). Most otolaryngologists in Thailand do not have experience with the use of balloon dilatation and lack of exposure remains the largest barrier to its use. Otolaryngologists in Thailand feel that increased usage of balloons in the airway could improve airway stenosis treatment in the country.

  11. Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy for the management of cholelithiasis with choledocholithiasis

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Introduction : The ′Rendezvous′ technique consists of laparoscopic cholecystectomy (LC standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. Materials And Methods: From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In ′group-A′,41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP and common bile duct (CBD clearance and second by LC. In ′group-B′, 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. Results: In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5% and in arm-B in 39 cases (93%. In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22% and severe pancreatitis in five patients (12% versus none of the patients (0% in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. Conclusion: One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient′s compliance and prevents unnecessary intervention to CBD.

  12. Balloon dilatations of esophageal strictures

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeong Jin; Juhng, Seon Kwan; Kim, Jae Kyu; Chung, Hyon De [Chonnam National University College of Medicine, Seoul (Korea, Republic of)

    1990-04-15

    Most benign esophageal strictures can be successfully dilated with conventional bougienage technique. But occasionally strictures are so tight, lengthy, or sometimes irregular that this technique fail, and surgical intervention is required. Since 1974 Gruentzig balloon catheter has succeed when used for strictures in the cardiac and peripheral vasculatures, the biliary and urinary tracts, the colon of neonates after inflammatory disease and also in the esophagus. Fluoroscopically guided balloon catheters were used to dilate 30 esophageal strictures in 30 patients over 3 years at Department of Diagnostic Radiology, Chonnam University, College of Medicine. The distribution of age was from 7 years to 71 days and the ratio of male to female was 15:15. The causes of benign stricture (23 cases) were post-operative strictures (13), chemical (4), achalasia (3), chronic inflammation (2), esophageal rupture (1) and those of malignant stricture (7 cases) were post-radiation stricture of primary esophageal cancer (6) and metastatic esophageal cancer (1). The success rate of procedure was 93% (28/30). The causes of failure were the failure of passage of stricture due to markedly dilated proximal segment of esophagus (1 case) and too long segment of stricture (1 case). Complication of procedure was the diverticular-formation of esophagus in 3 cases, but has no clinical significance in follow-up esophagography. In conclusion, fluoroscopically guided balloon dilation of esophageal stricture appears to be safe, effective treatment and may be have theoretical advantages over conventional bougienage and also should be considered before other methods of treatment are used.

  13. Balloon dilatations of esophageal strictures

    International Nuclear Information System (INIS)

    Seo, Jeong Jin; Juhng, Seon Kwan; Kim, Jae Kyu; Chung, Hyon De

    1990-01-01

    Most benign esophageal strictures can be successfully dilated with conventional bougienage technique. But occasionally strictures are so tight, lengthy, or sometimes irregular that this technique fail, and surgical intervention is required. Since 1974 Gruentzig balloon catheter has succeed when used for strictures in the cardiac and peripheral vasculatures, the biliary and urinary tracts, the colon of neonates after inflammatory disease and also in the esophagus. Fluoroscopically guided balloon catheters were used to dilate 30 esophageal strictures in 30 patients over 3 years at Department of Diagnostic Radiology, Chonnam University, College of Medicine. The distribution of age was from 7 years to 71 days and the ratio of male to female was 15:15. The causes of benign stricture (23 cases) were post-operative strictures (13), chemical (4), achalasia (3), chronic inflammation (2), esophageal rupture (1) and those of malignant stricture (7 cases) were post-radiation stricture of primary esophageal cancer (6) and metastatic esophageal cancer (1). The success rate of procedure was 93% (28/30). The causes of failure were the failure of passage of stricture due to markedly dilated proximal segment of esophagus (1 case) and too long segment of stricture (1 case). Complication of procedure was the diverticular-formation of esophagus in 3 cases, but has no clinical significance in follow-up esophagography. In conclusion, fluoroscopically guided balloon dilation of esophageal stricture appears to be safe, effective treatment and may be have theoretical advantages over conventional bougienage and also should be considered before other methods of treatment are used

  14. Simulation of stratospheric balloon environment

    International Nuclear Information System (INIS)

    Sable, C.

    1974-01-01

    The behavior of materials used for the construction of stratospheric balloons is studied at DERTS by means of irradiations performed in reals time and simulating the exact flight environment. Two chambers were designed in the laboratory and are described together with the experimental procedure. In order to reduce cost and save time, it is worth accelerating the simulation when only a preliminary evaluation of the sample's properties is required. For this reason, a systematic study was undertaken in order to evaluate the respective effects of different parameters on the material degradation. The results of this study are given [fr

  15. Balloon dilatation of iatrogenic urethral strictures

    International Nuclear Information System (INIS)

    Acunas, B.; Acunas, G.; Gokmen, E.; Celik, L.

    1988-01-01

    Balloon dilatation of the urethra was performed in five patients with iatrogenic urethral strictures. The urethral strictures were successfully negotiated and dilated in all patients. Redilatation became necessary in a period ranging from 3 to 10 months. The authors believe that balloon dilatation of the urethra can be safely and successfully performed; the procedure produces minimal trauma and immediate relief of symptoms. (orig.)

  16. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures

    NARCIS (Netherlands)

    Vos, P. M.; van Beek, E. J.; Smits, N. J.; Rauws, E. A.; Gouma, D. J.; Reeders, J. W.

    2000-01-01

    BACKGROUND: Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in

  17. Early Cosmic Ray Research with Balloons

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Michael, E-mail: michael.walter@desy.de

    2013-06-15

    The discovery of cosmic rays by Victor Hess during a balloon flight in 1912 at an altitude of 5350 m would not have been possible without the more than one hundred years development of scientific ballooning. The discovery of hot air and hydrogen balloons and their first flights in Europe is shortly described. Scientific ballooning was mainly connected with activities of meteorologists. It was also the geologist and meteorologist Franz Linke, who probably observed first indications of a penetrating radiation whose intensity seemed to increase with the altitude. Karl Bergwitz and Albert Gockel were the first physicists studying the penetrating radiation during balloon flights. The main part of the article deals with the discovery of the extraterrestrial radiation by V. Hess and the confirmation by Werner Kolhörster.

  18. Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y gastric bypass: technical features.

    Science.gov (United States)

    Facchiano, Enrico; Quartararo, Giovanni; Pavoni, Vittorio; Liscia, Gadiel; Naspetti, Riccardo; Sturiale, Alessandro; Lucchese, Marcello

    2015-02-01

    Laparoscopic gastric bypass is one of the most performed bariatric operations worldwide. The exclusion of stomach and duodenum after this operation makes the access to the biliary tree, in order to perform an endoscopic retrograde cholangiopancreatography (ERCP), very difficult. This procedure could be more often required than in overall population due to the increased incidence of gallstones after bariatric operations. Among the different techniques proposed to overcome this drawback, laparoscopic access to the excluded stomach has been described by many authors with a high rate of success reported. We herein describe our technique to perform laparoscopic transgastric ERCP. A gastrotomy on the excluded stomach is performed to introduce a 15-mm trocar. Two stitches are passed through the abdominal wall and placed at the two sides of the gastrotomy for traction. The intragastric trocar is used to pass a side-viewing endoscope to access the biliary tree. In patients with a past history of Roux-en-Y gastric bypass (RYGB), the present technique allows us a standardized, safe, and reproducible access to the major papilla and the biliary tree using a transgastric access. This will lead to simplify the procedure and reduce the risk of peritoneal contamination.

  19. Trajectory Control For High Altitude Balloons

    Science.gov (United States)

    Aaron, K.; Nock, K.; Heun, M.; Wyszkowski, C.

    We will discuss the continuing development of the StratoSailTM Balloon Trajectory Control System presented at the 33rd COSPAR in 2000. A vertical wing suspended on a 15-km tether from a high altitude balloon uses the difference in wind velocity between the altitude of the balloon and the altitude of the wing to create an aerodynamic sideforce. This sideforce, transmitted to the balloon gondola via the tether, causes the balloon to move laterally. Although the balloon's resultant drift velocity is quite small (a few meters per second), the effect becomes significant over long periods of time (hours to days). Recently, a full-scale wing, rudder and boom assembly has been fabricated, a winch system testbed has been completed, and a lightweight tether with reduced susceptibility to ultraviolet damage has been developed. The development effort for this invention, with pending international patents, has been funded by the NASA/SBIR program in support of the Ultra Long Duration Balloon (ULDB) program.

  20. 14 CFR 61.115 - Balloon rating: Limitations.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Balloon rating: Limitations. 61.115 Section... rating: Limitations. (a) If a person who applies for a private pilot certificate with a balloon rating... operate a gas balloon. (b) If a person who applies for a private pilot certificate with a balloon rating...

  1. Accurate Determination of the Volume of an Irregular Helium Balloon

    Science.gov (United States)

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine

    2013-01-01

    In a recent paper, Zable described an experiment with a near-spherical balloon filled with impure helium. Measuring the temperature and the pressure inside and outside the balloon, the lift of the balloon, and the mass of the balloon materials, he described how to use the ideal gas laws and Archimedes' principal to compute the average molecular…

  2. Abdominal cavity balloon for preventing a patient's bleeding

    NARCIS (Netherlands)

    Naber, E.E.H.; Rutten, H.J.T.; Jakimowicz, J.J.; Goossens, R.H.M.; Moes, C.C.M.; Buzink, S.N.

    2007-01-01

    The invention relates to an abdominal cavity balloon for preventing a haemorrhage in a patient's pelvic region, comprising an inflatable balloon, wherein the balloon is pro vided with a smooth surface and with a strip that is flex- urally stiff and formed to follow the balloon's shape for po

  3. Looners: Inside the world of balloon fetishism

    OpenAIRE

    McIntyre, Karen E

    2011-01-01

    In the spring of 1997, Shaun had just broken up with a boyfriend, and his roommate had moved out. Living alone for the first time and relieved of the fear that someone might walk in the door, he was finally able to indulge his fantasy. The young man sat on his couch and started blowing up balloons. Shaun had loved playing with balloons since he was a child. When he hit puberty, he felt his first orgasm rubbing against a balloon. It was then that his relationship with the object took ...

  4. A comparative study of internally and externally capped balloons using small scale test balloons

    Science.gov (United States)

    Bell, Douglas P.

    1994-01-01

    Caps have been used to structurally reinforce scientific research balloons since the late 1950's. The scientific research balloons used by the National Aeronautics and Space Administration (NASA) use internal caps. A NASA cap placement specification does not exist since no empirical information exisits concerning cap placement. To develop a cap placement specification, NASA has completed two in-hangar inflation tests comparing the structural contributions of internal caps and external caps. The tests used small scale test balloons designed to develop the highest possible stresses within the constraints of the hangar and balloon materials. An externally capped test balloon and an internally capped test balloon were designed, built, inflated and simulated to determine the structural contributions and benefits of each. The results of the tests and simulations are presented.

  5. Recent Developments in Balloon Support Instrumentation at TIFR Balloon Facility, Hyderabad.

    Science.gov (United States)

    Vasudevan, Rajagopalan

    2012-07-01

    The Balloon Facility of Tata Institute of Fundamental Research has been conducting stratospheric balloon flights regularly for various experiments in Space Astronomy and Atmospheric Sciences. A continuous improvement in Balloon flight Support instrumentation by the Control Instrumentation Group to keep in space with the growing complexities of the scientific payloads have contributed to the total success of balloon flights conducted recently. Recent improvements in display of Balloon position during balloon flight by showing on real time the balloon GPS position against Google TM maps is of immense help in selecting the right spot for payload landing and safe recovery . For further speeding up the payload recovery process, a new GPS-GSM payload system has been developed which gives SMS of the payload position information to the recovery team on their cell phones. On parallel footing, a new GPS- VHF system has been developed using GPS and Radio Modems for Balloon Tracking and also for obtaining the payload impact point. On the Telecommand side, a single board Telecommand/ Timer weighing less than 2 Kg has been specially developed for use in the mesosphere balloon test flight. The interference on the existing Short Range Telemetry System has been eliminated by introducing a Band Pass Filter and LNA in the Receiving system of the modules, thereby enhancing its reliability. In this paper , we present the details of the above mentioned developments.

  6. Deployment Instabilities of Lobed-Pumpkin Balloon

    Science.gov (United States)

    Nakashino, Kyoichi

    A lobed-pumpkin balloon, currently being developed in ISAS/JAXA as well as in NASA, is a promising vehicle for long duration scientific observations in the stratosphere. Recent ground and flight experiments, however, have revealed that the balloon has deployment instabilities under certain conditions. In order to overcome the instability problems, a next generation SPB called 'tawara' type balloon has been proposed, in which an additional cylindrical part is appended to the standard lobed-pumpkin balloon. The present study investigates the deployment stability of tawara type SPB in comparison to that of standard lobed-pumpkin SPB through eigenvalue analysis on the basis of finite element methods. Our numerical results show that tawara type SPB enjoys excellent deployment performance over the standard lobed-pumpkin SPBs.

  7. Magnetometer for Balloons and UAVs Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This Phase I SBIR project will investigate a new, low-cost approach to atomic magnetometry that is suited for operation from UAVs and research balloons. Atomic...

  8. Solid State Inflation Balloon Active Deorbiter

    Data.gov (United States)

    National Aeronautics and Space Administration — The Solid State Inflation Balloon (SSIB) is a simple, reliable, low-cost, non-propulsive system for deliberate deorbit and control of downrange point-of-impact that...

  9. Shielded Mars Balloon Launcher (SMBL) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences, along with its partner Vertigo Industries, proposes a novel approach to deployment of balloon-based payloads into the Martian atmosphere....

  10. Test ventilation with smoke, bubbles, and balloons

    International Nuclear Information System (INIS)

    Pickering, P.L.; Cucchiara, A.L.; McAtee, J.L.; Gonzales, M.

    1987-01-01

    The behavior of smoke, bubbles, and helium-filled balloons was videotaped to demonstrate the mixing of air in the plutonium chemistry laboratories, a plutonium facility. The air-distribution patterns, as indicated by each method, were compared. Helium-filled balloons proved more useful than bubbles or smoke in the visualization of airflow patterns. The replay of various segments of the videotape proved useful in evaluating the different techniques and in identifying airflow trends responsible for air mixing. 6 refs

  11. Significance of balloon pressure recording during angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zollikofer, C.L.; Salomonowitz, E.; Frick, M.P.; Castaneda-Zuniga, W.R.; Amplatz, K.; Bruehlmann, W.F.

    1985-05-01

    During angioplasty of artificial stenoses, atherosclerotic human cadaver arteries, and normal canine arteries, pressure and volume of the dilatation balloons were continuously recorded. We found that a sudden yield of a lesion corresponded to a sudden drop in the pressure curve and an increase of the balloon volume. Volume monitoring was insensitive, but pressure recording was very precise. Continuous pressure recording, using a non-compliant inflation system, correctly demonstrated small breaks and ruptures of atherosclerotic vessels, changes not seen on fluoroscopy.

  12. Gondola development for CNES stratospheric balloons

    Science.gov (United States)

    Vargas, A.; Audoubert, J.; Cau, M.; Evrard, J.; Verdier, N.

    The CNES has been supporting scientific ballooning since its establishment in 1962. The two main parts of the balloon system or aerostat are the balloon itself and the flight train, comprising the house-keeping gondola, for the control of balloon flight (localization and operational telemetry & telecommand - TM/TC), and the scientific gondola with its dedicated telecommunication system. For zero pressure balloon, the development of new TM/TC system for the housekeeping and science data transmission are going on from 1999. The main concepts are : - for balloon house-keeping and low rate scientific telemetry, the ELITE system, which is based on single I2C bus standardizing communication between the different components of the system : trajectography, balloon control, power supply, scientific TM/TC, .... In this concept, Radio Frequency links are developed between the house keeping gondola and the components of the aerostat (balloon valve, ballast machine, balloon gas temperature measurements, ...). The main objectives are to simplify the flight train preparation in term of gondola testing before flight, and also by reducing the number of long electrical cables integrated in the balloon and the flight train; - for high rate scientific telemetry, the use of functional interconnection Internet Protocol (IP) in interface with the Radio Frequency link. The main idea is to use off-the-shelf IP hardware products (routers, industrial PC, ...) and IP software (Telnet, FTP, Web-HTTP, ...) to reduce the development costs; - for safety increase, the adding, in the flight train, of a totally independent house keeping gondola based on the satellite Inmarsat M and Iridium telecommunication systems, which permits to get real time communications between the on-board data mobile and the ground station, reduced to a PC computer with modem connected to the phone network. These GEO and LEO telecommunication systems give also the capability to operate balloon flights over longer distance

  13. [Coronary angioplasty using double balloon in artery of large calibre (hugging balloons)].

    Science.gov (United States)

    Centemero, M P; Cano, M N; Maldonado, G; de Almeida, J D; Sousa, A G; Sousa, J E

    1993-07-01

    In this case report the transluminal coronary angioplasty was performed in a oversized right coronary artery with a severe lesion with thrombus inside, using the Hugging balloon technique (two dilatation balloon catheters used simultaneously). This technique achieved minimal residual lesion and had a favorable clinical outcome of the patient.

  14. Outcomes of Endoscopic Retrograde Cholangiopancreatography (ERCP) and Sphincterotomy for Suspected Sphincter of Oddi Dysfunction (SOD) Post Roux-En-Y Gastric Bypass.

    Science.gov (United States)

    Lim, Chin Hong; Jahansouz, Cyrus; Freeman, Martin L; Leslie, Daniel B; Ikramuddin, Sayeed; Amateau, Stuart K

    2017-10-01

    Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD. Over a period of 5 years at the University of Minnesota, we retrospectively reviewed a prospectively collected database of a cohort of patients whom had a previous Roux-en-Y gastric bypass and whom had a subsequent ERCP for suspected SOD. Patients were categorized by modified Milwaukee classification, and outcomes were evaluated by patients' self-reporting of symptoms at follow-up. We identified 50 patients who underwent laparoscopic-assisted gastrostomy for endoscopic retrograde cholangiopancreatography post Roux-en-Y gastric bypass over the study period. Within this group, 35 patients (70%) were suspected to have SOD. Nine patients (25.7%) were classified as type I, 19 patients (54.3%) type II, and seven patients (20%) type III. Thirty-four patients (97.1%) had biliary sphincterotomy, and 17 patients (48.6%) had both biliary and pancreatic sphincterotomy. Fourteen (40%) had repeated ERCP. At median follow-up of 11.5 months, type I SOD had two responders (25%), type II had nine responders (52.9%), and type III had one responder (14.3%). A subgroup analysis did not show significant differences in improvement of symptoms between patients whom had single versus repeated ERCP or biliary sphincterotomy alone versus both biliary and pancreatic sphincterotomy. Three patients (9%) had post-ERCP pancreatitis. SOD in patients post Roux-en-Y gastric bypass is complex due to multiple confounding

  15. Advanced Onboard Energy Storage Solution for Balloons, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Balloon Programs at NASA are looking for a potential 100 day missions at mid-altitudes. These balloons would be powered by solar panels to take advantage of...

  16. Crash in Australian outback ends NASA ballooning season

    Science.gov (United States)

    Harris, Margaret

    2010-06-01

    NASA has temporarily suspended all its scientific balloon launches after the balloon-borne Nuclear Compton Tele scope (NCT) crashed during take-off, scattering a trail of debris across the remote launch site and overturning a nearby parked car.

  17. Spectrum of ballooning instabilities in a stellarator

    International Nuclear Information System (INIS)

    Cooper, W.A.; Singleton, D.B.; Dewar, R.L.

    1995-08-01

    The recent revival of interest in the application of the 'ballooning formalism' to low-frequency plasma instabilities has prompted a comparison of the Wentzel-Brillouin-Kramers (WKB) ballooning approximation with an (in principle) exact normal mode calculation for a three-dimensional plasma equilibrium. Semiclassical quantization, using the ideal magnetohydrodynamic (MHD) ballooning eigenvalue to provide a local dispersion relation, is applied to a ten-field period stellarator test case. Excellent qualitative agreement, and good quantitative agreement is found with predictions from the TERPSICHORE code for toroidal mode numbers from 1 to 14 and radial mode numbers from 0 to 2. The continuum bands predicted from three-dimensional WKB theory are too narrow to resolve. (author) 3 figs., 24 refs

  18. [Intraaortic balloon pumping( IABP) in Japan].

    Science.gov (United States)

    Ono, Tomoyuki; Tanoue, Yoshihisa; Tominaga, Ryuji

    2014-07-01

    The intraaortic balloon pumping (IABP) is the most widely used circulatory assist device. IABP increases coronary perfusion in diastolic phase by the inflation of the balloon in the descending aorta (diastolic augmentation) and reduces afterload in systolic phase by the deflation of the balloon( systolic unloading). IABP improves the hemodynamic condition of patients who fall into acute heart failure and/or cardiogenic shock. Six-type IABP system can be used in Japan. The IABP-SHOCK II trial shows that there is no significant difference in mortality between optimal medical treatment with IABP and without IABP in addition to early revascularization. Clinical backgrounds in Japan are different from those in IABP-SHOCK II trial, and the further prospective studies of IABP in Japan thus called for.

  19. Performance of the EUSO-Balloon electronics

    International Nuclear Information System (INIS)

    Barrillon, P.; Dagoret, S.; Miyamoto, H.; Moretto, C.; Bacholle, S.; Blaksley, C; Gorodetzky, P.; Jung, A.; Prévôt, G.; Prat, P.; Bayer, J.; Blin, S.; Taille, C. De La; Cafagna, F.; Fornaro, C.; Karczmarczyk, J.; Tanco, G. Medina; Osteria, G.; Perfetto, F.; Park, I.

    2016-01-01

    The 24th of August 2014, the EUSO-Balloon instrument went for a night flight for several hours, 40 km above Timmins (Canada) balloon launching site, concretizing the hard work of an important part of the JEM-EUSO collaboration started 3 years before. This instrument consists of a telescope made of two lenses and a complex electronic chain divided in two main sub-systems: the PDM (Photo Detector Module) and the DP (Data Processor). Each of them is made of several innovative elements developed and tested in a short time. This paper presents their performances before and during the flight

  20. Exponential Growth of Nonlinear Ballooning Instability

    International Nuclear Information System (INIS)

    Zhu, P.; Hegna, C. C.; Sovinec, C. R.

    2009-01-01

    Recent ideal magnetohydrodynamic (MHD) theory predicts that a perturbation evolving from a linear ballooning instability will continue to grow exponentially in the intermediate nonlinear phase at the same linear growth rate. This prediction is confirmed in ideal MHD simulations. When the Lagrangian compression, a measure of the ballooning nonlinearity, becomes of the order of unity, the intermediate nonlinear phase is entered, during which the maximum plasma displacement amplitude as well as the total kinetic energy continues to grow exponentially at the rate of the corresponding linear phase.

  1. Efficacy and safety of ERCP in a low-volume hospital Eficacia y seguridad de la CPRE en un hospital con bajo volumen

    OpenAIRE

    José María Riesco-López; Manuel Vázquez-Romero; Juana María Rizo-Pascual; Miguel Rivero-Fernández; Rebeca Manzano-Fernández; Rosario González-Alonso; Eloísa Moya-Valverde; Antonio Díaz-Sánchez; Rocío Campos-Cantero

    2013-01-01

    Background and aims: there is little scientific evidence on the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) performed in low-volume hospitals; however, in our country, it is growing up its implementation. The objectives of our study were to evaluate the efficacy and safety of this technique performed by two endoscopists with basic training in a center of this nature and analyze the learning curve in the first procedures. Patients and methods: single-center retrospective ...

  2. Ballooning behavior in the golden orbweb spider Nephilapilipes (Araneae: Nephilidae

    Directory of Open Access Journals (Sweden)

    Vanessa M.J. Lee

    2015-01-01

    Full Text Available Ballooning, a mode of aerial dispersal in spiders, is an innate behavior that requires appropriate physiological and meteorological conditions. Although only rarely reported in the golden orbweb spiders, family Nephilidae, the large geographic distributions of most nephilids—in particular of Nephila species—would imply that these spiders likely routinely disperse by ballooning in spite of giant female sizes. Here we study ballooning behavior in the golden orbweb spider Nephila pilipes (Fabricius, 1793. Specifically, we test for the propensity of spiderlings to deploy ballooning as a dispersal mechanism. We subjected a total of 59 first-instar spiderlings to a wind experiment at two wind speeds (2.17 ± 0.02 m s-1 and 3.17 ± 0.02 m s-1 under laboratory conditions. Under an average wind speed of 3.17 m s-1, none of the spiderlings exhibited pre-ballooning or ballooning behavior. However, at an average wind speed of 2.17 m s-1, 53 (89.8% spiderlings showed pre-ballooning behavior, and 17 (32.1% of the pre-ballooners ultimately ballooned. Our results concur with prior reports on spiderlings of other families that pre-ballooning behavior is a requirement for ballooning to occur. Furthermore, although we cannot rule out other dispersal mechanisms such as synanthropic spread, our findings suggest that the widespread N. pilipes uses ballooning to colonize remote oceanic islands.

  3. Outcomes of intragastric balloon placements in a private practice setting

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; Alders, Peter R. H.; Chuttani, Ram; Scherpenisse, Joost

    2015-01-01

    Intragastric balloons are used as a treatment for obesity. Much of the data collected on balloons has been in the context of clinical trials in academic medical centers or as a bridge to bariatric surgery in obesity centers. The aim of this study was to investigate the efficacy and safety of balloon

  4. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  5. Fasting and meal-suppressed ghrelin levels before and after intragastric balloons and balloon-induced weight loss

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M. H.; Eichenberger, R. I.

    2014-01-01

    Intragastric balloons may be an option for obese patients with weight loss failure. Its mode of action remains enigmatic. We hypothesised depressed fasting ghrelin concentrations and enhanced meal suppression of ghrelin secretion by the gastric fundus through balloon contact and balloon-induced

  6. Viscoresistive g-modes and ballooning

    International Nuclear Information System (INIS)

    Dagazian, R.Y.; Paris, R.B.

    1980-01-01

    The resistive G-mode and its particular form, the resistive ballooning mode, are treated as limits of a single simple model. MHD theory including parallel and perpendicular viscosity, finite shear, and finite beta is employed to study their linear stability

  7. Treatment of tuberculous bronchostenosis: balloon bronchoplasty

    International Nuclear Information System (INIS)

    Ahn, Joong Mo; Im, Jung Gi; Han, Joon Koo; Park, Jae Hyung

    1993-01-01

    The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/ FVC. There was an improvement of dyspnea in 69% (9/13), decrease of wheezing in 69% (9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84% (11/13) and 53% (7/13), respectively. The significant increase of FEV1/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculous less than one third of left upper lobe, whereas there was no increase in those of more than one third. The was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment

  8. Low dose intravaginal misoprostol versus intracervical balloon ...

    African Journals Online (AJOL)

    Background:The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. Objective:To compare the safety and efficacy of a low dose intravaginal misoprostol and intracervical Foley's catheter for cervical ripening. Design:A ...

  9. Double-balloon endoscopy: Who needs it?

    DEFF Research Database (Denmark)

    Hendel, J.W.; Vilmann, P.; Jensen, T.

    2008-01-01

    Objective. Double-balloon endoscopy (DBE) made the small bowel accessible to inspection and therapy in its entirety. However, DBE is a time-consuming procedure that requires a highly skilled endoscopist, several nurses and - more often than not - anesthesiological support. This makes the selection...

  10. Mechanical properties of ANTRIX balloon film and fabrication of single cap large volume balloons

    Science.gov (United States)

    Suneel Kumar, B.; Sreenivasan, S.; Subba Rao, J. V.; Manchanda, R. K.

    2008-11-01

    The zero pressure plastic balloons used for high altitude studies are generally made from polyethylene material. Tensile properties of the thin film polymer are the key parameters for material selection due to extremely low temperature of -90 °C encountered by the balloons in the tropopause region during the ascent at equatorial latitudes. The physical and structural properties of the material determine the uniformity of the stress distribution over the entire shell. Load stresses from the suspended load propagate via load tapes heat sealed along with the gore seals as per the balloon design. A balance between this heat seal strength and the film strength is a desirable property of the basic resin in terms of the bubble strength, gauge uniformity, and long-term storage properties. In addition, the design of the top shell of the balloon and its stress distribution play an important role since only a fraction of the balloon is deployed during the filling operation and the ascent. In this paper we describe the mechanical properties of the 'ANTRIX' film developed by us and the optimized design of single cap balloons, which have been successfully used in our experiments over the past 5 years.

  11. MELD scores and Child-Pugh classifications predict the outcomes of ERCP in cirrhotic patients with choledocholithiasis: a retrospective cohort study.

    Science.gov (United States)

    Zhang, Jinshun; Ye, Liping; Zhang, Jinlan; Lin, Minhua; He, Saiqin; Mao, Xinlin; Zhou, Xianbin; Zhi, Fachao

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is challenging in cirrhotic patients with choledocholithiasis. We evaluated the safety and efficacy of ERCP in cirrhotic patients with choledocholithiasis and accessed the model for end-stage liver disease (MELD) scores and Child-Pugh classifications for prediction of morbidity and mortality.From January 2000 to June 2014, 77 ERCP operations were performed in cirrhotic patients with choledocholithiasis. The data on operative complications were analyzed. MELD scores and Child-Pugh classifications were calculated and associated with operative outcomes and survival. Telephone follow-up was performed to determine survival situations.No death, perforation, or hemorrhage caused by gastroesophageal varices occurred as a result of the procedure. The rate of intraoperative hemorrhage was 13.0%, and the rate of postoperative morbidity was 27.3% including hemorrhage (18.2%), post-ERCP pancreatitis (6.1%), aggravated infection of the biliary tract (1.3%), hepatic encephalopathy (1.3%), and respiratory failure (1.3%). Four (5.2%) patients had both intraoperative and postoperative hemorrhage. Receiver operating characteristic analysis identified MELD scores higher than 11.5 as the best cutoff value for predicting complication incidence (95% confidence interval = 0.63-0.87). Twenty-one (44.7%) patients with a MELD score above 11.5 developed a complication, and 3 (10%) patients who had a lower MELD score developed a complication (P = 0.001). Both MELD score and Child-Pugh classification had prognostic value in patients without jaundice, although sex may result in different prognostic values based on the 2 scores. The rate of complications was not significantly different among patients with different Child-Pugh classifications. No significant difference was observed in patients with different MELD scores or Child-Pugh classifications in terms of median survival times.ERCP is an effective and safe procedure in cirrhotic

  12. NASA balloon design and flight - Philosophy and criteria

    Science.gov (United States)

    Smith, I. S., Jr.

    1993-01-01

    The NASA philosophy and criteria for the design and flight of scientific balloons are set forth and discussed. The thickness of balloon films is standardized at 20.3 microns to isolate potential film problems, and design equations are given for specific balloon parameters. Expressions are given for: flight-stress index, total required thickness, cap length, load-tape rating, and venting-duct area. The balloon design criteria were used in the design of scientific balloons under NASA auspices since 1986, and the resulting designs are shown to be 95 percent effective. These results represent a significant increase in the effectiveness of the balloons and therefore indicate that the design criteria are valuable. The criteria are applicable to four balloon volume classes in combination with seven payload ranges.

  13. In vitro analysis of balloon cuffing phenomenon: inherent biophysical properties of catheter material or mechanics of catheter balloon deflation?

    Science.gov (United States)

    Chung, Eric; So, Karina

    2012-06-01

    To investigates the different methods of balloon deflation, types of urinary catheters and exposure to urine media in catheter balloon cuffing. Bardex®, Bard-Lubri-Sil®, Argyle®, Releen® and Biocath® were tested in sterile and E.Coli inoculated urine at 0, 14 and 28 days. Catheter deflation was performed with active deflation; passive deflation; passive auto-deflation; and excision of the balloon inflow channel. Balloon cuffing was assessed objectively by running the deflated balloon over a plate of agar and subjectively by 3 independent observers. Bardex®, Argyle® and Biocath® showed greater degree of catheter balloon cuffing (p deflation was the worst method (p 0.05). Linear regression model analysis confirmed time as the most significant factor. The duration of catheters exposure, different deflation methods and types of catheters tested contributed significantly to catheter balloon cuffing (p < 0.01).

  14. Ballooning for Biologists: Mission Essentials for Flying Experiments on Large NASA Balloons

    Science.gov (United States)

    Smith, David J.; Sowa, Marianne

    2017-01-01

    Despite centuries of scientific balloon flights, only a handful of experiments have produced biologically-relevant results. Yet unlike orbital spaceflight, it is much faster and cheaper to conduct biology research with balloons, sending specimens to the near space environment of Earths stratosphere. Samples can be loaded the morning of a launch and sometimes returned to the laboratory within one day after flying. The National Aeronautics and Space Administration (NASA) flies large, unmanned scientific balloons from all over the globe, with missions ranging from hours to weeks in duration. A payload in the middle portion of the stratosphere (approx. 35 km above sea level) will be exposed to an environment similar to the surface of Mars: temperatures generally around -36 C, atmospheric pressure at a thin 1 kPa, relative humidity levels <1%, and a harsh illumination of ultraviolet (UV) and cosmic radiation levels (about 100 W/sq m and 0.1 mGy/d, respectively) that can be obtained nowhere else on the surface of the Earth, including environmental chambers and particle accelerator facilities attempting to simulate space radiation effects. Considering the operational advantages of ballooning and the fidelity of space-like stressors in the stratosphere, researchers in aerobiology, astrobiology, and space biology can benefit from balloon flight experiments as an intermediary step on the extraterrestrial continuum (ground, low Earth orbit, and deep space studies). Our presentation targets biologists with no background or experience in scientific ballooning. We will provide an overview of large balloon operations, biology topics that can be uniquely addressed in the stratosphere, and a roadmap for developing payloads to fly with NASA.

  15. Evolution of scientific ballooning and its impact on astrophysics research

    Science.gov (United States)

    Jones, William Vernon

    2014-05-01

    As we celebrate the centennial year of the discovery of cosmic rays on a manned balloon, it seems appropriate to reflect on the evolution of ballooning and its scientific impact. Balloons have been used for scientific research since they were invented in France more than 200 years ago. Ballooning was revolutionized in 1950 with the introduction of the so-called natural shape balloon with integral load tapes. This basic design has been used with more or less continuously improved materials for scientific balloon flights for more than a half century, including long-duration balloon (LDB) flights around Antarctica for the past two decades. The U.S. National Aeronautics and Space Administration (NASA) is currently developing the next generation super-pressure balloon that would enable extended duration missions above 99.5% of the Earth's atmosphere at any latitude. The Astro2010 Decadal Survey report supports super-pressure balloon development and the giant step forward it offers with ultra-long-duration balloon (ULDB) flights at constant altitudes for about 100 days.

  16. Retrograde prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    The authors performed retrograde prostatic urethroplasty in 18 patients using a 25-mm urethroplasty balloon catheter. The procedure was performed on an outpatient basis under local anesthesia. Voiding cystourethrography, retrograde urethrography, rectal US, and MRE imaging were performed before and immediately after the procedure and at 2 weeks and 3, 6, 12, and 18 months. Long-term results at 18 months and possible clinical implications are discussed

  17. Numerical Modelling Of Pumpkin Balloon Instability

    Science.gov (United States)

    Wakefield, D.

    Tensys have been involved in the numerical formfinding and load analysis of architectural stressed membrane structures for 15 years. They have recently broadened this range of activities into the `lighter than air' field with significant involvement in aerostat and heavy-lift hybrid airship design. Since early 2004 they have been investigating pumpkin balloon instability on behalf of the NASA ULDB programme. These studies are undertaken using inTENS, an in-house finite element program suite based upon the Dynamic Relaxation solution method and developed especially for the non-linear analysis and patterning of membrane structures. The paper describes the current state of an investigation that started with a numerical simulation of the lobed cylinder problem first studied by Calladine. The influence of material properties and local geometric deformation on stability is demonstrated. A number of models of complete pumpkin balloons have then been established, including a 64-gore balloon with geometry based upon Julian Nott's Endeavour. This latter clefted dramatically upon initial inflation, a phenomenon that has been reproduced in the numerical model. Ongoing investigations include the introduction of membrane contact modelling into inTENS and correlation studies with the series of large-scale ULDB models currently in preparation.

  18. Long Duration Balloon Charge Controller Stack Integration

    Science.gov (United States)

    Clifford, Kyle

    NASA and the Columbia Scientific Balloon Facility are interested in updating the design of the charge controller on their long duration balloon (LDB) in order to enable the charge controllers to be directly interfaced via RS232 serial communication by a ground testing computers and the balloon's flight computer without the need to have an external electronics stack. The design involves creating a board that will interface with the existing boards in the charge controller in order to receive telemetry from and send commands to those boards, and interface with a computer through serial communication. The inputs to the board are digital status inputs indicating things like whether the photovoltaic panels are connected or disconnected; and analog inputs with information such as the battery voltage and temperature. The outputs of the board are 100ms duration command pulses that will switch relays that do things like connect the photovoltaic panels. The main component of this design is a PIC microcontroller which translates the outputs of the existing charge controller into serial data when interrogated by a ground testing or flight computer. Other components involved in the design are an AD7888 12-bit analog to digital converter, a MAX3232 serial transceiver, various other ICs, capacitors, resistors, and connectors.

  19. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; Tytgat, Guido N. J.

    2005-01-01

    Background: Prior efforts to treat obesity with intragastric balloons were thwarted by high complication rates. Therefore, fundamental requirements for optimal balloon designs were defined. The aim of the present study was to investigate the effectiveness, the safety; and the tolerance of a new

  20. Biliary transpapillary endoscopic balloon dilation for treating choledocholithiasis.

    Science.gov (United States)

    Daniel, Lubia B; Favaro, Gabriel M; Filho, Tiago F V; Cunha, Marco A B; AparÍcio, Dayse S P; Uemura, Ricardo S; Furuya, Carlos K; Artifon, Everson L A

    2015-01-01

    To evaluate the efficacy and safety of transpapillary papilloplasty in patients with choledocholithiasis. All endoscopic retrograde cholangiopancreatography (ERCP) procedures performed at Hospital Ana Costa, in the city of Santos, Brazil, over the last five years were retrospectively evaluated using the hospital's information database. The success of the procedure and complications due to residual calculi, pancreatitis, bleeding and perforation were evaluated. From January 2010 to May 2014, 1860 ERCP procedures were performed. Fifty-five patients were evaluated here. Their ages ranged from 12 to 98 years (mean, 66.3; standard deviation, 19.34; median, 71). Thirty-two patients (58.2%) were women. Sixteen (29.1%) presented giant choledocholithiasis, with calculi larger than 12 mm. Twenty-seven (49.1%) had mul-tiple choledocholithiasis. In view of the therapeutic efficacy and low complication rate among our patients, we can conclude that endoscopic papilloplasty is a safe and effective method for endoscopic treatment of choledocolithiasis in selected cases.

  1. Efficacy and safety of ERCP in a low-volume hospital Eficacia y seguridad de la CPRE en un hospital con bajo volumen

    Directory of Open Access Journals (Sweden)

    José María Riesco-López

    2013-02-01

    Full Text Available Background and aims: there is little scientific evidence on the outcomes of endoscopic retrograde cholangiopancreatography (ERCP performed in low-volume hospitals; however, in our country, it is growing up its implementation. The objectives of our study were to evaluate the efficacy and safety of this technique performed by two endoscopists with basic training in a center of this nature and analyze the learning curve in the first procedures. Patients and methods: single-center retrospective study of the first 200 ERCP performed in our hospital (analyzing the evolution between the first 100 and 100 following procedures, comparing them with the quality standards proposed in the literature. Results: from February 2009 to April 2011, we performed 200 ERCP in 169 patients, and the most common indications were: Choledocholithiasis (77 %, tumors (14.5 % and other conditions (8.5 %. The cannulation rate rose from 85 % in the first 100 ERCP to 89 % in the next 100 procedures, clinical success from 81 % to 87 %, decreasing the post-ERCP acute pancreatitis rate from 11 % to 4 %, upper gastrointestinal bleeding (UGIB from 3 % to 2 % and acute cholangitis from 4 % to 1 %. There was a death from a massive UGIB in a cirrhotic patient in the first group of patients and a case of biliary perforation resolved by surgery in the second one. Conclusions: the results obtained after performing 200 procedures support the ability to practice ERCP in low-volume hospitals obtaining levels of efficacy and safety in accordance with published quality standards.Introducción y objetivos: existe poca evidencia científica sobre los resultados de la CPRE realizada en hospitales con bajo volumen, sin embargo su puesta en marcha en nuestro medio es creciente. Los objetivos de nuestro estudio son evaluar la eficacia y seguridad de dicha técnica realizada por dos endoscopistas biliares noveles en un centro de estas características y analizar la curva de aprendizaje en los

  2. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won [Konyang University Hospital, Daejeon (Korea, Republic of)

    2005-12-15

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful.

  3. Percutaneous treatment of extrahepatic bile duct stones assisted by balloon sphincteroplasty and occlusion balloon

    International Nuclear Information System (INIS)

    Park, Yong Sung; Kim, Ji Hyung; Choi, Young Woo; Lee, Tae Hee; Hwang, Cheol Mog; Cho, Young Jun; Kim, Keum Won

    2005-01-01

    To describe the technical feasibility and usefulness of extrahepatic biliary stone removal by balloon sphincteroplasty and occlusion balloon pushing. Fifteen patients with extrahepatic bile duct stones were included in this study. Endoscopic stone removal was not successful in 13 patients, and two patients refused the procedure due to endoscopy phobia. At first, all patients underwent percutaneous transhepatic biliary drainage (PTBD). A few days later, through the PTBD route, balloon assisted dilatation for common bile duct (CBD) sphincter was performed, and then the stones were pushed into the duodenum using an 11.5 mm occlusion balloon. Success rate, reason for failure, and complications associated with the procedure were evaluated. Eight patients had one stone, five patients had two stones, and two patients had more than five stones. The procedure was successful in 13 patients (13/15). In 12 of the patients, all stones were removed in the first trial. In one patients, residual stones were discovered on follow-up cholangiography, and were subsequently removed in the second trial. Technical failure occurred in two patients. Both of these patients had severely dilated CBD and multiple stones with various sizes. Ten patients complained of pain in the right upper quadrant and epigastrium of the abdomen immediately following the procedure, but there were no significant procedure-related complications such as bleeding or pancreatitis. Percutaneous extrahepatic biliary stone removal by balloon sphincteroplasty and subsequent stone pushing with occlusion balloon is an effective, safe, and technically feasible procedure which can be used as an alternative method in patients when endoscopic extrahepatic biliary stone removal was not successful

  4. Superpressure Balloon Design Using Nonlinear Viscoelasticity

    Science.gov (United States)

    Rand, James; Rand, James; Wakefield, David

    Stratospheric balloon platforms are used extensively by scientists for a variety of purposes. The typical balloon used today is the zero pressure natural shape fabricated from a thin film of linear low density polyethylene. This material has been found to possess a variety of desirable characteristics suitable to this environment. This film will remain ductile at very low temperatures which will permit it to develop large strains if necessary to satisfy equilibrium considerations. However, in order to achieve long duration flight without significant changes in altitude, the balloon should be pressurized to the extent necessary to maintain constant volume during typical variations in temperature. In the past, pressurized balloons were fabricated from other materials in order to achieve significant increases in strength. Thin films of polyester or polyimide have been used to make relatively small spheres capable of long duration flight. Unfortunately, these materials do not have the ductility of polyethylene at low temperature and are somewhat more fragile and subject to damage. In recent years various organizations have attempted to use the characteristic shape of a pumpkin to limit the stresses in a balloon envelope to that which can be accommodated by laminated fabric materials. While developing the design, analysis and construction techniques for this type of system, the use of polyethylene has been successfully demonstrated to provide a reliable envelope. This shape is achieved by using high strength members in the meridional direction to carry the very high loads generated by the pressure. These so called "tendons" have very low elongation and serve to limit the deformation of the film in that direction. However, earlier designs attempted to limit the stresses in the circumferential direction by using a lobe angle to control the stress. Unfortunately this has led to a number of stability problems with this type of balloon. In order to control the stability of

  5. [Balloon cell nevi of the conjunctiva (author's transl)].

    Science.gov (United States)

    Schlageter, P E; Daicker, B

    1975-06-01

    The clinical and histological features of three cases of conjunctival balloon cell nevi are described. This peculiar form of nevus is very rare in the conjunctiva. The findings are compared with the descriptions in the literature of dermal balloon cell nevi. They demonstrate, that the conjunctival and dermal tumours are of idential histological structure. The proliferations of the conjunctival epithelium often found in conjunctival nevi do not modify the balloon cell nevi. These can not be diagnosed clinically. The problems of the pathogenesis of the balloon cell nevi are discussed.

  6. Advanced Li batteries for terrestrial balloons, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — For future advanced terrestrial balloon missions, NASA requires energy dense and power dense energy storage solutions significantly exceeding the performance of...

  7. Hyperspectral Polarimeter for Monitoring Balloon Strain, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's latest generation of superpressure, ultra long duration balloons (ULDB) extend the flight time for stratospheric experiments to levels previously unattainable...

  8. Deflation of gastric band balloon in pregnancy for improving outcomes.

    Science.gov (United States)

    Jefferys, Amanda E; Siassakos, Dimitrios; Draycott, Tim; Akande, Valentine A; Fox, Robert

    2013-04-30

    In line with the rise in the prevalence of obesity, an increasing number of women of childbearing age are undergoing laparoscopic adjustable gastric banding (LAGB), resulting in an increasing number of pregnancies with a band in place. Currently, there is no consensus on optimal band management in pregnancy. Some clinicians advocate leaving the band balloon inflated to reduce gestational weight gain and associated adverse perinatal outcomes. However, there are concerns that maintaining balloon inflation during pregnancy might increase the risk of band complications and adversely affect fetal development and/or growth as a result of reduced nutritional intake. To compare maternal and perinatal outcomes for elective gastric band balloon deflation versus intention to maintain balloon inflation during pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012) and the Web of Science database (1940 to September 2012). Randomised-controlled trials comparing elective deflation of the gastric band balloon with intention to maintain balloon inflation in pregnant women who have undergone LAGB. Two review authors independently assessed studies for inclusion. No studies met the criteria for inclusion in the review. To date no randomised controlled trials exist that compare elective deflation of the gastric band balloon in pregnancy versus intention to maintain balloon inflation. Further research is needed to define the optimum management of the gastric band balloon in pregnancy.

  9. An Overview of Current and Future Stratospheric Balloon Mission Capabilities

    Science.gov (United States)

    Smith, Michael

    The modern stratospheric balloon has been used for a variety of missions since the late 1940's. Capabilities of these vehicles to carry larger payloads, fly to higher altitudes, and fly for longer periods of time have increased dramatically over this time. In addition to these basic performance metrics, reliability statistics for balloons have reached unprecedented levels in recent years. Balloon technology developed in the United States in the last decade has the potential to open a new era in economical space science using balloons. As always, the advantage of the balloon platform is the fact that missions can be carried out at a fraction of the cost and schedule of orbital missions. A secondary advantage is the fact that instruments can be re-flown numerous times while upgrading sensor and data processing technologies from year to year. New mission capabilities now have the potential for enabling ground breaking observations using balloons as the primary platform as opposed to a stepping stone to eventual orbital observatories. The limit of very high altitude balloon missions will be explored with respect to the current state of the art of balloon materials and fabrication. The same technological enablers will also be applied to possibilities for long duration missions at mid latitudes with payloads of several tons. The balloon types and their corresponding mission profiles will be presented in a performance matrix that will be useful for potential scientific users in planning future research programs.

  10. AUTOPERFUSION BALLOON CATHETER FOR COMPLICATED CORONARY ANGIOPLASTY - A PROSPECTIVE-STUDY WITH RETROSPECTIVE CONTROLS

    NARCIS (Netherlands)

    DEMUINCK, ED; VANDIJK, RB; DENHEIJER, P; MEEDER, JG; LIE, KI

    1992-01-01

    Prolonged angioplasty balloon inflation with an autoperfusion balloon for failed conventional coronary angioplasty, was compared with emergency surgery for this condition. Restenosis was assessed 6 weeks after successful intervention with the autoperfusion balloon. Forty consecutive patients with

  11. Trainee involvement increases precut rates and delays access to the common bile duct without an increase in procedure-related adverse events: a brave new world of ERCP training?

    Science.gov (United States)

    Voiosu, Theodor; Voiosu, Andrei; Benguş, Andreea; Rimbaş, Mihai; Mateescu, Bogdan

    2018-03-01

    Selective cannulation of the desired duct is a key element in ERCP procedures and an important step in the training of fellows. However, there is limited data about technical success and patient safety for ERCPs conducted in a training setting.We aimed to evaluate the impact of trainee involvement on the cannulation technique and procedure related outcomes at ERCP. We conducted an observational study of all ERCP conducted in an endoscopy unit with an on-going training program. Patient related data and procedure-related data (method of cannulation, time to cannulation, degree of trainee involvement, technical success and procedure-related adverse events) were collected using a standard form. The method of cannulation, time to cannulation and procedure-related adverse events were compared between ERCPs with trainee involvement and those without. 641 consecutive ERCPs were evaluated and 474 native papilla cases performed by 4 trainers and 3 trainees were included in the final analysis. Trainees were involved in 171 procedures (36.1%), achieving cannulation of the desired duct in 50.8% of the cases. Cannulation rates were similar in the trainee group compared to the control group (91.7% vs. 88.7%) and there was no increase in the rate of adverse events. However, cannulation time was significantly longer in the trainee group with a significant increase in the rate of precut use (32.1% vs. 23.4%, p < 0.001). Trainee involvement resulted in longer cannulation times and increased use of precut sphincterotomy, but, was not associated with an increased risk of procedure related adverse events.

  12. Quantitative angiographic comparison of elastic recoil after coronary excimer laser-assisted balloon angioplasty and balloon angioplasty alone.

    Science.gov (United States)

    Strikwerda, S; van Swijndregt, E M; Melkert, R; Serruys, P W

    1995-02-01

    Coronary lumen changes during and after excimer laser-assisted balloon angioplasty were measured by quantitative coronary angiography, and the results were compared with the effects of balloon angioplasty alone. Reduction of atherosclerotic tissue mass by laser ablation in the treatment of coronary artery disease may be more effective in enlarging the lumen than balloon angioplasty alone. A series of 57 consecutive coronary lesions successfully treated by xenon chloride excimer laser-assisted balloon angioplasty were individually matched with 57 coronary artery lesions successfully treated by balloon angioplasty alone. The following variables were measured by quantitative coronary analysis: 1) ablation by laser, 2) stretch by balloon dilation, 3) elastic recoil, and 4) acute gain. Matching by stenosis location, reference diameter and minimal lumen diameter resulted in two comparable groups of 57 lesions with identical baseline stenosis characteristics. Minimal lumen diameter before excimer laser-assisted balloon angioplasty and balloon angioplasty alone were (mean +/- SD) 0.73 +/- 0.44 and 0.74 +/- 0.43 mm, respectively. Laser ablation significantly improved minimal lumen diameter by 0.56 +/- 0.44 mm before adjunctive balloon dilation. In both treatment groups, similar-sized balloon catheters (2.59 +/- 0.35 and 2.56 +/- 0.40 mm, respectively) were used. After laser-assisted balloon angioplasty, elastic recoil was 0.84 +/- 0.30 mm (32% of balloon size), which was identical to that after balloon angioplasty alone, namely, 0.82 +/- 0.32 mm (32%). Consequently, both interventions resulted in similar acute gains of 1.02 +/- 0.52 and 1.00 +/- 0.56 mm, respectively. Minimal lumen diameter after intervention was equal in both groups: 1.75 +/- 0.35 and 1.75 +/- 0.34 mm, respectively. The statistical power of this study in which a 25% difference in elastic recoil (0.2 mm) between groups was considered clinically important was 95%. In matched groups of successfully treated

  13. Planetary Science with Balloon-Borne Telescopes

    Science.gov (United States)

    Kremic, Tibor; Cheng, Andy; Hibbitts, Karl; Young, Eliot

    2015-01-01

    The National Aeronautics and Space Administration (NASA) and the planetary science community have recently been exploring the potential contributions of stratospheric balloons to the planetary science field. A study that was recently concluded explored the roughly 200 or so science questions raised in the Planetary Decadal Survey report and found that about 45 of those questions are suited to stratospheric balloon based observations. In September of 2014, a stratospheric balloon mission called BOPPS (which stands for Balloon Observation Platform for Planetary Science) was flown out of Fort Sumner, New Mexico. The mission had two main objectives, first, to observe a number of planetary targets including one or more Oort cloud comets and second, to demonstrate the applicability and performance of the platform, instruments, and subsystems for making scientific measurements in support planetary science objectives. BOPPS carried two science instruments, BIRC and UVVis. BIRC is a cryogenic infrared multispectral imager which can image in the.6-5 m range using an HgCdTe detector. Narrow band filters were used to allow detection of water and CO2 emission features of the observed targets. The UVVis is an imager with the science range of 300 to 600 nm. A main feature of the UVVis instrument is the incorporation of a guide camera and a Fine Steering Mirror (FSM) system to reduce image jitter to less than 100 milliarcseconds. The BIRC instrument was used to image targets including Oort cloud comets Siding Spring and Jacques, and the dwarf planet 1 Ceres. BOPPS achieved the first ever earth based CO2 observation of a comet and the first images of water and CO2 of an Oort cloud comet (Jacques). It also made the first ever measurement of 1Ceres at 2.73 m to refine the shape of the infrared water absorption feature on that body. The UVVis instrument, mounted on its own optics bench, demonstrated the capability for image correction both from atmospheric disturbances as well as some

  14. Evaluation of staff, patient and foetal radiation doses due to endoscopic retrograde cholangio-pancreatography (ERCP) procedures in a pregnant patient

    International Nuclear Information System (INIS)

    Huda, A.; Garzon, W.J.; Kramer, R.; Khoury, H.J.; Filho, G.C.L.; Vieira, B.; Xu, X.G.; Gao, Y.

    2016-01-01

    The use of endoscopic retrograde cholangio-pancreatography (ERCP) in pregnant patients is not rare. Most studies on the safety and efficacy of these procedures report short- and long-term pregnancy outcomes and but not foetal absorbed doses. This investigation reports on an ERCP procedure for a 40-y-old woman who was 32-34 weeks pregnant. Thermoluminescent dosemeters (TLD 100) were used to measure doses received by the patient and the staff. Additionally, Monte Carlo calculations were performed using a 3D computational phantom representing a 9-month pregnant patient to estimate the foetal absorbed dose. The results show that the spleen of the mother received the largest absorbed dose of 12.18 mGy since it was closer to the source than other internal organs. For the foetus and uterus, the lowest absorbed dose was found to be 0.01 mGy to the foetal brain, while the largest absorbed dose was estimated to be 0.13 mGy to the placenta. (authors)

  15. Safety and efficacy of large balloon sphincteroplasty in a third care hospital Dilatación con balón asociada a esfinterotomía, evaluación de eficacia y seguridad en un hospital terciario

    Directory of Open Access Journals (Sweden)

    Eduardo Martín-Arranz

    2012-07-01

    Full Text Available Background and aims: large balloon sphincteroplasty (LBS associated with sphincterotomy (ES has gained acceptance as a useful tool in extracting difficult bile duct stones. Our purpose was to evaluate the efficacy and safety of LBS with balloons ≥ 10 mm in clinical practice setting. Patients and methods: unicentre prospective study in a tertiary care hospital. All patients who underwent LBS associated with ES between July 2007 and March 2011 were included prospectively in a database recording clinical aspects, procedure data, outcome and complications. Success is the main outcome defined as complete stone removal documented by absence of any filling defect during a final occlusion cholangiogram and absence of clinical or radiological findings after the ERCP consistent with remaining stones. Complications as pancreatitis, cholangitis, post-ERCP bleeding, perforation and others were also measured. Results: one hundred twenty procedures were made in 109 patients with balloons ranging from 10 to 20 mm. Success rate was 91% in the first attempt and 96.7% after two procedures. Mechanical lithotripsy was only needed in one case (0.8%. Complication rate was 4.2% due to five cases of post-ERCP bleeding in high risk patients. Conclusion: large balloon sphincteroplasty associated to sphincterotomy in clinical practice is a very effective and safe technique.Introducción y objetivos: la dilatación con balón de gran tamaño asociada a esfinterotomía es un recurso cada vez más utilizado en la extracción de coledocolitiasis de gran tamaño. El objetivo de este estudio es evaluar la eficacia y seguridad de la dilatación con balones mayores de 10 mm en un entorno de práctica clínica habitual. Pacientes y métodos: estudio prospectivo en un hospital terciario. Todos los pacientes en los que se realizó dilatación con balón mayor de 10 mm asociado a esfinterotomía entre julio de 2007 y marzo de 2011 se incluyeron prospectivamente en una base de datos

  16. Pneumothorax, music and balloons: A case series

    Directory of Open Access Journals (Sweden)

    Shiferaw Dejene

    2013-01-01

    Full Text Available We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation.

  17. Retrograde transurethral balloon dilation of the prostate

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Wasserman, N.F.; Lund, G.; Hulbert, J.; Hunter, D.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1986-01-01

    A series of patients with documented benign prostatic hypertrophy evaluated by urodynamic studies, voiding cystourethrography, retrograde urethrography, and MR imaging underwent dilation performed using a retrograde transurethral approach with 25-mm balloon dilators inflated at a pressure of 3-4 atm for 10 minutes. Immediately after the procedure, retrograde and voiding cystourethrography as well as MR imaging were performed. A Foley catheter was left in place for 24 hours. Complete relief of symptoms has occurred in all of the patients during the follow-up period. No significant complications other than transient hematuria resulted from the procedure. Results of the comparison studies and of MR imaging are discussed

  18. Resistive G-modes and ballooning

    International Nuclear Information System (INIS)

    Dagazian, R.Y.; Mondt, J.P.; Paris, R.B.

    1980-01-01

    A unified theory of the linear stability of the Roberts and Taylor type of resistive interchange and ballooning is presented. The effects of both parallel and perpendicular viscosity as well as of finite shear and finite β are included in a MHD treatment of the problem. Kinetic effects are also studied. The hybrid kinetic model with Vlasov ions and guiding center electrons has been appropriately generalized to allow for electron-ion collisions. The geometry is that of a plane slab with magnetic shear

  19. Simultaneous stent expansion/balloon deflation technique to salvage failed balloon remodeling.

    Science.gov (United States)

    Ladner, Travis R; He, Lucy; Davis, Brandon J; Froehler, Michael T; Mocco, J

    2016-04-01

    Herniation, with possible embolization, of coils into the parent vessel following aneurysm coiling remains a frequent challenge. For this reason, balloon or stent assisted embolization remains an important technique. Despite the use of balloon remodeling, there are occasions where, on deflation of the balloon, some coils, or even the entire coil mass, may migrate. We report the successful use of a simultaneous adjacent stent deployment bailout technique in order to salvage coil prolapse during balloon remodeling in three patients. Case No 1 was a wide neck left internal carotid artery bifurcation aneurysm, measuring 9 mm×7.9 mm×6 mm with a 5 mm neck. Case No 2 was a complex left superior hypophyseal artery aneurysm, measuring 5.3 mm×4 mm×5 mm with a 2.9 mm neck. Case No 3 was a ruptured right posterior communicating artery aneurysm, measuring 4 mm×4 mm×4.5 mm with a 4 mm neck. This technique successfully returned the prolapsed coil mass into the aneurysm sac in all cases without procedural complications. The closed cell design of the Enterprise VRD (Codman and Shurtleff Inc, Raynham, Massachusetts, USA) makes it ideal for this bailout technique, by allowing the use of an 0.021 inch delivery catheter (necessary for simultaneous access) and by avoiding the possibility of an open cell strut getting caught on the deflated balloon. We hope this technique will prove useful to readers who may find themselves in a similar predicament. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The Evaluation of Endoscopic Balloon Dilation Treatment for

    Directory of Open Access Journals (Sweden)

    Shokri-Shirvani Javad

    2009-10-01

    Full Text Available Balloon dilatation of stricture is one of the new treatment methods among patients with gastric outlet obstruction (GOO. However, the prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that would affect its success rate patients with benign etiology for GOO. Forty-five patients with the symptoms of benign GOO were randomly selected. Gastric outlet was delineated using double channel videoendoscopy. The information of initial balloon dilation was collected from recorded files. Balloon dilatation was repeated during the mean follow up of 9.9 ± 5.8 months. The severity of gastric pain was measured immediately before balloon dilatation and one month after procedure and was rated on a 10 cm visual analogue scale. The mean age of patients was 43.7 ± 18.1 years and 86.7% of them were men. Furthermore, 71.1% were H pylori positive. Response rate to endoscopic balloon dilatation was 80% and 8 patients underwent surgical resection. Weight loss was more frequent in non-responding group. The pain severity was significantly reduced more in responding subjects. No meaningful relationships were found between the responses to balloon dilatation and positive H pylori and cigarette smoking. Endoscopic balloon dilation is safe and effective for most patients with benign gastric outlet obstruction and has favorable long-term outcome.

  1. The Balloon Foot ; A Rare Presentation Of Congenital Constricting ...

    African Journals Online (AJOL)

    We present a case of a rare manifestation of congenital constricting annular band (CAB) in the lower extremity resulting in a severe excessive swelling of the foot which we have termed Balloon foot. The ballooned foot is caused by a progressive deepening of the circumferential constriction into the soft tissue of the lower ...

  2. Scientific ballooning in the 20 th century; a historical perspective

    Science.gov (United States)

    Nishimura, J.

    Hess discovered the cosmic rays in 1912. Using a manned balloon, he found the altitude variation of the radiation. After this discovery, many balloon experiments were performed to explore the most mysterious radiation coming from outside of the earth during the 1920's to the 1930's. At the end of the 1940's, balloon systems were revolutionized by the use of new plastic films and telemetry systems. At almost the same time, highly sensitive nuclear emulsions were developed. Balloon exposures of emulsions brought us new discoveries of the heavy primaries in cosmic rays. Extensive studies with nuclear emulsions discovered high-energy phenomena and new particles between the end of 1940's to the 1960's. At the same time, in various countries, experiments with more sophisticated electronic devices were begun together with ingenious work on balloon technology. Inventions were made in the areas of designing, manufacturing, materials, telemetry systems for balloons and long duration flight systems etc. Several permanent launching stations were established in various countries in the 1960's Here, I review the development of essential technologies in scientific ballooning, and their value in contributing to the growth of space physics. As the future prospect, I stress the point that scientific ballooning is indispensable and a most cost-effective way to explore space astrophysics and Earth science, in addition to the preparation of satellite and the space station experiments.

  3. Coronary artery angioplasty with a helical autoperfusion balloon catheter

    NARCIS (Netherlands)

    Gurbel, PA; Anderson, RD; vanBoven, AJ; denHeijer, P

    The initial in-hospital and long-term clinical experience with a helical autoperfusion balloon catheter in the treatment of coronary artery disease is reported, This new catheter design allows blood to flow passively around the inflated balloon through a protected helical channel molded into the

  4. External caps: An approach to stress reduction in balloons

    Science.gov (United States)

    Hazlewood, K. H.

    Recent findings of the catastrophic balloon failures investigation in the U.S.A. indicate that very large gross inflations, in balloons using present design philosophy, over-stress currently available materials. External caps are proposed as an economic approach to reducting those stresses to an acceptable level.

  5. ERCP (Endoscopic Retrograde Cholangiopancreatography)

    Science.gov (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  6. The ballooning of fuel cladding tubes: theory and experiment

    International Nuclear Information System (INIS)

    Shewfelt, R.S.W.

    1988-01-01

    Under some conditions, fuel clad ballooning can result in considerable strain before rupture. If ballooning were to occur during a loss-of-coolant accident (LOCA), the resulting substantial blockage of the sub-channel would restrict emergency core cooling. However, circumferential temperature gradients that would occur during a LOCA may significantly limit the average strain at failure. Understandably, the factors that control ballooning and rupture of fuel clad are required for the analysis of a LOCA. Considerable international effort has been spent on studying the deformation of Zircaloy fuel cladding under conditions that would occur during a LOCA. This effort has established a reasonable understanding of the factors that control the ballooning, failure time, and average failure strain of fuel cladding. In this paper, both the experimental and theoretical studies of the fuel clad ballooning are reviewed. (author)

  7. Spectrum of the ballooning Schroedinger equation

    International Nuclear Information System (INIS)

    Dewar, R.L.

    1997-01-01

    The ballooning Schroedinger equation (BSE) is a model equation for investigating global modes that can, when approximated by a Wentzel-Kramers-Brillouin (WKB) ansatz, be described by a ballooning formalism locally to a field line. This second order differential equation with coefficients periodic in the independent variable θ k is assumed to apply even in cases where simple WKB quantization conditions break down, thus providing an alternative to semiclassical quantization. Also, it provides a test bed for developing more advanced WKB methods: e.g. the apparent discontinuity between quantization formulae for open-quotes trappedclose quotes and open-quotes passingclose quotes modes, whose ray paths have different topologies, is removed by extending the WKB method to include the phenomena of tunnelling and reflection. The BSE is applied to instabilities with shear in the real part of the local frequency, so that the dispersion relation is inherently complex. As the frequency shear is increased, it is found that trapped modes go over to passing modes, reducing the maximum growth rate by averaging over θ k

  8. THE KISSING BALLOON TECHNIQUE WITH 2 OVER-THE-WIRE BALLOON CATHETERS THROUGH A SINGLE 8-FRENCH GUIDING CATHETER

    NARCIS (Netherlands)

    DENHEIJER, P; BERNINK, PJLM; VANDIJK, RB; TWISK, SPM; LIE, KI

    Some of the newer over-the-wire coronary angioplasty catheters have shaft sizes of 3.0 French (F) or less. The inner diameter of modern 8-F guiding catheters is large enough to accommodate two of such balloon catheters. We report a kissing balloon procedure with two over-the-wire catheters through a

  9. Detecting Seismic Infrasound Signals on Balloon Platforms

    Science.gov (United States)

    Krishnamoorthy, S.; Komjathy, A.; Cutts, J. A.; Pauken, M.; Garcia, R.; Mimoun, D.; Jackson, J. M.; Kedar, S.; Smrekar, S. E.; Hall, J. L.

    2017-12-01

    The determination of the interior structure of a planet requires detailed seismic investigations - a process that entails the detection and characterization of seismic waves due to geological activities (e.g., earthquakes, volcanoes, etc.). For decades, this task has primarily been performed on Earth by an ever-expanding network of terrestrial seismic stations. However, on planets such as Venus, where the surface pressure and temperature can reach as high as 90 atmospheres and 450 degrees Celsius respectively, placing seismometers on the planet's surface poses a vexing technological challenge. However, the upper layers of the Venusian atmosphere are more benign and capable of hosting geophysical payloads for longer mission lifetimes. In order to achieve the aim of performing geophysical experiments from an atmospheric platform, JPL and its partners (ISAE-SUPAERO and California Institute of Technology) are in the process of developing technologies for detection of infrasonic waves generated by earthquakes from a balloon. The coupling of seismic energy into the atmosphere critically depends on the density differential between the surface of the planet and the atmosphere. Therefore, the successful demonstration of this technique on Earth would provide ample reason to expect success on Venus, where the atmospheric impedance is approximately 60 times that of Earth. In this presentation, we will share results from the first set of Earth-based balloon experiments performed in Pahrump, Nevada in June 2017. These tests involved the generation of artificial sources of known intensity using a seismic hammer and their detection using a complex network of sensors, including highly sensitive micro-barometers suspended from balloons, GPS receivers, geophones, microphones, and seismometers. This experiment was the first of its kind and was successful in detecting infrasonic waves from the earthquakes generated by the seismic hammer. We will present the first comprehensive analysis

  10. Microcontroller uses in Long-Duration Ballooning

    Science.gov (United States)

    Jones, Joseph

    This paper discusses how microcontrollers are being utilized to fulfill the demands of long duration ballooning (LDB) and the advantages of doing so. The Columbia Scientific Balloon Facility (CSBF) offers the service of launching high altitude balloons (120k ft) which provide an over the horizon telemetry system and platform for scientific research payloads to collect data. CSBF has utilized microcontrollers to address multiple tasks and functions which were previously performed by more complex systems. A microcontroller system has been recently developed and programmed in house to replace our previous backup navigation system which is used on all LDB flights. A similar microcontroller system was developed to be independently launched in Antarctica before the actual scientific payload. This system's function is to transmit its GPS position and a small housekeeping packet so that we can confirm the upper level float winds are as predicted from satellite derived models. Microcontrollers have also been used to create test equipment to functionally check out the flight hardware used in our telemetry systems. One test system which was developed can be used to quickly determine if our communication link we are providing for the science payloads is functioning properly. Another system was developed to provide us with the ability to easily determine the status of one of our over the horizon communication links through a closed loop system. This test system has given us the capability to provide more field support to science groups than we were able to in years past. The trend of utilizing microcontrollers has taken place for a number of reasons. By using microcontrollers to fill these needs, it has given us the ability to quickly design and implement systems which meet flight critical needs, as well as perform many of the everyday tasks in LDB. This route has also allowed us to reduce the amount of time required for personnel to perform a number of the tasks required

  11. Rectal Balloon for the Immobilization of the Prostate Internal Motion

    International Nuclear Information System (INIS)

    Lee, Sang Kyu; Beak, Jong Geal; Kim, Joo Ho; Jeon, Byong Chul; Cho, Jeong Hee; Kim, Dong Wook; Song, Tae Soo; Cho, Jae Ho; Na, Soo Kyong

    2005-01-01

    The using of endo-rectal balloon has proposed as optimal method that minimized the motion of prostate and the dose of rectum wall volume for treated prostate cancer patients, so we make the customized rectal balloon device. In this study, we analyzed the efficiency of the Self-customized rectal balloon in the aspects of its reproducibility. In 5 patients, for treatment planning, each patient was acquired CT slice images in state of with and without rectal balloon. Also they had CT scanning same repeated third times in during radiation treatment (IMRT). In each case, we analyzed the deviation of rectal balloon position and verified the isodose distribution of rectum wall at closed prostate. Using the rectal balloon, we minimized the planning target volume (PTV) by decreased the internal motion of prostate and overcome the dose limit of radiation therapy in prostate cancer by increased the gap between the rectum wall and high dose region. The using of rectal balloon, although, was reluctant to treat by patients. View a point of immobilization of prostate internal motion and dose escalation of GTV (gross tumor volume), its using consider large efficient for treated prostate cancer patients.

  12. Graph-Based Path-Planning for Titan Balloons

    Science.gov (United States)

    Blackmore, Lars James; Fathpour, Nanaz; Elfes, Alberto

    2010-01-01

    A document describes a graph-based path-planning algorithm for balloons with vertical control authority and little or no horizontal control authority. The balloons are designed to explore celestial bodies with atmospheres, such as Titan, a moon of Saturn. The algorithm discussed enables the balloon to achieve horizontal motion using the local horizontal winds. The approach is novel because it enables the balloons to use arbitrary wind field models. This is in contrast to prior approaches that used highly simplified wind field models, such as linear, or binary, winds. This new approach works by discretizing the space in which the balloon operates, and representing the possible states of the balloon as a graph whose arcs represent the time taken to move from one node to another. The approach works with arbitrary wind fields, by looking up the wind strength and direction at every node in the graph from an arbitrary wind model. Having generated the graph, search techniques such as Dijkstra s algorithm are then used to find the set of vertical actuation commands that takes the balloon from the start to the goal in minimum time. In addition, the set of reachable locations on the moon or planet can be determined.

  13. A Survey of Titan Balloon Concepts and Technology Status

    Science.gov (United States)

    Hall, Jeffery L.

    2011-01-01

    This paper surveys the options for, and technology status of, balloon vehicles to explore Saturn's moon Titan. A significant amount of Titan balloon concept thinking and technology development has been performed in recent years, particularly following the spectacular results from the descent and landing of the Huygens probe and remote sensing observations by the Cassini spacecraft. There is widespread recognition that a balloon vehicle on the next Titan mission could provide an outstanding and unmatched capability for in situ exploration on a global scale. The rich variety of revealed science targets has combined with a highly favorable Titan flight environment to yield a wide diversity of proposed balloon concepts. The paper presents a conceptual framework for thinking about balloon vehicle design choices and uses it to analyze various Titan options. The result is a list of recommended Titan balloon vehicle concepts that could perform a variety of science missions, along with their projected performance metrics. Recent technology developments for these balloon concepts are discussed to provide context for an assessment of outstanding risk areas and technological maturity. The paper concludes with suggestions for technology investments needed to achieve flight readiness.

  14. Ballooning modes or Fourier modes in a toroidal plasma?

    International Nuclear Information System (INIS)

    Connor, J.W.; Taylor, J.B.

    1987-01-01

    The relationship between two different descriptions of eigenmodes in a torus is investigated. In one the eigenmodes are similar to Fourier modes in a cylinder and are highly localized near a particular rational surface. In the other they are the so-called ballooning modes that extend over many rational surfaces. Using a model that represents both drift waves and resistive interchanges the transition from one of these structures to the other is investigated. In this simplified model the transition depends on a single parameter which embodies the competition between toroidal coupling of Fourier modes (which enhances ballooning) and variation in frequency of Fourier modes from one rational surface to another (which diminishes ballooning). As the coupling is increased each Fourier mode acquires a sideband on an adjacent rational surface and these sidebands then expand across the radius to form the extended mode described by the conventional ballooning mode approximation. This analysis shows that the ballooning approximation is appropriate for drift waves in a tokamak but not for resistive interchanges in a pinch. In the latter the conventional ballooning effect is negligible but they may nevertheless show a ballooning feature. This is localized near the same rational surface as the primary Fourier mode and so does not lead to a radially extended structure

  15. N-dependence of ballooning instabilities

    International Nuclear Information System (INIS)

    Dewar, R.L.; Manickam, J.; Grimm, R.C.; Chance, M.S.

    1980-05-01

    The critical β for stability against ideal hydromagnetic internal ballooning modes as a function of toroidal mode number, n, is calculated for two different equilibrium sequences by use of a finite element technique (n less than or equal to 20), and a WKB formalism (n greater than or equal to 5). The agreement between the two methods is good in the overlap region 5 approx.less than or equal to n approx. less than or equal to 20. The WKB formula reduces to the 1/n correction at very high n, but is much more accurate at moderate n. The critical β vs n curves exhibit oscillatory structure at low n, but in both sequences the lower bound on β/sub c/ approx. 5%. For reactor parameters, finite Larmor radius effects are not expected to have a large effect on this β-limitation

  16. Management of intra-aortic balloon pumps.

    Science.gov (United States)

    Webb, Christopher A-J; Weyker, Paul D; Flynn, Brigid C

    2015-06-01

    Intra-aortic balloon pumps (IABPs) continue to be the most widely used cardiac support devices with an annual estimate of 200 000 IABPs placed worldwide. IABPs enhance myocardial function by maximizing oxygen supply and minimizing oxygen demand. The use of IABPs is not without risk, with major vascular injury, ischemia, and infection being the most common complications, especially in high-risk patients. While recent studies have questioned the use of IABPs in patients with cardiogenic shock secondary to myocardial infarction, these studies have limitations making it difficult to formulate definitive conclusions. This review will focus on the mechanisms of counterpulsation, the management of IABPs and the evidence supporting this ventricular support therapy. © The Author(s) 2014.

  17. High Energy Antimatter Telescope (HEAT) Balloon Experiment

    Science.gov (United States)

    Beatty, J. J.

    1995-01-01

    This grant supported our work on the High Energy Antimatter Telescope(HEAT) balloon experiment. The HEAT payload is designed to perform a series of experiments focusing on the cosmic ray positron, electron, and antiprotons. Thus far two flights of the HEAT -e+/- configuration have taken place. During the period of this grant major accomplishments included the following: (1) Publication of the first results of the 1994 HEAT-e+/- flight in Physical Review Letters; (2) Successful reflight of the HEAT-e+/- payload from Lynn Lake in August 1995; (3) Repair and refurbishment of the elements of the HEAT payload damaged during the landing following the 1995 flight; and (4) Upgrade of the ground support equipment for future flights of the HEAT payload.

  18. The MIPAS balloon borne trace constitutent experiment

    Science.gov (United States)

    Oelhaf, H.; Vonclarmann, TH.; Fischer, H.; Friedl-Vallon, F.; Fritzsche, CHR.; Piesch, CHR.; Rabus, D.; Seefeldner, M.; Voelker, W.

    1994-01-01

    A novel cryogenic Fourier transform spectrometer (FTS) has been developed for limb emission measurements in the mid IR-region from balloon-borne platforms. The FTS is a rapid scanning interferometer using a modified Michelson arrangement which allows a spectral resolution of 0.04 cm(exp -1) to be achieved. Solid carbon-dioxide cooling of the spectrometer and liquid-helium cooling of the detectors provide adequate sensitivity. The line of sight can be stabilized in terms of azimuth and elevation. A three-mirror off-axis telescope provides good vertical resolution and straylight rejection. Calibration is performed by high elevation and internal blackbody measurements. Four balloon flights were performed, two of them during spring turn-around 1989 and 1990 over mid-latitudes (Aire sur L'Adour, France, 44 deg N) and two near the northern polar circle in winter 1992 (Esrange, Sweden, 68 deg N). Limb emission spectra were collected from 32 km to 39 km floating altitudes covering tangent heights between the lower troposphere and the floating altitude. The trace gases CO2, H2O, O3, CH4, N2O, HNO3, N2O5, ClONO2, CF2Cl2, CFCl3, CHF2Cl, CCl4, and C2H6 have been identified in the measured spectra. The 1989 data have been analyzed to retrieve profiles of O3, HNO3, CFCl3 and CF2Cl2. The flights over Kiruna have provided the first ever reported profile measurements of the key reservoir species ClONO2 and N2O5 inside the polar vortex.

  19. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    International Nuclear Information System (INIS)

    Pretolesi, F.; Derchi, L.E.; Redaelli, G.; Papagni, L.

    2001-01-01

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  20. An investigation of electrostatically deposited radionuclides on latex balloons

    International Nuclear Information System (INIS)

    Price, T.; Caly, A.

    2012-01-01

    Use of Canadian Nuclear Society (CNS) education material for a community science education event to promote science awareness, science culture and literacy (Science Rendezvous 2011) lead to investigation of observed phenomena. Experiments are done on balloons that are electrostatically charged then left to collect particulate. Alpha spectroscopy was performed to identify alpha emitting radioisotopes present on the balloons. The time dependent behaviour of the activity was investigated. Additionally, the Alpha activity of the balloon was compared to Beta activity. The grounds for further investigations are proposed. (author)

  1. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Pretolesi, F.; Derchi, L.E. [Dept. of Radiology, University of Genoa (Italy); Redaelli, G.; Papagni, L. [IRCCS, Ist. Auxologico Italiano, Milan (Italy)

    2001-04-01

    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  2. Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Lei-Min Yu

    2018-01-01

    Full Text Available The aim of this study was to assess the efficacy of the rectal administration of nonsteroidal anti-inflammatory drugs (NSAIDs in preventing post-ERCP pancreatitis (PEP. We searched database for randomized controlled trials (RCTs comparing periprocedural rectal administration of NSAIDs with placebo for the prevention of PEP. The rectal administration of NSAIDs significantly decreased the incidence of PEP in the whole patient population (odds ratio (OR: 0.44, 95% confidence interval (CI: 0.30–0.64, P<0.0001, high-risk patients (OR: 0.34, 95% CI: 0.19–0.58, P=0.0001, and all-risk patients (OR: 0.51, 95% CI: 0.31–0.84, P=0.008. The incidence of PEP was reduced by indomethacin (OR: 0.54, 95% CI: 0.36–0.82, P=0.004 and diclofenac (OR: 0.27, 95% CI: 0.15–0.46, P<0.00001. The administration of NSAIDs before (OR: 0.42, 95% CI: 0.25–0.73, P=0.002 or after (OR: 0.39, 95% CI: 0.27–0.56, P<0.00001 ERCP reduced PEP. The NSAIDs were associated with a reduction in mild PEP (OR: 0.55, 95% CI: 0.36–0.83, P=0.004 and moderate-to-severe PEP (OR: 0.47, 95% CI: 0.28–0.79, P=0.004. The rectal administration of NSAIDs reduced the incidence of PEP in high-risk and all-risk patients.

  3. Development of a New Coaxial Balloon Catheter System for Balloon-Occluded Retrograde Transvenous Obliteration (B-RTO)

    International Nuclear Information System (INIS)

    Tanoue, Shuichi; Kiyosue, Hiro; Matsumoto, Shunro; Hori, Yuzo; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu

    2006-01-01

    Purpose. To develop a new coaxial balloon catheter system and evaluate its clinical feasibility for balloon-occluded retrograde transvenous obliteration (B-RTO). Methods. A coaxial balloon catheter system was constructed with 9 Fr guiding balloon catheter and 5 Fr balloon catheter. A 5 Fr catheter has a high flexibility and can be coaxially inserted into the guiding catheter in advance. The catheter balloons are made of natural rubber and can be inflated to 2 cm (guiding) and 1 cm (5 Fr) maximum diameter. Between July 2003 and April 2005, 8 consecutive patients (6 men, 2 women; age range 33-72 years, mean age 55.5 years) underwent B-RTO using the balloon catheter system. Five percent ethanolamine oleate iopamidol (EOI) was used as sclerosing agent. The procedures, including maneuverability of the catheter, amount of injected sclerosing agent, necessity for coil embolization of collateral draining veins, and initial clinical results, were evaluated retrospectively. The occlusion rate was assessed by postcontrast CT within 2 weeks after B-RTO. Results. The balloon catheter could be advanced into the proximal potion of the gastrorenal shunt beyond the collateral draining vein in all cases. The amount of injected EOI ranged from 3 to 34 ml. Coil embolization of the collateral draining vein was required in 2 cases. Complete obliteration of gastric varices on initial follow-up CT was obtained in 7 cases. The remaining case required re-treatment that resulted in complete obstruction of the varices after the second B-RTO. No procedure-related complications were observed. Conclusion. B-RTO using the new coaxial balloon catheter is feasible. Gastric varices can be treated more simply by using this catheter system

  4. OCT evaluation of directional atherectomy compared to balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Marmagkiolis, Konstantinos [Citizens Memorial Hospital Heart and Vascular Institute, Bolivar, MO (United States); Lendel, Vasili [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Koc University, School of Medicine, Istanbul (Turkey)

    2015-09-15

    Directional atherectomy (DA) is one of the most commonly used modalities for the treatment of obstructive femoropopliteal peripheral arterial disease (PAD), especially in patients with large and calcified atherosclerotic plaques. The effect of directional atherectomy to the vascular wall compared to balloon angioplasty by optical coherence tomography (OCT) has not been previously described. We present the first case of OCT after directional atherectomy with SilverHawk followed by angiosculpt balloon angioplasty. - Highlights: • Directional atherectomy avoids the vascular mechanical damage caused by angioplasty balloons and the exposure of stent struts or the potential of stent fracture with stents. • OCT can accurately assess the effect of endovacular interventions to the vessel wall. • Although angiographic results after directional atherectomy are acceptable, OCT use demonstrated suboptimal improvement of the MLA requiring additional balloon angioplasty. • Longer studies are needed to define whether the improved OCT results with angioplasty compared to DA may offer better clinical outcomes.

  5. Remote sensing and sensor testing via hot air balloons

    Energy Technology Data Exchange (ETDEWEB)

    Watson, S.M. [Univ. of Utah, Salt Lake City, UT (United States); Kroutil, R.T. [Army Edgewood Research, Development and Engineering Center, Aberdeen Proving Ground, MD (United States); Traynor, C.A. [DARPA High Performance Computing Applications, Arlington, VA (United States)] [and others

    1996-11-01

    Tethered and free-flying manned hot air balloons have been demonstrated as platforms for various remote sensing asks and sensor testing and atmospheric measurements. These platforms are inexpensive to operate, do not cause atmospheric disturbances as do higher speed platforms, and are extremely stable and free of vibrations inherent in aircraft structures. The equipment operated and tested on the balloons in connection with this project includes a prototype multispectral imaging spectrometer, high resolution CCD cameras, mid- and far-infrared cameras, a radiometer, FTIR spectrometers, video recording equipment and portable power generators carried beneath the balloon providing power to the equipment The experiments conducted on and from the balloon include chemical effluents characterization, atmospheric propagation through slant paths, obscurants imaging and scene reflectance. 7 refs.

  6. Development of Venus Balloon Seismology Missions Through Earth Analog Experiments

    Science.gov (United States)

    Krishnamoorthy, S.; Komjathy, A.; Cutts, J. A.; Pauken, M. T.; Garcia, R. F.; Mimoun, D.; Jackson, J. M.; Kedar, S.; Smrekar, S. E.; Hall, J. L.

    2017-11-01

    The study of a planet’s seismic activity is central to the understanding of its internal structure. We discuss advances made through Earth analog testing for performing remote seismology on Venus using balloons floated in the mid-atmosphere.

  7. Stabilization of ballooning modes with sheared toroidal rotation

    International Nuclear Information System (INIS)

    Miller, R.L.; Waelbroeck, F.L.; Hassam, A.B.; Waltz, R.E.

    1995-01-01

    Stabilization of magnetohydrodynamic ballooning modes by sheared toroidal rotation is demonstrated using a shifted circle equilibrium model. A generalized ballooning mode representation is used to eliminate the fast Alfven wave, and an initial value code solves the resulting equations. The s-α diagram (magnetic shear versus pressure gradient) of ballooning mode theory is extended to include rotational shear. In the ballooning representation, the modes shift periodically along the field line to the next point of unfavorable curvature. The shift frequency (dΩ/dq, where Ω is the angular toroidal velocity and q is the safety factor) is proportional to the rotation shear and inversely proportional to the magnetic shear. Stability improves with increasing shift frequency and direct stable access to the second stability regime occurs when this frequency is approximately one-quarter to one-half the Alfven frequency, ω A =V A /qR. copyright 1995 American Institute of Physics

  8. SMEX02 Balloon-borne Radiosonde Data, Iowa, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set includes radiosonde measurements of upper air temperature and pressure, relative humidity, and wind direction and speed during the balloons' ascent to...

  9. Design Evolution and Methodology for Pumpkin Super-Pressure Balloons

    Science.gov (United States)

    Farley, Rodger

    The NASA Ultra Long Duration Balloon (ULDB) program has had many technical development issues discovered and solved along its road to success as a new vehicle. It has the promise of being a sub-satellite, a means to launch up to 2700 kg to 33.5 km altitude for 100 days from a comfortable mid-latitude launch point. Current high-lift long duration ballooning is accomplished out of Antarctica with zero-pressure balloons, which cannot cope with the rigors of diurnal cycles. The ULDB design is still evolving, the product of intense analytical effort, scaled testing, improved manufacturing, and engineering intuition. The past technical problems, in particular the s-cleft deformation, their solutions, future challenges, and the methodology of pumpkin balloon design will generally be described.

  10. A battery-operated pilot balloon time-signal generator

    Science.gov (United States)

    Ralph H. Moltzau

    1966-01-01

    Describes the design and construction of a 1-pound, battery-operated, time-signal transmitter, which is usable with portable radio or field telephone circuits for synchronizing multi-theodolite observation of pilot balloons.

  11. Balloon valvuloplasty for severe mitral valve stenosis in pregnancy

    African Journals Online (AJOL)

    . Commerford, B. Levetan. Balloon Valvuloplasties for severe mitral stenosis were performed on 11 ... 140 patients each year with cardiac disease - an incidence of 0.5%. ... Department of Medicine, Groote Schuur Hospital and University of.

  12. Ballooning stability analysis of JET H-mode discharges

    International Nuclear Information System (INIS)

    O'Brien, D.P.; Galvao, R.; Keilhacker, M.; Lazzaro, E.; Watkins, M.L.

    1989-01-01

    Previous studies of the stability of a large aspect ratio model equilibrium to ideal MHD ballooning modes have shown that across the bulk of the plasma there exist two marginally stable values of the pressure gradient parameter α. These define an unstable zone which separates the first (small α) stable region from the second (large α) stable region. Close to the separatrix, however, the first and second regions can coalesce when the surface averaged current density, Λ, exceeds a critical value. The plasma in this region is then stable to ballooning modes at all values of the pressure gradient. In this paper we extend these results to JET H-mode equilibria using a finite aspect ratio ballooning formalism, and assess the relevance of ideal ballooning stability in these discharges. In particular we analyse shot 15894 at time 56 sec. which is 1.3 s into the H-phase. (author) 4 refs., 4 figs

  13. 10 meter Sub-Orbital Large Balloon Reflector (LBR)

    Data.gov (United States)

    National Aeronautics and Space Administration — This is the lead NIAC Phase II proposal for “10 meter Sub-Orbital Large Balloon Reflector (LBR)” with Christopher K. Walker as PI. We propose to develop and...

  14. SMEX02 Balloon-borne Radiosonde Data, Iowa

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set includes radiosonde measurements of upper air temperature and pressure, relative humidity, and wind direction and speed during the balloons' ascent to...

  15. Ideal ballooning stability near an equilibrium magnetic island

    Energy Technology Data Exchange (ETDEWEB)

    Hegna, C.C.; Callen, J.D.

    1992-03-01

    The stability properties of ideal ballooning modes on toroidal flux surfaces near a quasistatic magnetic island is examined. On these surfaces, magnetic field-line trajectories tend to bunch on that part of the magnetic surface closet to the X-point of the magnetic island. Because of this preferential bunching, the stabilizing effect of field-line bending due to magnetic shear can be reduced. Eigenfunctions localized in helical angle near the X-point and in poloidal angle on the bad curvature side of the tokamak are more susceptible to ballooning instability than are modes in corresponding equilibria without the magnetic island. For a slowly growing island, a growing number of flux surfaces located near the separatrix become ballooning unstable. Secondary ballooning instabilities may play a part in the crash phase of sawteeth or macroscopic island dynamics.

  16. Properties of ballooning modes in the Heliotron configurations

    International Nuclear Information System (INIS)

    Nakajima, N.; Hudson, S.R.; Hegna, C.C.

    2005-01-01

    The stability of ballooning modes is influenced by the local and global magnetic shear and local and global magnetic curvature so significantly that it is fairly difficult to get those general properties in the three dimensional configurations with strong flexibility due to the external coil system. In the case of the planar axis heliotron configurations allowing a large Shafranov shift, like LHD, properties of the high-mode-number ballooning modes have been intensively investigated. It has been analytically shown that the local magnetic shear comes to disappear in the stellarator-like global magnetic shear region, as the Shafranov shift becomes large. Based on this mechanism and the characteristics of the local and global magnetic curvature, it is numerically shown that the destabilized ballooning modes have strong three-dimensional properties (both poloidal and toroidal mode couplings) in the Mercier stable region, and that those are fairly similar to ballooning modes in the axisymmetric system in the Mercier unstable region. As is well known, however, no quantization condition is applicable to the ballooning modes in the three-dimensional system without symmetry, and so the results of the high-mode-number ballooning modes in the covering space had to be confirmed in the real space. Such a confirmation has been done in the Mercier stable region and also in the Mercier unstable region by using three dimensional linearized ideal MHD stability code cas3d. Confirming the relation between high-mode-number ballooning analyses by the global mode analyses, the method of the equilibrium profile variations has been developed in the tree dimensional system, giving dt/dψ - dP/dψ stability diagram corresponding to the s - α diagram in tokamaks. This method of profile variation are very powerful to investigate the second stability of high-mode-number ballooning modes and has been more developed. Recently it has been applied to the plasma in the inward-shifted LHD

  17. Overview of the Scientific Balloon Activity in Sweden

    Science.gov (United States)

    Abrahamsson, Mattias; Kemi, Stig; Lockowandt, Christian; Andersson, Kent

    SSC, formerly known as Swedish Space Corporation, is a Swedish state-owned company working in several different space related fields, including scientific stratospheric balloon launches. Esrange Space Centre (Esrange in short) located in the north of Sweden is the launch facility of SSC, where both sounding rocket launches and stratospheric balloon launches are conducted. At Esrange there are also facilities for satellite communication, including one of the largest civilian satellite data reception stations in the world. Stratospheric balloons have been launched from Esrange since 1974, when the first flights were performed together with the French space agency CNES. These balloon flights have normally flown eastward either only over Sweden or into Finland. Some flights have also had permission to fly into Russia, as far as the Ural Mountains. Normal flight times are from 4 to 12 hours. These eastward flights are conducted during the winter months (September to May). Long duration flights have been flown from ESC since 2005, when NASA flew the BLAST payload from Sweden to north Canada. The prevailing westerly wind pattern is very advantageous for trans-Atlantic flights during summer (late May to late July). The long flight times are very beneficial for astronomical payloads, such as telescopes that need long observation times. In 2013 two such payloads were flown, the first called SUNRISE was a German/US solar telescope, and the other called PoGOLite with a Swedish gamma-ray telescope. In 14 days PoGOLite, which had permission to fly over Russia, made an almost complete circumpolar flight. Typical scientific balloon payload fields include atmospheric research, including research on ozone depletion, astronomical and cosmological research, and research in technical fields such as aerodynamics. University students from all over Europe are involved in flights from Esrange under a Swedish/German programme called BEXUS. Two stratospheric balloons are flown with student

  18. The Evaluation of Endoscopic Balloon Dilation Treatment for Benign

    Directory of Open Access Journals (Sweden)

    H. Ghofrani

    2008-04-01

    Full Text Available Background and ObjectiveBalloon dilatation of stricture is one of the new treatment methods for patients with Gastric Outlet Obstruction (GOO. Prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that could affect method advantage among patients with benign etiology for GOO. Methods Forty-five patients with symptoms of benign GOO were randomly selected. The mean age of patients was 43.7±18.1 years and 86.7% of them were men. Gastric outlet was delineated using double channel videoendoscopy. The severity of gastric pain was measured by VAS test immediately before and one month after balloon dilatation. Patients were followed after procedure weekly (for the first month and then monthly. Balloon dilatation was repeated for 27% patients during the follow up period.ResultsPatients were followed for 9.9±5.8 months. Furthermore, 71.1% were H. pylori positive. Positive response percent to endoscopic balloon dilatation was 80% and eight patients were took under surgical resection. Weight loss was seen frequently in the non-respondent group. The pain severity was significantly reduced in respondent subjects. No meaningful correlations were found between the response to balloon dilatation and positive H. pylori and cigarette smoking.ConclusionEndoscopic balloon dilatation is a safe and effective method for treating most of patients with benign gastric outlet obstruction and has favorable long-term outcome. Keywords: Endoscopy, Gastric Outlet Obstruction (GOO, Balloon Dilatation

  19. Ballooning Stability of the Compact Quasiaxially Symmetric Stellarator

    International Nuclear Information System (INIS)

    Redi, M.H.; Canik, J.; Dewar, R.L.; Johnson, J.L.; Klasky, S.; Cooper, W.A.; Kerbichler, W.

    2001-01-01

    The magnetohydrodynamic (MHD) ballooning stability of a compact, quasiaxially symmetric stellarator (QAS), expected to achieve good stability and particle confinement is examined with a method that can lead to estimates of global stability. Making use of fully 3D, ideal-MHD stability codes, the QAS beta is predicted to be limited above 4% by ballooning and high-n kink modes. Here MHD stability is analyzed through the calculation and examination of the ballooning mode eigenvalue isosurfaces in the 3-space [s, alpha, theta(subscript ''k'')]; s is the edge normalized toroidal flux, alpha is the field line variable, and theta(subscript ''k'') is the perpendicular wave vector or ballooning parameter. Broken symmetry, i.e., deviations from axisymmetry, in the stellarator magnetic field geometry causes localization of the ballooning mode eigenfunction, with new types of nonsymmetric, eigenvalue isosurfaces in both the stable and unstable spectrum. The isosurfaces around the most unstable points i n parameter space (well above marginal) are topologically spherical. In such cases, attempts to use ray tracing to construct global ballooning modes lead to a k-space runaway. Introduction of a reflecting cutoff in k(perpendicular) to model numerical truncation or finite Larmor radius (FLR) yields chaotic ray paths ergodically filling the allowed phase space, indicating that the global spectrum must be described using the language of quantum chaos theory. However, the isosurface for marginal stability in the cases studied are found to have a more complex topology, making estimation of FLR stabilization more difficult

  20. Controlled weather balloon ascents and descents for atmospheric research and climate monitoring

    Science.gov (United States)

    Kräuchi, Andreas; Philipona, Rolf; Romanens, Gonzague; Hurst, Dale F.; Hall, Emrys G.; Jordan, Allen F.

    2016-03-01

    In situ upper-air measurements are often made with instruments attached to weather balloons launched at the surface and lifted into the stratosphere. Present-day balloon-borne sensors allow near-continuous measurements from the Earth's surface to about 35 km (3-5 hPa), where the balloons burst and their instrument payloads descend with parachutes. It has been demonstrated that ascending weather balloons can perturb the air measured by very sensitive humidity and temperature sensors trailing behind them, particularly in the upper troposphere and lower stratosphere (UTLS). The use of controlled balloon descent for such measurements has therefore been investigated and is described here. We distinguish between the single balloon technique that uses a simple automatic valve system to release helium from the balloon at a preset ambient pressure, and the double balloon technique that uses a carrier balloon to lift the payload and a parachute balloon to control the descent of instruments after the carrier balloon is released at preset altitude. The automatic valve technique has been used for several decades for water vapor soundings with frost point hygrometers, whereas the double balloon technique has recently been re-established and deployed to measure radiation and temperature profiles through the atmosphere. Double balloon soundings also strongly reduce pendulum motion of the payload, stabilizing radiation instruments during ascent. We present the flight characteristics of these two ballooning techniques and compare the quality of temperature and humidity measurements made during ascent and descent.

  1. Balloon catheter dilatation of benign urethral strictures

    International Nuclear Information System (INIS)

    Perini, L.; Cavallo, A.; Perin, B.; Bighi, G.

    1988-01-01

    The authors report their experience of benign urethral stricture dilatation by balloon catheter in 11 male patients. Ten posterior and 2 anterior urethral strictures were treated; in 1 patients several narrowings coexisted at various levels. Etiology was inflammatory in 4 cases, iatrogen in 3, post-traumatic in 2, and equivocal in 2. The patients were studied both before and soon after dilatation by means of retrograde and voiding cystourethrogram and uroflowgraphy; the follow-up (2-14 months) was performed by urodynamic alone. In all cases, dilatation was followed by the restoration of urethral gauge, together with prompt functional improvement of urodynamic parameters. The latter result subsisted in time in 9 patients. In 2 cases recurrences were observed demonstrated at once by clinics and urodynamics. Both lesions were successfully re-treated. Neither early not late complication occurred. In spite of the limited material, the valuable results obtained, together with the absence of complications, the peculiar morphology of recurrences, and the chance of repeating it make the procedure advisable as a valid alternative to conventional techniques for these pathologies

  2. Retrograde prostatic urethroplasty with a balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Reddy, P.; Hulbert, J.; Letourneau, J.G.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Amplatz, K.

    1987-01-01

    Twenty-five patients with prostatism and documented BPH who were candidates for transurethral resection of the prostate were dilated for 10 minutes with 25-mm urethroplasty balloons using a retrograde transurethral approach. The procedure was performed under local anesthesia using 2% viscous lidocaine on an outpatient basis. A mild discomfort was experienced by all patients with a moderate urgency sensation. Mild transient hematuria was present in all, which cleared in 4 to 6 hours. Dysuria usually lasted for 72 hours. Significant improvement has been seen in the relief of symptoms in patients without middle-lobe hypertrophy as documented by uroflow studies, voiding cystourethrograms, and retrograde urethrograms. In patients with middle-lobe hypertrophy, moderate improvement in uroflow studies was observed, which correlated well with symptomatic improvement. Rectal US and MR studies have shown no evidence of intraprostatic or periprostatic abnormalities. No complications have been encountered so far. The longest current follow-up is 20 months, with a mean of 10 months

  3. Mechanism of prostatic urethroplasty with balloon catheter

    International Nuclear Information System (INIS)

    Castaneda, F.; Maynar, M.; Hulbert, J.

    1988-01-01

    A series of 60 patients have undergone prostatic urethroplasty with balloon catheters at our institution. The follow-up of these patients has ranged from more than 3 years to not less than 6 months. The preliminary results have been excellent, with a success rate of 75% in patients with predominant lateral lobe hypertrophy. This success rate drops to 25% in patients with predominant middle lobe hypertrophy. In previous communications the authors have proposed that the mechanism of prostatic urethral relief of obstruction is due to stretching of the prostatic capsule, tissue compression, and possible subsequent atrophy, as suggested by findings of transrectal US, MR imaging, voiding and retrograde urethrography, and urinary flow studies. Recent clinical information that has led to further animal research has shown that in addition to the previously supposed mechanism of action, separation of the prostatic lobes occurs by splitting of the anterior and posterior commissures of the prostatic gland tissue. This separation of the prostatic lobes is therefore the goal of the procedure. As more experience is gained, the already high success rate can probably be improved

  4. Percutaneous balloon valvuloplasty in mitral stenosis

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Oh, Byung Hee; Park, Kyung Ju; Kim, Seung Hyup; Lee, Young Woo; Han, Man Chung

    1989-01-01

    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 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

  5. The University of Alberta High Altitude Balloon Program

    Science.gov (United States)

    Johnson, W.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Mann, I. R.; Mazzino, L.; Rae, J.; University of Alberta High Altitude Balloon Team

    2011-12-01

    The University of Alberta High Altitude Balloon (UA-HAB) program is a one and half year program sponsored by the Canadian Space Agency (CSA) that offers hands on experience for undergraduate and graduate students in the design, build, test and flight of an experimental payload on a high altitude balloon platform. Utilising low cost weather balloon platforms, and through utilisation of the CSA David Florida Laboratory for thermal-vacuum tests , in advance of the final flight of the payload on a NASA high altitude balloon platform. Collectively the program provided unique opportunities for students to experience mission phases which parallel those of a space satellite mission. The program has facilitated several weather balloon missions, which additionally provide educational opportunities for university students and staff, as well as outreach opportunities among junior and senior high school students. Weather balloon missions provide a cheap and quick alternative to suborbital missions; they can be used to test components for more expensive missions, as well as to host student based projects from different disciplines such as Earth and Atmospheric Sciences (EAS), Physics, and Engineering. In addition to extensive skills development, the program aims to promote recruitment of graduate and undergraduate students into careers in space science and engineering. Results from the UA-HAB program and the flight of the UA-HAB shielded Gieger counter payload for cosmic ray and space radiation studies will be presented. Lessons learned from developing and maintaining a weather balloon program will also be discussed. This project is undertaken in partnership with the High Altitude Student Platform, organized by Louisiana State University and the Louisiana Space Consortium (LaSpace), and sponsored by NASA, with the financial support of the Canadian Space Agency.

  6. Cerebral ischemia associated with PercuSurge balloon occlusion balloon during carotid stenting: Incidence and possible mechanisms.

    Science.gov (United States)

    Chaer, Rabih A; Trocciola, Susan; DeRubertis, Brian; Lin, Stephanie C; Kent, K Craig; Faries, Peter L

    2006-05-01

    Interruption of antegrade cerebral perfusion results in transient neurologic intolerance in some patients undergoing carotid angioplasty and stenting (CAS). This study sought to evaluate factors that contributed to the development of cerebral ischemia during PercuSurge balloon occlusion and techniques used to allow successful completion of the CAS procedure. The PercuSurge occlusion balloon was used in 43 of 165 patients treated with CAS for high-grade stenosis (mean stenosis, 90%). All 43 patients were at increased risk for endarterectomy (7 restenosis, 3 irradiation, 3 contralateral occlusion, and 30 Goldman class II-III); 20% were symptomatic. Symptoms of cerebral hypoperfusion during temporary occlusion of the internal carotid artery occurred in 10 of 43 and included dysarthria (7/10), agitation (6/10), decreased level of consciousness (5/10), and focal hemispheric deficit (3/10). An incomplete circle of Willis or contralateral carotid artery occlusion, or both, was present in 8 of 10 patients. Symptoms resulting from PercuSurge balloon occlusion were managed by balloon deflation with or without evacuation of blood from the internal carotid artery using the Export catheter. All symptoms resolved completely without deficit after deflation of the occlusion balloon. The development of neurologic symptoms after initial PercuSurge balloon inflation and occluded internal carotid artery flow was associated with a decrease in the mean Glasgow Coma Scale (GCS) from 15 to 10 (range, 9 to 14); the GCS returned to normal after occlusion balloon deflation and remained normal during subsequent reinflation. The mean time to spontaneous recovery of full neurologic function was 8 minutes (range, 4 to 15 minutes). No thrombotic or embolic events were present on cerebral angiography or computed tomography scan. Balloon reinflation was performed after a mean reperfusion interval of 10 minutes after full neurologic recovery (range, 4 to 20 minutes). The mean subsequent procedure

  7. The ATIC Long Duration Balloon Project

    Science.gov (United States)

    Guzik, T.

    Long Duration Balloon (LDB) scientific experiments, launched to circumnavigate the south pole over Antarctica, have particular advantages compared to Shuttle or other Low Earth Orbit (LEO) missions in terms of cost, weight, scientific "duty factor" and work force development. The Advanced Thin Ionization Calorimeter (ATIC) cosmic ray astrophysics experiment is a good example of a university-based project that takes full advantage of current LDB capability and could effectively use future expansion in launch weight and flight duration. The ATIC experiment is currently being shipped to Antarctica in preparation for its first LDB science flight that will investigate the charge composition and energy spectra of primary cosmic rays over the energy range from about 101 0 to 10 1 4 eV. The instrument is built around a fully active, Bismuth Germanate (BGO) ionization calorimeter to measure the energy deposited by the cascades formed by particles interacting in a thick carbon target. A highly segmented silicon matrix, located above the target, provides good incident charge resolution plus rejection of the "backscattered" particles from the interaction. Trajectory reconstruction is based on the cascade profile in the BGO calorimeter, plus information from the three scintillator hodoscope layers in the target section above it. The hodoscope planes also provide the primary event trigger to initiate the detector readout, another measure of the incident particle charge and an indicator of the interaction point in the carbon material. The scientific payload weighs ~1,540 kg and consumes ~300 Watts of power supplied by a ~580 Watt solar array system. A full evaluation of the experiment was performed during a test flight occurring between 28 December 2000 and 13 January 2001 where ATIC was carried3 to an altitude of ~37 km above Antarctica by a ~850,000 m helium filled balloon for one circumnavigation of the continent. All systems behaved well, the detectors performed as expected

  8. Ideal ballooning stability of JET discharges

    International Nuclear Information System (INIS)

    Galvao, R.M.O.; Lazzaro, E.; O'Rourke, J.; Smeulders, P.; Schmidt, G.

    1989-01-01

    Conditions under which ballooning modes are expected to be excited have recently been obtained in two different types of discharges in JET. In the first type, discharges with β approaching the Troyon-Sykes-Wesson critical value β c for optimised pressure profiles have been produced at low toroidal fields (B T =1.5T). In the second type, extremely high pressure gradients have been produced in the plasma core through pellet injection in the current rise phase of the discharge followed by strong additional heating. The stability of these discharges has been studied with the stability code HBT coupled to the equilibrium identification code IDENTC. The equilibrium pressure and diamagnetic function profiles are determined in IDENTC by an optimisation procedure to fit the external magnetic measurements. The resulting pressure profile in the equatorial plane is then compared with the profile derived from 'direct' measurements, i.e. electron density and temperature profiles measured by the LIDAR diagnostic system, ion-temperature profile measured by the charge-exchange diagnostic system, and ion density profile calculated from the Z eff and electron density profiles. Furthermore, the value of the safety factor q on axis is compared with that determined from polarimetry. When good agreement is found, the output data from IDENTC is passed directly to HBT to carry out the stability analysis. When there is not a good agreement, as in the case of pellet discharges with highly peaked pressure profiles, the equilibrium is reevaluated using the 'experimental' profile and the data from polarimetry. (author) 6 refs., 4 figs

  9. Advances in the Remote Monitoring of Balloon Flights

    Science.gov (United States)

    Breeding, S.

    At the National Scientific Balloon Facility (NSBF), we must staff the Long Duration Balloon (LDB) control center 24 hours a day during LDB flights. This requires three daily shifts of two operators (balloon control and tdrss scheduling). In addition to this we also have one engineer on-call as LDB Lead to resolve technical issues and one manager on-call for flight management. These on-call periods are typically 48 to 72 hours in length. In the past the on-call staff had to travel to the LDB control center in order to monitor the status of a flight in any detail. This becomes problematic as flight durations push out beyond 20 to 30 day lengths, as these staff members are not available for business travel during these periods. This paper describes recent advances which allow for the remote monitoring of scientific balloon flight ground station computer displays. This allows balloon flight managers and lead engineers to check flight status and performance from any location with a network or telephone connection. This capability frees key personnel from the NSBF base during flights. It also allows other interested parties to check on the flight status at their convenience.

  10. Time-dependent strains and stresses in a pumpkin balloon

    Science.gov (United States)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    This paper presents a study of pumpkin-shaped superpressure balloons consisting of gores made from a thin polymeric film attached to high stiffness meridional tendons This type of design is being used for the NASA ULDB balloons The gore film shows considerable time-dependent stress relaxation whereas the behaviour of the tendons is essentially time-independent Upon inflation and pressurization the instantaneous i e linear-elastic strain and stress distributions in the film show significantly higher values in the meridional direction However over time and due to the biaxial visco-elastic stress relaxation of the the gore material the em hoop strains increase and the em meridional stresses decrease whereas the em remaining strain and stress components remain substantially unchanged These results are important for a correct assessment of the structural integrity of a pumpkin balloon in a long-duration mission both in terms of the material performance and the overall stability of the shape of the balloon An experimental investigation of the time dependence of the biaxial strain distribution in the film of a 4 m diameter 48 gore pumpkin balloon is presented The inflated shape of selected gores has been measured using photogrammetry and the time variation in strain components at some particular points of these gores has been measured under constant pressure and temperature The results show good correlation with a numerical study using the ABAQUS finite-element package that includes a widely used model of

  11. Aerial Deployment and Inflation System for Mars Helium Balloons

    Science.gov (United States)

    Lachenmeler, Tim; Fairbrother, Debora; Shreves, Chris; Hall, Jeffery, L.; Kerzhanovich, Viktor V.; Pauken, Michael T.; Walsh, Gerald J.; White, Christopher V.

    2009-01-01

    A method is examined for safely deploying and inflating helium balloons for missions at Mars. The key for making it possible to deploy balloons that are light enough to be buoyant in the thin, Martian atmosphere is to mitigate the transient forces on the balloon that might tear it. A fully inflated Mars balloon has a diameter of 10 m, so it must be folded up for the trip to Mars, unfolded upon arrival, and then inflated with helium gas in the atmosphere. Safe entry into the Martian atmosphere requires the use of an aeroshell vehicle, which protects against severe heating and pressure loads associated with the hypersonic entry flight. Drag decelerates the aeroshell to supersonic speeds, then two parachutes deploy to slow the vehicle down to the needed safe speed of 25 to 35 m/s for balloon deployment. The parachute system descent dynamic pressure must be approximately 5 Pa or lower at an altitude of 4 km or more above the surface.

  12. High n ballooning modes in highly elongated tokamaks

    International Nuclear Information System (INIS)

    An, C.H.; Bateman, G.

    1980-02-01

    An analytic study of stability against high n ballooning modes in highly elongated axisymmetric plasmas is presented and compared with computational results. From the equation for the marginal pressure gradient, it is found that the local shear plays an important role on the stability of elongated and shifted plasma, and that high elongation deteriorates the stability by decreasing the stabilizing effects of field line bending and local shear. The net contribution of the local shear to stability decreases with elongation and shift for strongly ballooning modes (eigenfunctions strongly localized near the outer edge of the toroidal flux surfaces) but increases for interchange modes (eigenfunctions more uniform along the flux surfaces). The computational study of high n ballooning modes in a highly elongated plasma reveals that lowering the aspect ratio and broadening the pressure profile enhance the marginal beta for β/sub p/ less than unity but severely reduce the marginal beta for β/sub p/ larger than unity

  13. Review of the British scientific sounding rocket and balloon programmes

    International Nuclear Information System (INIS)

    Delury, J.T.

    1978-01-01

    This review describes the UK scientific sounding rocket programmes which have utilised Skylarks for 21 years, Petrels for 10 years and Fulmars for 2 years. The SRC's ongoing programme is now based on the Petrel and Fulmar rockets, and approved proposals by 5 UK scientific groups covering 1978 and 1979 are outlined. The British scientific balloon programme, which serves 14 scientific groups within UK universities, involves a planned 10 flights per annum using balloons of 3 M cu ft to 31 M cu ft capacity and payloads up to 2 tons in weight. The review outlines the balloon programme of flights planned mainly from Palestine in Texas and Alice Springs/Mildura in Australia. (author)

  14. Popping balloons: formation of a crack network in rubber membranes

    Science.gov (United States)

    Moulinet, Sebastien; Adda-Bedia, Mokhtar; Equipe Morphogenèse et phénomènes multi-échelle Team

    2015-03-01

    Everyone can make the observation: a rubber balloon inflated until it spontaneously pop breaks into a large number of shreds. In contrast, a balloon pierced with a needle at an early stage of its inflation breaks into two large pieces. Using model latex balloons, we have experimentally investigated the transition between these two breaking regimes. We have showed that, above a threshold stress in the latex membrane, a single crack become unstable and separates into two new cracks. Then, a cascade of tip-splitting generates a network of cracks that eventually form a large number of fragments. We have observed that the instability of the crack occurs when it reaches a limit velocity that could the speed of sound. By studying the energy balance during the explosion, we can determine the intrinsic fracture energy of rubber, a measurement difficult to achieve with usual tensile testing.

  15. JUBA (Joint UAS-Balloon Activities) Final Campaign Report.

    Energy Technology Data Exchange (ETDEWEB)

    Dexheimer, Darielle [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Apple, Monty [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Callow, Diane Schafer [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Longbottom, Casey Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Novick, David K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wilson, Christopher W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-02-01

    Using internal investment funds within Sandia National Laboratories’ (SNL) Division 6000, JUBA was a collaborative exercise between SNL Orgs. 6533 & 6913 (later 8863) to demonstrate simultaneous flights of tethered balloons and UAS on the North Slope of Alaska. JUBA UAS and tethered balloon flights were conducted within the Restricted Airspace associated with the ARM AMF3 site at Oliktok Point, Alaska. The Restricted Airspace occupies a 2 nautical mile radius around Oliktok Point. JUBA was conducted at the Sandia Arctic Site, which is approximately 2 km east-southeast of the AMF3. JUBA activities occurred from 08/08/17 – 08/10/17. Atmospheric measurements from tethered balloons can occur for a long duration, but offer limited spatial variation. Measurements from UAS could offer increased spatial variability.

  16. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients

    DEFF Research Database (Denmark)

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik

    2015-01-01

    , and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess...... if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected...... patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction...

  17. Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration.

    Science.gov (United States)

    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

    2009-04-01

    A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment.

  18. Iridium: Global OTH data communications for high altitude scientific ballooning

    Science.gov (United States)

    Denney, A.

    While the scientific community is no stranger to embracing commercially available technologies, the growth and availability of truly affordable cutting edge technologies is opening the door to an entirely new means of global communications. For many years high altitude ballooning has provided science an alternative to costly satellite based experimental platforms. As with any project, evolution becomes an integral part of development. Specifically in the NSBF ballooning program, where flight durations have evolved from the earlier days of hours to several weeks and plans are underway to provide missions up to 100 days. Addressing increased flight durations, the harsh operational environment, along with cumbersome and outdated systems used on existing systems, such as the balloon vehicles Support Instrumentation Package (SIP) and ground-based systems, a new Over-The-Horizon (OTH) communications medium is sought. Current OTH equipment planning to be phased-out include: HF commanding systems, ARGOS PTT telemetry downlinks and INMARSAT data terminals. Other aspects up for review in addition to the SIP to utilize this communications medium include pathfinder balloon platforms - thereby, adding commanding abilities and increased data rates, plus providing a package for ultra-small experiments to ride aloft. Existing communication systems employed by the National Scientific Balloon Facility ballooning program have been limited not only by increased cost, slow data rates and "special government use only" services such as TDRSS (Tracking and Data Relay Satellite System), but have had to make special provisions to geographical flight location. Development of the Support Instrumentation Packages whether LDB (Long Duration Balloon), ULDB (Ultra Long Duration Balloon) or conventional ballooning have been plagued by non-standard systems configurations requiring additional support equipment for different regions and missions along with a myriad of backup for redundancy. Several

  19. Post-ERCP pancreatogastric fistula associated with an intraductal papillary-mucinous neoplasm of the pancreas – a case report and literature review

    Directory of Open Access Journals (Sweden)

    Yasuda Yoshikazu

    2005-10-01

    Full Text Available Abstract Background Fistula formation has been reported in intraductal papillary-mucinous neoplasms (IPMNs with or without invasion of the adjacent organs. The presence or absence of invasion is mostly determined by postoperative histological examination rather than by preoperative work-up. Case presentation A 72 year-old Japanese woman showed remarkable dilatation of the main pancreatic duct (MPD in the distal region of the pancreas. Subsequent ERCP also showed MPD dilatation, after which the patient suffered moderate pancreatitis. A subsequent gastroscopy revealed a small ulceration that had not been observed in a gastroscopy performed 3 months prior. Mucinous discharge from the ulceration suggested it might be the orifice of a fistula connected to the MPD. En bloc resection including the distal region of the pancreas, spleen, stomach and part of the transverse colon was performed under the pre- and intraoperative diagnosis of an invasive malignant IPMN. However, histopathology revealed the lesion to be of "borderline malignancy" without apparent invasion of the stomach. Light microscopy showed inflammatory cellular infiltrates (mainly neutrophils around the pancreatogastric fistula, but there was no evidence of neoplastic epithelia lining the fistulous tract. Conclusion This case highlights that a pancreatogastric fistula can develop after acute inflammation of the pancreas in the absence of cancer invasion. Further information regarding IPMN-associated fistulae is necessary to clarify the pathogenesis, diagnosis, appropriate surgical intervention and prognosis for this disorder.

  20. Blood pressure normalization post-jugular venous balloon angioplasty.

    Science.gov (United States)

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

    2015-05-01

    This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the

  1. Particle Astrophysics in NASA's Long Duration Balloon Program

    Energy Technology Data Exchange (ETDEWEB)

    Gorham, Peter W.

    2013-10-15

    A century after Viktor Hess' discovery of cosmic rays, balloon flights still play a central role in the investigation of cosmic rays over nearly their entire spectrum. We report on the current status of NASA balloon program for particle astrophysics, with particular emphasis on the very successful Antarctic long-duration balloon program, and new developments in the progress toward ultra-long duration balloons.

  2. Properties of nylon 12 balloons after thermal and liquid carbon dioxide treatments.

    Science.gov (United States)

    Ro, Andrew J; Davé, Vipul

    2013-03-01

    Critical design attributes of angioplasty balloons include the following: tear resistance, high burst pressures, controlled compliance, and high fatigue. Balloons must have tear resistance and high burst pressures because a calcified stenosis can be hard and nominal pressures of up to 16 atm can be used to expand the balloon. The inflated balloon diameter must be a function of the inflation pressure, thus compliance is predictable and controlled. Reliable compliance is necessary to prevent damage to vessel walls, which may be caused by over-inflation. Balloons are often inflated multiple times in a clinical setting and they must be highly resistant to fatigue. These design attributes are dependent on the mechanical properties and polymer morphology of the balloon. The effects of residual stresses on shrinkage, crystallite orientation, balloon compliance, and mechanical properties were studied for angioplasty nylon 12 balloons. Residual stresses of these balloons were relieved by oven heat treatment and liquid CO2 exposure. Residual stresses were measured by quantifying shrinkage at 80 °C of excised balloon samples using a dynamic mechanical analyzer. Shrinkage was lower after oven heat treatment and liquid CO2 exposure compared to the as-received balloons, in the axial and radial directions. As-received, oven heat treated, and liquid CO2-exposed balloon samples exhibited similar thermal properties (T(g), T(m), X(t)). Crystallite orientation was not observed in the balloon cylindrical body using X-ray scattering and polarized light microscopy, which may be due to balloon fabrication conditions. Significant differences were not observed between the stress-strain curves, balloon compliance, and average burst pressures of the as-received, oven heat treated, and liquid CO2-exposed balloons. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. AIAA Educator Academy: The Space Weather Balloon Module

    Science.gov (United States)

    Longmier, B.; Henriquez, E.; Bering, E. A.; Slagle, E.

    2013-12-01

    Educator Academy is a K-12 STEM curriculum developed by the STEM K-12 Outreach Committee of the American Institute of Aeronautics and Astronautics (AIAA). Consisting of three independent curriculum modules, K-12 students participate in inquiry-based science and engineering challenges to improve critical thinking skills and enhance problem solving skills. The Space Weather Balloon Curriculum Module is designed for students in grades 9-12. Throughout this module, students learn and refine physics concepts as well as experimental research skills. Students participate in project-based learning that is experimental in nature. Students are engaged with the world around them as they collaborate to launch a high altitude balloon equipped with HD cameras.The program leaders launch high altitude weather balloons in collaboration with schools and students to teach physics concepts, experimental research skills, and to make space exploration accessible to students. A weather balloon lifts a specially designed payload package that is composed of HD cameras, GPS tracking devices, and other science equipment. The payload is constructed and attached to the balloon by the students with low-cost materials. The balloon and payload are launched with FAA clearance from a site chosen based on wind patterns and predicted landing locations. The balloon ascends over 2 hours to a maximum altitude of 100,000 feet where it bursts and allows the payload to slowly descend using a built-in parachute. The payload is located using the GPS device. In April 2012, the Space Weather Balloon team conducted a prototype field campaign near Fairbanks Alaska, sending several student-built experiments to an altitude of 30km, underneath several strong auroral displays. To better assist teachers in implementing one or more of these Curriculum Modules, teacher workshops are held to give teachers a hands-on look at how this curriculum is used in the classroom. And, to provide further support, teachers are each

  4. Cloud Water Content Sensor for Sounding Balloons and Small UAVs

    Science.gov (United States)

    Bognar, John A.

    2009-01-01

    A lightweight, battery-powered sensor was developed for measuring cloud water content, which is the amount of liquid or solid water present in a cloud, generally expressed as grams of water per cubic meter. This sensor has near-zero power consumption and can be flown on standard sounding balloons and small, unmanned aerial vehicles (UAVs). The amount of solid or liquid water is important to the study of atmospheric processes and behavior. Previous sensing techniques relied on strongly heating the incoming air, which requires a major energy input that cannot be achieved on sounding balloons or small UAVs.

  5. Cosmic ray abundance measurements with the CAKE balloon experiment

    CERN Document Server

    Cecchini, S.; Giacomelli, G.; Manzoor, S.; Medinaceli, E.; Patrizii, L.; Togo, V.

    2005-01-01

    We present the results from the CAKE (Cosmic Abundance below Knee Energy) balloon experiment which uses nuclear track detectors. The final experiment goal is the determination of the charge spectrum of CR nuclei with Z $>$ 30 in the primary cosmic radiation. The detector, which has a geometric acceptance of $\\sim$ 1.7 m$^2$sr, was exposed in a trans-mediterranean stratospheric balloon flight. Calibrations of the detectors used (CR39 and Lexan), scanning strategies and algorithms for tracking particles in an automatic mode are presented. The present status of the results is discussed

  6. Polymer blends for LDB applications. [Long Duration Ballooning

    Science.gov (United States)

    Lichkus, Andrew M.; Harrison, Ian R.

    1991-01-01

    A series of LCP/PE blends have been studied to determine the potential of such systems to produce a high modulus balloon film material which retains the balloon fabrication and low temperature flight advantages of the current PE films. Blown films of blends of 5 and 15 percent LCP in PE have been produced which show a 28 percent enhancement in modulus over the neat PE matrix. These results are substantially lower than anticipated and are explained in terms of the LCP reinforcement aspect ratio and fibril diameter.

  7. Emerging Stent and Balloon Technologies in the Femoropopliteal Arteries

    Directory of Open Access Journals (Sweden)

    Georgios Pastromas

    2014-01-01

    Full Text Available Endovascular procedures for the management of the superficial femoral (SFA and popliteal artery disease are increasingly common. Over the past decade, several stent technologies have been established which may offer new options for improved clinical outcomes. This paper reviews the current evidence for SFA and popliteal artery angioplasty and stenting, with a focus on randomized trials and registries of nitinol self-expanding stents, drug-eluting stents, dug-coated balloons, and covered stent-grafts. We also highlight the limitations of the currently available data and the future routes in peripheral arterial disease (PAD stent and balloon technology.

  8. The German scientific balloon and sounding rocket programme

    International Nuclear Information System (INIS)

    Dahl, A.F.

    1980-01-01

    This report contains information on sounding rocket projects in the scientific field of astronomy, aeronomy, magnetosphere, and material science under microgravity. The scientific balloon projects are performed with emphasis on astronomical research. By means of tables it is attempted to give a survey, as complete as possible, of the projects the time since the last symposium in Ajaccio, Corsica, and of preparations and plans for the future until 1983. The scientific balloon and sounding rocket projects form a small successful part of the German space research programme. (Auth.)

  9. BioEnterics Intragastric Balloon (BIB) versus Spatz Adjustable Balloon System (ABS): Our experience in the elderly.

    Science.gov (United States)

    Russo, Teresa; Aprea, Giovanni; Formisano, Cesare; Ruggiero, Simona; Quarto, Gennaro; Serra, Raffaele; Massa, Guido; Sivero, Luigi

    2017-02-01

    The BioEnterics Intragastric Balloon (BIB) and the Spatz Adjustable Balloon System (ABS) are in fact recommended for weight reduction as a bridge to bariatric surgery. We retrospected studied patients with body mass index (BMI) and age ranges of 37-46 and 70-80 years, respectively, who had undergone BIB from January 2010 to July 2012 and prospected studied patients who had undergone Spatz balloon from July 2012 to August 2014. The aim of this study is to compare BIB and Spatz in terms of weight loss, complications, and maintenance of weight after removal. For both procedures, the median weight loss was 20 ± 3 kg, median BMI at the end of the therapy was 32 ± 2, and no severe complication occurred. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. 28. Critical pulmonary valve stenosis: Medical management beyond balloon dilation

    Directory of Open Access Journals (Sweden)

    Muhammad Arif Khan

    2015-10-01

    Conclusion: Phentolamine and/or Captopril have a therapeutic role in neonates with critical PVS who remain oxygen dependent after balloon dilation. Both medicationslead to vasodilatation of pulmonary and systemic vascularity. They facilitate inflowto the right ventricle. Right to left shunt across a PFO or/ ASD minimizesand saturation improves leading to a significantreduction in length of hospitalization.

  11. Balloon dacryocystoplasty study in the management of adult epiphora.

    LENUS (Irish Health Repository)

    Fenton, S

    2012-02-03

    PURPOSE: To determine the efficacy of dacryocystoplasty with balloon dilation in the treatment of acquired obstruction of the nasolacrimal system in adults. METHODS: Balloon dacryocystoplasty was performed in 52 eyes of 42 patients under general anaesthetic. A Teflon-coated guidewire was introduced through the canaliculus and manipulated through the nasolacrimal system and out of the nasal aperture. A 4 mm wide 3 cm coronary angioplasty balloon catheter was threaded over the guidewire in a retrograde fashion and dilated at the site of obstruction. RESULTS: There was complete obstruction in 30% of cases and partial obstruction in 70%. The most common site of obstruction was the nasolacrimal duct. The procedure was technically successful in 94% of cases. The overall re-obstruction rate was 29% within 1 year of the procedure. There was an anatomical failure rate of 17% for partial obstruction and 69% for complete obstruction within 1 year. CONCLUSIONS: Balloon dacryocystoplasty has a high recurrence rate. There may be a limited role for this procedure in partial obstructions. Further refinements of the procedure are necessary before it can be offered as a comparable alternative to a standard surgical dacryocystorhinostomy.

  12. Percutaneous transvenous angioplasty of inferior vena cava by balloon dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Suk; Kim, Jae Kyu; Park, Jin Gyun; Kang, Heung Keun; Chung, Hyon De; Kim, Shin Kon; Chung, Sang Young [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    1989-10-15

    3 patients with membranous (2 patients) and segmental (1 patient) obstruction of IVC were successfully treated by percutaneous transvenous angioplasty using balloon catheter. Improvements of clinical and radiological findings could be obtained after procedures. Relatively good patency was obtained in all cases without complications. This procedure can be applied safely to membranous or segmental obstructions of IVC and elsewhere in the venous systems.

  13. Meshed-Pumpkin Super-Pressure Balloon Design

    Science.gov (United States)

    Jones, Jack; Yavrouian, Andre

    2003-01-01

    An improved, lightweight design has been proposed for super-pressure balloons used to carry scientific instruments at high altitudes in the atmosphere of Earth for times as long as 100 days. [A super-pressure balloon is one in which the pressure of the buoyant gas (typically, helium) is kept somewhat above ambient pressure in order to maintain approximately constant density and thereby regulate the altitude.] The proposed design, called "meshed pumpkin," incorporates the basic concept of the pumpkin design, which is so named because of its appearance. The pumpkin design entails less weight than does a spherical design, and the meshed-pumpkin design would reduce weight further. The basic idea of the meshed-pumpkin design is to reinforce the membrane of a pumpkin balloon by attaching a strong, lightweight fabric mesh to its outer surface. The reinforcement would make it possible to reduce the membrane mass to one-third or less of that of the basic pumpkin design while retaining sufficient strength to enable the balloon to remain at approximately constant altitude for months.

  14. Balloon atrial septostomy under echocardiographic guide: case series

    Directory of Open Access Journals (Sweden)

    SM Meraji

    2012-12-01

    Full Text Available Background: Balloon atrial septostomy is an emergent procedure in pediatric cardiology. Nowadays, most patients in need of the procedure have acceptable outcomes after surgical repair. Thus, it is important to perform this procedure as safe as possible. By performing early arterial switch operation and prostaglandin infusion, the rate of balloon atrial septostomy has markedly decreased. However, not all centers performing early arterial switch repairs have abandoned atrial septostomy, even in patients who respond favorably to prostaglandin infusion.Case presentation: In total, eight 1- to 15-day old term neonates admitted in Shahid Rajaee Heart Center in Tehran, Iran from October 2009 to February 2011, with congenital heart diseases were scheduled for balloon atrial septostomy. In six cases the procedure was done exclusively under echocardiographic guidance and in two cases with the help of fluoroscopy. Success was defined as the creation of an atrial septal defect with a diameter equal to or more than 5 mm and ample mobility of its margins.Results: Male sex was predominant (87% and the mean age of the neonates was six days. The diagnosis in all cases was simple transposition of great arteries. The procedure was successful in all patients with any cardiovascular complication.Conclusion: Balloon atrial septostomy is an emergent procedure that can be done safely and effectively under echocardiographic guidance. According to the feasibility of this technique it could be performed fast, safe and effective at bedside, avoiding patient transportation to hemodynamic laboratory or referral center.

  15. Balloon valvuloplasty for severe mitral valve stenosis in pregnancy ...

    African Journals Online (AJOL)

    Balloon valvuloplasties for severe mitral stenosis were performed on 11 pregnant patients with excellent resutts and no complications. The mitral valve area was increased from a mean of 0.9 cnr to 2.1 cnr. There was no clinically significant mitral regurgitation. The pregnancies proceeded normally to delivery at or near tenn, ...

  16. Balloon test project: Cosmic Ray Antimatter Calorimeter (CRAC)

    Science.gov (United States)

    Christy, J. C.; Dhenain, G.; Goret, P.; Jorand, J.; Masse, P.; Mestreau, P.; Petrou, N.; Robin, A.

    1984-01-01

    Cosmic ray observations from balloon flights are discussed. The cosmic ray antimatter calorimeter (CRAC) experiment attempts to measure the flux of antimatter in the 200-600 Mev/m energy range and the isotopes of light elements between 600 and 1,000 Mev/m.

  17. Achilles tests finally nail PWR fuel clad ballooning fears

    International Nuclear Information System (INIS)

    Dore, P.; McMinn, K.

    1992-01-01

    A conclusive series of experiments carried out by AEA Reactor Services at its Achilles rig in the UK has finally allayed fears that fuel clad ballooning is a major safety problem for Sizewell B, Britain's first Pressurized Water Reactor. The experiments are described in this article. (author)

  18. Balloon dilatation of isolated severe tricuspid valve stenosis

    Directory of Open Access Journals (Sweden)

    Rajeev Bhardwaj

    2015-12-01

    Full Text Available Tricuspid valve stenosis is mostly rheumatic in origin. It almost always occurs in association with mitral valve disease. There are only few case reports of isolated tricuspid valve stenosis. We report a case of isolated tricuspid valve stenosis, which was treated with balloon dilatation.

  19. Balloon dilatation of isolated severe tricuspid valve stenosis

    OpenAIRE

    Bhardwaj, Rajeev; Sharma, Rajesh

    2015-01-01

    Tricuspid valve stenosis is mostly rheumatic in origin. It almost always occurs in association with mitral valve disease. There are only few case reports of isolated tricuspid valve stenosis. We report a case of isolated tricuspid valve stenosis, which was treated with balloon dilatation.

  20. Latex Micro-balloon Pumping in Centrifugal Microfluidic Platforms

    Science.gov (United States)

    Aeinehvand, Mohammad Mahdi; Ibrahim, Fatimah; Al-Faqheri, Wisam; Thio, Tzer Hwai Gilbert; Kazemzadeh, Amin; Wadi harun, Sulaiman; Madou, Marc

    2014-01-01

    Centrifugal microfluidic platforms have emerged as point-of-care diagnostic tools. However, the unidirectional nature of the centrifugal force limits the available space for multi-stepped processes on a single microfluidics disc. To overcome this limitation, a passive pneumatic pumping method actuated at high rotational speeds has been previously proposed to pump liquid against the centrifugal force. In this paper, a novel micro-balloon pumping method that relies on elastic energy stored in a latex membrane is introduced. It operates at low rotational speeds and pumps a larger volume of liquid towards the centre of the disc. Two different micro-balloon pumping designs have been developed to study the pump performance and capacity at a range of rotational frequencies from 0 to 1500 rpm. The behaviour of the micro-balloon pump on the centrifugal microfluidic platforms has been theoretically analysed and compared with the experimental data. The experimental data shows that, the developed pumping method dramatically decreases the required rotational speed to pump liquid compared to the previously developed pneumatic pumping methods. It also shows that within a range of rotational speed, desirable volume of liquid can be stored and pumped by adjusting the size of the micro-balloon. PMID:24441792

  1. [Expansion dilatation balloons for cervical ripening in obstetric practice].

    Science.gov (United States)

    Ducarme, G; Grange, J; Vital, M

    2016-02-01

    During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Lightweight Liquid Helium Dewar for High-Altitude Balloon Payloads

    Science.gov (United States)

    Kogut, Alan; James, Bryan; Fixsen, Dale

    2013-01-01

    Astrophysical observations at millimeter wavelengths require large (2-to-5- meter diameter) telescopes carried to altitudes above 35 km by scientific research balloons. The scientific performance is greatly enhanced if the telescope is cooled to temperatures below 10 K with no emissive windows between the telescope and the sky. Standard liquid helium bucket dewars can contain a suitable telescope for telescope diameter less than two meters. However, the mass of a dewar large enough to hold a 3-to-5-meter diameter telescope would exceed the balloon lift capacity. The solution is to separate the functions of cryogen storage and in-flight thermal isolation, utilizing the unique physical conditions at balloon altitudes. Conventional dewars are launched cold: the vacuum walls necessary for thermal isolation must also withstand the pressure gradient at sea level and are correspondingly thick and heavy. The pressure at 40 km is less than 0.3% of sea level: a dewar designed for use only at 40 km can use ultra thin walls to achieve significant reductions in mass. This innovation concerns new construction and operational techniques to produce a lightweight liquid helium bucket dewar. The dewar is intended for use on high-altitude balloon payloads. The mass is low enough to allow a large (3-to-5-meter) diameter dewar to fly at altitudes above 35 km on conventional scientific research balloons without exceeding the lift capability of the balloon. The lightweight dewar has thin (250- micron) stainless steel walls. The walls are too thin to support the pressure gradient at sea level: the dewar launches warm with the vacuum space vented continuously during ascent to eliminate any pressure gradient across the walls. A commercial 500-liter storage dewar maintains a reservoir of liquid helium within a minimal (hence low mass) volume. Once a 40-km altitude is reached, the valve venting the vacuum space of the bucket dewar is closed to seal the vacuum space. A vacuum pump then

  3. Complications of endoscopic retrograde cholangiopancreatography: A study in a small ERCP unit Complicaciones de la colangiopancreatografía retrógrada endoscópica: Estudio en una unidad pequeña de CPRE

    Directory of Open Access Journals (Sweden)

    J García-Cano Lizcano

    2004-03-01

    Full Text Available Backgrounds and aim: endoscopic retrograde cholangiopancreatography (ERCP is an established procedure to drain the biliary and pancreatic ducts. Nevertheless, there are complications which seem to be more common in centers performing less than 200 ERCPs per year. Sometimes, however, due to the distribution of health resources, it is necessary to perform this technique in centers with a smaller number of procedures. We present the experience of ERCP-related complications in a small unit. Material and methods: this is a retrospective study on prospective data recorded during six years (1997-2002. In this period, two endoscopists working together performed 507 ERCPs, which yields an approximately average of 84 procedures per year. Results: in 507 ERCPs performed during this period of time, 55 complications arose (10.85%, and four patients died (0.79% as a consequence of the procedure. There were 28 pancreatitis (5.5%, eight post-sphincterotomy bleeding events (1.6%, seven bilioduodenal perforations (1.4%, eight sepsis episodes of biliary origin (1.6%, and other 4 different complications. There were 418 (82.4% successful ERCPs -either diagnostic or therapeutic-, which gave rise to 46 (11% complications. There were 89 (17.6% failed diagnostic or therapeutic ERCPs, which gave rise to 9 (10.11% complications (p = 0.8 between both groups. Thirty five (7% ERCPs were exclusively diagnostic and caused 6 (17% complications. The 187 procedures performed for coledocho-lithiasis originated 14 (7.4% complications, and represented the group with the lowest morbidity rate (p = 0.04. Conclusions: the complications rate in our center is within the range of reported figures. ERCPs performed for choledoco-lithiasis was associated with the lowest complications rate. The risk-benefit ratio in the anticipated, purely diagnostic ERCP must be carefully weighed due to its morbidity.Antecedentes y objetivo: la colangiopancreatografía retrógrada endoscópica (CPRE es un

  4. National Report on the NASA Sounding Rocket and Balloon Programs

    Science.gov (United States)

    Eberspeaker, Philip; Fairbrother, Debora

    2013-01-01

    The U. S. National Aeronautics and Space Administration (NASA) Sounding Rockets and Balloon Programs conduct a total of 30 to 40 missions per year in support of the NASA scientific community and other users. The NASA Sounding Rockets Program supports the science community by integrating their experiments into the sounding rocket payloads, and providing both the rocket vehicle and launch operations services. Activities since 2011 have included two flights from Andoya Rocket Range, more than eight flights from White Sands Missile Range, approximately sixteen flights from Wallops Flight Facility, two flights from Poker Flat Research Range, and four flights from Kwajalein Atoll. Other activities included the final developmental flight of the Terrier-Improved Malemute launch vehicle, a test flight of the Talos-Terrier-Oriole launch vehicle, and a host of smaller activities to improve program support capabilities. Several operational missions have utilized the new Terrier-Malemute vehicle. The NASA Sounding Rockets Program is currently engaged in the development of a new sustainer motor known as the Peregrine. The Peregrine development effort will involve one static firing and three flight tests with a target completion data of August 2014. The NASA Balloon Program supported numerous scientific and developmental missions since its last report. The program conducted flights from the U.S., Sweden, Australia, and Antarctica utilizing standard and experimental vehicles. Of particular note are the successful test flights of the Wallops Arc Second Pointer (WASP), the successful demonstration of a medium-size Super Pressure Balloon (SPB), and most recently, three simultaneous missions aloft over Antarctica. NASA continues its successful incremental design qualification program and will support a science mission aboard WASP in late 2013 and a science mission aboard the SPB in early 2015. NASA has also embarked on an intra-agency collaboration to launch a rocket from a balloon to

  5. Generalised ballooning theory of two-dimensional tokamak modes

    Science.gov (United States)

    Abdoul, P. A.; Dickinson, D.; Roach, C. M.; Wilson, H. R.

    2018-02-01

    In this work, using solutions from a local gyrokinetic flux-tube code combined with higher order ballooning theory, a new analytical approach is developed to reconstruct the global linear mode structure with associated global mode frequency. In addition to the isolated mode (IM), which usually peaks on the outboard mid-plane, the higher order ballooning theory has also captured other types of less unstable global modes: (a) the weakly asymmetric ballooning theory (WABT) predicts a mixed mode (MM) that undergoes a small poloidal shift away from the outboard mid-plane, (b) a relatively more stable general mode (GM) balloons on the top (or bottom) of the tokamak plasma. In this paper, an analytic approach is developed to combine these disconnected analytical limits into a single generalised ballooning theory. This is used to investigate how an IM behaves under the effect of sheared toroidal flow. For small values of flow an IM initially converts into a MM where the results of WABT are recaptured, and eventually, as the flow increases, the mode asymptotically becomes a GM on the top (or bottom) of the plasma. This may be an ingredient in models for understanding why in some experimental scenarios, instead of large edge localised modes (ELMs), small ELMs are observed. Finally, our theory can have other important consequences, especially for calculations involving Reynolds stress driven intrinsic rotation through the radial asymmetry in the global mode structures. Understanding the intrinsic rotation is significant because external torque in a plasma the size of ITER is expected to be relatively low.

  6. Cryo-balloon catheter position planning using AFiT

    Science.gov (United States)

    Kleinoeder, Andreas; Brost, Alexander; Bourier, Felix; Koch, Martin; Kurzidim, Klaus; Hornegger, Joachim; Strobel, Norbert

    2012-02-01

    Atrial fibrillation (AFib) is the most common heart arrhythmia. In certain situations, it can result in life-threatening complications such as stroke and heart failure. For paroxsysmal AFib, pulmonary vein isolation (PVI) by catheter ablation is the recommended choice of treatment if drug therapy fails. During minimally invasive procedures, electrically active tissue around the pulmonary veins is destroyed by either applying heat or cryothermal energy to the tissue. The procedure is usually performed in electrophysiology labs under fluoroscopic guidance. Besides radio-frequency catheter ablation devices, so-called single-shot devices, e.g., the cryothermal balloon catheters, are receiving more and more interest in the electrophysiology (EP) community. Single-shot devices may be advantageous for certain cases, since they can simplify the creation of contiguous (gapless) lesion sets around the pulmonary vein which is needed to achieve PVI. In many cases, a 3-D (CT, MRI, or C-arm CT) image of a patient's left atrium is available. This data can then be used for planning purposes and for supporting catheter navigation during the procedure. Cryo-thermal balloon catheters are commercially available in two different sizes. We propose the Atrial Fibrillation Planning Tool (AFiT), which visualizes the segmented left atrium as well as multiple cryo-balloon catheters within a virtual reality, to find out how well cryo-balloons fit to the anatomy of a patient's left atrium. First evaluations have shown that AFiT helps physicians in two ways. First, they can better assess whether cryoballoon ablation or RF ablation is the treatment of choice at all. Second, they can select the proper-size cryo-balloon catheter with more confidence.

  7. Embolization of carotid-cavernous fistula using a silicone balloon and a tracker-catheter system

    International Nuclear Information System (INIS)

    Kim, Sun Yong; Cho, Kil Ho; Park, Bok Hwan

    1992-01-01

    With the recent introduction and development of the detachable balloon system, it has become the treatment of choice in the management of carotid cavernous fistulas(CCFs). But, since most delivery systems for embolization of CCF mainly depend on flow guidance for balloon delivery, in case of small fistula, pseudo aneurysm and arterialized venous collaterals, failure of balloon embolization can occur. To overcome these limitation, the authors designed and used a new versatile, steerable, and flow-guided detachable balloon system by using a Tracker catheter system with silicone or latex balloons. Using this maneuver, we could get successful fistula occlusion in 7 out of 8 patients (silicone balloon). But in one case, we had to occlude the internal carotid artery at the fistula site, proximal and distal cervical portions of the internal carotid artery. This balloon delivery system proved to provide high selectivity for fistula and relatively ease of handing

  8. Adverse events of ERCP at San José Hospital of Bogotá (Colombia Eventos adversos de la CPRE en el Hospital de San José de Bogotá

    Directory of Open Access Journals (Sweden)

    A. Peñaloza-Ramírez

    2009-12-01

    Full Text Available Endoscopic retrograde cholangiopancreatography (ERCP has become the preferred treatment method for hepatobiliary and pancreatic disease. Despite technological progress this technique continues to account for the greatest morbidity and mortality caused by digestive endoscopic procedures. ERCP carries a risk of pancreatitis, perforation, hemorrhage, cholangitis and cardiopulmonary events occurring in upto 10% of patients in referral centers, implying a mortality of up to 1%, not including therapeutic failures or the need for re-intervention. A greater mortality rate has been demonstrated in prospective studies rather than in retrospective studies, but overall, the number of complications described in the literature is much lower than the number of complications that actually occur. A descriptive prospective study was conducted at San José Hospital from April 1, 2006 to April 30, 2007 in patients who underwent an ERCP and had a 1-month follow-up. A total of 381 patients were included; 9 (2.3% were excluded, and of the remaining 372 there was an overall success in 79.6% of cases, 8.3% had a second intervention, 7.6% developed complications (pancreatitis, perforation, hemorrhage, cholangitis, pain, intolerance to sedatives, and cardiopulmonary events, and 4.3% were failed ERCP studies. The mortality rate of the ERCP procedure was 0.8%. ERCP-related complications were determined at a teaching center, and this suggests the need to implement centers of excellence in order to improve the efficacy of the procedure.La colangiopancreatografía retrograda endoscópica (CPRE se ha convertido en el procedimiento terapéutico por excelencia de la vía biliopancreática. A pesar de los avances tecnológicos continúa siendo la técnica con mayor morbimortalidad de la endoscopia digestiva. Las complicaciones de la CPRE incluyen la pancreatitis, perforación, hemorragia, colangitis y eventos cardiopulmonares que en centros de referencia ocurren hasta en un 10

  9. Resultados del drenaje de la vía biliar por CPRE en pacientes con edad geriátrica Outcomes of bile duct drainage by means of ERCP in geriatric patients

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2007-08-01

    Full Text Available Antecedentes y objetivo: la colangiopancreatografía retrógrada endoscópica (CPRE es habitualmente la técnica de elección para desobstruir la vía biliar. Una gran parte de los pacientes a los que se realiza esta intervención están en edad geriátrica (mayores de 75 años. Nuestro objetivo ha sido valorar la eficacia de la CPRE en este grupo de pacientes, comparado con los de menor edad. Pacientes y métodos: estudio retrospectivo en el que se han incluido los pacientes a quienes se realizó terapéutica biliar endoscópica mediante CPRE en un periodo de cuatro años (2002-2005. Resultados: se realizó CPRE a 178 pacientes en edad geriátrica y a 159 de menor edad. No hubo diferencias en el éxito del drenaje biliar (97,7-98,7%, en el número de complicaciones (11,8-14,4%, ni en la mortalidad (1,1-0,6%. Por el contrario, en el grupo geriátrico hubo más coledocolitiasis (57,3-39,6%, p = 0,004 y se utilizaron más prótesis metálicas autoexpandibles para drenar la ictericia obstructiva tumoral (47-8%, p = 0,0035. En el grupo de menor edad se repitieron más CPRE a los mismos pacientes (4-10%, p = 0,001. Conclusiones: el éxito y la morbimortalidad para drenar la vía biliar mediante CPRE son similares en los pacientes con edad geriátrica y en los de edad inferior. La coledocolitiasis es más frecuente en los pacientes mayores. No se debe excluir a ningún paciente que precise de una CPRE sólo por la edad.Background and objective: endoscopic retrograde cholangiopancreatography (ERCP is usually the procedure of choice for relieving bile duct obstruction. A large number of patients undergoing this intervention are geriatric population (aged 75 years of age and older. Our aim was to assess the efficacy of ERCP in this group of patients as compared to younger ones. Patients and methods: a retrospective study. All patients in whom a therapeutic biliary endoscopy had been performed over a four-year period of time (2002-2005 were included

  10. The data processor of the EUSO-Balloon experiment

    International Nuclear Information System (INIS)

    Scotti, V; Osteria, G

    2014-01-01

    The JEM-EUSO instrument is a wide-angle refractive telescope in near-ultraviolet wavelength region being proposed for attachment to the Japanese Experiment Module (JEM) onboard International Space Station (ISS). The main scientific goal of the mission is the study of Extreme Energy Cosmic Rays (EECR) above 5 × 10 19 eV. The instrument consists of high transmittance optical Fresnel lenses with a diameter of 2.5 m, a focal surface covered by ∼ 5000 Multi Anode Photo Multiplier Tubes of 64 pixels, front-end readout, trigger and system electronics. The EUSO-Balloon experiment is a pathfinder mission in which a telescope of smaller dimension than the one designed for the ISS will be mounted onboard a stratospheric balloon. The main objective of this pathfinder mission, planned for 2014, is to perform a full scale end-to-end test of all the key technologies and instrumentation of JEM-EUSO detectors and to prove the global detection chain. Furthermore, EUSO-Balloon will measure the atmospheric and terrestrial UV background components, in different observational modes, fundamental for the development of the simulations. Through a series of stratospheric balloon flights performed by the French Space Agency CNES, EUSO-Balloon also has the potential to detect Extensive Air Showers from above, paving the way for any future large scale, space-based EECR observatory. In this paper we will present the Data Processor (DP) of EUSO-Balloon, which is the component of the Electronics System which performs the data management and the instrument control. More in detail, the DP controls the front-end electronics, performs the 2nd level trigger filtering, tags events with arrival time and payload position through a GPS system, manages the Mass Memory for data storage, measures live and dead time of the telescope, provides signals for time synchronization of the event, performs housekeeping monitor, and handles the interface to the telemetry system. The DP has to operate at high

  11. An analysis of the deployment of a pumpkin balloon at Mars

    Science.gov (United States)

    Rand, J. L.; Phillips, M. L.

    2004-01-01

    The design of large superpressure balloons has received significant attention in recent years due to the successful demonstration of various enabling technologies and materials. Of particular note is the "pumpkin" shaped balloon concept, which allows the stress in the envelope to be limited by the surface geometry. Unlike a sphere, where the radius used to determine the stress is determined by the volume of the balloon, the pumpkin utilizes a system of meridional tendons to react the loading in one direction, and form a number of lobes, which limit the stress in the circumferential direction. A suitable superpressure balloon has been designed using this technology which will carry 2 kg in the atmosphere of Mars. The deployment of this balloon is assumed to occur while falling on a decelerator suitably designed for the Mars atmosphere. The inflation is accomplished by a 10 kg system suspended at the nadir of the balloon. As the system falls toward the surface of the planet, helium gas is transferred into the balloon, forming a partially inflated system very similar to an ascending zero pressure balloon. This analysis incorporates the flow of the planetary gas around the inflating balloon which alters the pressure distribution and shape. As a result, stresses are seen to increase beyond the design values which will require the balloon to be redesigned to accommodate this type of dynamic deployment.

  12. Experimental characterization and numerical modelling of polymeric film damage, constituting the stratospheric super pressurized balloons

    Science.gov (United States)

    Chaabane, Makram; Chaabane, Makram; Dalverny, Olivier; Deramecourt, Arnaud; Mistou, Sébastien

    The super-pressure balloons developed by CNES are a great challenge in scientific ballooning. Whatever the balloon type considered (spherical, pumpkin...), it is necessary to have good knowledge of the mechanical behavior of the envelope regarding to the flight level and the lifespan of the balloon. It appears during the working stages of the super pressure balloons that these last can exploded prematurely in the course of the first hours of flight. For this reason CNES and LGP are carrying out research programs about experimentations and modelling in order to predict a good stability of the balloons flight and guarantee a life time in adequacy with the technical requirement. This study deals with multilayered polymeric film damage which induce balloons failure. These experimental and numerical study aims, are a better understanding and predicting of the damage mechanisms bringing the premature explosion of balloons. The following damages phenomena have different origins. The firsts are simple and triple wrinkles owed during the process and the stocking stages of the balloons. The second damage phenomenon is associated to the creep of the polymeric film during the flight of the balloon. The first experimental results we present in this paper, concern the mechanical characterization of three different damage phenomena. The severe damage induced by the wrinkles of the film involves a significant loss of mechanical properties. In a second part the theoretical study, concerns the choice and the development of a non linear viscoelastic coupled damage behavior model in a finite element code.

  13. Stability of Balloon-Retention Gastrostomy Tubes with Different Concentrations of Contrast Material: In Vitro Study

    International Nuclear Information System (INIS)

    Lopera, Jorge E.; Alvarez, Alex; Trimmer, Clayton; Josephs, Shellie; Anderson, Matthew; Dolmatch, Bart

    2009-01-01

    The purpose of this study was to determine the performance of two balloon-retention-type gastrostomy tubes when the balloons are inflated with two types of contrast materials at different concentrations. Two commonly used balloon-retention-type tubes (MIC and Tri-Funnel) were inflated to the manufacturer's recommended volumes (4 and 20 cm 3 , respectively) with normal saline or normal saline plus different concentrations of contrast material. Five tubes of each brand were inflated with normal saline and 0%, 25%, 50%, 75%, and 100% contrast material dilutions, using either nonionic hyperosmolar contrast, or nonionic iso-osmolar contrast. The tubes were submerged in a glass basin containing a solution with a pH of 4. Every week the tubes were visually inspected to determine the integrity of the balloons, and the diameter of the balloons was measured with a caliper. The tests were repeated every week for a total of 12 weeks. The MIC balloons deflated slightly faster over time than the Tri-Funnel balloons. The Tri-Funnel balloons remained relatively stable over the study period for the different concentrations of contrast materials. The deflation rates of the MIC balloons were proportionally related to the concentration of saline and inversely related to the concentration of the contrast material. At high contrast material concentrations, solidification of the balloons was observed. In conclusion, this in vitro study confirms that the use of diluted amounts of nonionic contrast materials is safe for inflating the balloons of two types of balloon-retention feeding tubes. High concentrations of contrast could result in solidification of the balloons and should be avoided.

  14. Ballooning instabilities in tokamaks with sheared toroidal flows

    International Nuclear Information System (INIS)

    Waelbroeck, F.L.; Chen, L.

    1990-11-01

    The stability of ballooning modes in the presence of sheared toroidal flows is investigated. The eigenmodes are shown to be related by a Fourier transformation to the non-exponentially growing Floquet solutions found by Cooper. It is further shown that the problem cannot be reduced further than to a two dimensional partial differential equation. Next, the generalized ballooning equation is solved analytically for a circular tokamak equilibrium with sonic flows, but with a small rotation shear compared to the sound speed. With this ordering, the centrifugal forces are comparable to the pressure gradient forces driving the instability, but coupling of the mode with the sound wave is avoided. A new stability criterion is derived which explicitly demonstrates that flow shear is stabilizing at constant centrifugal force gradient. 34 refs

  15. Dosimetry of beta emitting radionuclides for use in balloon angioplasty

    International Nuclear Information System (INIS)

    Fox, R.A.

    1997-01-01

    The dose at varying distances from the surface of an infinite cylinder containing 90 Y, 32 P and 188 Re respectively is calculated using published scaled point dose kernels for these three radionuclides. It is shown that all are suitable radionuclides for use in the irradiation of arteries subsequent to balloon angioplasty. All three may be used as a radioactive liquid in the angioplasty balloon, thereby simplifying the procedure and enabling a uniform radiation dose to be given to the arterial wall. It is however shown that there is a rapid reduction in dose with distance from the arterial wall which demands careful specification of the prescribed radiation dose. A similar rapid reduction with distance is also found with a central radioactive wire or with a radioactive stent containing the same radionuclides. (author)

  16. Star camera aspect system suitable for use in balloon experiments

    International Nuclear Information System (INIS)

    Hunter, S.D.; Baker, R.G.

    1985-01-01

    A balloon-borne experiment containing a star camera aspect system was designed, built, and flown. This system was designed to provide offset corrections to the magnetometer and inclinometer readings used to control an azimuth and elevation pointed experiment. The camera is controlled by a microprocessor, including commendable exposure and noise rejection threshold, as well as formatting the data for telemetry to the ground. As a background program, the microprocessor runs the aspect program to analyze a fraction of the pictures taken so that aspect information and offset corrections are available to the experiment in near real time. The analysis consists of pattern recognition of the star field with a star catalog in ROM memory and a least squares calculation. The performance of this system in ground based tests is described. It is part of the NASA/GSFC High Energy Gamma-Ray Balloon Instrument (2)

  17. Balloon-borne disposable radiometer for cloud detection.

    Science.gov (United States)

    Nicoll, K A; Harrison, R G

    2012-02-01

    A low cost, disposable instrument for measuring solar radiation during meteorological balloon flights through cloud layers is described. Using a photodiode detector and low thermal drift signal conditioning circuitry, the device showed less than 1% drift for temperatures varied from +20 °C to -35 °C. The angular response to radiation, which declined less rapidly than the cosine of the angle between the incident radiation and normal incidence, is used for cloud detection exploiting the motion of the platform. Oriented upwards, the natural motion imposed by the balloon allows cloud and clear air to be distinguished by the absence of radiation variability within cloud, where the diffuse radiation present is isotropic. The optical method employed by the solar radiation instrument has also been demonstrated to provide higher resolution measurements of cloud boundaries than relative humidity measurements alone.

  18. Accelerated partial breast irradiation utilizing balloon brachytherapy techniques

    International Nuclear Information System (INIS)

    Strauss, Jonathan B.; Dickler, Adam

    2009-01-01

    To overcome the barriers to BCT, methods of PBI in the setting of breast conservation have been explored. The method of PBI with the longest published follow-up is multi-catheter interstitial brachytherapy. Balloon-based brachytherapy with the MammoSite brachytherapy applicator was designed to simplify the brachytherapy procedure for PBI, enhance the reproducibility of the dosimetry, and improve patient comfort. The rates of local recurrence following PBI with the MammoSite applicator have been low, but there are few published reports and follow-up has been relatively short. The cosmetic outcomes and toxicity of MammoSite PBI are comparable to those seen after multicatheter-based PBI. Additional methods of balloon brachytherapy, including Xoft and SenoRx Contura have been developed. Finally, long-term follow-up after PBI is important for the welfare of individual patients and in order to establish the efficacy, late toxicity and cosmetic outcomes of this technique.

  19. Transjugular balloon mitral valvotomy in a patient with severe kyphoscoliosis

    Directory of Open Access Journals (Sweden)

    George Joseph

    2016-09-01

    Full Text Available Balloon mitral valvotomy (BMV performed by the conventional transfemoral approach can be difficult or even impossible in the presence of structural impediments such as severe kyphoscoliosis, gross cardiac anatomic distortion and inferior vena caval anomalies. A 25-year-old woman with severe thoracolumbar kyphoscoliosis due to poliomyelitis presented with symptomatic rheumatic mitral valve stenosis. After the failure of transfemoral BMV, the procedure was attempted from the right jugular access, using a modified septal puncture technique. The left atrium was entered from the jugular access and the mitral valve was crossed and dilated successfully using over the wire balloon technique. Transjugular BMV is an effective alternative in patients with kyphoscoliotic spine that preclude transfemoral approach. The detailed technique used for the procedure, its advantages as well as the other percutaneous treatment options are also discussed.

  20. The Inflammatory Sequelae of Aortic Balloon Occlusion in Hemorrhagic Shock

    Science.gov (United States)

    2014-04-13

    metabolic profile was significantly different. Clamp occlusion was associated with a significantly higher lactate burden and vasopressor requirement in...balloon occlusion. This was associated with a significant metabolic burden as measured by serum lactate; however, with suitable resuscitation, this...interleukin 10, reduces nuclear factor kB DNA binding, and improves short term survival in lethal endotoxemia . Crit Care Med 2004;32:801. [36] Manning JE

  1. Asymptotic stability boundaries of ballooning modes in circular tokamaks

    International Nuclear Information System (INIS)

    Chen, L.; Bondeson, A.; Chance, M.S.

    1987-06-01

    The model ballooning mode equation of Connor, Hastie, and Taylor for large-aspect-ratio circular tokamaks is analyzed in the limit of large pressure gradient, and corresponding expressions for stability boundaries are derived. In particular, it is found that for a fixed radial wave number, there exists an infinite sequence of unstable bands, and that minimizing over the radial wave numbers leads to asymptotic merging between the neighboring bands

  2. Percutaneous balloon valvuloplasty of a stenosed mitral bioprosthesis.

    Science.gov (United States)

    Fernandez, J J; DeSando, C J; Leff, R A; Ord, M; Sabbagh, A H

    1990-01-01

    A 62-year-old woman with disabling mitral prosthetic stenosis underwent percutaneous balloon valvuloplasty. The transvalvular gradient preoperatively was 22 mm Hg and was reduced to 6 mm Hg after the valvuloplasty. the valve area was increased from an initial value of 0.77 cm2 to 1.53 cm2. No complications occurred related to the Further studies are necessary to ascertain the indications and long-term results of percutaneous valvuloplasty on bioprosthesis in the mitral position.

  3. Prime time for drug eluting balloons in SFA interventions?

    Science.gov (United States)

    Brodmann, M

    2014-08-01

    Peripheral arterial disease most commonly affects the femoropopliteal segment. Despite enormous improvements in device and treatment technology the long-term patency rate and clinical benefit of endovascular treatment in the respective vascular bed is not satisfying. Drug coated balloon technology as a treatment option in femoropopliteal disease has shown encouraging results in first-in-man trials, which have now been proven in large randomized controlled trials.

  4. A Sensitivity Analysis of fMRI Balloon Model

    KAUST Repository

    Zayane, Chadia

    2015-04-22

    Functional magnetic resonance imaging (fMRI) allows the mapping of the brain activation through measurements of the Blood Oxygenation Level Dependent (BOLD) contrast. The characterization of the pathway from the input stimulus to the output BOLD signal requires the selection of an adequate hemodynamic model and the satisfaction of some specific conditions while conducting the experiment and calibrating the model. This paper, focuses on the identifiability of the Balloon hemodynamic model. By identifiability, we mean the ability to estimate accurately the model parameters given the input and the output measurement. Previous studies of the Balloon model have somehow added knowledge either by choosing prior distributions for the parameters, freezing some of them, or looking for the solution as a projection on a natural basis of some vector space. In these studies, the identification was generally assessed using event-related paradigms. This paper justifies the reasons behind the need of adding knowledge, choosing certain paradigms, and completing the few existing identifiability studies through a global sensitivity analysis of the Balloon model in the case of blocked design experiment.

  5. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey

    2015-01-01

    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  6. The Rocket Balloon (Rocketball): Applications to Science, Technology, and Education

    Science.gov (United States)

    Esper, Jaime

    2009-01-01

    Originally envisioned to study upper atmospheric phenomena, the Rocket Balloon system (or Rocketball for short) has utility in a range of applications, including sprite detection and in-situ measurements, near-space measurements and calibration correlation with orbital assets, hurricane observation and characterization, technology testing and validation, ground observation, and education. A salient feature includes the need to reach space and near-space within a critical time-frame and in adverse local meteorological conditions. It can also provide for the execution of technology validation and operational demonstrations at a fraction of the cost of a space flight. In particular, planetary entry probe proof-of-concepts can be examined. A typical Rocketball operational scenario consists of a sounding rocket launch and subsequent deployment of a balloon above a desired location. An obvious advantage of this combination is the additional mission 'hang-time' rendered by the balloon once the sounding rocket flight is completed. The system leverages current and emergent technologies at the NASA Goddard Space Flight Center and other organizations.

  7. A meta-analysis for the effect of prophylactic GTN on the incidence of post-ERCP pancreatitis and on the successful rate of cannulation of bile ducts

    Directory of Open Access Journals (Sweden)

    Wang Chun-hui

    2010-07-01

    Full Text Available Abstract Background Glyceryl trinitrate (GTN has been shown to be able to relax the sphincter of Oddi (SO both in animals and humans. Theoretically, the use of these compounds during and after endoscopic retrograde cholangiopancreatgraphy (ERCP could relax the biliary and pancreatic sphincters, facilitating cannulation of common bile duct (CBD during the procedure, or minimizing potential pancreatic outflow obstruction after the procedure. However, clinical trials evaluating the protective effect of GTN on the post-endoscopic retrograde cholangiopancreatgraphy pancreatitis (PEP have yielded inconclusive results. This meta-analysis is to systematically assess the effect of prophylactic administration of glyceryl trinitrate (GTN on the prevention of PEP and the effect on the cannulation of bile ducts. Methods By searching PubMed (1966 to September 2009, CENTRAL (Cochrane Controlled trials Register; issue 3, 2009 and EMBASE.com (1984 to September 2009, two independent reviewers systematically identified prospective randomized controlled trials (RCTs detecting the effect of prophylactic GTN on the incidence of PEP and on the cannulation of bile ducts. A meta-analysis of these clinical trials was then performed. Results There are 55/899(6.1% patients suffering PEP in the treatment group versus 95/915(10.4% patients in the placebo group. The overall pooled risk of PEP was significantly lower in the GTN group than in the placebo group (OR 0.56, 95% CI: 0.40 to 0.79, p = 0.001. Subgroup analyses suggested that GTN administered by the sublingual form (OR 0.34,95% CI:0.16 to 0.75, p = 0.007 is more effective than transdermal route(OR 0.64,95% CI:0.40 to 1.01, p = 0.05, and the protective effect of GTN was far more obvious in the centers with high incidence of PEP (OR 0.40, 95% CI:0.24 to 0.67, p = 0.0006 than those centers with a low incidence of PEP (OR 0.75, 95% CI: 0.47 to 1.20, p = 0.22. Additionally, the meta-analysis suggests that GTN was not

  8. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Sasa, Hidenori; Ishibashi, Hiroki; Yoshida, Masashi; Nakatsuka, Masaya; Takano, Masashi; Furuya, Kenichi

    2017-09-01

    To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study. Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed. Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p placenta previa.

  9. Experimental investigation of undesired stable equilibria in pumpkin shape super-pressure balloon designs

    Science.gov (United States)

    Schur, W. W.

    2004-01-01

    Excess in skin material of a pneumatic envelope beyond what is required for minimum enclosure of a gas bubble is a necessary but by no means sufficient condition for the existence of multiple equilibrium configurations for that pneumatic envelope. The very design of structurally efficient super-pressure balloons of the pumpkin shape type requires such excess. Undesired stable equilibria in pumpkin shape balloons have been observed on experimental pumpkin shape balloons. These configurations contain regions with stress levels far higher than those predicted for the cyclically symmetric design configuration under maximum pressurization. Successful designs of pumpkin shape super-pressure balloons do not allow such undesired stable equilibria under full pressurization. This work documents efforts made so far and describes efforts still underway by the National Aeronautics and Space Administration's Balloon Program Office to arrive on guidance on the design of pumpkin shape super-pressure balloons that guarantee full and proper deployment.

  10. Immediate balloon deflation for prevention of persistent phrenic nerve palsy during pulmonary vein isolation by balloon cryoablation.

    Science.gov (United States)

    Ghosh, Justin; Sepahpour, Ali; Chan, Kim H; Singarayar, Suresh; McGuire, Mark A

    2013-05-01

    Persistent phrenic nerve palsy is the most frequent complication of cryoballoon ablation for atrial fibrillation and can be disabling. To describe a technique-immediate balloon deflation (IBD)-for the prevention of persistent phrenic nerve palsy, provide data for its use, and describe in vitro simulations performed to investigate the effect of IBD on the atrium and pulmonary vein. Cryoballoon procedures for atrial fibrillation were analyzed retrospectively (n = 130). IBD was performed in patients developing phrenic nerve dysfunction (n = 22). In vitro simulations were performed by using phantoms. No adverse events occurred, and all patients recovered normal phrenic nerve function before leaving the procedure room. No patient developed persistent phrenic nerve palsy. The mean cryoablation time to onset of phrenic nerve dysfunction was 144 ± 64 seconds. Transient phrenic nerve dysfunction was seen more frequently with the 23-mm balloon than with the 28-mm balloon (11 of 39 cases vs 11 of 81 cases; P = .036). Balloon rewarming was faster following IBD. The time to return to 0 and 20° C was shorter in the IBD group (6.7 vs 8.9 seconds; P = .007 and 16.7 vs 37.6 seconds; P<.0001). In vitro simulations confirmed that IBD caused more rapid tissue warming (time to 0°C, 14.0 ± 3.4 seconds vs 46.0 ± 8.1; P = .0001) and is unlikely to damage the atrium or pulmonary vein. IBD results in more rapid tissue rewarming, causes no adverse events, and appears to prevent persistent phrenic nerve palsy. Simulations suggest that IBD is unlikely to damage the atrium or pulmonary vein. Copyright © 2013 Heart Rhythm Society. All rights reserved.

  11. Anchoring barbs and balloon expandable stents: what is the risk of perforation and failed stent deployment?

    Science.gov (United States)

    Bown, M J; Harrison, G J; How, T V; Brennan, J A; Fisher, R K; Vallabhaneni, S R; McWilliams, R G

    2012-09-01

    Balloon expandable stents may on occasion be deployed in close proximity to the anchoring barbs of endovascular grafts. The aim of this study was to determine the risk and effect of balloon perforation by anchoring barbs and to assess whether these risks are different if the balloon is protected by a covered stent mounted upon it. A bench-top model was developed to mimic the penetration of anchoring barbs into the lumen of medium sized blood vessels. The model allowed variation of angle and depth of vessel penetration. Both bare balloons and those with covered stents mounted upon them were tested in the model to determine whether there was a risk of perforation and which factors increased or decreased this risk. All combinations of barb angle and depth caused balloon perforation but this was most marked when the barb was placed perpendicular to the long axis of the balloon. When the deployment of covered stents was attempted balloon perforation occurred in some cases but full stent deployment was achieved in all cases where the perforation was in the portion of the balloon covered by the stent. The only situation in which stent deployment failed was where the barb was intentionally placed in the uncovered portion of the balloon. This resulted in only partial deployment of the stent. Balloon rupture is a distinct possibility when deploying balloon-expandable stents in close proximity to anchoring barbs. Care should be taken in this circumstance to ensure that the barb is well away from the uncovered portion of the balloon. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  12. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao

    2016-01-01

    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  13. Intra-aortic balloon shape change: effects on volume displacement during inflation and deflation.

    Science.gov (United States)

    Khir, Ashraf William; Bruti, Gianpaolo

    2013-07-01

    It has been observed that operating the intra-aortic balloon at an angle to the horizontal resulted in a reduction of the volume displaced toward the coronary arteries and compromised afterload reduction. Therefore, the aim of this work is to examine whether changing the current balloon shape, which has not been altered for 40 years, could compensate for the negative hemodynamic effects due to angulation. We tested two tapered balloons, increasing diameter (TID) and decreasing diameter (TDD), and compared the results with those obtained from a standard cylindrical balloon. The balloons were tested in vitro at 60 beats/min and a static pressure of 90 mm Hg. The balloons were operated at four angles (0°, 20°, 30°, 45°), and the pressure at three locations along the balloon (base, middle, and tip) was also measured. Flow rate upstream of the tip of the balloon was also measured to indicate the flow displaced toward the coronary circulation. The relative volume displaced toward (VUTVi) and suctioned away from (VUTVd) the simulated ascending aorta, during inflation and deflation, respectively, is reduced when a standard cylindrical balloon is operated at an angle to the horizontal. The TDD provided the greatest VUTVi and also produced the largest pulse pressure during deflation. Although the TID provided less VUTVi and VUTVd at smaller angles, it was not markedly affected by the change of angle. According to these results, different balloon shapes analyzed, with comparable volume to that of a cylindrical balloon, produced greater inflation and deflation benefits, at the horizontal and at a range of angles to the horizontal. Further investigations are required to optimize the shape of the tapered balloons to fit into the available physiological space. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  14. Planetary Balloon-Based Science Platform Evaluation and Program Implementation

    Science.gov (United States)

    Dankanich, John W.; Kremic, Tibor; Hibbitts, Karl; Young, Eliot F.; Landis, Rob

    2016-01-01

    This report describes a study evaluating the potential for a balloon-based optical telescope as a planetary science asset to achieve decadal class science. The study considered potential science achievable and science traceability relative to the most recent planetary science decadal survey, potential platform features, and demonstration flights in the evaluation process. Science Potential and Benefits: This study confirms the cost the-benefit value for planetary science purposes. Forty-four (44) important questions of the decadal survey are at least partially addressable through balloon based capabilities. Planetary science through balloon observations can provide significant science through observations in the 300 nm to 5 m range and at longer wavelengths as well. Additionally, balloon missions have demonstrated the ability to progress from concept to observation to publication much faster than a space mission increasing the speed of science return. Planetary science from a balloon-borne platform is a relatively low-cost approach to new science measurements. This is particularly relevant within a cost-constrained planetary science budget. Repeated flights further reduce the cost of the per unit science data. Such flights offer observing time at a very competitive cost. Another advantage for planetary scientists is that a dedicated asset could provide significant new viewing opportunities not possible from the ground and allow unprecedented access to observations that cannot be realized with the time allocation pressures faced by current observing assets. In addition, flight systems that have a relatively short life cycle and where hardware is generally recovered, are excellent opportunities to train early career scientists, engineers, and project managers. The fact that balloon-borne payloads, unlike space missions, are generally recovered offers an excellent tool to test and mature instruments and other space craft systems. Desired Gondola Features: Potential

  15. Design and evaluation of a continuum robot with extendable balloons

    Directory of Open Access Journals (Sweden)

    E. Y. Yarbasi

    2018-02-01

    Full Text Available This article presents the design and preliminary evaluation of a novel continuum robot actuated by two extendable balloons. Extendable balloons are utilized as the actuation mechanism of the robot, and they are attached to the tip from their slack sections. These balloons can extend very much in length without having a significant change in diameter. Employing two balloons in an axially extendable, radially rigid flexible shaft, radial strain becomes constricted, allowing high elongation. As inflated, the balloons apply a force on the wall of the tip, pushing it forward. This force enables the robot to move forward. The air is supplied to the balloons by an air compressor and its flow rate to each balloon can be independently controlled. Changing the air volumes differently in each balloon, when they are radially constricted, orients the robot, allowing navigation. Elongation and force generation capabilities and pressure data are measured for different balloons during inflation and deflation. Afterward, the robot is subjected to open field and maze-like environment navigation tests. The contribution of this study is the introduction of a novel actuation mechanism for soft robots to have extreme elongation (2000 % in order to be navigated in substantially long and narrow environments.

  16. Use of Cutting Balloon in the Treatment of Urethral Stricture: A Novel Technique

    International Nuclear Information System (INIS)

    Yildirim, Erkan; Cicek, Tufan; Istanbulluoglu, Okan; Ozturk, Bulent

    2009-01-01

    The peripheral cutting balloon has been used to treat various nonvascular strictures as well as vascular stenosis. In this article, we describe for the first time the use of the cutting balloon in the treatment of patients with urethral stricture. Four patients with bulbar urethral stricture were included in the study. All strictures were successfully dilated with the cutting balloon, and patients were free of symptoms at 6-month follow-up. Cutting-balloon dilatation is a safe, easy-to-perform, and effective treatment for patients with tight urethral strictures.

  17. Balloon sheaths for gastrointestinal guidance and access: a preliminary phantom study

    Energy Technology Data Exchange (ETDEWEB)

    He, Xu; Shin, Ji Hoon; Kim, Hyo Cheol; Woo, Cheol Woong; Woo, Sung Ha; Choi, Won Chan; Kim, Jong Gyu; Lim, Jin Oh; Kim, Tae Hyung; Yoon, Chang Jin; Song, Ho Young [Univerisyt of Ulsan College of Medicine, Seoul (Korea, Republic of); Kang, Wee Chang [Daejeon University, Daejeon (Korea, Republic of)

    2005-09-15

    We wanted to evaluate the feasibility and usefulness of a newly designed balloon sheath for gastrointestinal guidance and access by conducting a phantom study. The newly designed balloon sheath consisted of an introducer sheath and a supporting balloon. A coil catheter was advanced over a guide wire into two gastroduodenal phantoms (one was with stricture and one was without stricture); group I was without a balloon sheath, group II was with a deflated balloon sheath, and groups III and IV were with an inflated balloon and with the balloon in the fundus and body, respectively. Each test was performed for 2 minutes and it was repeated 10 times in each group by two researchers, and the positions reached by the catheter tip were recorded. Both researchers had better performances with both phantoms in order of group IV, III, II and I. In group IV, both researchers advanced the catheter tip through the fourth duodenal segment in both the phantoms. In group I, however, the catheter tip never reached the third duodenal segment in both the phantoms by both the researchers. The numeric values for the four study groups were significantly different for both the phantoms ({rho} < 0.001). A significant difference was also found between group III and IV for both phantoms ({rho} < 0.001). The balloon sheath seems to be feasible for clinical use, and it has good clinical potential for gastrointestinal guidance and access, particularly when the inflated balloon is placed in the gastric body.

  18. Hybrid cutting balloon dilatation for treatment of cor triatriatum sinister in a cat.

    Science.gov (United States)

    Stern, Joshua A; Tou, Sandra P; Barker, Piers C A; Hill, Kevin D; Lodge, Andrew J; Mathews, Kyle G; Keene, Bruce W

    2013-09-01

    A hybrid surgical approach and balloon dilatation were performed successfully in a cat with cor triatriatum sinister and clinical signs of congestive heart failure. Left lateral thoracotomy was used to access the heart and cutting balloon followed by standard balloon dilatation were utilized to dilate the perforation in the anomalous left atrial membrane. Clinical signs resolved completely after dilation of the anomalous left atrial membrane. Based upon the outcome of this case, balloon dilatation appears to be a viable treatment option for cats affected with cor triatriatum sinister. Published by Elsevier B.V.

  19. Wave power absorption by a submerged balloon fixed to the sea bed

    DEFF Research Database (Denmark)

    Kurniawan, Adi; Greaves, Deborah

    2016-01-01

    The possibility of absorbing wave energy using a submerged balloon fixed to the sea bed is investigated. The balloon is in the form of a fabric encased within an array of meridional tendons which terminate at a point at the top of the balloon and at some radius at the bottom. The expansion...... and contraction of the balloon in waves pump air via a turbine into and out of a chamber of constant volume. A more refined model than that used by Kurniawan and Greaves [Proc. 2nd Offshore Energy and Storage Symposium , 2015] predicts a similarly broad-banded response, but the maximum absorption is less than...

  20. Balloon sheaths for gastrointestinal guidance and access: a preliminary phantom study

    International Nuclear Information System (INIS)

    He, Xu; Shin, Ji Hoon; Kim, Hyo Cheol; Woo, Cheol Woong; Woo, Sung Ha; Choi, Won Chan; Kim, Jong Gyu; Lim, Jin Oh; Kim, Tae Hyung; Yoon, Chang Jin; Song, Ho Young; Kang, Wee Chang

    2005-01-01

    We wanted to evaluate the feasibility and usefulness of a newly designed balloon sheath for gastrointestinal guidance and access by conducting a phantom study. The newly designed balloon sheath consisted of an introducer sheath and a supporting balloon. A coil catheter was advanced over a guide wire into two gastroduodenal phantoms (one was with stricture and one was without stricture); group I was without a balloon sheath, group II was with a deflated balloon sheath, and groups III and IV were with an inflated balloon and with the balloon in the fundus and body, respectively. Each test was performed for 2 minutes and it was repeated 10 times in each group by two researchers, and the positions reached by the catheter tip were recorded. Both researchers had better performances with both phantoms in order of group IV, III, II and I. In group IV, both researchers advanced the catheter tip through the fourth duodenal segment in both the phantoms. In group I, however, the catheter tip never reached the third duodenal segment in both the phantoms by both the researchers. The numeric values for the four study groups were significantly different for both the phantoms (ρ < 0.001). A significant difference was also found between group III and IV for both phantoms (ρ < 0.001). The balloon sheath seems to be feasible for clinical use, and it has good clinical potential for gastrointestinal guidance and access, particularly when the inflated balloon is placed in the gastric body

  1. Usefulness of cutting balloon angioplasty for the treatment of congenital heart defects.

    Science.gov (United States)

    Kusa, Jacek; Mazurak, Magdalena; Skierska, Agnieszka; Szydlowski, Leslaw; Czesniewicz, Pawel; Manka, Lukasz

    2017-11-13

    Patients with complex congenital heart defects may have different hemodynamic problems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects. Cutting balloon angioplasty was performed in 28 children with different congenital heart defects. The indication for cutting balloon angioplasty was: pulmonary artery stenosis in 17 patients, creating or dilatation of interatrial communication in 10 patients, and stenosis of left subclavian artery in 1 patient. In the pulmonary arteries group there was a significant decrease in systolic blood pressure (SBP) in the proximal part of the artery from the average 74.33 ± 20.4 mm Hg to 55 ± 16.7 mm Hg (p cutting balloon angioplasty was performed after an unsuccessful classic Rashkind procedure. After cutting balloon angioplasty there was a significant widening of the interatrial communication. Cutting balloon angioplasty is a feasible and effective treatment option indifferent congenital heart defects.

  2. Long-Duration Altitude-Controlled Balloons for Venus: A Feasibility Study Informed by Balloon Flights in Remote Environments on Earth

    Science.gov (United States)

    Voss, P. B.; Nott, J.; Cutts, J. A.; Hall, J. L.; Beauchamp, P. M.; Limaye, S. S.; Baines, K. H.; Hole, L. R.

    2013-12-01

    In situ exploration of the upper atmosphere of Venus, approximately 65-77 km altitude, could answer many important questions (Limaye 2013, Crisp 2013). This region contains a time-variable UV absorber of unknown composition that controls many aspects of the heat balance on Venus. Understanding the composition and dynamics of this unknown absorber is an important science goal; in situ optical and chemical measurements are needed. However, conventional approaches do not provide access to this altitude range, repeated traverses, and a mission lifetime of several months needed to effectively carry out the science. This paper examines concepts for altitude-controlled balloons not previously flown on planetary missions that could potentially provide the desired measurements. The concepts take advantage of the fact that at 60 km altitude, for example, the atmospheric density on Venus is about 40% of the sea-level density on earth and the temperature is a moderate 230 K. The solar flux is approximately double that on earth, creating some thermal challenges, but making photovoltaic power highly effective. Using a steady-state thermodynamic model and flight data from Earth, we evaluate the suitability of two types of altitude-controlled balloons for a potential mission on Venus. Such balloons could repeatedly measure profiles, avoid diurnal temperature extremes, and navigate using wind shear. The first balloon design uses air ballast (AB) whereby ambient air can be compressed into or released from a constant-volume balloon, causing it to descend or ascend accordingly. The second design uses lift-gas compression (LGC) to change the volume of a zero-pressure balloon, thereby changing its effective density and altitude. For an altitude range of 60-75 km on Venus, we find that the superpressure volume for a LGC balloon is about 5% of that needed for an AB balloon while the maximum pressurization is the same for both systems. The compressor work per km descent of the LGC balloon

  3. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity.

    Science.gov (United States)

    Mathus-Vliegen, Elisabeth M H; de Groot, Gerrit H

    2013-05-01

    Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion. Patients referred for obesity treatment were randomised to 13 weeks of sham treatment followed by 13 weeks of balloon treatment (group 1; sham/balloon) or to twice a 13-week period of balloon treatment (group 2; balloon/balloon). Blood samples were taken for fasting and meal-stimulated CCK and PP levels at the start (T0) and after 13 (T1) and 26 (T2) weeks. Patients filled out visual analogue scales (VAS) to assess satiety. Forty-two patients (35 females, body weight 125.1 kg, BMI 43.3 kg/m(2)) participated. In group 1, basal CCK levels decreased but meal-stimulated response remained unchanged after 13 weeks of sham treatment. In group 2, basal and meal-stimulated CCK levels decreased after 13 weeks of balloon treatment. At the end of the second 13-week period, when group 1 had their first balloon treatment, they duplicated the initial 13-week results of group 2, whereas group 2 continued their balloon treatment and reduced meal-stimulated CCK release. Both groups showed reduced meal-stimulated PP secretions at T1 and T2 compared to T0. Changes in diet composition and VAS scores were similar. Improvements in glucose homeostasis partly explained the PP results. The reduced CCK and PP secretion after balloon positioning was unexpected and may reflect delayed gastric emptying induced by the balloon. Improved glucose metabolism partly explained the reduced PP secretion. Satiety and weight loss were not adversely influenced by these hormonal changes.

  4. Complex Coronary Interventions with the Novel Mozec™ CTO Balloon: The MOZART Registry.

    Science.gov (United States)

    Lupi, Alessandro; Rognoni, Andrea; Schaffer, Alon; Secco, Gioel G; Bongo, Angelo S

    2015-01-01

    Mozec™ CTO is a novel semicompliant rapid-exchange PTCA balloon catheter with specific features dedicated to treat complex coronary lesions like chronic total occlusions (CTOs). However, no data have been reported about the performance of this device in an all-comers population with complex coronary lesions. We evaluated the safety and success rate of Mozec™ CTO balloon in 41 consecutive patients with chronic stable angina and complex coronary lesions (15 severe calcified coronary stenoses, 15 bifurcation lesions with planned two-stent intervention, and 11 CTOs). Safety was assessed reporting the balloon burst rate after inflation exceeding the rated burst pressure (RBP) according to the manufacturer's reference table. Success was defined as the possibility to advance the device further the target lesion. The Mozec™ CTO balloon showed an excellent performance with a 93.3% success in crossing tight and severely calcified lesions (14/15 pts), a 93.3% success in engaging jailed side branches after stent deployment across bifurcations (14/15 pts), and a 90.9% success in crossing CTO lesions (10/11 pts). The burst rate at RBP of the Mozec™ CTO balloon was 6.7% (1/15 balloons) in the tight and severely calcified lesions, 6.7% (1/15 balloons) when dilating jailed vessels, and 9.1% (1/11 balloons) in CTOs. The novel Mozec™ CTO balloon dilatation catheter showed promising results when employed to treat complex lesions in an all-comers population. Further studies should clarify if this kind of balloon might reduce the need of more costly devices like over-the-wire balloons and microcatheters for complex lesions treatment.

  5. A device for performing automated balloon catheter inflation ischemia studies.

    Science.gov (United States)

    Leavesley, Silas J; Ledkins, Whitley; Rocic, Petra

    2014-01-01

    Coronary collateral growth (arteriogenesis) is a physiological adaptive response to transient and repetitive occlusion of major coronary arteries in which small arterioles (native collaterals) with minimal to no blood flow remodel into larger conduit arteries capable of supplying adequate perfusion to tissue distal to the site of occlusion. The ability to reliably and reproducibly mimic transient, repetitive coronary artery occlusion (ischemia) in animal models is critical to the development of therapies to restore coronary collateral development in type II diabetes and the metabolic syndrome. Current animal models for repetitive coronary artery occlusion implement a pneumatic occluder (balloon) that is secured onto the surface of the heart with the suture, which is inflated manually, via a catheter connected to syringe, to effect occlusion of the left anterior descending coronary artery (LAD). This method, although effective, presents complications in terms of reproducibility and practicality. To address these limitations, we have designed a device for automated, transient inflation of balloon catheters in coronary artery occlusion models. This device allows repeated, consistent inflation (to either specified pressure or volume) and the capability for implementing very complex, month-long protocols. This system has significantly increased the reproducibility of coronary collateral growth studies in our laboratory, resulting in a significant decrease in the numbers of animals needed to complete each study while relieving laboratory personnel from the burden of extra working hours and enabling us to continue studies over periods when we previously could not. In this paper, we present all details necessary for construction and operation of the inflator. In addition, all of the components for this device are commercially available and economical (Table S1). It is our hope that the adoption of automated balloon catheter inflation protocols will improve the experimental

  6. Anisotropic Alfven-ballooning modes in the Earth's magnetosphere

    International Nuclear Information System (INIS)

    Chan, A.A.; Xia, Mengfen; Chen, Liu

    1993-05-01

    We have carried out a theoretical analysis of the stability and parallel structure of coupled shear-Alfven and slow-magnetosonic waves in the Earth's inner magnetosphere including effects of finite anisotropic plasma pressure. Multiscale perturbation analysis of the anisotropic Grad-Shafranov equation yields an approximate self-consistent magnetohydrodynamic (MHD) equilibrium. This MHD equilibrium is used in the numerical solution of a set of eigenmode equations which describe the field line eigenfrequency, linear stability, and parallel eigenmode structure. We call these modes anisotropic Alfven-ballooning modes. The main results are: The field line eigenfrequency can be significantly lowered by finite pressure effects. The parallel mode structure of the transverse wave components is fairly insensitive to changes in the plasma pressure but the compressional magnetic component can become highly peaked near the magnetic equator due to increased pressure, especially when P perpendicular > P parallel. For the isotropic case ballooning instability can occur when the ratio of the plasma pressure to the magnetic pressure, exceeds a critical value β o B ∼ 3.5 at the equator. Compared to the isotropic case the critical beta value is lowered by anisotropy, either due to decreased field-line-bending stabilization when P parallel > P perpendicular, or due to increased ballooning-mirror destabilization when P perpendicular > P parallel. We use a ''β-6 stability diagram'' to display the regions of instability with respect to the equatorial values of the parameters bar β and δ, where bar β = (1/3)(β parallel + 2 β perpendicular) is an average beta value and δ = 1 - P parallel/P perpendicular is a measure of the plasma anisotropy

  7. Biogenic nonmethane hydrocarbon emissions estimated from tethered balloon observations

    Science.gov (United States)

    Davis, K. J.; Lenschow, D. H.; Zimmerman, P. R.

    1994-01-01

    A new technique for estimating surface fluxes of trace gases, the mixed-layer gradient technique, is used to calculate isoprene and terpene emissions from forests. The technique is applied to tethered balloon measurements made over the Amazon forest and a pine-oak forest in Alabama at altitudes up to 300 m. The observations were made during the dry season Amazon Boundary Layer Experiment (ABLE 2A) and the Rural Oxidants in the Southern Environment 1990 experiment (ROSE I). Results from large eddy simulations of scalar transport in the clear convective boundary layer are used to infer fluxes from the balloon profiles. Profiles from the Amazon give a mean daytime emission of 3630 +/- 1400 micrograms isoprene sq m/h, where the uncertainty represents the standard deviation of the mean of eight flux estimates. Twenty profiles from Alabama give emissions of 4470 +/- 3300 micrograms isoprene sq m/h, 1740 +/- 1060 micrograms alpha-pinene sq m/h, and 790 +/- 560 micrograms beta-pinene sq m/h, respectively. These results are in agreement with emissions derived from chemical budgets. The emissions may be overestimated because of uncertainty about how to incorporate the effects of the canopy on the mixed-layer gradients. The large variability in these emission estimates is probably due to the relatively short sampling times of the balloon profiles, though spatially heterogeneous emissions may also play a role. Fluxes derived using this technique are representative of an upwind footprint of several kilometers and are independent of hydrocarbon oxidation rate and mean advection.

  8. A device for performing automated balloon catheter inflation ischemia studies.

    Directory of Open Access Journals (Sweden)

    Silas J Leavesley

    Full Text Available Coronary collateral growth (arteriogenesis is a physiological adaptive response to transient and repetitive occlusion of major coronary arteries in which small arterioles (native collaterals with minimal to no blood flow remodel into larger conduit arteries capable of supplying adequate perfusion to tissue distal to the site of occlusion. The ability to reliably and reproducibly mimic transient, repetitive coronary artery occlusion (ischemia in animal models is critical to the development of therapies to restore coronary collateral development in type II diabetes and the metabolic syndrome. Current animal models for repetitive coronary artery occlusion implement a pneumatic occluder (balloon that is secured onto the surface of the heart with the suture, which is inflated manually, via a catheter connected to syringe, to effect occlusion of the left anterior descending coronary artery (LAD. This method, although effective, presents complications in terms of reproducibility and practicality. To address these limitations, we have designed a device for automated, transient inflation of balloon catheters in coronary artery occlusion models. This device allows repeated, consistent inflation (to either specified pressure or volume and the capability for implementing very complex, month-long protocols. This system has significantly increased the reproducibility of coronary collateral growth studies in our laboratory, resulting in a significant decrease in the numbers of animals needed to complete each study while relieving laboratory personnel from the burden of extra working hours and enabling us to continue studies over periods when we previously could not. In this paper, we present all details necessary for construction and operation of the inflator. In addition, all of the components for this device are commercially available and economical (Table S1. It is our hope that the adoption of automated balloon catheter inflation protocols will improve the

  9. Aluminum Micro-Balloons as Improved Fuel for Warhead Explosives

    Science.gov (United States)

    2018-01-29

    8725 John J. Kingman Road , MS 6201 Fort Belvoir, VA 22060-6201 T E C H N IC A L R E P O R T DTRA-TR-16-11 Aluminum Micro-Balloons as... ROAD , MS-6201, FT BELVOIR, VA 22060-6201, IF YOUR ADDRESS IS INCORRECT, IF YOU WISH IT DELETED FROM THE DISTRIBUTION LIST, OR IF THE ADDRESSEE...active in getting aluminum particles with oxide coatings to react with water under shock loading as reported in the literature. It is useful to note

  10. Cineangiographic findings and balloon catheter angioplasty of pulmonic valvular stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyung Mo; Yoon, Yong Soo; Kim, In One; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1987-08-15

    Transluminal balloon valvuloplasty was performed in the treatment of congenital pulmonic valvular stenosis in 55 children, aged 4 months to 15 years. The right ventricular outflow tract pressure gradient decreased significantly immediately after the procedure from 87.18 {+-} 56mmHg to 29.62 {+-} 26.48mmHg ({rho} < 0.001). Technical success rate was 98% (54/55 patients) and failed case (1 patient) was due to severe fibrous thickening of valve. Complication occurred in one case, that is tricuspid regurgitation (Grade II) due to suspected rupture of chordae tendinae. The degree of pulmonary conus dilatation was closely related with age than the pressure gradient.

  11. Balloon-Assisted Chemoembolization Using a Micro-Balloon Catheter Alongside a Microcatheter for a Hepatocellular Carcinoma with a Prominent Arterioportal Shunt: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshiai, Sodai, E-mail: hoshiai@sb4.so-net.ne.jp; Mori, Kensaku; Ishiguro, Toshitaka; Konishi, Takahiro; Uchikawa, Yoko [University of Tsukuba Hospital, Department of Diagnostic and Interventional Radiology (Japan); Fukuda, Kuniaki [University of Tsukuba Hospital, Department of Gastroenterology (Japan); Minami, Manabu [University of Tsukuba Hospital, Department of Diagnostic and Interventional Radiology (Japan)

    2017-04-15

    Although transcatheter arterial chemoembolization is one of the established treatments for hepatocellular carcinoma (HCC), it is difficult to treat HCCs with prominent arterioportal (AP) shunts because anticancer drugs and embolic materials migrate into the non-tumorous liver through the AP shunts and may cause liver infarction. We developed a novel method of balloon-assisted chemoembolization using a micro-balloon catheter alongside a microcatheter simultaneously inserted through a single 4.5-Fr guiding sheath, comprising proximal chemoembolization with distal arterial balloon occlusion. We applied this method to treat an HCC with a prominent distal AP shunt induced by previous proton beam therapy and achieved successful chemoembolization without non-tumorous liver infarction under temporal balloon occlusion of a distal AP shunt.

  12. Solar energy collector including a weightless balloon with sun tracking means

    Science.gov (United States)

    Hall, Frederick F.

    1978-01-01

    A solar energy collector having a weightless balloon, the balloon including a transparent polyvinylfluoride hemisphere reinforced with a mesh of ropes secured to its outside surface, and a laminated reflector hemisphere, the inner layer being clear and aluminized on its outside surface and the outer layer being opaque, the balloon being inflated with lighter-than-air gas. A heat collection probe extends into the balloon along the focus of reflection of the reflective hemisphere for conducting coolant into and out of the balloon. The probe is mounted on apparatus for keeping the probe aligned with the sun's path, the apparatus being founded in the earth for withstanding wind pressure on the balloon. The balloon is lashed to the probe by ropes adhered to the outer surface of the balloon for withstanding wind pressures of 100 miles per hour. Preferably, the coolant is liquid sodium-potassium eutectic alloy which will not normally freeze at night in the temperate zones, and when heated to 4,000.degree. R exerts a pressure of only a few atmospheres.

  13. Endoscopic balloon dilatation as treatment of gastric outlet obstruction in infancy and childhood

    NARCIS (Netherlands)

    Heymans, H. S.; Bartelsman, J. W.; Herweijer, T. J.

    1988-01-01

    The application of balloon dilatation as treatment of gastric outlet obstruction is described. In two infants after inadequate pyloromyotomy and in an 11-year-old boy with surgical damage to the vagus, balloon dilatation was successful and considered a good alternative to surgery in these conditions

  14. Feasibility of Balloon-Borne Optical Measurement of (C sub n) Squared.

    Science.gov (United States)

    1981-10-26

    attached to two meteorological balloons. Tether lines to the balloons are attached to a trailing package which contains a telemetry trasmitter and...R.J. Cook, Beam wander in a turbulent medium: An application of Ehrenfest’s theorem, J. Opt. Soc. Am ., 1975, 8, 942. 28 DAT FILM

  15. Adjustable intragastric balloons: a 12-month pilot trial in endoscopic weight loss management

    NARCIS (Netherlands)

    Machytka, Evzen; Klvana, Pavel; Kornbluth, Asher; Peikin, Steven; Mathus-Vliegen, Lisbeth E. M.; Gostout, Christopher; Lopez-Nava, Gontrand; Shikora, Scott; Brooks, Jeffrey

    2011-01-01

    Intragastric balloons are associated with (1) early period intolerance, (2) diminished effect within 3-4 months, and (3) bowel obstruction risk mandating removal at 6 months. The introduction of an adjustable balloon could improve comfort and offer greater efficacy. A migration prevention function,

  16. Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: results of cutting balloon angioplasty

    DEFF Research Database (Denmark)

    Heerwagen, Søren Thorup; Lönn, Lars; Schroeder, Torben V

    2010-01-01

    Cephalic arch stenosis is a known cause of hemodialysis access failure in patients with brachiocephalic fistulas (BCFs). Outcomes of endovascular treatment are affected by resistance of the stenosis to balloon dilation, a high vein rupture rate and the development of early restenosis. The purpose...... of this retrospective study was to report outcomes after cutting balloon angioplasty (CBA) of cephalic arch stenosis....

  17. Membranous duodenal stenosis: initial experience with balloon dilatation in four children

    NARCIS (Netherlands)

    van Rijn, R. R.; van Lienden, K. P.; Fortuna, T. L.; D'Alessandro, L. C. A.; Connolly, B.; Chait, P. G.

    2006-01-01

    INTRODUCTION: We present a novel approach to the treatment of membranous duodenal stenosis (MDS). To our knowledge this is the first paper to describe balloon dilatation for this entity. MATERIAL AND METHODS: Four children, 2 boys and 2 girls, aged between 8 and 28 days, underwent duodenal balloon

  18. Single-centre comparison of a novel single-step balloon inflation ...

    African Journals Online (AJOL)

    Objective. A new second-generation balloon dilatation device for percutaneous nephrolithotomy (PCNL) has been launched, promising to challenge the traditional Amplatz serial dilators (ASDs). This device allows for the polyurethane sheath to be deployed on balloon inflation. Our primary objective in this pilot study was to ...

  19. Goldvalve detachable balloon: ''in vitro'' assessment of safety and imaging artifacts in a 3-T MR system

    International Nuclear Information System (INIS)

    Dabus, Guilherme; Gerstle, Ronald J.; Goodman, James; Cross, Witte T. de; Moran, Christopher J.; Derdeyn, Colin P.

    2006-01-01

    The Goldvalve balloon is the only currently available detachable balloon. We undertook a study to determine safety and imaging artifacts in a MR environment. We found no evidence for heating or deflection of the balloon in a comprehensive series of in vitro experiments at 3 T. MR imaging at field strengths up to 3 T of patients with implanted Goldvalve balloons is safe. Imaging artifacts are minimal. (orig.)

  20. Schematics of a Water Balloon Launcher Design and Reproducible Water-Balloon-Filling Procedures Used for a Middle School Summer Science Camp

    OpenAIRE

    Christiansen, Mike A; Edwards, Boyd F.; Sam, David D.

    2013-01-01

    We recently held a Science Summer Camp for middle school students, designed to infuse young people with increased excitement for STEM (Science, Technology, Engineering, and Math) subjects. Our efforts, which received nationally-syndicated news coverage,1 included the invention of a versatile water balloon launcher. This document contains: (1) detailed construction schematics and user operation guidelines for our balloon launcher; (2) data and instructions for reproducibly filling ...

  1. Fracture of the delivery balloon shaft during balloon-expandable prosthesis alignment during implantation of an Edwards SAPIEN 3.

    Science.gov (United States)

    Arai, Takahide; Hovasse, Thomas; Chevalier, Bernard

    2018-04-01

    The expandable sheath was designed with a lower profile in order to reduce the incidence of vascular complications of transcatheter aortic valve implantation using transfemoral approach. However, once the prosthesis has crossed the sheath, it could be difficult to retrieve it from the body. This is the first case of successful bail-out in an instance of delivery balloon shaft malfunction subsequent to the crossing of an expandable sheath during implantation of an Edwards SAPIEN 3 prosthesis. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. MHD simulation of high wavenumber ballooning-like modes in LHD

    International Nuclear Information System (INIS)

    Miura, H.; Nakajima, N.

    2008-10-01

    Dynamical growths of high-wavenumber ballooning modes are studied through full-3D nonlinear MHD simulations of the Large Helical Device. The growths of the ballooning modes are identified by studying the growth rates and the radial profiles of the Fourier coefficients of fluctuation variables. The mechanisms to weaken the growth of instability, such as the local fattening of the pressure and the energy release to the parallel kinetic energy, are found being insufficient to suppress the high-wavenumber ballooning modes. Consequently, the mean pressure profile is totally modified when the evolutions of the ballooning modes are saturated. The numerical results reveal that we need some mechanisms which do not originate from an ideal MHD to achieve a mild, saturated behaviors beyond the growths of unstable high ballooning modes in the helical device. The parallel heat conductivity is proposed as one of possible non-ideal mechanisms. (author)

  3. Impact of balloon inflation pressure on cell viability with single and multi lumen catheters.

    Science.gov (United States)

    Dib, N; Schwalbach, D B; Plourde, B D; Kohler, R E; Dana, D; Abraham, J P

    2014-12-01

    Infusion catheters, when used in combination with balloons, are subjected to pressure created by inflation of the balloon. The compression can reduce the catheter flow area and cause elevated shear stresses in the fluid. A model and experiments were developed with a range of applied balloon pressures to investigate whether such situations may cause cell lysis during stem-cell infusion through single-lumen catheters. It was found that for balloon inflation pressures in excess of ~7 atm, it is possible for cell injury to occur, although the critical pressure depends on the fluid viscosity. The study was then applied to a multi-lumen catheter which was designed to resist compression. That device was able to handle very elevated balloon pressures and flow rates before cell lysis became a concern.

  4. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Gulcan, Oner; Turkoz, Riza

    2005-01-01

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD

  5. Current status of endoscopic balloon dilation for Crohn's disease

    Directory of Open Access Journals (Sweden)

    Fumihito Hirai

    2017-04-01

    Full Text Available The therapeutic target in Crohn's disease (CD has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.

  6. Electron observation with the balloon-borne CALET prototype detector

    Science.gov (United States)

    Torii, Shoji; Ozawa, Shunsuke; Kasahara, Katsuaki; Murakami, Hiroyuki; Akaike, Yosui; Aiba, Toshihide; Ueyama, Yoshitaka; Nakai, Mikio; Kai, Yuuichirou; Tamura, Tadahisa; Yoshida, Kenji; Katayose, Yusaku; Kawada, Jiro; Mizuta, Eiichi; Marrocchesi, Pier Simone; Kim, Meyoung; Bigongiari, Gabriele

    We have been carrying out an observation of the cosmic ray electrons, using the CALET prototype detector: bCALET. After the first flight of bCALET-1, the bCALET-2 was flown in 2009 at the JAXA balloon center at Taikicho for observing the electrons in 1-100 GeV. The detector is composed IMaging Calorimeter(IMC), Total AbSorption Calorimeter(TASC). IMC has an area of 256mmx256mm, and is consisted 8 layers of scintillating fiber belts intserted below tungsten plate (3 r.l. in total) for a fine imaging of shower particles. TASC is made 6 layers of BGO scintillator logs (25mm x 25mm x 300 mm in each) with an active area of 250mm x 250mm, for measurement the total energy deposit of incoming shower particles. The observation was successfully carried out, and the basic performance of the detector was confirmed to be consistent with the expectation by simulations. We will have the third flight of the bCALET-3 in 2010 at the Balloon Launch Center of Cachoeira Paulista in Brazil, to extend the energy region up to 1000 GeV. We will present the results of the bCALET-2 and the RD of the bCALET-3 detector.

  7. Barrage balloons against aircraft threat: A well proven concept revisited

    International Nuclear Information System (INIS)

    Petrangeli, Gianni

    2010-01-01

    Since the event of September 11, 2001 in New York City, many people started to speculate that the same type of attack could in future be brought against other installations. Indeed, the U.S. Nuclear Regulatory Commission decided to require for future plants to assess their resistance to the impact of a large civil airliner. Nuclear plant control authorities of other countries decided in a similar direction. The solutions to the technical problem is usually pursued in the direction of a reinforcement of external plant structures and, in some case, they may not be sufficient. Other solutions of more psychological nature have also been adopted. This paper aims at the demonstration that the use of barrage balloons, already adopted with success in both World Wars and also occasionally after these events, can afford a satisfactory solution to the protection problem at a reasonable cost. This solution is also applicable to existing plants. The history of barrage balloons is summarized. Modern technology offers electronic devices capable to detect in time an approaching threat and the paper describes a new barrage system based also on such new possibilities. If the aircraft crash problem is a real one or not for the next years, nobody knows for sure; however some considerations should be kept in mind: ·The fact that an accident of this kind 'anywhere' is an accident 'everywhere' as usual; ·The extremely uncertain political outlook worldwide, the peculiarities of the oil market and the possible nuclear renaissance.

  8. Balloon sinuplasty: a new concept in the endoscopic nasal surgery

    Directory of Open Access Journals (Sweden)

    Nogueira Júnior, João Flávio

    2008-12-01

    Full Text Available Introduction: Sinus diseases affect millions of people annually. Clinical treatment is effective in most patients, but in case of failure of this therapy the functional endoscopic surgery is currently the treatment choice for surgical treatment. The objective of the functional endoscopic surgery is to increase the aeration and drainage of the involved paranasal sinuses, which allows for the adequate functioning of the nasal mucosa mucociliary clearance. However, this method still has some limitations, mainly because it removes the nasal mucosa and bone tissue, and it may lead to physiologic alterations of the nasosinusal mucosa and cicatricial fibrosis. Many of these patients could be benefited from less invasive methods, with larger nasal mucosa preservation. Since 2006, an even less invasive procedure was remarked in our specialty: the balloon dilatation of the paranasal sinus ostia. Objective: The objective of this article is to define the concept of sinuplasty, its action mechanism, and present the necessary material for the procedures performance; to describe the techniques with the equipment in a nasosinusal endoscopic surgery simulator model and review the current literature about the indications, complications, results, and follow-up of patients submitted to this procedure. Balloon sinuplasty is safe and appears to be effective in the improvement of the quality of life of patients not responsive to conventional clinical therapy. New applications and indications for this equipment should be described and researched.

  9. Beam Tests of the Balloon-Borne ATIC Experiment

    Science.gov (United States)

    Ganel, O.; Adams, J. H., Jr.; Ahn, E. J.; Ampe, J.; Bashindzhagyan, G.; Case, G.; Chang, J.; Ellison, S.; Fazely, A.; Gould, R.

    2003-01-01

    The Advanced Thin Ionization Calorimeter (ATIC) balloon-borne experiment is designed to perform cosmic-ray elemental spectra measurement from 50 GeV to 100 TeV for nuclei from hydrogen to iron. These measurements are expected to provide crucial hints about some of the most fundamental questions in astroparticle physics today. ATTIC'S design centers on an 18 radiation length (X(sub Omnicron)) deep bismuth germanate (BGO) calorimeter, preceded by a 0.75 lambda(sub int) graphite target. In September 1999 the ATIC detector was exposed to high-energy beams at CERN's SPS accelerator, within the framework of the development program for the Advanced Cosmic-ray Composition Experiment for the Space Station (ACCESS). In December 2000 - January 2001, ATIC flew on the first of a series of long duration balloon (LDB) flights from McMurdo Station, Antarctica. We present here results from the 1999 beam-tests, including energy resolutions for electrons and protons at several beam energies from 100 GeV to 375 GeV, as well as signal linearity and collection efficiency estimates. We show how these results compare with expectations based on simulations, and their expected impacts on mission performance.

  10. Treatment of urethral strictures with balloon dilation: A forgotten tale

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2015-09-01

    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization and dilation, urethroplasty and endoscopic internal urethrotomy as well. Although treatment option depends on the type, length and aetiology of stricture, the choice can be influenced to varying degrees by the simplicity of the method, the preferences of the patient the available accoutrements and the patient health condition. Both urethroplasty and endoscopic internal urethrotomy require anaesthesia and thus are not suitable for many elder and unfit for surgical treatment patients. On the other hand, dilations are easy to perform in every day clinical practice however they have been associated with iatrogenic urethral trauma. In contrast, balloon dilation under vision dilates by radial application of forces against the stricture, avoiding the potentially shearing forces associated with sequential rigid dilation. Since it reduces the possibility of an iatrogenic urethral trauma and the subsequent spongiofibrosis may lead into improved therapeutic outcomes. In this report we describe a technique for the treatment of urethral strictures with balloon dilation in elder and unfit for surgical treatment patients.

  11. Polar Balloon Experiment for Astrophysics Research (Polar BEAR)

    Science.gov (United States)

    Bashindzhagyan, G.; Adams, James H., Jr.; Bashindzhagyan, P.; Chilingarian, A.; Donnelly, J.; Drury, L.; Egorov, N.; Golubkov, S.; Grebenyuk, V.; Kalinin, A.; hide

    2001-01-01

    A new balloon experiment is proposed for a long duration flight around the North Pole. The primary objective of the experiment is to measure the elemental energy spectra of high-energy cosmic rays in the region up to 10(exp 15) eV. The proposed instrument involves the combination of a large collecting area (approximately 1 x 1 square m) KLEM (Kinematic Lightweight Energy Meter) device with an ionization calorimeter having a smaller collecting area (approximately 0.5 x 0.5 square m) and integrated beneath the KLEM apparatus. This combination has several important advantages. Due to the large aperture (greater than 2 square m sr) of the KLEM device a large exposure factor can be achieved with a long duration balloon flight (2-4 weeks). The calorimeter will collect about 10% of the events already registered by KLEM and provide effective cross-calibration for both energy measurement methods. Details of the experiment and its astrophysical significance will be presented.

  12. Beam tests of the balloon-borne ATIC experiment

    CERN Document Server

    Ganel, O; Ahn, H S; Ampe, J; Bashindzhagian, G L; Case, G; Chang, H; Ellison, S; Fazely, A; Gould, R; Granger, D; Gunasingha, R M; Guzik, T G; Han, Y J; Isbert, J; Kim, H J; Kim, K C; Kim, S K; Kwon, Y; Panasyuk, M Y; Panov, A; Price, B; Samsonov, G; Schmidt, W K H; Sen, M; Seo, E S; Sina, R; Sokolskaya, N; Stewart, M; Voronin, A; Wagner, D; Wang, J Z; Wefel, J P; Wu, J; Zatsepin, V

    2005-01-01

    The Advanced Thin Ionization Calorimeter (ATIC) balloon-borne experiment is designed to perform cosmic-ray elemental spectra measurements from 50 GeV to 100 TeV for nuclei from hydrogen to iron. These measurements are expected to provide information about some of the most fundamental questions in astroparticle physics today. ATIC's design centers on an 18 radiation length (X0) deep bismuth germanate (BGO) calorimeter, preceded by a 0.75λint graphite target. In September 1999, the ATIC detector was exposed to high-energy beams at CERN's SPS accelerator within the framework of the development program for the Advanced Cosmic-ray Composition Experiment for the Space Station (ACCESS). In December 2000–January 2001 and again in December 2002–January 2003, ATIC flew on the first two of a series of long-duration balloon (LDB) flights from McMurdo Station, Antarctica. We present here results from the 1999 beam tests, including energy resolutions for electrons and protons at several beam energies from 100 to 375 G...

  13. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  14. Impact of contrast agent viscosity on coronary balloon deflation times: bench testing results.

    Science.gov (United States)

    Mogabgab, Owen; Patel, Vishal G; Michael, Tesfaldet T; Kotsia, Anna; Christopoulos, George; Banerjee, Subhash; Brilakis, Emmanouil S

    2014-04-01

    To assess the impact of viscosity on angioplasty balloon deflation times. Lower contrast viscosity could result in more rapid coronary balloon deflation times. We performed a bench comparison of coronary balloon deflation times using 2 contrast agents with different viscosity (ioxaglate and iodixanol), 3 contrast dilutions, and 2 inflation syringe filling volumes. Ten identical pairs of coronary angioplasty balloons were used to conduct each comparison after balloon inflation to 12 atmospheres. Simultaneous deflations were performed under cineangiography. The time to full contrast extraction and the area of contrast remaining after 5 seconds of deflation (quantified by opaque pixel count) were compared between groups. The mean time to full contrast extraction during balloon deflation was 8.3 ± 2.5 seconds for ioxaglate (lower viscosity) versus 10.1 ± 2.9 seconds for iodixanol (higher viscosity) (17.4% decrease, P = 0.005), with a 35.6% (P = 0.004) reduction in contrast area at 5 seconds. Compared to 1:1 ioxaglate-saline mixture, 1:2 and 1:3 ioxaglate/saline mixes resulted in 26.7% (P deflation time, respectively, but at the expense of decreased balloon opacity. Filling the inflation syringe with 5 versus 15 ml of contrast/saline solution was associated with 7.5% decrease in balloon deflation time (P = 0.005), but no difference in contrast area at 5 seconds (P = 0.749). Use of a lower viscosity contrast agent and higher contrast dilution significantly reduced coronary balloon deflation times, whereas use of lower syringe filling volume had a modest effect. Rapid coronary balloon deflation could improve the safety of interventional procedures. © 2014 Wiley Periodicals, Inc.

  15. Safety and effectiveness of gastric balloons associated with hypocaloric diet for the treatment of obesity

    Directory of Open Access Journals (Sweden)

    M.ª Luisa de Castro

    2013-10-01

    Full Text Available Introduction: intragastric balloons provide early satiety and thereby induce short-term weight loss. The aim of this study was to evaluate safety and short and medium-term effectiveness of gastric balloons associated to hypocaloric diet in obesity. Material and methods: from May 2004 to June 2011 91 obese patients, body mass index [BMI] 45.2 ± 7.2 kg/m² were prospectively followed after endoscopic implantation of a gastric balloon associated to restricted diet. Successful therapy was defined as percent loss of total weight (%LTW ≥ 5% at six months after balloon placement and 6 and 12 months after their withdrawal. All analyses followed intention-to treat principles considering significant p-values < 0.05. Results: we placed 73 fluid-filled balloons (80.2% and 18 air-filled ones (19.8%. Compared to baseline values, at 6-month 73.7% subjects succeeded, showing significant reductions in weight (13.3 ± 8.8 kg, BMI (5 ± 3.4 kg/m² (p < 0.0001, with% LTW 11 ± 7%. Six and twelve months after retrieval 45.1% and 28.6% patients reached% LTW ≥ 5%. Short-term and medium-term effectiveness was negatively associated to obesity in first-grade relatives (p = 0.003 and p = 0.04. Higher weight loss 6 months after balloon placement independently predicted medium-term effectiveness (p = 0.0001. Mortality was absent but there were two spontaneous deflations of air-filled balloons and severe withdrawal difficulties in 8 patients, leading to surgery in one case. Retrieval complications associated to air-filled balloons (p = 0.0005. Conclusions: in obesity, effectiveness of gastric balloons associated to hypocaloric diet decreases over time. Complications occurred mainly in the retrieval endoscopic procedure and related to air-filled balloons.

  16. The use of a cutting balloon in contemporary reverse controlled antegrade and retrograde subintimal tracking (reverse CART) technique.

    Science.gov (United States)

    Nakabayashi, Keisuke; Okada, Hisayuki; Oka, Toshiaki

    2017-07-01

    The key concept of reverse controlled antegrade and retrograde tracking (CART) technique is retrograde puncture with a tapered wire to an antegrade balloon (contemporary reverse CART) or new connections between the antegrade and retrograde subintimal space (classical reverse CART). In our case, a 75-year-old man with severe chronic total occlusion of the right coronary artery, reverse CART with conventional balloons could not be accomplished. Externalization wiring was completed by contemporary reverse CART using a cutting balloon as an antegrade balloon to improve the fenestration force of the retrograde guidewire. Thus, the use of a cutting balloon for contemporary reverse CART might be promising.

  17. Multiorder etalon sounder (MOES) development and test for balloon experiment

    Science.gov (United States)

    Hays, Paul B.; Wnag, Jinxue; Wu, Jian

    1993-12-01

    concept and laboratory experiments were worked on for the past several years. Both theoretical studies and laboratory prototype experiments showed that MOES is very competitive compared with other high resolution sounders in terms of complexity and performance and has great potential as a compact and rugged high resolution atmospheric temperature and trace species sounder from the polar platform or the geostationary platform. The logical next step is to convert our laboratory prototype to a balloon instrument, so that field test of MOES can be carried out to prove the feasibility and capability of this new technology. Some of the activities related to the development of MOES for a possible balloon flight demonstration are described. Those research activities include the imaging quality study on the CLIO, the design and construction of a MOES laboratory prototype, the test and calibration of the MOES prototype, and the design of the balloon flight gondola.

  18. Stellarex Drug-Coated Balloon for Treatment of Femoropopliteal Disease

    Science.gov (United States)

    Faries, Peter; Niazi, Khusrow; Jain, Ash; Sachar, Ravish; Bachinsky, William B.; Cardenas, Joseph; Werner, Martin; Brodmann, Marianne; Mustapha, J. A.; Mena-Hurtado, Carlos; Jaff, Michael R.; Holden, Andrew H.; Lyden, Sean P.

    2017-01-01

    Background: Drug-coated balloons (DCBs) are a predominant revascularization therapy for symptomatic femoropopliteal artery disease. Because of the differences in excipients, paclitaxel dose, and coating morphologies, varying clinical outcomes have been observed with different DCBs. We report the results of 2 studies investigating the pharmacokinetic and clinical outcomes of a new DCB to treat femoropopliteal disease. Methods: In the ILLUMENATE Pivotal Study (Prospective, Randomized, Single-Blind, U.S. Multi-Center Study to Evaluate Treatment of Obstructive Superficial Femoral Artery or Popliteal Lesions With A Novel Paclitaxel-Coated Percutaneous Angioplasty Balloon), 300 symptomatic patients (Rutherford class 2–4) were randomly assigned to DCB (n=200) or standard angioplasty (percutaneous transluminal angioplasty [PTA]) (n=100). The primary safety end point was freedom from device- and procedure-related death through 30 days, and freedom from target limb major amputation and clinically driven target lesion revascularization through 12 months. The primary effectiveness end point was primary patency through 12 months. In the ILLUMENATE PK study (Pharmacokinetic Study of the Stellarex Drug-Coated Angioplasty Balloon), paclitaxel plasma concentrations were measured after last DCB deployment and at prespecified times (at 1, 4, 24 hours and at 7 and 14 days postprocedure) until no longer detectable. Results: In the ILLUMENATE Pivotal Study, baseline characteristics were similar between groups: 50% had diabetes mellitus, 41% were women, mean lesion length was 8.3 cm, and 44% were severely calcified. The primary safety end point was met (92.1% for DCB versus 83.2% for PTA, P=0.025 for superiority) and the primary patency rate was significantly higher with DCB (76.3% for DCB versus 57.6% for PTA, P=0.003). Primary patency per Kaplan-Meier estimates at day 365 was 82.3% for DCB versus 70.9% for PTA (P=0.002). The rate of clinically driven target lesion revascularization

  19. Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Fumie; Murata, Satoru; Ueda, Tatsuo; Yasui, Daisuke; Yamaguchi, Hidenori; Miki, Izumi; Kumita, Shin-ichiro [Nippon Medical School, Department of Radiology, Center for Advanced Medical Technology, Tokyo (Japan); Kawamoto, Chiaki [Nippon Medical School, Department of Internal Medicine, Tokyo (Japan); Uchida, Eiji [Nippon Medical School, Department of Surgery, Tokyo (Japan)

    2017-06-15

    To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion. Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver. In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group. Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion. (orig.)

  20. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Science.gov (United States)

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all pplacenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  1. A new approach to the diagnosis of esophageal rupture due to balloon dilatation

    International Nuclear Information System (INIS)

    Song, Ho Young; Han, Young Min; Lee, Sang Young; Kuh, Ja Hong; Lee, Dong Kun; Chae, Soo Wan

    1990-01-01

    The diagnosis of esophageal rupture in balloon dilatation is usually made from clinical symptom of sharp chest pain, plain chest radiographs and esophagograms after dilation. It has some problems; the pain is varied patients to patients and bacterial flora in the mouth or esophagus can be mixed with the contrast media to flow into the mediastinum during esophagography, to create mediastinitis. We could make the diagnosis of esophageal rupture without using contrast media by the observation of the pressure change in the balloon during dilatation. An infusion pump, transducer and esophageal balloon were connected through a multi-way connector, and the transducer of them was also connected to an amplifier which was connected to a pressure monitor to record the balloon pressure. As balloon(20mm/3cm) inserted in the mid-thoracic esophagus under the fluoroscopic control was inflated until the esophagus was ruptured. Balloon was distended by injecting air in 15 rabbits(A group), and by injecting diluted contrast medium in 15 rabbits(B group). The pressure decrease after esophageal rupture was ranged from 94 to 160 mmHg(mean; 103) in A group and 340 to 1040 mmHg(mean; 537) in B group. The pressure curve of A group was smooth, regular and so accurate to make the diagnosis of esophageal rupture, whereas that of B group was irregular and not so accurate. In conclusion, our new method to make the diagnosis of esophageal rupture during balloon dilatation may be useful in patients of esophageal stricture

  2. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

    International Nuclear Information System (INIS)

    Andersen, Poul Erik; Kjeldsen, Anette D.

    2008-01-01

    Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available anymore, but use of these balloons for embolization of pulmonary arteriovenous malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing the pulmonary arteriovenous malformation. No case of recanalization has been discovered, and these results seem to justify a reduced number of controls of these balloon-embolized malformations

  3. Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

    International Nuclear Information System (INIS)

    Sugihara, Fumie; Murata, Satoru; Ueda, Tatsuo; Yasui, Daisuke; Yamaguchi, Hidenori; Miki, Izumi; Kumita, Shin-ichiro; Kawamoto, Chiaki; Uchida, Eiji

    2017-01-01

    To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion. Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver. In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group. Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion. (orig.)

  4. Static and quasi-static analysis of lobed-pumpkin balloon

    Science.gov (United States)

    Nakashino, Kyoichi; Sasaki, Makoto; Hashimoto, Satoshi; Saito, Yoshitaka; Izutsu, Naoki

    The present study is motivated by the need to improve design methodology for super pressure balloon with 3D gore design concept, currently being developed at the Scientific Balloon Center of ISAS/JAXA. The distinctive feature of the 3-D gore design is that the balloon film has excess materials not only in the circumferential direction but also in the meridional direction; the meridional excess is gained by attaching the film boundaries to the corresponding tendons of a shorter length with a controlled shortening rate. The resulting balloon shape is a pumpkin-like shape with large bulges formed between adjacent tendons. The balloon film, when fully inflated, develops wrinkles in the circumferential direction over its entire region, so that the stresses in the film are limited to a small amount of uniaxial tension in the circumferential direction while the high meridional loads are carried by re-enforced tendons. Naturally, the amount of wrinkling in the film is dominated by the shortening rate between the film boundaries and the tendon curve. In the 3-D gore design, as a consequence, the shortening rate becomes a fundamental design parameter along with the geometric parameters of the gore. In view of this, we have carried out a series of numerical study of the lobed-pumpkin balloon with varying gore geometry as well as with varying shortening rate. The numerical simula-tions were carried out with a nonlinear finite element code incorporating the wrinkling effect. Numerical results show that there is a threshold value for the shortening rate beyond which the stresses in the balloon film increases disproportionately. We have also carried out quasi-static simulations of the inflation process of the lobed-pumpkin balloon, and have obtained asymmetric deformations when the balloon films are in uniaxial tension state.

  5. Initial Results from the ANITA 2006-2007 Balloon Flight

    Energy Technology Data Exchange (ETDEWEB)

    Gorham, P.W.; /Hawaii U.; Allison, P.; /Hawaii U.; Barwick, S.W.; /UC, Irvine; Beatty, J.J.; /Ohio State U.; Besson, D.Z.; /Kansas U.; Binns, W.R.; /Washington U., St. Louis; Chen, C.; /SLAC; Chen, P.; /SLAC; Clem, J.M.; /Delaware U.; Connolly, A.; /University Coll. London; Dowkontt, P.F.; /Washington U., St. Louis; DuVernois, M.A.; /Minnesota U.; Field, R.C.; /SLAC; Goldstein, D.; /UC, Irvine; Goodhue, A.; /UCLA; Hast, C.; /SLAC; Hebert, C.L.; /Hawaii U.; Hoover, S.; /UCLA; Israel, M.H.; /Washington U., St. Louis; Kowalski, J.; /Hawaii U.; Learned, J.G.; /Hawaii U. /Caltech, JPL /Hawaii U. /Minnesota U. /Hawaii U. /Ohio State U. /Hawaii U. /Hawaii U. /UC, Irvine /Taiwan, Natl. Taiwan U. /Caltech, JPL /SLAC /University Coll. London /Ohio State U. /SLAC /Hawaii U. /Hawaii U. /Hawaii U. /UCLA /Delaware U. /Hawaii U. /SLAC /Taiwan, Natl. Taiwan U. /UC, Irvine

    2011-11-16

    We report initial results of the Antarctic Impulsive Transient Antenna (ANITA) 2006-2007 Long Duration Balloon flight, which searched for evidence of the flux of cosmogenic neutrinos. ANITA flew for 35 days looking for radio impulses that might be due to the Askaryan effect in neutrino-induced electromagnetic showers within the Antarctic ice sheets. In our initial high-threshold robust analysis, no neutrino candidates are seen, with no physics background. In a non-signal horizontal-polarization channel, we do detect 6 events consistent with radio impulses from extensive air showers, which helps to validate the effectiveness of our method. Upper limits derived from our analysis now begin to eliminate the highest cosmogenic neutrino models.

  6. Audit of radiation dose during balloon mitral valvuloplasty procedure

    International Nuclear Information System (INIS)

    Livingstone, Roshan S; Chandy, Sunil; Peace, B S Timothy; George, Paul; John, Bobby; Pati, Purendra

    2006-01-01

    Radiation doses to patients during cardiological procedures are of concern in the present day scenario. This study was intended to audit the radiation dose imparted to patients during the balloon mitral valvuloplasty (BMV) procedure. Thirty seven patients who underwent the BMV procedure performed using two dedicated cardiovascular machines were included in the study. The radiation doses imparted to patients were measured using a dose area product (DAP) meter. The mean DAP value for patients who underwent the BMV procedure from one machine was 19.16 Gy cm 2 and from the other was 21.19 Gy cm 2 . Optimisation of exposure parameters and radiation doses was possible for one machine with the use of appropriate copper filters and optimised exposure parameters, and the mean DAP value after optimisation was 9.36 Gy cm 2

  7. NASA balloon: Aircraft ranging, data and voice experiment

    Science.gov (United States)

    Wishna, S.; Hamby, C.; Reed, D.

    1972-01-01

    A series of tests to evaluate, at L-band, the ranging, voice, and data communications concepts proposed for the air traffic control experiment of the Applications Technology Satellite-F are described. The ground station facilities, balloon platforms and the aircraft were supplied by the European Space Research Organization. One ground simulation and two aircraft flights at low elevation angles were conducted. Even under high interference conditions good performance was obtained for both voice communications and side tone ranging. High bit errors occurred in the data channels resulting in false commands. As a result of the experience gained in operating the equipment in an aircraft environment several recommendations were made for improving the equipment performance.

  8. Pseudo-MHD ballooning modes in tokamak plasmas

    International Nuclear Information System (INIS)

    Callen, J.D.; Hegna, C.C.

    1996-08-01

    The MHD description of a plasma is extended to allow electrons to have both fluid-like and adiabatic-regime responses within an instability eigenmode. In the resultant open-quotes pseudo-MHDclose quotes model, magnetic field line bending is reduced in the adiabatic electron regime. This makes possible a new class of ballooning-type, long parallel extent, MHD-like instabilities in tokamak plasmas for α > s 2 (2 7/3 /9) (r p /R 0 ) or-d√Β/dr > (2 1/6 /3)(s/ R 0q ), which is well below the ideal-MHD stability boundary. The marginally stable pressure profile is similar in both magnitude and shape to that observed in ohmically heated tokamak plasmas

  9. Ballooning of pressure tubes - Construction of a test facility

    International Nuclear Information System (INIS)

    Forrest, C.F.

    1995-09-01

    The test facility has been built to enable creep testing of reactor pressure tube specimens under conditions which represent those likely to be encountered in a reactor loss-of-coolant accident. The facility has been designed to be capable of specimen heating rates up to 30 K.s -1 , temperatures up to 1200 C and internal pressurization up to 6 MPa with either argon or steam. Pressure tube temperature, strain rate, and pressure instrumentation have been provided for collection of data required for analysis of creep behaviour. The facility has been designed to be suitable for testing irradiated specimens in a hot cell. The report provides a detailed description of the test rig and results from two commissioning ballooning tests. (author). 2 refs., 1 tab., 4 figs

  10. [Coronary angioplasty: efficacy of the new low profile balloon catheters].

    Science.gov (United States)

    Feres, F; Tanajura, L F; Pinto, I M; Cano, M N; Maldonado, G; Mattos, L A; de Araújo, E C; Sousa, A G; Sousa, J E

    1989-12-01

    New low profile balloon catheter have allowed the indication of percutaneous transluminal coronary angioplasty (PTCA) for more complex lesions. We report our initial experience with these systems in 50 out of 101 patients (50%) who underwent a PTCA from March 15 to May 15, 1989 in "Instituto Dante Pazzanese de Cardiologia". Mean age was 58.6 +/- 10.4 years and most of the patients were male (78%). We dilated 54 lesions. Single vessel disease was the case for 84% of the patients. As for the localization of the lesions in the coronary arteries, 56% of the lesions were in the proximal or mid segments of the coronary arteries and the mean diameter stenosis pre-PTCA was 84 +/- 10.2%. Left ventricular function was normal in 60% of the patients. Primary success rate (per patient) was 95% and the coronary stenosis was crossed in all the cases. The mean inflation number was 2.7 +/- 0.6 per patient, the mean highest pressure was 8 +/- 1.15 atm and the mean maximum time of inflation was 86.1 +/- 29.6 sec. The mean residual stenosis was 15.2 +/- 10.6%. There was only one major complication, namely an acute myocardial infarction of the lateral wall. There were no emergency CABG surgery or deaths. We conclude that the new low profile balloon catheters have broadened the indication for PTCA in more complicated lesions, showing a high rate of primary success (95%), but did not increase the number of procedural complications (2.5%).

  11. Coordinated weather balloon solar radiation measurements during a solar eclipse.

    Science.gov (United States)

    Harrison, R G; Marlton, G J; Williams, P D; Nicoll, K A

    2016-09-28

    Solar eclipses provide a rapidly changing solar radiation environment. These changes can be studied using simple photodiode sensors, if the radiation reaching the sensors is unaffected by cloud. Transporting the sensors aloft using standard meteorological instrument packages modified to carry extra sensors, provides one promising but hitherto unexploited possibility for making solar eclipse radiation measurements. For the 20 March 2015 solar eclipse, a coordinated campaign of balloon-carried solar radiation measurements was undertaken from Reading (51.44°N, 0.94°W), Lerwick (60.15°N, 1.13°W) and Reykjavik (64.13°N, 21.90°W), straddling the path of the eclipse. The balloons reached sufficient altitude at the eclipse time for eclipse-induced variations in solar radiation and solar limb darkening to be measured above cloud. Because the sensor platforms were free to swing, techniques have been evaluated to correct the measurements for their changing orientation. In the swing-averaged technique, the mean value across a set of swings was used to approximate the radiation falling on a horizontal surface; in the swing-maximum technique, the direct beam was estimated by assuming that the maximum solar radiation during a swing occurs when the photodiode sensing surface becomes normal to the direction of the solar beam. Both approaches, essentially independent, give values that agree with theoretical expectations for the eclipse-induced radiation changes.This article is part of the themed issue 'Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse'. © 2016 The Authors.

  12. Balloon Borne Arc-Second Pointer Feasibility Study

    Science.gov (United States)

    Ward, Philip R.; DeWeese, Keith D.

    2003-01-01

    For many years scientists have been utilizing stratospheric balloons as low-cost platforms on which to conduct space science experiments. A major hurdle in extending the range of experiments for which these vehicles are useful has been the imposition of the gondola dynamics on the accuracy with which an instrument can be kept pointed at a celestial target. A significant number of scientists have sought the ability to point their instruments with jitter in the arc-second range. This paper presents the design and analysis of a stratospheric balloon borne pointing system that is able to meet this requirement. The foundation for a high fidelity controller simulation is presented. The flexibility of the flight train is represented through generalized modal analysis. A multiple controller scheme is introduced for coarse and fine pointing. Coarse azimuth pointing is accomplished by an established pointing system, with extensive flight history, residing above the gondola structure. A pitch-yaw gimbal mount is used for fine pointing, providing orthogonal axes when nominally on target. Fine pointing actuation is from direct drive dc motors, eliminating backlash problems. An analysis of friction nonlinearities and a demonstration of the necessity in eliminating static fiction are provided. A unique bearing hub design is introduced that eliminates static fiction from the system dynamics. A control scheme involving linear accelerometers for enhanced disturbance rejection is also presented. Results from a linear analysis of the total system and the high fidelity simulation are given. This paper establishes that the proposed control strategy can be made robustly stable with significant design margins. Also demonstrated is the efficacy of the proposed system in rejecting disturbances larger than those considered realistic. Finally, we see that sub arc-second pointing stability can be achieved for a large instrument pointing at an inertial target.

  13. Primary balloon angioplasty for symptomatic, high-grade intracranial stenosis.

    Science.gov (United States)

    Tomycz, Luke; Bansal, Neil K; Lockney, Tim; Strothers, Megan; Connors, John J; Shay, Scott; Singer, Robert J

    2013-01-01

    In light of recent controversy about the safety and efficacy of intracranial stenting, we sought to evaluate our experience with primary balloon angioplasty for symptomatic, high-grade intracranial stenosis. All intracranial angioplasty cases performed at Vanderbilt University Medical Center from 2006 to 2011 were retrospectively reviewed for degree of stenosis pre- and post-procedure. Immediate peri-procedural complications were evaluated as well as one-month and long-term outcomes. A total of 26 patients were included in the study with a mean age of 63.0 years and a mean follow-up of 350.2 days. The average pre-procedure stenosis was 71.2%. The immediate, average post-procedure stenosis was 46.6%, and the average post-procedure stenosis at last angiographic follow-up was 44.5%. Retreatment was required in only 3.8% of patients. The primary end-point of major stroke or death at 30 days was observed in 11.5%, and the overall intra-procedural complication rate was 7.7%. The incidence of stroke or death at last follow-up was 15.4%, which is comparable to the one-year stroke or death rate in the medical arm of the SAMPRISS trial. In this retrospective series, primary balloon angioplasty was found to be effective as a treatment option for symptomatic intracranial stenosis with the risk of stroke or death at 30 days higher than the medical arm of SAMPRIS but lower than the stenting arm. The one-year risk of stroke was comparable to that reported for the one-year outcomes in the SAMPRISS medical arm.

  14. Drug-eluting balloons for treatment of SFA and popliteal disease - A review of current status.

    Science.gov (United States)

    van den Berg, Jos C

    2017-06-01

    The endovascular treatment of atherosclerotic disease of the infra-inguinal arteries has changed significantly over the last decades. In an attempt to overcome the high restenosis rates that characterize plain balloon angioplasty and stenting using bare mate stents drug-eluting balloon technology has been applied in the treatment of lesions of the superficial femoral and popliteal artery. This paper will give an overview of the rationale and the technology of drug-eluting balloons and will review currently available data from registries and randomized controlled trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Intragastric balloon treatment of obesity must be combined with bariatric surgery: a pilot study in Turkey.

    Science.gov (United States)

    Saruç, Murat; Böler, Deniz; Karaarslan, Mehmet; Baysal, Çağlar; Rasa, Kemal; Çakmakçi, Metin; Uras, Cihan; Tözün, Nurdan

    2010-12-01

    The treatment of morbid obesity by intragastric balloon (BioEnterics) placement is a safe and effective procedure. Cultural, social and economical factors are known to have an impact on the outcome of therapeutic interventions. This study aimed to evaluate the effect of this method on weight loss and long-term outcome following balloon removal in a cohort of Turkish patients. Twenty-five patients (11 male, 14 female) who selected BioEnterics intragastric balloon method for weight loss over surgery were included in the study. Their mean age was 35.2±13.4 and mean body mass index was 43.5±8.7 kg/m2. Patients who had any contraindication for endoscopic BioEnterics intragastric balloon placement were excluded. BioEnterics intragastric balloon was performed under deep sedation with propofol, and all patients were placed on a 1000 kcal/day diet for six months. Patients were reevaluated six months following balloon removal. Excess weight loss of greater than 25% was considered as end of treatment success. Maintenance of excess weight loss greater than 25% at the end of a six-month follow-up period was considered as long-term success. Results were reported as mean body mass index and mean %excess weight loss±SD. Statistical analysis was done using SPSS computer program. One patient was excluded from the study because of psychological intolerance (1/25) prompting early balloon removal. Twenty-four patients completed both the initial phase and the follow-up period. At the end of the initial six months, the mean body mass index was 35.7±4.6 kg/m2 and mean excess weight loss was 46.9±11.3%. Although 22 out of 24 patients (91.6%) had achieved end of treatment success, the mean body mass index was back to 41.9±7.7 kg/m2 at the end of the follow-up period. Only two patients were able to maintain excess weight loss of 25% at the completion of the study, resulting in a long-term success rate of 8.3%. BioEnterics intragastric balloon is a safe and effective but temporary

  16. The therapy of esophageal stricture caused by erosive through balloon dilation

    International Nuclear Information System (INIS)

    Li Yi; Zeng Xianqiang; Wang Rongqin; Ding Xiaolin; You Guoqing; Shao Hede; Zhang Xinyuan

    2004-01-01

    Objective: To evaluate the therapy of esophageal stricture caused by erosive burn of esophagus through balloon dilation. Methods: 9 patients of esophageal stricture caused by erosive burn of esophagus have been treated by balloon dilation. Results: 9 patients have been dilated 26 times altogether 7 of them can eat normally. 2 patients' symptoms were improved. Six months to two years after operation, the symptoms were not reoccurred. All of them have no serious complications. Conclusion: Balloon dilation is one of the effective and safe therapy of esophageal stricture caused by erosive burn. (authors)

  17. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette D

    2008-01-01

    Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months...... anymore, but use of these balloons for embolization of pulmonary arteriovenous malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing...

  18. SBARMO-79 a multi-balloon campaign in the auroral zone

    International Nuclear Information System (INIS)

    Tanskanen, P.; Kangas, J.; Bjordal, J.; Bronstad, K.; Block, L.P.; Holtet, T.

    1982-01-01

    A joint European International Magnetospheric Study (IMS) balloon campaign was conducted within the framework of the Scientific Ballooning and Radiation Monitoring Organization (SBARMO). The campaign was carried out during the time from May 30 to July 10, 1979. A total of 29 successful balloon launches were made from four launch sites located in Norway and in Finland. The campaign has the objective to provide information for a better understanding of temporal and spatial variations of magnetospheric processes, giving particular attention to the coupling between the magnetosphere and the ionosphere

  19. First-in-human experience using the Volcano VIBE-RX vascular imaging balloon catheter system (Volcano IVUS-guided Balloon Evaluation - New Zealand: VIBE-NZ Study).

    Science.gov (United States)

    Watson, Timothy; El-Jack, Seifeddin; Stewart, James T; Ormiston, John

    2013-09-01

    Intravascular ultrasound (IVUS) is a proven and safe imaging modality used to guide percutaneous coronary intervention (PCI). The Volcano VIBE™ RX Vascular Imaging Balloon Catheter is a novel rapid exchange, 0.014" wire-compatible multi-lumen conventional balloon catheter modified with the addition of an IVUS transducer proximal to the balloon, delivered via a standard 6 Fr sheath. We sought to evaluate the safety, balloon performance, and image quality of the VIBE™ RX in patients scheduled for coronary intervention. Patients aged >21 and <85 years with single or multivessel coronary disease scheduled for PCI due to coronary ischaemic symptoms were included. Those with angiographic features that precluded the safe or informative use of the device were excluded. Twenty-nine patients having angiography because of ischaemic symptoms underwent 44 VIBE RX imaging runs, with balloon dilation in 20. Successful device deployment was achieved in all but one patient. All images were adequate and reproducible. One patient had a non-ST-elevation MI felt to be due to the complexity of the procedure rather than directly related to the VIBE™ RX. The study demonstrated the safety and effectiveness of the VIBE™ RX for its intended purpose with minimal failure rate and no directly related complications.

  20. Percutaneous balloon pulmonary valvuloplasty: A modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy

    Directory of Open Access Journals (Sweden)

    Surender Deora

    2014-03-01

    Full Text Available Percutaneous balloon pulmonary valvuloplasty (BPV is the mainstay of treatment for significant pulmonary stenosis with doming leaflets. Various techniques have been described in the literature including the use of Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC catheter with standard 0.025″ guidewire. But if right ventricular anatomy is not suitable, 0.025″ guidewire doesn't provide enough support to track the Inoue PTMC catheter. Here, we report a case of successful BPV using a novel technique of slenderizing the Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC catheter over an Amplatz superstiff 0.035″ guidewire. This technique may be useful during BPV in difficult right ventricular inflow and outflow tract anatomy in patients with congenital pulmonary valve stenosis.

  1. Diagnostic yield of brush cytology for biliary stenosis during ERCP Rentabilidad diagnóstica de la citología por cepillado de las estenosis biliares durante la CPRE

    Directory of Open Access Journals (Sweden)

    R. Temiño López-Jurado

    2009-06-01

    Full Text Available Aim: to evaluate the diagnostic yield of brush cytology for biliary strictures detected on ERCP when a systematic approach is used. Patients and methods: data on 62 consecutive patients with a biliary stricture on ERCP were collected. Cytological samples were processed immediately after brushing in the endoscopy room, and all were analyzed by the same pathologist. For the statistical analysis specimens were classified as positive, negative, suspicious for malignancy (presence of atypias, and unsatisfactory for evaluation. Final diagnosis was based on either histopathologic (surgery or biopsies by other techniques or clinical/radiographic diagnosis. Results: a total of 71 cytological specimens were included. Definite diagnosis was malignancy in 49 samples, and benign stricture in 22. Three samples were excluded because of insufficient material or processing artifacts. The sensitivity of biliary brushing was 62% (95% CI 0.47-0.77, specificity was 100%, positive predictive value was 100%, and negative predictive value was 58% (95% CI 0.43-0.75. When suspicious samples were included as malignant, sensitivity was 67% (95% CI 0.54-0.81 without changes in the remaining parameters. Eight patients underwent more than one ERCP. Repeated brush cytology exams in these patients yielded a definitive diagnosis in every case. Conclusions: brush cytology has intermediate sensitivity with a high specificity. A systematic approach with a dedicated pathologist and the inclusion of significant atypias as malignant results improves sensitivity. Due to its simplicity brush cytology should be performed in all cases of biliary strictures detected on ERCP, and in case of repeated ERCPs additional cytology brushings are recommended.Objetivo: evaluar la rentabilidad de la citología por cepillado de las estenosis biliares diagnosticadas por CPRE cuando se aplica una metodología sistemática. Pacientes y métodos: se recogieron muestras de 62 pacientes consecutivos con

  2. Balloon-Borne Electric-Field Observations Relevant to Models for Sprites and Jets

    National Research Council Canada - National Science Library

    Beasley, William

    1999-01-01

    We designed and built a new balloon-borne electric-field-change instrument and launched five of them into thunderstorms to observe changes in the vertical component of electric field caused by lightning...

  3. Novel Ultralow-Weight Metal Rubber Sensor System for Ultra Long-Duration Scientific Balloons Project

    Data.gov (United States)

    National Aeronautics and Space Administration — NanoSonic proposes to develop an innovative, ultralow mass density, and non-intrusive sensor system for ultra long duration balloons that will operate in the most...

  4. The Balloon Experimental Twin Telescope for Infrared Interferometry : Returning to Flight

    Data.gov (United States)

    National Aeronautics and Space Administration — The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII) is an 8-meter far-infrared (30-90 micron) Michelson interferometer, designed to fly on a...

  5. Sub-Scale Re-entry Capsule Drop via High Altitude Balloons

    Data.gov (United States)

    National Aeronautics and Space Administration — The project objective is to develop and test a sub-scale version of the Maraia Entry Capsule on a high altitude balloon. The capsule is released at 100,000 ft. The...

  6. The prevention and management of complications during and immediately after percutaneous balloon mitral valvuloplasty

    International Nuclear Information System (INIS)

    Jiang Shiliang; Huang Lianjun; Xu Zhongying; Zhao Shihua; Zheng Hong; Ling Jian; Xie Ruolan; Dai Ruping

    2002-01-01

    Objective: To approach the cause and treatment of complication during and immediately after percutaneous balloon mitral valvuloplasty. Methods: One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results: The overall complications rate was 3.2% (42/1311) including atrial fibrillation 0.8% (10/1311), acute pericardial tamponade 0.31% (4/1311), severe mitral insufficiency 0.46% (6/1311), femoral arterial venous fistula 0.69% (9/1311), acute pulmonary edema and iatrogenic atrial septal defect 0.23% (3/1311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15% (2/1311) for every other one. Balloon rupture was 0.08%(1/1311). Conclusions: The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis

  7. Induced Radioactivity Measured in a Germanium Detector After a Long Duration Balloon Flight

    Science.gov (United States)

    Starr, R.; Evans, L. G.; Floyed, S. R.; Drake, D. M.; Feldman, W. C.; Squyres, S. W.; Rester, A. C.

    1997-01-01

    A 13-day long duration balloon flight carrying a germanium detector was flown from Williams Field, Antartica in December 1992. After recovery of the payload the activity induced in the detector was measured.

  8. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; de Groot, Gerrit H.

    2013-01-01

    Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion. Patients

  9. Double balloon esophageal catheter for diagnosis of tracheo-esophageal fistula

    International Nuclear Information System (INIS)

    Kiyan, Guersu; Dagli, Tolga E.; Tugtepe, Halil; Kodalli, Nihat

    2003-01-01

    Congenital H-type and recurrent tracheo-esophageal fistulas (TEF) are always difficult to diagnose. For a more accurate diagnosis we designed a new double balloon catheter, which is a modification of esophageal dilatation balloon. The catheter has two balloons to occlude the esophagus proximal and distal to the fistula. The fistula can be identified by passing of the contrast material to the tracheal tree, which was injected into the esophageal segment between the inflated balloons. To prove the efficiency of this catheter, a TEF was created surgically in a New Zealand rabbit. On the postoperative fourteenth day the catheter was tried and the fistula could be visualized easily by injecting the contrast material. We think this technique may be of use in the diagnosis of TEF in children. (orig.)

  10. Clinics in diagnostic imaging (165). Oesophageal rupture secondary to malposition of an SB tube gastric balloon.

    Science.gov (United States)

    Chan, Wan Ying; Cheong, Hsueh Wen; Tan, Tien Jin

    2016-02-01

    Oesophageal rupture is a life-threatening complication of balloon tamponade for bleeding oesophageal varices. We herein describe the clinical course and imaging findings in a 33-year-old Indian man who had a Sengstaken-Blakemore (SB) tube inserted for uncontrolled haematemesis, which was unfortunately complicated by malposition of the gastric balloon with resultant oesophageal rupture. The inflated SB tube gastric balloon was visualised within the right hemithorax on chest radiography after the SB tube insertion. Further evaluation of the thorax on computed tomography confirmed the diagnosis of oesophageal rupture associated with right-sided haemopneumothorax. It is crucial for both the referring clinician and reporting radiologist to recognise early the imaging features of an incorrectly positioned SB tube gastric balloon, so as to ensure prompt intervention and a reduction in patient morbidity and mortality. Copyright © Singapore Medical Association.

  11. Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Stensballe, Jakob; Albrechtsen, Charlotte K

    2013-01-01

    Objective. To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta. Design. Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample. S...

  12. Transcatheter pulmonary valve perforation and balloon dilatation in neonates with pulmonary atresia and intact ventricular septum

    NARCIS (Netherlands)

    Gerestein, C.G.; Berger, R.M.F.; Dalinghaus, M.; Bogers, A.J.J.C.; Witsenburg, M.

    2003-01-01

    BACKGROUND: Pulmonary atresia and intact ventricular septum is characterised by a great morphological variety. Treatment is not uniform. OBJECTIVE: To evaluate our experience with transcatheter valvotomy and balloon dilatation in neonates with pulmonary atresia and intact ventricular septum. DESIGN:

  13. Transthoracic ultrasound guided balloon dilation of cor triatriatum dexter in 2 Rottweiler puppies.

    Science.gov (United States)

    Birettoni, F; Caivano, D; Bufalari, A; Giorgi, M E; Miglio, A; Paradies, P; Porciello, F

    2016-12-01

    Balloon dilation was performed in two Rottweiler puppies with cor triatriatum dexter and clinical signs of ascites using transthoracic echocardiographic guidance. The dogs were positioned on a standard echocardiography table in right lateral recumbency, and guide wires and balloon catheters were imaged by echocardiographic views optimized to allow visualization of the defect. The procedures were performed successfully without complications and clinical signs were resolved completely in both cases. Guide wires and balloon catheters appeared hyperechoic on transthoracic echocardiography image and could be clearly monitored and guided in real-time. These two cases demonstrate that it is possible to perform balloon catheter dilation of cor triatriatum dexter under transthoracic guidance alone. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Demonstrating Classical Conditioning in Introductory Psychology: Needles Do Not Always Make Balloons Pop!

    Science.gov (United States)

    Vernoy, Mark W.

    1987-01-01

    Describes a method of teaching classical conditioning to an introductory psychology class which involves demonstrating the conditioned response that occurs when a needle pierces, but does not pop, a balloon. (GEA)

  15. Endoscopic balloon dilatation for Crohn's strictures of the gastrointestinal tract is feasible

    DEFF Research Database (Denmark)

    Karstensen, John Gásdal; Hendel, Jakob; Vilmann, Peter

    2012-01-01

    Despite optimized medical treatment, Crohn´s disease can cause gastrointestinal (GI) strictures, which requires surgical intervention. Lately, endoscopic balloon dilatation has been established as an alternative to surgery. In the following, we report our experiences with endoscopic dilatation...

  16. Refractivity Turbulence Observation Using a New Balloon-Ring Platform (Preprint)

    National Research Council Canada - National Science Library

    Eaton, Frank D; Kelly, Patrick R; Kyrazis, Demos T; Stokes, Sheldon S

    2002-01-01

    This paper presents new methodology to address critical refractivity turbulence issues for laser propagation using a new measurement system-a portable "balloon-ring" platform with multiple fine wire...

  17. Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Rygaard, Carsten

    1998-01-01

    OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure...... was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After...... in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium...

  18. Deflation of the ′obstinate′ Foley′s urinary catheter balloon : a new technique.

    Directory of Open Access Journals (Sweden)

    Ramakantan R

    1989-01-01

    Full Text Available We have successfully deflated "obstinate" Foley′s urinary catheter balloons in 15 cases in the last six months with the help of a simple bedside procedure using an angiographic guide-wire.

  19. Hardware, integration & support for the ASI BIRBA balloon campaigns since year 2000

    Science.gov (United States)

    Donati, A.; Petracchi, L.; Neri, G.; Zolesi, V.

    In the history of the space exploration, the stratospheric balloons have been among the first platforms used to carry out scientific experiments. The Italian Space Agency (ASI) has a long experience of missions with sounding balloons, managing the launch base of Trapani-Milo and executing launches over the Mediterranean sea with flight duration of about 24 hours. From year 2000 Kayser Italia (KI) have been commissioned by ASI to develop incubators for biology and physical science to be used for balloon missions, and to provide mission support during the balloon campaigns. On this basis KI developed the BIRBA incubator, that was used in four mission campaigns from 2000 to 2002. A large set of BIRBA incubators are currently available at ASI for carrying out new mission campaigns.

  20. Low Cost Variable Conductance Heat Pipe for Balloon Payload, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — While continuously increasing in complexity, the payloads of terrestrial high altitude balloons need a thermal management system to reject their waste heat and to...

  1. Private Pilot Practical Test Standards for Lighter-Than-Air Balloon, Airship

    Science.gov (United States)

    1996-06-01

    The Private Pilot - Lighter-Than-Air (Balloon and Airship) Practical Test Standards (PTS) book has been published by the Federal Aviation Administration (FAA) to establish the standards for private pilot certification practical tests for the lighter-...

  2. Predictors for outcome of failure of balloon dilatation in patients with achalasia

    NARCIS (Netherlands)

    J. Alderliesten (Joyce); J.M. Conchillo; I. Leeuwenburgh (Ivonne); E.W. Steyerberg (Ewout); E.J. Kuipers (Ernst)

    2011-01-01

    textabstractBackground: Pneumatic balloon dilatation (PD) is a regular treatment modality for achalasia. The reported success rates of PD vary. Recurrent symptoms often require repeated PD or surgery. Objective: To identify predicting factors for symptom recurrence requiring repeated treatment.

  3. Intracervical Foley balloon catheter for cervical ripening and labor induction: A review.

    Science.gov (United States)

    Greenberg, Victoria; Khalifeh, Adeeb

    2015-10-01

    Labor induction is a common obstetric practice. Optimal methods of both ripening and induction are debated. This article assesses the intracervical Foley balloon catheter through review of literature, including meta-analyses, randomized controlled trials, and retrospective data. Discussion includes comparison of Foley balloon catheters to pharmacologic agents, safety profile in various clinical scenarios, and cost-effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Environmental effects of the US Antarctic Program`s use of balloons in Antarctica

    Energy Technology Data Exchange (ETDEWEB)

    McCold, L.N.; Eddlemon, G.K.; Blasing, T.J.

    1995-06-01

    The USAP uses balloons in Antarctica to conduct scientific research, to facilitate safe air transport, and to provide data for global weather predictions. However, there is the possibility that balloons or their payloads may adversely affect Antarctic fauna or flora. The purpose of this study is to provide background information upon which the USAP may draw when complying with its responsibilities under the National Environmental Policy Act of 1969, the Antarctic Treaty, and the Madrid Protocol.

  5. Design of experiments and equipment to test the ballooning characteristics of CANDU pressure tubes

    International Nuclear Information System (INIS)

    Forrest, C.F.; Stern, F.; Hart, R.G.

    1992-01-01

    Experiments have been planned and an apparatus has been designed to enable creep testing of end-of-life pressure tube specimens in a LOCA environment. Effects that could be studied include: annealing of irradiation damage during transient heating; effects of hydride blisters on pressure tube ballooning strains; and, effects of uniformly-distributed hydrogen content on pressure tube ballooning strains. The proposed experimental program will consist of separate effects creep tests on pressure tube sections under transient heating conditions

  6. Potential of balloon payloads for in flight validation of direct and nulling interferometry concepts

    Science.gov (United States)

    Demangeon, Olivier; Ollivier, Marc; Le Duigou, Jean-Michel; Cassaing, Frédéric; Coudé du Foresto, Vincent; Mourard, Denis; Kern, Pierre; Lam Trong, Tien; Evrard, Jean; Absil, Olivier; Defrere, Denis; Lopez, Bruno

    2010-07-01

    While the question of low cost / low science precursors is raised to validate the concepts of direct and nulling interferometry space missions, balloon payloads offer a real opportunity thanks to their relatively low cost and reduced development plan. Taking into account the flight capabilities of various balloon types, we propose in this paper, several concepts of payloads associated to their flight plan. We also discuss the pros and cons of each concepts in terms of technological and science demonstration power.

  7. Stenting for curved lesions using a novel curved balloon: Preliminary experimental study.

    Science.gov (United States)

    Tomita, Hideshi; Higaki, Takashi; Kobayashi, Toshiki; Fujii, Takanari; Fujimoto, Kazuto

    2015-08-01

    Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curved fashion, stent and balloon assembly also rotated conjointly during expansion of its curved portion. In the primary stenting of the short stent, the stent was dilated with rotation of the curved portion. The excised stent conformed to the curved vessel. As the long stent could not be negotiated across the mid-portion with the balloon in expansion when it started curving, the mid-portion of the stent failed to expand fully. Furthermore, the balloon, which became entangled with the stent strut, could not be retrieved even after complete deflation. This novel curved balloon catheter might be used for implantation of the short stent in a curved lesion; however, it should not be used for primary stenting of the long stent. Post-dilation to conform the stent to the angled vessel would be safer than primary stenting irrespective of stent length. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  8. Balloon catheter versus basket catheter for endoscopic bile duct stone extraction: a multicenter randomized trial.

    Science.gov (United States)

    Ishiwatari, Hirotoshi; Kawakami, Hiroshi; Hisai, Hiroyuki; Yane, Kei; Onodera, Manabu; Eto, Kazunori; Haba, Shin; Okuda, Toshinori; Ihara, Hideyuki; Kukitsu, Takehiro; Matsumoto, Ryusuke; Kitaoka, Keisuke; Sonoda, Tomoko; Hayashi, Tsuyoshi

    2016-04-01

    Endoscopic bile duct stone (BDS) removal is a well-established treatment; however, the preference for basket or balloon catheters for extraction is operator-dependent. We therefore conducted a multicenter prospective randomized trial to compare catheter performance. We enrolled patients with a BDS diameter ≤ 10 mm and common bile duct diameter ≤ 15 mm. Participants were randomly assigned to groups that were treated with basket or balloon catheters between October 2013 and September 2014. The primary endpoint was the rate of complete clearance of the duct; the secondary endpoints were the rate and time to complete clearance in one endoscopic session. We initially enrolled 172 consecutive patients; 14 were excluded after randomization. The complete clearance rates were 92.3 % (72/78) in the balloon group and 80.0 % (64 /80) in the basket group. The difference in the rates between the two groups was 12.3 percentage points, indicating non-inferiority of the balloon method (non-inferiority limit -10 %; P < 0.001 for non-inferiority). Moreover, the balloon was superior to the basket (P = 0.037). The rate of complete clearance in one endoscopic session was 97.4 % using the balloon and 97.5 % using the basket (P = 1.00). The median times to complete clearance in one endoscopic session were 6.0 minutes (1 - 30) and 7.8 minutes (1 - 37) in the balloon and basket groups, respectively (P = 0.15). For extraction of BDSs ≤ 10 mm, complete endoscopic treatment with a single catheter is more likely when choosing a balloon catheter over a basket catheter.University Hospital Medical Information Network Trials Registry: UMIN000011887. © Georg Thieme Verlag KG Stuttgart · New York.

  9. [The Application of Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa].

    Science.gov (United States)

    Qi, Xiao-Rong; Liu, Xing-Hui; You, Yong; Wang, Xiao-Dong; Zhou, Rong; Xing, Ai-Yun; Zhang, Li; Ning, Gang; Zhao, Fu-Min; Li, Kai-Ming

    2016-07-01

    To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups. The balloon occlusion group had significantly less blood loss, the volume of transfused blood products, caesarean hysterectomy, hospital day after operation than the control group had. There was no statistical difference in operating time, intensive care units (ICU), hypotension, infection, hypoxemia, bladder injury, bowel obstruction, neonatal asphyxia between the two groups. The balloon occlusion group had significantly higher rate in coagulopathy, hypoalbuminemia, electrolyte imbalance. Among the patients whose uterus were preserved, the blood loss was not significantly difference between the two groups. Among the patients with the complication of placenta accreta, caesarean hysterectomy was less in balloon group, and blood loss between the two groups was not significantly different. Among the patients without placenta accrete, the blood loss was less in balloon group, and caesarean hysterectomy between the two groups was not significantly different. The risk of hysterectomy in balloon group was related to placenta accreta, uterine arteries engorgement, placental invasive serosa, taking placenta by hand, placental invasive bladder, barrel-shaped thickening of lower uterine segment, unable to remove placenta. Internal iliac artery balloon occlusion is an effective treatment for pernicious placenta previa.

  10. Comparative study of proliferation kinetics of paramecium tetraurelia aboard a satellite and a balloon flight

    International Nuclear Information System (INIS)

    Tixador, Rene; Richoilley, Gerard; Gasset, Gilbert; Planel, Hubert

    1982-01-01

    A possible effect of cosmic rays on cell proliferation was investigated in cultures of Paramecium tetraurelia during a stratospheric balloon flight, with the techniques already used for the CYTOS experiments, performed aboard the orbital station Salyut 6. The results show that the stimulating effect of space on cell proliferation, reported in the CYTOS experiments, also occurs in the balloon flight. The respective roles of cosmic rays and weightlesness in the biological responses are discussed [fr

  11. Bakri balloon as a uterus preserving treatment of uncontrollable haemorrhage one month post-partum

    DEFF Research Database (Denmark)

    Bonnici, Mia; Markauskas, Algirdas; Munk, Torben

    2014-01-01

    In this case Bakri balloon was used to stop haemorrhage one month post-partum. The case introduces the use of this device outside usual indications. A 27-year-old woman was admitted several times with vaginal bleeding after caesarean section. She was treated pharmacologically and with curettage....... One month post-partum hysteroscopic removal of placental tissue was done. During this uncontrollable haemorrhage occurred and hysterectomy was considered. An attempt to save the uterus with Bakri balloon was made succesfully....

  12. Measurements of Intra‐Aortic Balloon Wall Movement During Inflation and Deflation: Effects of Angulation

    Science.gov (United States)

    Bruti, Gianpaolo; Kolyva, Christina; Pepper, John R.

    2015-01-01

    Abstract The intra‐aortic balloon pump (IABP) is a ventricular assist device that is used with a broad range of pre‐, intra‐, and postoperative patients undergoing cardiac surgery. Although the clinical efficacy of the IABP is well documented, the question of reduced efficacy when patients are nursed in the semi‐recumbent position remains outstanding. The aim of the present work is therefore to investigate the underlying mechanics responsible for the loss of IABP performance when operated at an angle to the horizontal. Simultaneous recordings of balloon wall movement, providing an estimate of its diameter (D), and fluid pressure were taken at three sites along the intra‐aortic balloon (IAB) at 0 and 45°. Flow rate, used for the calculation of displaced volume, was also recorded distal to the tip of the balloon. An in vitro experimental setup was used, featuring physiological impedances on either side of the IAB ends. IAB inflation at an angle of 45° showed that D increases at the tip of the IAB first, presenting a resistance to the flow displaced away from the tip of the balloon. The duration of inflation decreased by 15.5%, the inflation pressure pulse decreased by 9.6%, and volume decreased by 2.5%. Similarly, changing the position of the balloon from 0 to 45°, the balloon deflation became slower by 35%, deflation pressure pulse decreased by 14.7%, and volume suctioned was decreased by 15.2%. IAB wall movement showed that operating at 45° results in slower deflation compared with 0°. Slow wall movement, and changes in inflation and deflation onsets, result in a decreased volume displacement and pressure pulse generation. Operating the balloon at an angle to the horizontal, which is the preferred nursing position in intensive care units, results in reduced IAB inflation and deflation performance, possibly compromising its clinical benefits. PMID:25959284

  13. Intraluminal pressure of uterine balloon tamponade in the management of severe post-partum hemorrhage.

    Science.gov (United States)

    Kong, Choi Wah; To, William W K

    2018-02-01

    Intrauterine balloon tamponade has been increasingly used for the management of post-partum hemorrhage (PPH) in recent years. However, data on the precise mechanisms and pressure required for the balloon tamponade are scanty in the literature. This study aims to review the intraluminal pressure (ILP) generated by the Bakri intrauterine balloon that is necessary to produce a 'positive tamponade test' during severe PPH. This was a prospective cohort study. The ILP of the Bakri balloon was measured using a manometer after a positive tamponade test was clinically achieved during severe PPH (blood loss >1 L). The patient's blood pressure was recorded, and ultrasound scan was performed to verify the position of the balloon and the presence of forward flow in the uterine arteries. The main outcome measure is the ILP of the Bakri balloon required to achieve a positive tamponade test. Twenty patients were included for final analysis. The net ILP measured ranged from 67 to 92 mmHg, and this pressure was lower than the concurrent systolic pressure in all cases. Color Doppler confirmed positive forward flow in the uterine vessels in all cases. There were no differences in the pressure measured with the balloon position, and there was no relationship between the volumes of saline infused and the net pressure. A positive tamponade test in an intrauterine balloon is probably achieved by local compression pressure exerted on the vasculature of the placental bed rather than by generating an ILP exceeding systemic blood pressure or by occlusion of flow to the uterine arteries. © 2018 Japan Society of Obstetrics and Gynecology.

  14. Successful Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varix Mainly Draining into the Pericardiophrenic Vein

    International Nuclear Information System (INIS)

    Kageyama, Ken; Nishida, N.; Matsui, H.; Yamamoto, A.; Nakamura, K.; Miki, Y.

    2012-01-01

    Two cases of gastric varices were treated by balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein at our hospital, and both were successful. One case developed left hydrothorax. Gastric varices did not bled and esophageal varices were not aggravated in both cases for 24–30 months thereafter. These outcomes indicate the feasibility of balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein.

  15. Geometrical improvements of rotational stabilization of high-n ballooning modes in tokamaks

    International Nuclear Information System (INIS)

    Furukawa, Masaru; Tokuda, S.

    2003-01-01

    We have found numerically that damping phases appear in the time evolution of the perturbation energy of high-n ballooning modes in the presence of toroidal shear flows. The damping dominates exponential growth which occurs in the bad curvature region, resulting in stabilization of ballooning modes. D-shaping of plasma cross-section, reduction of aspect ratio, and arrangement of X-point at inner side of the torus enhance the stabilization effect of the toroidal flow through this mechanism. (author)

  16. Development of a novel endorectal balloon for two-dimensional in-vivo rectal dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Kyung; Jeang, Eun Hee; Min, Soon Ki; Cho, Kwan Ho [National Cancer Center, Goyang (Korea, Republic of); Hwang, Ui Jung [National Medical Center, Seoul (Korea, Republic of); Choi, Sang Hyoun [Korea Cancer Center Hospital, Seoul (Korea, Republic of); Kwak, Jung Won [Asan Medical Center, Seoul (Korea, Republic of)

    2016-05-15

    In the present study, a new endorectal balloon equipped with radiochromic film was developed, and its dosimetric property was evaluated. A metal-oxide-semiconductor field-effect transistor (MOSFET) was used in a rectal balloon to measure the rectal dose in 3D-CRT and IMRT. Additionally, a thermoluminescent dosimeter (TLD) was attached directly onto the rectal balloon to measure the rectal dose in IMRT and proton therapy. However, in vivo dosimetry that uses such point dosimeters cannot provide 2D dose distribution in a rectal wall (RW). In order to obtain the 2D dose distribution in the rectal wall, a 2D dosimeter that incorporates radiosensitive film is required. A new endorectal balloon capable of 2D in vivo rectal dosimetry was developed. Unlike conventional ERBs, this 2DD-ERB was equipped with a radiosensitive film on the outside of the balloon to directly measure the 2D dose distribution delivered to the ARW by the treatment beam. The dosimetric properties of the 2DD-ERB were measured, and the results showed that the measured dose distributions agreed well with their respective treatment plans within 4%. The film-equipped endorectal balloon is expected to be used as an in vivo dosimeter for measuring the dose distribution in the rectal wall in the modern radiotherapy techniques, such as IMRT, VMAT, HT, and IMPT.

  17. Innovative technologies for SFA occlusions: drug coated balloons in SFA lesions.

    Science.gov (United States)

    Minar, E; Schillinger, M

    2012-08-01

    The concept of using a balloon catheter to directly deliver an antiproliferative drug at the site of injury has become one of the most interesting technological developments in endovascular therapy. There have been important advances in knowledge concerning balloon-based drug delivery technologies during the last years, and different methods have been developed by different companies to coat the balloon with the antiproliferative agent. Currently there is a rapidly increasing clinical study program using drug coated balloons (DCB) in different locations and indications. There are four already finished randomized studies in patients with superficial femoral artery lesions investigating the efficacy of paclitaxel release by DCB, and all demonstrated significantly improved patency rates compared to balloon angioplasty with non coated balloons. DCB offer several advantages compared to drug eluting stents, since any stentless technology for improvement of longterm patency is preferable to overcome the drawbacks of stenting. This technology has demonstrated the capacity to have a significant impact on the practice of percutaneous cardiovascular interventions in the future.

  18. Colchicine reduces restenosis after balloon angioplasty treatment for in-stent restenosis.

    Science.gov (United States)

    Kong, Junying; Deng, Ying; Dong, Qiang; Liu, Wenhua; Lu, Ying

    2015-02-01

    Treatment of coronary in-stent restenosis (ISR) is hampered by a high incidence of recurrent ISR. Colchicine is an old drug with known anti-inflammatory and antiproliferative actions. We evaluated the strategy of colchicine combined with conventional balloon angioplasty for the treatment of ISR. Sixty coronary arteries of 60 mini-pigs underwent oversized bare-metal stent implantation to induce ISR. After 28 days, vessels with ISR (≥50% diameter stenosis) were randomly divided into three groups: control (conventional balloon angioplasty combined with placebo), colchicine (conventional balloon angioplasty combined with colchicine) and drug-eluting balloon (DEB). Restenosis and neointima formation were elevated with angiography and histological and morphometric analysis at 28 days after different interventions. Late lumen loss and percent area stenosis at follow-up were lower in colchicine group compared to control group but were similar to those of DEB group. There was no significant difference in proliferating cell nuclear antigen-positive vascular smooth muscle cells and inflammatory score between the colchicine group and the DEB group. The efficacy of colchicine combined with conventional balloon angioplasty for treatment of ISR was comparable to that of DEB. Treatment of ISR might not require a second stent implantation, and colchicine combined with conventional balloon angioplasty seemed to be another consideration. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

  19. Significant skin burns may occur with the use of a water balloon in HIFU treatment

    Science.gov (United States)

    Ritchie, Robert; Collin, Jamie; Wu, Feng; Coussios, Constantin; Leslie, Tom; Cranston, David

    2012-10-01

    HIFU is a minimally-invasive therapy suitable for treating selected intra-abdominal tumors. Treatment is safe although skin burns may occur due to pre-focal heating. HIFU treatment of a renal transplant tumor located in the left lower abdomen was undertaken in our centre. Treatment was performed prone, requiring displacement of the abdominal wall away from the treatment field using a water balloon, constructed of natural rubber latex and filled with degassed water. Intra-operatively, ultrasound imaging and physical examination of the skin directly over the focal region was normal. Immediately post-operative, a full-thickness skin burn was evident at the periphery of the balloon location, outside the expected HIFU path. Three possibilities may account for this complication. Firstly, the water balloon may have acted as a lens, focusing the HIFU to a neo-focus off axis. Secondly, air bubbles may have been entrapped between the balloon and the skin, causing heating at the interface. Finally, heating of the isolated water within the balloon may have been sufficient to cause burning. In this case, the placement of a water balloon caused a significant skin burn. Care should be taken in their use as burns, situated off axis, may occur even if the overlying skin appears normal.

  20. Predictors of cardiogenic shock in cardiac surgery patients receiving intra-aortic balloon pumps.

    Science.gov (United States)

    Iyengar, Amit; Kwon, Oh Jin; Bailey, Katherine L; Ashfaq, Adeel; Abdelkarim, Ayman; Shemin, Richard J; Benharash, Peyman

    2018-02-01

    Cardiogenic shock after cardiac surgery leads to severely increased mortality. Intra-aortic balloon pumps may be used during the preoperative period to increase coronary perfusion. The purpose of this study was to characterize predictors of postoperative cardiogenic shock in cardiac surgery patients with and without intra-aortic balloon pumps support. We performed a retrospective analysis of our institutional database of the Society of Thoracic Surgeons for patients operated between January 2008 to July 2015. Multivariable logistic regression was used to model postoperative cardiogenic shock in both the intra-aortic balloon pumps and matched control cohorts. Overall, 4,741 cardiac surgery patients were identified during the study period, of whom 192 (4%) received a preoperative intra-aortic balloon pump. Intra-aortic balloon pumps patients had a greater prevalence of diabetes, previous cardiac surgery, congestive heart failure, and an urgent/emergent status (P pumps patients also had greater 30-day mortality and more postoperative cardiogenic shock (9% vs 3%, P pumps cohort, only sex, previous percutaneous coronary intervention and preoperative arrhythmia remained significant on multivariable analysis (all P pumps and those who do not. Further analysis of the effects of prophylactic intra-aortic balloon pumps support is warranted. (Surgery 2017;160:XXX-XXX.). Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A rectal balloon catheter as internal immobilization device for conformal radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Gerstner, N.; Wachter, S.; Dorner, D.; Goldner, G.; Colotto, A.; Poetter, R.

    1999-01-01

    Background: As known from the literature, prostate motion depends on different bladder and/or rectum fillings. The aim of this study was to analyze the influence of a rectum balloon catheter, used as an internal immobilization device, on prostate and rectum motion during the treatment course. Moreover we have analysed if the balloon enables an increase of the distance between the prostate and the posterior rectum wall. Results: An increase of the distance between the prostate and the posterior rectal wall of 8 mm was observed at the base of the prostate when using the rectum balloon. Moreover prostate motion in the ventrodorsal direction ≥4 mm (1 SD) was reduced from 6/10 patients (60%) to 1/10 patients (10%) using the rectal balloon. In general, deviations in the latero-lateral and cranio-caudal directions were less (mean ≤ 2 mm, 1 SD), no difference between both examination series (with and without balloon) was observed. Conclusion: Rectal balloon catheter offers a possibility to reduce prostate motion and rectum filling variations during treatment course. In addition it enables an increase in the distance between prostate and posterior rectal wall, which could enable an improved protection of the posterior rectal wall. (orig./AJ) [de

  2. Non-linear analysis and the design of Pumpkin Balloons: stress, stability and viscoelasticity

    Science.gov (United States)

    Rand, J. L.; Wakefield, D. S.

    Tensys have a long-established background in the shape generation and load analysis of architectural stressed membrane structures Founded upon their inTENS finite element analysis suite these activities have broadened to encompass lighter than air structures such as aerostats hybrid air-vehicles and stratospheric balloons Winzen Engineering couple many years of practical balloon design and fabrication experience with both academic and practical knowledge of the characterisation of the non-linear viscoelastic response of the polymeric films typically used for high-altitude scientific balloons Both companies have provided consulting services to the NASA Ultra Long Duration Balloon ULDB Program Early implementations of pumpkin balloons have shown problems of geometric instability characterised by improper deployment and these difficulties have been reproduced numerically using inTENS The solution lies in both the shapes of the membrane lobes and also the need to generate a biaxial stress field in order to mobilise in-plane shear stiffness Balloons undergo significant temperature and pressure variations in flight The different thermal characteristics between tendons and film can lead to significant meridional stress Fabrication tolerances can lead to significant local hoop stress concentrations particularly adjacent to the base and apex end fittings The non-linear viscoelastic response of the envelope film acts positively to help dissipate stress concentrations However creep over time may produce lobe geometry variations that may

  3. Clinical application of Inoue-balloon in percutaneous transluminal angioplasty for Budd-Chiari syndrome

    International Nuclear Information System (INIS)

    Mei Jian; Qu Jian; Zhu Yaoqing; Wang Lei; Liu Cheng

    2007-01-01

    Objective: To investigate the feasibility and effect of recanalization of inferior vena cava with percutaneous transluminal angioplasty(PTA)by Inoue-balloon. Methods: Eighty-nine patients with Budd-chiari syndrome (BCS )were treated with PTA by Inoue-balloon. Results: After PTA, the median (interquartile range)diameter of hepatic segment inferior vena cava increased from 0.00 (0.20-0.00) cm to 1.90 (2.00 1.47)cm; (P < 0.001), and the mean pressure of inferior vena cava reduced from (20.63 ± 7.22) mmHg to (12.13 ± 5.60) mmHg; (P < 0.001); with only less serious complications as rupture in two cases and without need of prior minor diameter balloon dilation in Inoue-balloon PTA. Conclusion: The advantages of Inoue- balloon PTA for BCS are more reliable and facile than those of polyethylene balloon, and may take the place in the foreseen future. (authors)

  4. The development of coastal diffusion observation method with a captive balloon

    International Nuclear Information System (INIS)

    Fukuda, Masaaki; Yamada, Masaharu

    1980-03-01

    Apparatus whereby the dye cloud in a coastal area in diffusion experiment can be photographed was developed. It consists of a vinyl balloon two meters in diameter, a photographic device with the camera shutter released by wireless signals from the ground, and a winch to raise or lower the balloon. A maximum height of the balloon for taking photographs is 1000 m. During the single balloon flight, thirty photographs can be taken. With the balloon at a certain height, dye as the tracer in diffusion experiment is released at sea surface or a certain sea depth by dye-throwing means or pump, and then taking the photographs is started. Movement and diffusion of the dye are analyzed by means of the photographs taken. The apparatus is simple in mechanism and easy to transport. Dye experiment is possible in the surfe zone where a boat cannot enter. It is impossible, however, to raise the balloon in strong wind or sea breeze. Typical results of the dye diffusion experiment with the apparatus are given. (author)

  5. The Balloon-borne Large Aperture Telescope for Polarization - BLASTPol

    Science.gov (United States)

    Devlin, Mark

    We are proposing a comprehensive program to study the link between Galactic magnetic fields and star formation. After decades of study, the physical processes regulating star formation still remain poorly understood. Large-scale observations of star forming regions provide counts of the number of dense clouds each of which will eventually evolve into tens to hundreds of stars. However, when simple models of gravitational collapse are applied to the clouds they yield a Galactic star formation rate (SFR) which is many times what is actually observed. Some process or combination of processes must be slowing the collapse of the clouds. The two prevailing theories involve turbulence which prevents the effective dissipation of energy and Galactic magnetic fields which are captured and squeezed by the collapsing cloud provide a mechanism for mechanical support. Understanding these effects fits very well the SMD 2010 Science Plan's Cosmic Origins program. The Balloon-borne Large Aperture Telescope - BLAST was originally designed to conduct confusion-limited and wide-area extragalactic and Galactic surveys at submillimeter wavelengths from a long-duration balloon (LDB) platform. These wavelengths are impossible or very difficult to observe from even the best groundbased telescope sites. After a series of successful flights (Ft. Sumner 2003, Sweden 2005, and Antarctica 2006) resulting in over 25 publications, BLAST was converted to BLASTPol. The combination of a polarizing grid in front of each of the 266 feed horns at 250, 350 and 500 micron with a stepped Half Wave Plate (HWP) provided a quick and inexpensive way to make initial measurements of polarized dust emission in star forming regions. By mapping polarization from dust grains aligned with respect to their local magnetic field, the field orientation (projected on the sky) can be traced. The development of the Next Generation BLASTPol instrument is now complete. It has increased spatial resolution (22 arcseconds at

  6. Arc-Second Pointer for Balloon-Borne Astronomical Instrument

    Science.gov (United States)

    Ward, Philip R.; DeWeese, Keith

    2004-01-01

    A control system has been designed to keep a balloon-borne scientific instrument pointed toward a celestial object within an angular error of the order of an arc second. The design is intended to be adaptable to a large range of instrument payloads. The initial payload to which the design nominally applies is considered to be a telescope, modeled as a simple thin-walled cylinder 24 ft (approx.= 7.3 m) long, 3 ft (approx.= 0.91 m) in diameter, weighing 1,500 lb (having a mass of .680 kg). The instrument would be mounted on a set of motor-driven gimbals in pitch-yaw configuration. The motors on the gimbals would apply the control torques needed for fine adjustments of the instrument in pitch and yaw. The pitch-yaw mount would, in turn, be suspended from a motor mount at the lower end of a pair of cables hanging down from the balloon (see figure). The motor in this mount would be used to effect coarse azimuth control of the pitch-yaw mount. A notable innovation incorporated in the design is a provision for keeping the gimbal bearings in constant motion. This innovation would eliminate the deleterious effects of static friction . something that must be done in order to achieve the desired arc-second precision. Another notable innovation is the use of linear accelerometers to provide feedback that would facilitate the early detection and counteraction of disturbance torques before they could integrate into significant angular-velocity and angular-position errors. The control software processing the sensor data would be capable of distinguishing between translational and rotational accelerations. The output of the accelerometers is combined with that of angular position and angular-velocity sensors into a proportional + integral + derivative + acceleration control law for the pitch and yaw torque motors. Preliminary calculations have shown that with appropriate gains, the power demand of the control system would be low enough to be satisfiable by means of storage

  7. Incremental balloon deflation following complete resuscitative endovascular balloon occlusion of the aorta results in steep inflection of flow and rapid reperfusion in a large animal model of hemorrhagic shock.

    Science.gov (United States)

    Davidson, Anders J; Russo, Rachel M; Ferencz, Sarah-Ashley E; Cannon, Jeremy W; Rasmussen, Todd E; Neff, Lucas P; Johnson, M Austin; Williams, Timothy K

    2017-07-01

    To avoid potential cardiovascular collapse after resuscitative endovascular balloon occlusion of the aorta (REBOA), current guidelines recommend methodically deflating the balloon for 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines. Eight Yorkshire-cross swine were splenectomized, instrumented, and subjected to rapid 25% total blood volume hemorrhage. After 30 minutes of shock, animals received 60 minutes of Zone 1 REBOA with a low-profile REBOA catheter. During subsequent resuscitation with shed blood, the aortic occlusion balloon was gradually deflated in stepwise fashion at the rate of 0.5 mL every 30 seconds until completely deflated. Aortic flow rate and proximal mean arterial pressure (MAP) were measured continuously over the period of balloon deflation. Graded balloon deflation resulted in variable initial return of aortic flow (median, 78 seconds; interquartile range [IQR], 68-105 seconds). A rapid increase in aortic flow during a single-balloon deflation step was observed in all animals (median, 819 mL/min; IQR, 664-1241 mL/min) and corresponded with an immediate decrease in proximal MAP (median, 30 mm Hg; IQR, 14.5-37 mm Hg). Total balloon volume and time to return of flow demonstrated no correlation (r = 0.016). This study is the first to characterize aortic flow during balloon deflation following REBOA. A steep inflection point occurs during balloon deflation that results in an abrupt increase in aortic flow and a concomitant decrease in MAP. Furthermore, the onset of distal aortic flow was inconsistent across study animals and did not correlate with initial balloon volume or relative deflation volume. Future studies to define the factors that affect aortic flow during balloon

  8. Intracervical Foley catheter balloon vs. prostaglandin in preinduction cervical ripening.

    Science.gov (United States)

    Niromanesh, S; Mosavi-Jarrahi, A; Samkhaniani, F

    2003-04-01

    The aim of this study is to compare the effectiveness of the intracervical Foley balloon catheter and 3 mg prostaglandin E(2) tablet(s) in preinduction cervical ripening. Ninety women referred to the maternity clinic for induction of labor with a Bishop score of less than or equal to 5 were randomized to receive an intracervical Foley catheter or prostaglandin E(2) tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. There were no differences in mean Bishop scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean+/-S.D.) after ripening were 6.6+/-0.80 and 6.7+/-0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The Foley catheter group showed a statistically shorter time to ripening compared with the prostaglandin group (3.4+/-2.1 and 6.5+/-3.2 h, respectively (P=0.001). There was no statistically significant difference in induction time (4.8+/-1.8 h and 5.3+/-2.4 h, respectively (P=0.36). There are no differences in preinduction cervical ripening efficacy between prostaglandin E(2) and the Foley catheter, but the Foley catheter has the advantage of ripening an unfavorable cervix in a shorter time.

  9. Assessing the Potential of Stratospheric Balloons for Planetary Science

    Science.gov (United States)

    Kremic, Tibor; Hibbitts, Karl; Young, Eliot; Landis, Robert; Noll, Keith; Baines, Kevin

    2013-01-01

    Recent developments in high altitude balloon platform capabilities, specifically long duration flights in excess of 50 days at over 100,000 ft and precision pointing with performance at the arc sec level or better have raised the question whether this platform can be utilized for high-value planetary science observations. In January of 2012 a workshop was held at NASA Glenn Research Center in Cleveland, Ohio to explore what planetary science can be achieved utilizing such a platform. Over 40 science concepts were identified by the scientists and engineers attending the workshop. Those ideas were captured and then posted to a public website for all interested planetary scientists to review and give their comments. The results of the workshop, and subsequent community review, have demonstrated that this platform appears to have potential for high-value science at very competitive costs. Given these positive results, the assessment process was extended to include 1) examining, in more detail, the requirements for the gondola platform and the mission scenarios 2) identifying technical challenges and 3) developing one or more platform concepts in enough fidelity to enable accurate estimating of development and mission costs. This paper provides a review of the assessment, a summary of the achievable science and the challenges to make that science a reality with this platform.

  10. Preliminary investigation of adjustable balloon implant for type I thyroplasty.

    Science.gov (United States)

    Hoffman, Matthew R; Witt, Rachel E; McCulloch, Timothy M; Jiang, Jack J

    2011-04-01

    We present the adjustable balloon implant (ABI), a novel implant to be used in type I thyroplasty for the treatment of vocal fold paralysis. The ABI offers the same medialization provided by other implants, but can easily be catered to individual patient anatomy as well as modified postoperatively without the need for a revision thyroplasty. Repeated measures with each larynx serving as its own control. Medialization thyroplasty (MT) with the ABI was performed on five excised canine larynges. Mucosal wave, aerodynamic, and acoustic parameters were measured for three conditions: normal; right vocal fold paralysis; and paralysis with the ABI. Insertion of the ABI resulted in significant decreases in both phonation threshold pressure and phonation threshold flow. Perturbation parameters of percent jitter and percent shimmer were also significantly decreased and restored to normal levels. Signal-to-noise ratio was significantly increased to the normal level as well. The mucosal wave was preserved after implant insertion. This preliminary experiment showing significant improvements in aerodynamic and acoustic parameters demonstrates the potential of the ABI as a thyroplasty implant. Effective medialization and preservation of the mucosal wave combined with postoperative adjustability makes it a potentially valuable clinical device. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc., Rhinological, and Otological Society, Inc.

  11. Malignant Arrhythmia in Apical Ballooning Syndrome: Risk Factors and Outcomes

    Directory of Open Access Journals (Sweden)

    Samuel J. Asirvatham

    2008-08-01

    Full Text Available Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS. Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group.Results: Out of 105 patients identified with ABS, 6 (5.7% women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole, 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis except for R-R interval variability (see comments below (30.6±6 vs 14.5±17 p = 0.0004, QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33% vs 80.6% p = 0.02. Conclusion: Life-threatening arrhythmia is uncommon (5.7% with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.

  12. Open-Access Single Balloon Enteroscopy: A Tertiary Care Experience.

    Science.gov (United States)

    Holman, Nathan; Wallace, Kristin; Moore, J Matthew; Brock, Andrew S

    2015-12-01

    To compare single balloon enteroscopy (SBE) between patients seen in consultation by a member of our gastroenterology team with those performed as open-access cases. Retrospective study of all patients who underwent SBE at a single tertiary care center from April 2008 to January 2012. Open- and closed-access procedures were compared in terms of diagnostic and therapeutic yield, adverse events, and procedural success. A total of 125 SBEs were performed on 125 patients. The mean age was 63.1 (53% men) years. In all, 43 procedures were performed open access and 82 after face-to-face consultation. Indications included anemia/gastrointestinal bleeding (110), abdominal pain (8), and other (7). Diagnostic yield for open- and closed-access procedures was 53% and 60%, respectively (P = 0.501) and therapeutic yield was 37% and 52%, respectively (P = 0.11). Overall technical success was 91% with no difference between the groups (P = 0.27). There were no major adverse events in either group. SBE can be performed as an open-access procedure without compromise to safety or diagnostic yield.

  13. DLR HABLEG- High Altitude Balloon Launched Experimental Glider

    Science.gov (United States)

    Wlach, S.; Schwarzbauch, M.; Laiacker, M.

    2015-09-01

    The group Flying Robots at the DLR Institute of Robotics and Mechatronics in Oberpfaffenhofen conducts research on solar powered high altitude aircrafts. Due to the high altitude and the almost infinite mission duration, these platforms are also denoted as High Altitude Pseudo-Satellites (HAPS). This paper highlights some aspects of the design, building, integration and testing of a flying experimental platform for high altitudes. This unmanned aircraft, with a wingspan of 3 m and a mass of less than 10 kg, is meant to be launched as a glider from a high altitude balloon in 20 km altitude and shall investigate technologies for future large HAPS platforms. The aerodynamic requirements for high altitude flight included the development of a launch method allowing for a safe transition to horizontal flight from free-fall with low control authority. Due to the harsh environmental conditions in the stratosphere, the integration of electronic components in the airframe is a major effort. For regulatory reasons a reliable and situation dependent flight termination system had to be implemented. In May 2015 a flight campaign was conducted. The mission was a full success demonstrating that stratospheric research flights are feasible with rather small aircrafts.

  14. Numerical modeling of the 2017 active seismic infrasound balloon experiment

    Science.gov (United States)

    Brissaud, Q.; Komjathy, A.; Garcia, R.; Cutts, J. A.; Pauken, M.; Krishnamoorthy, S.; Mimoun, D.; Jackson, J. M.; Lai, V. H.; Kedar, S.; Levillain, E.

    2017-12-01

    We have developed a numerical tool to propagate acoustic and gravity waves in a coupled solid-fluid medium with topography. It is a hybrid method between a continuous Galerkin and a discontinuous Galerkin method that accounts for non-linear atmospheric waves, visco-elastic waves and topography. We apply this method to a recent experiment that took place in the Nevada desert to study acoustic waves from seismic events. This experiment, developed by JPL and its partners, wants to demonstrate the viability of a new approach to probe seismic-induced acoustic waves from a balloon platform. To the best of our knowledge, this could be the only way, for planetary missions, to perform tomography when one faces challenging surface conditions, with high pressure and temperature (e.g. Venus), and thus when it is impossible to use conventional electronics routinely employed on Earth. To fully demonstrate the effectiveness of such a technique one should also be able to reconstruct the observed signals from numerical modeling. To model the seismic hammer experiment and the subsequent acoustic wave propagation, we rely on a subsurface seismic model constructed from the seismometers measurements during the 2017 Nevada experiment and an atmospheric model built from meteorological data. The source is considered as a Gaussian point source located at the surface. Comparison between the numerical modeling and the experimental data could help future mission designs and provide great insights into the planet's interior structure.

  15. Proliferation kinetics of paramecium tetraurelia in balloon-borne experiments

    International Nuclear Information System (INIS)

    Croute, F.; Soleilhavoup, J.P.; Vidal, S.; Rousseille, R.; Planel, H.

    1982-01-01

    Experiments were carried out to demonstrate the effect of cosmic radiation, at a balloon-flight ceiling of about 36,500 m (120,000 ft) on single-cell organism proliferation. Paramecium tetraurelia were placed in air-tight containers and maintained at 25 degrees +/- 0.1 degrees C. Cellular growth was determined by cell count, either after recovery or during the flight, by means of an automatic fixation device. Dosimetry was performed by a tissue equivalent proportional counter and was of about 0.5 mrad/h. Flight ceiling duration ranged from 48 min - 22 h. A secondary stimulating effect of growth rate, preceded by a temporary decrease, was observed after recovery. Because of the high bacterial concentration in the trans-Mediterranean flight culture medium, the temporary drop of the growth rate, due to the radiolysis products, disappears. Researchers consider that the stimulating effect can be the result of enzymatic intracellular scavenging of radiolysis products generated in the cell

  16. Resuscitative Endovascular Balloon Occlusion of the Aorta: Pushing Care Forward.

    Science.gov (United States)

    Teeter, William; Romagnoli, Anna; Glaser, Jacob; Fisher, Andrew D; Pasley, Jason; Scheele, Brian; Hoehn, Melanie; Brenner, Megan

    Resuscitative endovascular balloon occlusion of the aorta (REBOA), used to temporize noncompressible and junctional hemorrhage, may be deployable to the forward environment. Our hypothesis was that nonsurgeon physicians and high-level military medical technicians would be able to learn the theory and insertion of REBOA. US Army Special Operations Command medical personnel without prior endovascular experience were included. All participants received didactic instruction of the Basic Endovascular Skills for Trauma Course™ together, with individual evaluation of technical skills. A pretest and a posttest were administered to assess comprehension. Four members of US Army Special Operations Command-two nonsurgeon physicians, one physician assistant, and one Special Operations Combat Medic-were included. REBOA procedural times moving from trial 1 to trial 6 decreased significantly from 186 ± 18.7 seconds to 83 ± 10.3 seconds (ρ < .0001). All participants demonstrated safe REBOA insertion and verbalized the indications for REBOA insertion and removal through all trials. All five procedural tasks were performed correctly by each participant. Comprehension and knowledge between the pretest and posttest improved significantly from 67.6 ± 7.3% to 81.3 ± 8.1% (ρ = .039). This study demonstrates that nonsurgeon and nonphysician providers can learn the steps required for REBOA after arterial access is established. Although insertion is relatively straightforward, the inability to gain arterial access percutaneously is prohibitive in providers without a surgical skillset and should be the focus of further training. 2017.

  17. Nationwide network of total solar eclipse high altitude balloon flights

    Science.gov (United States)

    Des Jardins, A. C.

    2017-12-01

    Three years ago we envisioned tapping into the strength of the National Space Grant Program to make the most of a rare astronomical event to engage the general public through education and to create meaningful long-lasting partnerships with other private and public entities. We believe strongly in giving student participants career-making opportunities through the use of the most cutting edge tools, resources, and communication. The NASA Space Grant network was in a unique position to engage the public in the eclipse in an awe-inspiring and educational way at a surprisingly small cost. In addition to public engagement, the multidisciplinary project presented an in-depth hands-on learning opportunity for the thousands of student participants. The project used a network of high altitude ballooning teams positioned along the path of totality from Oregon to South Carolina to conduct coordinated collaborative activities during the eclipse. These activities included 1) capturing and streaming live video of the eclipse from near space, 2) partnering with NASA Ames on a space biology experiment, and 3) conducting high-resolution atmospheric radiosonde measurements. This presentation will summarize the challenges, results, lessons learned, and professional evaluation from developing, training, and coordinating the collaboration. Details of the live streaming HD video and radiosonde activities are described in separate submissions to this session.

  18. Balloon catheter dilatation for mitral stenosis and severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Wang Manhong

    2002-01-01

    Objective: To determine the safety and efficacy of percutaneous balloon mitral valvuloplasty (PBMV) for patients with mitral stenosis and severe pulmonary hypertension, and to assess the changes in pulmonary systolic pressure during follow-up. Methods: Forty-two patients with rheumatic mitral stenosis and severe pulmonary hypertension (pulmonary systolic pressure > 75 mmHg) underwent PBMV using standard Inoue technique, and the changes in clinical functional status and echo Doppler pulmonary systolic pressure during follow-up were assessed. Results: PBMV was successful in 39 patients. Immediately after the procedure, mitral valve area increased from (0.83 +- 0.12) cm 2 to (1.75 +- 0.11) cm 2 , pulmonary systolic pressure decreased from (85 +- 7) mmHg to (61 +- 13) mmHg (all P < 0.001). Severe mitral regurgitation occurred in 3 patients, one of whom underwent mitral valve replacement. During follow-up (average 6 months), in 39 patients with successful PBMV, the clinical functional status was improved and pulmonary systolic pressure was further decreased despite unchanged mitral valve area. Conclusions: PBMV was safe and effective for patients with mitral stenosis and severe pulmonary hypertension. Clinical functional status was improved and pulmonary systolic pressure was continuously decreased during the short-term follow-up

  19. Kinetic analysis of MHD ballooning modes in tokamaks

    International Nuclear Information System (INIS)

    Tang, W.M.; Rewoldt, G.; Cheng, C.Z.; Chance, M.S.

    1984-10-01

    A comprehensive analysis of the stability properties of the appropriate kinetically generalized form of MHD ballooning modes together with the usual trapped-particle drift modes is presented. The calculations are fully electromagnetic and include the complete dynamics associated with compressional ion acoustic waves. Trapped-particle effects along with all forms of collisionless dissipation are taken into account without approximations. The influence of collisions is estimated with a model Krook operator. Results from the application of this analysis to realistic tokamak operating conditions indicate that unstable short-wavelength modes with significant growth rates can extend from β = 0 to value above the upper ideal-MHD-critical-beta associated with the so-called second stability regime. Since the strength of the relevant modes appears to vary gradually with β, these results support a soft beta limit picture involving a continuous (rather than abrupt or hard) modification of anomalous transport already present in low-β-tokamaks. However, at higher beta the increasing dominance of the electromagnetic component of the perturbations indicated by these calculations could also imply significantly different transport scaling properties

  20. Infrared spectroscopy with a balloon borne Michelson interferometer. Pt. 2

    International Nuclear Information System (INIS)

    Moorwood, A.F.M.; Salinari, P.; Furniss, I.; Jennings, R.E.; King, K.J.

    1980-01-01

    Observations of the [O III] ionic fine structure lines at 52 μm and 88 μm, made at a resolution of 0.05 cm -1 with a balloon borne telescope and Michelson interferometer, are presented for the H II regions W 51, G33.6-0.2. M 17 S, M 17 N, NGC 6357, and NGC 6334. This is the first time that both [O III] lines have been measured simultaneously. Values for the electron density deduced from the line ratios are found to agree with the radio data, while the O ++ abundances indicate a lower excitation than expected in many cases. The [O I] line at 63 μm was also detected in NGC 6357. In addition, we report the first detection of the [N III] line at 57 μm which was observed from both sources in M 17 and gives the abundance ratio N/O = 0.13. This line was also marginally detected on W 51. (orig.)

  1. Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Yamagami, Takuji, E-mail: yamagami@kochi-u.ac.jp [Kochi University, Department of Radiology (Japan); Ishikawa, Masaki; Kajiwara, Kenji [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Aikata, Hiroshi; Chayama, Kazuaki [Hiroshima University, Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences (Japan); Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan)

    2016-06-15

    PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumor enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter; p = 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.

  2. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

    NARCIS (Netherlands)

    Grundeken, Maik J.; Lesiak, Maciej; Asgedom, Solomon; Garcia, Eulogio; Bethencourt, Armando; Norell, Michael S.; Damman, Peter; Woudstra, Pier; Koch, Karel T.; Vis, M. Marije; Henriques, Jose P.; Tijssen, Jan G.; Onuma, Yoshinobu; Foley, David P.; Bartorelli, Antonio L.; Stella, Pieter R.; de Winter, Robbert J.; Wykrzykowska, Joanna J.

    2014-01-01

    We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Clinical outcomes were defined as

  3. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

    NARCIS (Netherlands)

    M.J. Grundeken (Maik); M. Lesiak (MacIej); S. Asgedom (Solomon); E. Garcia (Eulogio); A. Bethencourt (Armando); M.S. Norell (Michael); K. Damman (Kevin); E. Woudstra (Evert); K. Koch (Karel); M.M. Vis (Marije); J.P.S. Henriques (Jose); J.G.P. Tijssen (Jan); Y. Onuma (Yoshinobu); D.P. Foley (David); A. Bartorelli (Antonio); P.R. Stella (Pieter); R.J. de Winter (Robbert); J.J. Wykrzykowska (Joanna)

    2014-01-01

    textabstractObjective We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Methods Clinical

  4. The Evaluation of Endoscopic Balloon Dilation Treatment for Benign Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    J Sokri Shirvani

    2012-05-01

    Full Text Available

    Background and Objective

    Balloon dilatation of stricture is one of the new treatment methods for patients with Gastric Outlet Obstruction (GOO. Prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that could affect method advantage among patients with benign etiology for GOO.

     

    Methods

     Forty-five patients with symptoms of benign GOO were randomly selected. The mean age of patients was 43.7±18.1 years and 86.7% of them were men. Gastric outlet was delineated using double channel videoendoscopy. The severity of gastric pain was measured by VAS test immediately before and one month after balloon dilatation. Patients were followed after procedure weekly (for the first month and then monthly. Balloon dilatation was repeated for 27% patients during the follow up period.

     

    Results

    Patients were followed for 9.9±5.8 months. Furthermore, 71.1% were H. pylori positive. Positive response percent to endoscopic balloon dilatation was 80% and eight patients were took under surgical resection. Weight loss was seen frequently in the non-respondent group. The pain severity was significantly reduced in respondent subjects. No meaningful correlations were found between the response to balloon dilatation and positive H. pylori and cigarette smoking.

     

    Conclusion

    Endoscopic balloon dilatation is a safe and effective method for treating most of patients with benign gastric outlet obstruction and has favorable long-term outcome. 

  5. Application of new balloon catheters in the treatment of congenital heart defects

    Directory of Open Access Journals (Sweden)

    Roland Fiszer

    2016-08-01

    Full Text Available Introduction : Balloon angioplasty (BAP and aortic or pulmonary balloon valvuloplasty (BAV, BPV are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice. Aim: To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland launched and developed. These catheters have not been clinically evaluated yet. Material and methods: We performed 64 interventions with Valver I and Valver II. With Valver I the following procedures were performed: 17 BPV (including 9 in tetralogy of Fallot – TOF, 10 BAV and 27 BAP in coarctations of the aorta (CoA – including 9 native and 18 after surgery. With Valver II ten interventions were done – 3 BPV, 2 pulmonary supravalvular BAP (after switch operations, 2 BAP of recoarctations and 3 other BAP. Age of the patients ranged from a few days to 40 years. Results: All procedures were completed successfully, without rupture of any balloon catheters. The pressure gradient drop was statistically significant in all groups: BPV in isolated pulmonary valvular stenosis 28.1 mm Hg (mean, BPV in TOF 18.7 mm Hg, BAV 32.8 mm Hg, BAP in native CoA 15.4 mm Hg and in recoarctations 18.6 mm Hg. In 3 cases during rapid deflation of Valver I, wrinkles of the balloons made it impossible to insert the whole balloon into the vascular sheath (all were removed surgically from the groin. No such complication occured with Valver II. Conclusions : Valver balloon catheters are an effective treatment modality in different valvular and vascular stenoses.

  6. The Renaissance of Transcervical Balloon Catheters for Cervical Ripening and Labour Induction.

    Science.gov (United States)

    Rath, W; Kehl, S

    2015-11-01

    Due to rising rates of labour induction in industrialised countries, safe and effective methods of induction have once again become a focus of interest and research. Prostaglandins are effective for cervical ripening and induction of uterine contractions. They do, however, cause overstimulation of the uterus in up to 20 % of cases, sometimes causing changes in fetal heart rate. Transcervical balloon catheters provide an alternative to prostaglandins for labour induction and have been used for this purpose for almost 50 years. This induction method has experienced a recent renaissance in clinical practice that is reflected in an annually rising number of publications on its use. Balloon catheters allow gentle ripening of the cervix without causing uterine overstimulation. The two catheters available are the Foley catheter (off-label use) and the double balloon catheter, which is licensed for use in induction of labour. Both are as effective as prostaglandins, and do not increase the risk of infection to mother or child. Catheter induction also requires less monitoring compared to prostaglandins resulting in improved patient satisfaction. Balloon catheters provide a useful and promising option to achieve vaginal delivery despite failed prostaglandin induction. Intravenous oxytocin is nevertheless required in up to 85 % of cases for adequate induction/augmentation of contractions. Balloon catheters, vaginal PGE 2 and misoprostol are equally effective in the context of an unripe/unfavourable cervix, the rate of uterine hyperstimulation being significantly lower, and the need for oxytocin significantly higher for catheters. Balloon catheters are increasingly being used in combination or sequentially with oral/vaginal misoprostol, although there is currently inadequate published data on the subject. International guidelines recommend the use of balloon catheters for labour induction with an unripe cervix (also following previous caesarean section) as an alternative

  7. Modeling the ascent of sounding balloons: derivation of the vertical air motion

    Directory of Open Access Journals (Sweden)

    A. Gallice

    2011-10-01

    Full Text Available A new model to describe the ascent of sounding balloons in the troposphere and lower stratosphere (up to ∼30–35 km altitude is presented. Contrary to previous models, detailed account is taken of both the variation of the drag coefficient with altitude and the heat imbalance between the balloon and the atmosphere. To compensate for the lack of data on the drag coefficient of sounding balloons, a reference curve for the relationship between drag coefficient and Reynolds number is derived from a dataset of flights launched during the Lindenberg Upper Air Methods Intercomparisons (LUAMI campaign. The transfer of heat from the surrounding air into the balloon is accounted for by solving the radial heat diffusion equation inside the balloon. In its present state, the model does not account for solar radiation, i.e. it is only able to describe the ascent of balloons during the night. It could however be adapted to also represent daytime soundings, with solar radiation modeled as a diffusive process. The potential applications of the model include the forecast of the trajectory of sounding balloons, which can be used to increase the accuracy of the match technique, and the derivation of the air vertical velocity. The latter is obtained by subtracting the ascent rate of the balloon in still air calculated by the model from the actual ascent rate. This technique is shown to provide an approximation for the vertical air motion with an uncertainty error of 0.5 m s−1 in the troposphere and 0.2 m s−1 in the stratosphere. An example of extraction of the air vertical velocity is provided in this paper. We show that the air vertical velocities derived from the balloon soundings in this paper are in general agreement with small-scale atmospheric velocity fluctuations related to gravity waves, mechanical turbulence, or other small-scale air motions measured during the SUCCESS campaign (Subsonic Aircraft: Contrail and Cloud Effects

  8. A semi-automatic parachute separation system for balloon payloads

    Science.gov (United States)

    Farman, M.

    At the National Scientific balloon Facility (NSBF), when operating stratospheric balloons with scientific payloads, the current practice for separating the payload from the parachute after descent requires the sending of commands, over a UHF uplink, from the chase airplane or the ground control site. While this generally works well, there have been occasions when, due to shadowing of the receive antenna or unfavorable aircraft attitude, the command has not been received and the parachute has failed to separate. In these circumstances the payload may be dragged for long distances before being recovered, with consequent danger of damage to expensive and sometimes irreplaceable scientific instrumentation. The NSBF has therefore proposed a system which would automatically separate the parachute without the necessity for commanding after touchdown. Such a system is now under development.. Mechanical automatic release systems have been tried in the past with only limited success. The current design uses an electronic system based on a tilt sensor which measures the angle that the suspension train subtends relative to the gravity vector. With the suspension vertical, there is minimum output from the sensor. When the payload touches down, the parachute tilts and in any tilt direction the sensor output increases until a predetermined threshold is reached. At this point, a threshold detector is activated which fires the pyrotechnic cutter to release the parachute. The threshold level is adjustable prior to the flight to enable the optimum tilt angle to be determined from flight experience. The system will not operate until armed by command. This command is sent during the descent when communication with the on-board systems is still normally reliable. A safety interlock is included to inhibit arming if the threshold is already high at the time the command is sent. While this is intended to be the primary system, the manual option would be retained as a back- up. A market

  9. [Endometrial ablation with thermal balloon, experience in a private hospital].

    Science.gov (United States)

    Quesnel-García-Benítez, C; Sánchez-Aranda, A; López-Rioja, M J

    2016-04-01

    Traditionally, the treatment for menorrhagia includes pharmacological therapies (hormones and uterotonics) or surgical (dilatation/curettage and hysterectomy). Recently the FDA approved a non-invasive therapeutic option, known as endometrial ablation. Which it consists in a thermal balloon delivers (ThermaChoice y Thermablate EAS) which energy destroys the uterine lining, thus reducing the bleeding and even producing amenorrhea. And could offer other benefits such as reduction of the surgical time, and therefore: anesthesia time, postoperative complications and costs. Highlighting a greater patient satisfaction. Describe the demographic characteristics, outcomes and patient satisfaction, which were treated with endometrial ablation for menorrhagia. A descriptive, observational and retrospective study. During a period of 11 years (March 2012 to December 2013), in a private hospital, that includes 124 patients with menorrhagia, which were treated with endometrial ablation: 53 (43%) ThermaChoice y 71 (57%) Thermablate EAS. We used T Student and Fisher method to study the results. The 124 patients (100%) achieve all the criteria's of endometrial ablation according ACOG (American College of Obstetricians and Gynecologists) were candidates for. The mean age of our patients were 38 years old, who didn't respond to pharmacologic treatment had a definitive contraception. Among these women, 119 (96%) had a reduction in bleeding en the first 12 months, 25 (31%) presented with amenorrhea and 1 (<1%) required a surgical approach. Overall, 119 patients (96%) were satisfied with their results. Endometrial ablation is an approved FDA treatment for menorrhagia, which is safe, accessible and effective. With an easy implementation and low rate of complications.

  10. Learning curve, diagnostic yield and safety of single balloon enteroscopy.

    Science.gov (United States)

    Dutta, Amit Kumar; Sajith, Kattiparambil Gangadharan; Joseph, Anjilivelil J; Simon, Ebby George; Chacko, Ashok

    2012-01-01

    Single balloon enteroscopy (SBE) is a recently developed diagnostic modality to assess small bowel mucosa. The data on learning curve of SBE is scanty. We aimed to assess the learning curve, diagnostic yield and safety of SBE. All patients who underwent SBE at our centre from December 2007 to December 2010 were included retrospectively. The clinical details, enteroscopy findings and procedure related details were obtained for each patient from a prospectively maintained database. The extent of small bowel visualised with increasing number of procedures by a single endoscopist (Endoscopist A) who performed most of the procedures was used to estimate the learning curve using locally weighted regression curve. The diagnostic yield and complications rates of SBE were also estimated. The study was approved by the institute review board and ethics committee. Ninety SBEs were performed in 84 patients (age: 42+15 years, 27.4% females). 57 procedures were performed (32 antegrade and 25 retrograde) by endoscopist A. There was gradual improvement in the extent of small bowel visualised during the first 15 procedures via antegrade route followed by flattening of curve. The retrograde route showed no definite trend towards improvement during the procedures performed. The overall diagnostic yield of SBE was 32.1%. There was no complication except for mild self-limiting abdominal pain in one patient. SBE via antegrade route has a higher success rate and better learning curve than the retrograde route. SBE is a safe procedure and helps in establishing a diagnosis in one-third of the patients examined.

  11. Late complications of percutaneous tracheostomy using the balloon dilation technique.

    Science.gov (United States)

    Araujo, J B; Añón, J M; García de Lorenzo, A; García-Fernandez, A M; Esparcia, M; Adán, J; Relanzon, S; Quiles, D; de Paz, V; Molina, A

    2018-04-01

    The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. A prospective, observational cohort study was carried out. Two medical-surgical intensive care units (ICU). All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy. All patients underwent PT according to the Ciaglia Blue Dolphin ® method, with endoscopic guidance. Survivors were interviewed and evaluated by fiberoptic laryngotracheoscopy and tracheal computed tomography at least 6 months after decannulation. Intraoperative, postoperative and long-term complications and mortality (in-ICU, in-hospital) were recorded. A total of 114 patients were included. The most frequent perioperative complication was minor bleeding (n=20) and difficult cannula insertion (n=19). Two patients had severe perioperative complications (1.7%) (major bleeding and inability to complete de procedure in one case and false passage and desaturation in the other). All survivors (n=52) were evaluated 211±28 days after decannulation. None of the patients had symptoms. Fiberoptic laryngotracheoscopy and computed tomography showed severe tracheal stenosis (>50%) in 2patients (3.7%), both with a cannulation period of over 100 days. Percutaneous tracheostomy using the Ciaglia Blue Dolphin ® technique with an endoscopic guide is a safe procedure. Severe tracheal stenosis is a late complication which although infrequent, must be taken into account due to its lack of clinical expressiveness. Evaluation should be considered in those tracheostomized critical patients who have been cannulated for a long time. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  12. Material Properties Analysis of Structural Members in Pumpkin Balloons

    Science.gov (United States)

    Sterling, W. J.

    2003-01-01

    The efficient design, service-life qualification, and reliability predictions for lightweight aerospace structures require careful mechanical properties analysis of candidate structural materials. The demand for high-quality laboratory data is particularly acute when the candidate material or the structural design has little history. The pumpkin-shaped super-pressure balloon presents both challenges. Its design utilizes load members (tendons) extending from apex to base around the gas envelope to achieve a lightweight structure. The candidate tendon material is highly weight-efficient braided HM cord. Previous mechanical properties studies of Zylon have focused on fiber and yarn, and industrial use of the material in tensile applications is limited. For high-performance polymers, a carefully plamed and executed properties analysis scheme is required to ensure the data are relevant to the desired application. Because no directly-applicable testing standard was available, a protocol was developed based on guidelines fiom professional and industry organizations. Due to the liquid-crystalline nature of the polymer, the cord is very stiff, creeps very little, and does not yield. Therefore, the key material property for this application is the breaking strength. The pretension load and gauge length were found to have negligible effect on the measured breaking strength over the ranges investigated. Strain rate was found to have no effect on breaking strength, within the range of rates suggested by the standards organizations. However, at the lower rate more similar to ULDB operations, the strength was reduced. The breaking strength increased when the experiment temperature was decreased from ambient to 183K which is the lowest temperature ULDB is expected to experience. The measured strength under all test conditions was well below that resulting from direct scale-up of fiber strength based on the manufacturers data. This expected result is due to the effects of the

  13. Refracture of osteoporotic vertebral body after treatment by balloon kyphoplasty

    Science.gov (United States)

    Li, Xigong; Lu, Yang; Lin, Xiangjin

    2017-01-01

    Abstract Rationale: Balloon kyphoplasty is a widely accepted treatment of osteoporotic vertebral compression fractures (OVCFs) with good results and a low risk for complications. A refracture of previously treated vertebra is a relatively rare condition. Patient concerns: We reported our 3 cases and reviewed all relevant literatures of 11 cases with refracture of osteoporotic vertebral body after kyphoplasty. Diagnoses: Follow-up radiographs or magnetic resonance imaging examination confirmed refractures of previously treated vertebrae after kyphoplasty. Interventions: One patient with 1 refracture of osteoporotic vertebral body after kyphoplasty was treated conservatively, but the other 2 patients were treated surgically because of multiple vertebral fractures or neurological deficits. Outcomes: The average age of the patients was 76.8 years (range, 63–86 years). All the patients had severe osteoporosis with a mean T-score of −3.46 (range −5.0 to −3.0). The sites of refractures are in the lumbar and thoracolumbar regions. Severe osteoporosis, the presence of intravertebral cleft, and a solid lump injection pattern of polymethylmethacrylate would result in insufficient strengthening effects of cement augmentation and therefore increased the likelihood of refractures of the kyphoplasty vertibrae. Lessons: Patients with OVCFs and intravertebral cleft who did not obtain complete pain-relief at the treated vertebral level after kyphoplasty should be strictly followed up. Early finding of this condition and rapid intervention might contribute to avoiding the occurrence of the cemented vertebral refracture after kyphoplasty. Conservative treatments such as back brace and antiosteoporotic medications were strongly recommended. PMID:29245267

  14. Balloon Dilatation of Pediatric Subglottic Laryngeal Stenosis during the Artificial Apneic Pause: Experience in 5 Children

    Directory of Open Access Journals (Sweden)

    J. Lisý

    2014-01-01

    Full Text Available Introduction. Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. Patients and Methods. The authors performed balloon dilatation of subglottic laryngeal strictures (SGS in 5 children (3 girls and 2 boys without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. Results. The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%. Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. Conclusion. Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.

  15. Combined CT and fluoroscopic guidance of balloon kyphoplasty versus fluoroscopy-only procedures

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas; Marcy, Pierre-Yves; Lesbats-Jacquot, Virginie; Fonquerne, Marie-Eve; Hericord, Olivier; Maratos, Yvonne [Centre Hospitalier Universitaire de Nice, Service de Radiologie, Nice (France); Hovorka, Istvan [Centre Hospitalier Universitaire de Nice, Spine Surgery Department, Nice (France); Roux, Christian; Euller-Ziegler, Liana [Centre Hospitalier Universitaire de Nice, Rheumatology Department, Nice (France)

    2009-07-15

    To evaluate the performance of combined (computed tomography (CT) and fluoroscopic) guidance of balloon kyphoplasty in comparison to fluoroscopic guidance alone. Forty-one kyphoplasties were performed between January 2005 and March 2006 according to two different protocols. Study group 1 consisted of 20 consecutive patients with 20 balloon kyphoplasty procedures under dual guidance (CT scan and fluoroscopy) for osteoporotic or traumatic vertebral fractures. Study group 2 consisted of 21 consecutive patients in whom kyphoplasty was performed with fluoroscopy alone. Visualization of the pedicles, the final of the balloon position, and cement distribution were evaluated(1 - poor, 2 - intermediate, 3 - good). Combined use of CT and fluoroscopy (group 1) was superior in identifying the pedicles (100% versus 66.7%, p = 0.009) and balloon placement (100% versus 71.4%, p = 0.02) but not in monitoring of cement distribution within the vertebral body (100% versus 90.5%, p = 0.49). The difference between the two groups was more pronounced in the thoracic spine than in the lumbar spine. CT/fluoroscopic guidance of kyphoplasty combines safe CT-guided insertion of the osteointroducers and balloons as well as fluoroscopic real-time monitoring of polymethylmethacrylate injection. (orig.)

  16. Efficacy of balloon temporary occlusion and intraoperative DSA in surgically difficult aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Ezura, Masayuki; Mizoi, Kazuo; Yoshimoto, Takashi (Tohoku Univ., Sendai (Japan). Inst. of Brain Diseases); Takahashi, Akira

    1993-11-01

    A digital subtraction angiographic (DSA) apparatus has been installed in one of our operating rooms since April 1987. We performed intraoperative DSA in 42 aneurysmal surgeries in 38 patients and balloon temporary occlusion in 33 surgeries. The aneurysm was on an internal carotid artery in 26 cases and on the vertebro-basilar system in 16. A heparin-coated catheter (Anthron, Toray, Tokyo), 6 french in diameter, was inserted transfemorally and was put in a parent artery under general anesthesia. A balloon was temporarily inflated to determine inflation volume. The balloon catheter was soon deflated and was drawn back into the introducing catheter to avoid developing microembolus. The patients were not systemically heparinized but the introducing catheters were slowly flushed with heparinized saline during operation. Then a craniotomy was carried out. Next DSA was performed when temporary occlusion or confirmation of clipping was necessary. In cases of balloon temporary occlusion, the operating field was not obstructed as it is when a temporary clip is used, despite adequate flow reduction of the parent artery. After DSA for confirmation of clipping adjustment of it was performed in 12 cases out of 42. No complications occurred due to use of an introducing or a balloon catheter. We conclude that combined intravascular and neurosurgical approach, particularly for the large aneurysms with the difficulty of proximal control, can be a useful method of treatment. (author).

  17. Efficacy of balloon temporary occlusion and intraoperative DSA in surgically difficult aneurysm

    International Nuclear Information System (INIS)

    Ezura, Masayuki; Mizoi, Kazuo; Yoshimoto, Takashi; Takahashi, Akira.

    1993-01-01

    A digital subtraction angiographic (DSA) apparatus has been installed in one of our operating rooms since April 1987. We performed intraoperative DSA in 42 aneurysmal surgeries in 38 patients and balloon temporary occlusion in 33 surgeries. The aneurysm was on an internal carotid artery in 26 cases and on the vertebro-basilar system in 16. A heparin-coated catheter (Anthron, Toray, Tokyo), 6 french in diameter, was inserted transfemorally and was put in a parent artery under general anesthesia. A balloon was temporarily inflated to determine inflation volume. The balloon catheter was soon deflated and was drawn back into the introducing catheter to avoid developing microembolus. The patients were not systemically heparinized but the introducing catheters were slowly flushed with heparinized saline during operation. Then a craniotomy was carried out. Next DSA was performed when temporary occlusion or confirmation of clipping was necessary. In cases of balloon temporary occlusion, the operating field was not obstructed as it is when a temporary clip is used, despite adequate flow reduction of the parent artery. After DSA for confirmation of clipping adjustment of it was performed in 12 cases out of 42. No complications occurred due to use of an introducing or a balloon catheter. We conclude that combined intravascular and neurosurgical approach, particularly for the large aneurysms with the difficulty of proximal control, can be a useful method of treatment. (author)

  18. Anderson localization of ballooning modes, quantum chaos and the stability of compact quasiaxially symmetric stellarators

    International Nuclear Information System (INIS)

    Redi, M.H.; Johnson, J.L.; Klasky, S.; Canik, J.; Dewar, R.L.; Cooper, W.A.

    2002-01-01

    The radially local magnetohydrodynamic (MHD) ballooning stability of a compact, quasiaxially symmetric stellarator (QAS), is examined just above the ballooning beta limit with a method that can lead to estimates of global stability. Here MHD stability is analyzed through the calculation and examination of the ballooning mode eigenvalue isosurfaces in the 3-space (s,α,θ k ); s is the edge normalized toroidal flux, α is the field line variable, and θ k is the perpendicular wave vector or ballooning parameter. Broken symmetry, i.e., deviations from axisymmetry, in the stellarator magnetic field geometry causes localization of the ballooning mode eigenfunction, and gives rise to new types of nonsymmetric eigenvalue isosurfaces in both the stable and unstable spectrum. For eigenvalues far above the marginal point, isosurfaces are topologically spherical, indicative of strong 'quantum chaos'. The complexity of QAS marginal isosurfaces suggests that finite Larmor radius stabilization estimates will be difficult and that fully three-dimensional, high-n MHD computations are required to predict the beta limit

  19. The effects of intra-aortic balloon pump in coronary stenting for high risk patients

    International Nuclear Information System (INIS)

    Zhang Qi; Shen Weifeng; Zhang Jianshen; Zhang Ruiyan; Hu Jian; Zhang Xian

    2003-01-01

    Objective: To evaluate the therapeutic efficacy of intra-aortic balloon supporting in coronary interventions for high risk patients with coronary artery disease (CAD). Methods: Sixteen high risk CAD patients accepted percutaneous coronary intervention assisted by intra-aortic balloon pumping together with clinical variables, procedural and follow-up informations were recorded and evaluated. Results: All patients presented with severe left ventricular dysfunction, multi-vessel disease and high jeopardy scores. 12 patients acquired complete revascularization. Mean duration of balloon pumping was (31 ± 17) minutes. Aortic diastolic and mean pressures were increased during balloon pumping [diastolic: (69±11) mmHg pre. vs (131±15) mmHg post.; mean: (82±13) mmHg pre. vs (111±7) mmHg post., P<0.001]. With average of 2 years follow-up, one patient died from pump failure but no MACE reaching survival rate of 75%. The ejection fraction and the NYHA grade were significantly improved. Conclusions: Intra-aortic balloon pumping is a safe and effective method in treating high risk CAD patients obtaining rather fare prognosis

  20. Neurovascular in-stent stenoses: treatment with conventional and drug-eluting balloons.

    Science.gov (United States)

    Vajda, Z; Güthe, T; Perez, M Aguilar; Heuschmid, A; Schmid, E; Bäzner, H; Henkes, H

    2011-01-01

    ISRs remain a major issue in the endovascular management of ICAD, requiring retreatment by reangioplasty. The aim of the present study was to evaluate the technical feasibility, safety, and efficiency of the novel DEBs for neurovascular ISRs. Fifty-one patients (median age, 67 years; age range, 34-82 years; male/female ratio, 37:14) underwent 63 balloon dilation procedures for ISRs in intracranial stented arterial segments between November 2007 and August 2010 in a single center. Of the 63 procedures, 20 (32%) were performed by using a conventional balloon and 43 (68%), by using a paclitaxel-eluting balloon (SeQuent Please). Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of a recurrent ISR after reangioplasty were analyzed. Technical success, defined as ISRs with DEBs are encouraging; further technical developments are, nevertheless, mandatory.

  1. Percutaneous Treatment of Intrahepatic Biliary Leak: A Modified Occlusion Balloon Technique

    Energy Technology Data Exchange (ETDEWEB)

    Nasser, Felipe; Rocha, Rafael Dahmer, E-mail: rafaeldrocha@gmail.com; Falsarella, Priscila Mina; Motta-Leal-Filho, Joaquim Maurício da; Azevedo, André Arantes; Valle, Leonardo Guedes Moreira; Cavalcante, Rafael Noronha; Garcia, Rodrigo Gobbo; Affonso, Breno Boueri; Galastri, Francisco Leonardo [Hospital Israelita Albert Einstein, Department of Interventional Radiology (Brazil)

    2016-05-15

    PurposeTo report a novel modified occlusion balloon technique to treat biliary leaks.MethodsA 22-year-old female patient underwent liver transplantation with biliary-enteric anastomosis. She developed thrombosis of the common hepatic artery and extensive ischemia in the left hepatic lobe. Resection of segments II and III was performed and a biliary-cutaneous leak originating at the resection plane was identified in the early postoperative period. Initial treatment with percutaneous transhepatic drainage was unsuccessful. Therefore, an angioplasty balloon was coaxially inserted within the biliary drain and positioned close to the leak.ResultsThe fistula output abruptly decreased after the procedure and stopped on the 7th day. At the 3-week follow-up, cholangiography revealed complete resolution of the leakage.ConclusionThis novel modified occlusion balloon technique was effective and safe. However, greater experience and more cases are necessary to validate the technique.

  2. Transarterial balloon-assisted glue embolization of high-flow arteriovenous fistulas

    International Nuclear Information System (INIS)

    Andreou, Alexander; Ioannidis, Ioannis; Nasis, Nickolaos

    2008-01-01

    We report here our experience in treating high-flow arteriovenous fistulas (AVFs) of the brain and spine using balloon-assisted glue injection. During a 3-year period (2003-2005) five patients with high-flow AVFs were treated at our hospital using transarterial balloon-assisted glue injection. There were two pial AVFs, one dural AVF, one vein of Galen malformation and one perimedullary AVF of the cervical spine. All patients were clinically followed-up for 12-48 months. Immediate angiographic obliteration was achieved in all patients. The fistulas remained closed in all patients, as ascertained by follow up-angiograms. No new neurological deficits related to the procedure were detected. Clinically, one patient with severe pre-treatment neurological deficit experienced excellent recovery. Transarterial balloon-assisted glue embolization of high-flow AVFs is a feasible and efficient treatment. This technique affords more control in the glue injection and minimizes the risk of distal embolization. (orig.)

  3. Ureteropelvic junction obstruction and ureteral strictures treated by simple high-pressure balloon dilation

    DEFF Research Database (Denmark)

    Osther, P J; Geertsen, U; Nielsen, H V

    1998-01-01

    congenital UPJO, previous stones, sequelae of endoscopic and open surgery, radiotherapy, and urinary tract reconstruction. A retrograde ureteroscopic approach was used. Evaluation included clinical and radiographic examinations and renal scintigraphy with diuretic wash-out. The procedure was repeated in 21......%, and in strictures secondary to reconstructive and ureteroscopic surgery, with a success rate of 91%. In congenital UPJO, the results were less encouraging: in patients with a symptom debut after the age of 18 years, balloon dilation was successful in 57% of cases; in patients with symptom debut before the age of 18...... years, success was achieved in only 25% of cases. There were no major complications. It was concluded that simple high-pressure balloon dilation is a safe and reasonably effective technique for the management of most ureteral strictures and congenital UPJO with symptom debut in adult life. Balloon...

  4. Fibular free flap with arteria peronea magna: the role of preoperative balloon occlusion.

    Science.gov (United States)

    Rahmel, Benjamin B; Snow, Thomas M; Batstone, Martin D

    2011-03-01

    The free fibular osteocutaneous flap is a commonly used donor for reconstruction of mandibular defects. Vascular abnormalities and leg trauma are relative contraindications to the use of a fibular free flap. Peroneal arteria magna (PAM) is one such vascular abnormality that may preclude the use of the graft due to the high risk of lower-limb ischemia. Lower-limb angiography is the standard for assessing the lower-limb vascular anatomy; however, the indications remain controversial. Although balloon occlusion has been used to assess the vascular supply in distal bypass surgery, there have no reported cases of balloon occlusion to assess the viability of the distal extremity with PAM. Intraoperative assessment of vascular anatomy with an aborted harvest can lead to significant morbidity and cost. Balloon occlusion provides a relatively safe and minimally invasive technique for assessment of potential lower-limb ischemia in patients with PAM. © Thieme Medical Publishers.

  5. Solid State Inflation Balloon Active Deorbiter: Scalable Low-Cost Deorbit System for Small Satellites

    Science.gov (United States)

    Huang, Adam

    2016-01-01

    The goal of the Solid State Inflation Balloon Active Deorbiter project is to develop and demonstrate a scalable, simple, reliable, and low-cost active deorbiting system capable of controlling the downrange point of impact for the full-range of small satellites from 1 kg to 180 kg. The key enabling technology being developed is the Solid State Gas Generator (SSGG) chip, generating pure nitrogen gas from sodium azide (NaN3) micro-crystals. Coupled with a metalized nonelastic drag balloon, the complete Solid State Inflation Balloon (SSIB) system is capable of repeated inflation/deflation cycles. The SSGG minimizes size, weight, electrical power, and cost when compared to the current state of the art.

  6. Loss of Guide Wire: A Rare Complication of Intra-Aortic Balloon Pump Insertion

    Directory of Open Access Journals (Sweden)

    Manouchehr Hekmat

    2015-10-01

    Full Text Available At the final stages of a coronary artery bypass graft operation on a 64-year-old man, an experienced physician attempted to insert an intra-aortic balloon pump into the femoral artery via the Seldinger technique. However, while the balloon pump was being passed over the guide wire, the latter was completely lost.The guide wire should be held at the tip at all times to prevent passage into the vessel. Strict adherence to this rule will prevent guide-wire loss, which is, albeit rare and completely avoidable, a potentially life-threatening complication of central vein or artery catheterization, with reported fatality rates of up to 20% when the whole wire is lost. The literature contains several reports on guide-wire loss during central venous, arterial, and hemodialysis catheterization, but we report for the first time the loss of a guide wire as a rare complication of intra-aortic balloon pump insertion.

  7. Measurement of hepatic venous pressure gradient revisited: Catheter wedge vs balloon wedge techniques

    Directory of Open Access Journals (Sweden)

    S Timothy Chelliah

    2011-01-01

    Full Text Available Aims: To evaluate the accuracy of measurement of hepatic venous pressure gradient by catheter wedge as compared to balloon wedge (the gold standard. Materials and Methods: Forty-five patients having a clinical diagnosis of intrahepatic portal hypertension were subjected to the two different types of pressure measurements (catheter wedge and balloon wedge during transjugular liver biopsy under fluoroscopic guidance. Statistical Analysis: Spearman′s rank correlation coefficient, Bland-Altman plot for agreement, and single measure intraclass correlation were used for analysis of data. Results: There was a close correlation between the results obtained by both the techniques, with highly significant concordance (P < 0.0001. Hepatic venous pressure gradients as measured by the catheter wedge technique were either equal to or less than those obtained by the balloon wedge technique. Conclusions: The difference in hepatic venous pressure gradients measured by the two techniques is insignificant.

  8. Influence of Pressure-gradient and Shear on Ballooning Stability in Stellarators

    International Nuclear Information System (INIS)

    Hudson, S.R.; Hegna, C.C.; Nakajima, N.

    2005-01-01

    Pressure-driven, ideal ballooning stability calculations are often used to predict the achievable plasma in stellarator configurations. In this paper, the sensitivity of ballooning stability to plasmas profile variations is addressed. A simple, semi-analytic method for expressing the ballooning growth rate, for each field line, as a polynomial function of the variation in the pressure gradient and the average magnetic shear from an original equilibrium has recently been introduced [Phys. Plasmas 11:9 (September 2004) L53]. This paper will apply the expression to various stellarator configurations and comment on the validity of various truncated forms of the polynomial expression. In particular, it is shown that in general it is insufficient to consider only the second order terms as previously assumed, and that higher order terms must be included to obtain accurate predictions of stability

  9. Transcervical double-balloon catheter as an alternative and salvage method for medical termination of pregnancy in midtrimester

    Directory of Open Access Journals (Sweden)

    Yi-An Tu

    2017-02-01

    Conclusion: There was no significant additional benefit of using a double-balloon catheter in midtrimester termination of pregnancy, although the technique was considered simple and generally well-tolerated. Placing a transcervical double-balloon catheter could be the primary method, or one of the alternative medical methods if the patient and/or obstetrician prefers no operation.

  10. The SABRE Trial (Sirolimus Angioplasty Balloon for Coronary In-Stent Restenosis) : Angiographic Results and 1-Year Clinical Outcomes

    NARCIS (Netherlands)

    Verheye, Stefan; Vrolix, Mathias; Kumsars, Indulis; Erglis, Andrejs; Sondore, Dace; Agostoni, Pierfrancesco|info:eu-repo/dai/nl/34169276X; Cornelis, Kristoff; Janssens, Luc P F; Maeng, Michael; Slagboom, Ton; Amoroso, Giovanni; Jensen, Lisette Okkels; Granada, Juan F; Stella, Pieter|info:eu-repo/dai/nl/304814717

    2017-01-01

    Objectives The aim of this first-in-human study was to assess the safety and effectiveness of the Virtue sirolimus-eluting balloon in a cohort of patients with in-stent restenosis (ISR). Background Angioplasty balloons coated with the cytotoxic drug paclitaxel have been widely used for ISR

  11. Underexpansion and Ad Hoc Post-dilation in Selected Patients Undergoing Balloon-Expandable Transcatheter Aortic Valve Replacement

    DEFF Research Database (Denmark)

    Barbanti, Marco; Leipsic, Jonathon; Binder, Ronald

    2014-01-01

    To assess the clinical outcomes and hemodynamic performance associated with a strategy of underexpanding balloon-expandable THVs when excessive oversizing is a concern.......To assess the clinical outcomes and hemodynamic performance associated with a strategy of underexpanding balloon-expandable THVs when excessive oversizing is a concern....

  12. Transcervical Foley's catheter versus Cook balloon for cervical ripening in stillbirth with a scarred uterus: a randomized controlled trial.

    Science.gov (United States)

    Rab, Mohammed T Gadel; Mohammed, Abdel Baset F; Zahran, Khalid A; Hassan, Mo'men M; Eldeen, Abdel Razek M; Ebrahim, Emad M; Yehia, Mohammed

    2015-07-01

    To compare the efficacy and safety of the use of transcervical Foley's catheter versus Cook cervical ripening balloon in pregnant women with stillbirth, unfavorable cervix and scarred uterus. Randomized controlled study. El Minia University Hospital, El Minia, Egypt. Two-hundred pregnant women with stillbirth, unfavorable cervix and scarred uterus were recruited into this study. They were randomized into two groups. In group I (n = 100), cervical ripening was done using Foley's catheter. In group II (n = 100), cervical ripening was done using Cook cervical ripening balloon. Balloon insertion to delivery interval, successful ripening rate, cesarean delivery rate, maternal adverse events and maternal satisfaction. Time from balloon insertion to expulsion and from balloon insertion to delivery was significantly shorter in Foley's catheter group. However, the difference between the two groups regarding time from balloon insertion to active labor, time from balloon expulsion to delivery, cervical ripening, cesarean section, instrumental delivery, pain score, need for analgesia, hospital stay and maternal satisfaction was not statistically significant. Foley's catheter and Cook cervical ripening balloon are comparable regarding efficacy and safety profile when used to ripen the cervix in pregnant women with stillbirth, unfavorable cervix and scarred uterus. However, Foley's catheter has a shorter induction to delivery interval and is relatively cheaper device.

  13. Utility of intracardiac ultrasound imaging to guide pulmonary vein ablation using laser balloon catheter.

    Science.gov (United States)

    Leite, Luiz; Su, Wilber; Johnson, Susan B; Milton, Mark; Henz, Benhur; Sarabanda, Alvaro; Santos, Simone N; Packer, Douglas L

    2009-12-01

    Pulmonary vein isolation (PVI) with balloon catheter has been used as the endpoint for AF ablation. To determine the usefulness of intracardiac ultrasound (ICUS) to guide PVI using laser balloon catheter. 59 PVs were ablated in 27 dogs. Doppler imaging was used to identify blood flow leaks between PV and balloon. After each energy delivery, the circular mapping catheter was repositioned to check if isolation had been achieved. The leak position was then correlated with the gap position at the pathological study. Multivariate logistic regression analysis was undertaken. 59 PV were ablated. Mean burn time was 279+/-177 sec, mean balloon diameter was 23+/-3 mm, and mean balloon length was 25+/-4 mm. Complete isolation was achieved in 38/59 (64%) cases, and it was significantly more common when there was no leak: [30/38 (79%) versus 8/23 (35%), p<0.001]. This occurred regardless of time of laser application (302+/-223 sec. vs. 266+/-148 sec., p=ns), laser power (3.5 W/cm, 4.5 W/cm, and 5.5 W/cm), balloon diameter (24+/- 3 mm vs. 22+/- 3 mm, p=ns) and length (27+/-4 mm vs. 24+/-4mm, p=ns). The positive predictive value for predicting incomplete isolation was 65% and the negative predictive value was 83%. An identifiable leak between PV and the LBA device seen at the ICUS is predictive of lower PV isolation rates. ICUS may be useful for leak detection to avoid ineffective energy application during circumferential PV ablation. This could also be helpful when other types of energy are used.

  14. [Large balloon dilation for removal of choledocholithiasis difficult to extract: clinical experience].

    Science.gov (United States)

    Marin Calderón, Luis; Vera Calderón, Augusto; Gómez Correa, Aldo; Cervera Reyes, Zenon; Dávalos Moscol, Milagros; Alva Alva, Edgar; Palacios Salas, Fernando; Díaz Ríos, Ramiro; Guzmán Calderón, Edson; García Chihuan, Grisley

    2016-01-01

    The aim of this study was to report the initial experience of the combined use of biliary sphincterotomy plus balloon dilatation of the papilla for management of large stones. Design: Retrospective, descriptive. This study included 18 patients in whom a hydrostatic dilatation of the papilla with large balloons was performed between June 2012 and April 2014. Patients had multiple large stones, tapered distal common bile duct, previous sphincterotomy, or peri/ intradiverticular papilla. CRE™ dilatation balloons with diameters ranging from 12 to 20 mm were used. Data were recorded as successful procedure, use of lithotripsy and complications during the procedure. The average age was 66.1 years. There was a predominance of the female gender (66.7%). The average size of the bile duct stones was 16.7 mm. The main indications were: giant choledocholithiasis (12 patients, 66.7%) and tapered distal common bile duct (6 patients, 33.3%). The dilatation balloons diameter used were: 15 mm (8 patients, 44.4%), 18 mm (5 patients, 27.8%), 12 mm (3 patients, 16.7%) and 20 mm (2 patients, 11.1%). Complete stone clearance was achieved in 15 patients (83.3%). Lithotripsy was performed in 4 patients (22.2%). There were 3 patients in whom the removal with balloon was unsuccessful, performed surgical management. It was reported 1 case of mild acute pancreatitis (5.5%). The results show that endoscopic papillary large balloon dilation after sphincterotomy is a safe and effective technique for treatment of difficult bile duct stones.

  15. Lifting options for stratospheric aerosol geoengineering: advantages of tethered balloon systems.

    Science.gov (United States)

    Davidson, Peter; Burgoyne, Chris; Hunt, Hugh; Causier, Matt

    2012-09-13

    The Royal Society report 'Geoengineering the Climate' identified solar radiation management using albedo-enhancing aerosols injected into the stratosphere as the most affordable and effective option for geoengineering, but did not consider in any detail the options for delivery. This paper provides outline engineering analyses of the options, both for batch-delivery processes, following up on previous work for artillery shells, missiles, aircraft and free-flying balloons, as well as a more lengthy analysis of continuous-delivery systems that require a pipe connected to the ground and supported at a height of 20 km, either by a tower or by a tethered balloon. Towers are shown not to be practical, but a tethered balloon delivery system, with high-pressure pumping, appears to have much lower operating and capital costs than all other delivery options. Instead of transporting sulphuric acid mist precursors, such a system could also be used to transport slurries of high refractive index particles such as coated titanium dioxide. The use of such particles would allow useful experiments on opacity, coagulation and atmospheric chemistry at modest rates so as not to perturb regional or global climatic conditions, thus reducing scale-up risks. Criteria for particle choice are discussed, including the need to minimize or prevent ozone destruction. The paper estimates the time scales and relatively modest costs required if a tethered balloon system were to be introduced in a measured way with testing and development work proceeding over three decades, rather than in an emergency. The manufacture of a tether capable of sustaining the high tensions and internal pressures needed, as well as strong winds, is a significant challenge, as is the development of the necessary pumping and dispersion technologies. The greatest challenge may be the manufacture and launch of very large balloons, but means have been identified to significantly reduce the size of such balloons or aerostats.

  16. Onyx HD-500 embolization of intracranial aneurysms: modified technique using continuous balloon inflation under conscious sedation.

    Science.gov (United States)

    Rahme, Ralph; Grande, Andrew; Jimenez, Lincoln; Abruzzo, Todd A; Ringer, Andrew J

    2014-08-01

    The conventional technique of intracranial aneurysm embolization using Onyx HD-500 (ev3 Neurovascular, Irvine, CA, USA) involves repetitive balloon inflation-deflation cycles under general anesthesia. By limiting parent artery occlusion to 5 minutes, this cyclic technique is thought to minimize cerebral ischemia. However, intermittent balloon deflation may lengthen procedure time and allow balloon migration, resulting in intimal injury or Onyx leakage. We report our experience using a modified technique of uninterrupted Onyx injection with continuous balloon occlusion under conscious sedation. All Onyx embolization procedures for unruptured aneurysms performed by the senior author (A.J.R.) between September 2008 and April 2010 were retrospectively reviewed. Demographic, clinical, angiographic, and procedural data were recorded. Twenty-four embolization procedures were performed in 21 patients with 23 aneurysms, including four recurrences. Twenty aneurysms (87%) involved the paraclinoid or proximal supraclinoid internal carotid artery. Size ranged from 2.5 to 24mm and neck diameter from 2 to 8mm. The modified technique was employed in 19 cases. All but one patient (94.4%) tolerated continuous balloon inflation. Complete occlusion was achieved in 20 aneurysms (83.3%) and subtotal occlusion in three (12.5%). Stable angiographic results were seen in 85%, 94%, 94%, and 100% of patients at 6, 12, 24, and 36months, respectively. There were no deaths. Permanent non-disabling neurological morbidity occurred in one patient (4.2%). Minor, transient, and/or angiographic complications were seen in three patients (12.5%), none related to the technique itself. Onyx embolization of unruptured intracranial aneurysms can be safely and effectively performed using continuous balloon inflation under conscious sedation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease.

    Science.gov (United States)

    Iezzi, Roberto; Posa, Alessandro; Santoro, Marco; Nestola, Massimiliano; Contegiacomo, Andrea; Tinelli, Giovanni; Paolini, Alessandra; Flex, Andrea; Pitocco, Dario; Snider, Francesco; Bonomo, Lorenzo

    2015-08-01

    To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy. © The Author(s) 2015.

  18. Is Removal of the Pressure-regulating Balloon Necessary After Artificial Urinary Sphincter Cuff Erosion?

    Science.gov (United States)

    Rozanski, Alexander T; Viers, Boyd R; Shakir, Nabeel A; Pagliara, Travis J; Scott, Jeremy M; Morey, Allen F

    2018-03-01

    To characterize the risk of delayed infectious complications from retained pressure-regulating balloons (PRBs) after artificial urinary sphincter (AUS) cuff erosion. From our database of 530 AUS cases between 2007 and 2016, we identified 40 total AUS cuff erosions. Twenty-four (60%) presented without evidence of gross device infection and underwent explant of cuff and pump without removal of the PRB. Space of Retzius (SoR) and high submuscular (HSM) balloon locations were analyzed to assess for ease of removal. Presenting clinical features and retained balloon-related outcomes are reported. Of the 24 AUS cuff erosions with retained balloons, 6 (25%) men subsequently required PRB removal for infection during the median follow-up of 36 months (interquartile range 29-53). The median time to balloon infection after AUS erosion surgery was 4 months (interquartile range 4-16). Infection risk was reduced in those without concurrent inflatable penile prosthesis (20%) and in those who underwent "drain and retain" of the PRB (13%). The most common presenting clinical symptoms with retained PRB infection were pain and erythema near the site of the PRB (83%). No patient developed sepsis-related complications. The location of the PRB in this subcohort included 2 SoR and 4 HSM placements. The median operative time for balloon removal in the SoR was 3.5 times greater than that for HSM PRBs (133 minutes vs 38 minutes). With extended follow-up, three-quarters of the men with retained PRBs after AUS cuff erosion experienced no infectious complications. Removal of infected SoR PRBs was associated with greater operative times and surgical complexity relative to HSM PRBs. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Theory of ballooning-mirror instabilities for anisotropic pressure plasmas in the magnetosphere

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, C.Z.; Qian, Q.

    1993-09-01

    This paper deals with a kinetic-MHD eigenmode stability analysis of low frequency ballooning-mirror instabilities for anisotropic pressure plasmas in the magnetosphere. The ballooning mode is a dominant transverse wave driven unstable by pressure gradient in the bad curvature region. The mirror mode with a dominant compressional magnetic field perturbation is excited when the product of plasma beta and pressure anisotropy is large. The field-aligned eigenmode equations take into account the coupling of the transverse and compressional components of the perturbed magnetic field and describe the coupled ballooning-mirror mode. Because the energetic trapped ions precess very rapidly across the {rvec B} field, their motion becomes very rigid with respect to low frequency MHD perturbations with symmetric structure of parallel perturbed magnetic field {delta}B{sub {parallel}} and electrostatic potential {Phi} along the north-south ambient magnetic field, and the symmetric ballooning-mirror mode is shown to be stable. On the other hand, the ballooning-mirror mode with antisymmetric {delta}B{sub {parallel}}, and {Phi} structure along the north-south ambient magnetic field is only weakly influenced by energetic trapped particle kinetic effects due to rapid trapped particle bounce motion and has the lowest instability threshold determined by MHD theory. With large plasma beta ({beta}{sub {parallel}} {ge} O(1)) and pressure anisotropy (P{sub {perpendicular}}/P{sub {parallel}} > 1) at equator the antisymmetric ballooning-mirror mode structures resemble the field-aligned wave structures of the multisatellite observations of a long lasting compressional Pc 5 wave event during November 14--15, 1979 [Takahashi et al.]. The study provides the theoretical basis for identifying the internal excitation mechanism of ULF (Pc 4-5) waves by comparing the plasma stability parameters computed from the satellite particle data with the theoretical values.

  20. Coriolis Mass-Flowmeter for aerostatic gas amount determination in zero pressure stratosperic balloons.

    Science.gov (United States)

    Behar, Jean-Baptiste

    2016-07-01

    The CNES ballooning community regularly operates zero pressure balloons in many countries around the world (recently in France, Sweden, Canada and soon, Australia in 2017). An important operational flight parameter is the aerostatic gas mass injected into the balloon (currently helium and hydrogen in the study). Besides the lifting force, it determines mainly the ascent rate from which the adiabatic expansion depends directly. A too high ascent velocity in very cold air temperature profiles could result in a gas temperature drop which if too great, might induce brittleness of the envelope. A precise gas mass determination is therefore critical for performance as well as for mission safety. The various gas supply tanks in various countries all have different characteristics with possible uncertainties with regard to their volumes. This makes the currently used gas mass determination method based on supply tank pressure measurements unreliable. This method also relies on tank temperature, another source of inaccuracy in the gas amount determination. CNES has therefore prospected for alternative methods to reduce inaccuracies and perhaps also ease the operational procedures during balloon inflation. Coriolis mass-flowmeters which have reached industrial maturity, offer the great advantage over other flowmeters to be able to directly measure the mass of the transferred fluid, and not deducing it from other parameters as other types of flowmeters would do. An industrial contractor has been therefore assigned to integrate this solution into the CNES operational setup. This new system is to be tested in February 2016. The presentation will briefly explain the Coriolis flowmeter's principle and display the February 2016 performance tests' results. The expected incidence on zero pressure balloons' trajectories will also be discussed based on simulations ran on a balloon flight simulator software.

  1. Assisted coiling of saccular wide-necked unruptured intracranial aneurysms: stent versus balloon.

    Science.gov (United States)

    Consoli, Arturo; Vignoli, Chiara; Renieri, Leonardo; Rosi, Andrea; Chiarotti, Ivano; Nappini, Sergio; Limbucci, Nicola; Mangiafico, Salvatore

    2016-01-01

    Assisted coiling with stents or balloons enables a higher percentage of complete occlusions of saccular unruptured intracranial aneurysms to be achieved with a reasonable complication rate. The aim of this study was to compare stent-assisted coiling and the balloon remodeling technique in terms of efficacy, stability, and safety for the treatment of comparable unruptured saccular intracranial aneurysms. 268 patients with 286 saccular unruptured wide-necked intracranial aneurysms were treated at our institution with stent- or balloon-assisted coiling and retrospectively reviewed. Statistical analysis was performed to assess significant differences between the two groups. The rate of complete occlusion at the end of the procedure was higher with stent-assisted coiling than with balloon-assisted coiling (86.8% vs 78%) and the same results were also observed after 6 months (92.1% vs 77.6%; p=0.05). About 50% of major recurrences occurred in large to giant aneurysms (p<0.001). The overall complication rate was similar in the stent-assisted and balloon-assisted groups (10.3% vs 9.3%). Independently of the technique, a higher complication rate was observed with bifurcational aneurysms, particularly in the middle cerebral artery (p=0.016). Stent-assisted coiling achieved better results in terms of complete occlusion and stability than balloon-assisted coiling with a lower rate of recurrence without being associated with a higher risk of intraprocedural complications. Bifurcational and large to giant aneurysms were associated with higher complication rates and higher recurrence rates, respectively, and still represent a challenge for both techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Optimal patient positioning for ligamentotaxis during balloon kyphoplasty of the thoracolumbar and lumbar spine.

    LENUS (Irish Health Repository)

    Cawley, D T

    2011-06-01

    Percutaneous balloon kyphoplasty aims to restore vertebral height, correct angular deformity and stabilize the spine in the setting of vertebral compression fractures. The patient is positioned prone with supports under the iliac crests and upper thorax to allow gravity to extend the spine. In the treatment of lumbar fractures, we evaluated patient positioning with the contribution of hip extension to increase anterior ligamentotaxis, thus facilitating restoration of vertebral height. Our positioning technique created a mean anterior height increase from 72% to 78% of the average height of the cranial and caudal vertebrae (p=0.037). Balloon inflation did not significantly further increase anterior or posterior vertebral height, or Cobb angle.

  3. Percutaneous sharp recanalization of a membranous IVC occlusion with an occlusion balloon as a needle target

    Directory of Open Access Journals (Sweden)

    Michael D. Rivers-Bowerman, MD, MSc, FRCPC

    2017-09-01

    Full Text Available A 50-year-old male with right upper quadrant symptoms and hepatic dysfunction was found to have multiple dilated hepatic veins (HVs with intrahepatic collateralization and membranous occlusion of the intrahepatic inferior vena cava (IVC consistent with primary Budd–Chiari syndrome. Venacavograms depicted drainage of the intrahepatic collaterals through a left-sided HV entering the IVC above the level of the occlusion. Sharp recanalization of the membranous IVC occlusion was performed with an occlusion balloon as a needle target under echocardiographic monitoring followed by balloon angioplasty with restoration of IVC patency. Clinical, laboratory, and venographic procedural success has been demonstrated to 9 months with minimal residual stenosis.

  4. Proceedings of the 3rd workshop on balloon-borne experiments with superconducting magnet spectrometers

    International Nuclear Information System (INIS)

    Yamamoto, Akira

    1992-04-01

    The Third Work Shop on Balloon Borne Experiment with a Superconducting Magnet Spectrometer was held at National Laboratory for High Energy Physics (KEK), Tsukuba, Japan on February 24 - 25, 1992. The main effort for this workshop was focused on the progress of the BESS (Balloon Borne Experiment with a Superconducting Spectrometer) experiment and on the scope for scientific investigation with the BESS detector. The progress was reviewed and further investigation was discussed for the BESS further scientific collaboration among Univ. of Tokyo, Kobe University, KEK, ISAS and NMSU. (J.P.N.)

  5. Generalized math model for simulation of high-altitude balloon systems

    Science.gov (United States)

    Nigro, N. J.; Elkouh, A. F.; Hinton, D. E.; Yang, J. K.

    1985-01-01

    Balloon systems have proved to be a cost-effective means for conducting research experiments (e.g., infrared astronomy) in the earth's atmosphere. The purpose of this paper is to present a generalized mathematical model that can be used to simulate the motion of these systems once they have attained float altitude. The resulting form of the model is such that the pendulation and spin motions of the system are uncoupled and can be analyzed independently. The model is evaluated by comparing the simulation results with data obtained from an actual balloon system flown by NASA.

  6. The SABRE Trial (Sirolimus Angioplasty Balloon for Coronary In-Stent Restenosis)

    DEFF Research Database (Denmark)

    Verheye, Stefan; Vrolix, Mathias; Kumsars, Indulis

    2017-01-01

    centers, 50 ISR patients were treated with the Virtue balloon. Angiographic measurements at 6 months are reported, along with 12-month clinical follow-up. RESULTS Procedural success in the intention-to-treat population was 100 The primary safety endpoint was target lesion failure (TLF) (cardiac death...... and 14.3% MACE and for the per-protocol population were 2.8% TLF and 2.8% MACE. CONCLUSIONS This first-in-human study showed excellent procedural success for the Virtue sirolimus-eluting angioplasty balloon, 6-month LLL rates in line with current stent-free ISR treatment options, and clinical outcomes...

  7. Certification and safety aspects relating to the transport of passengers on high altitude balloons in Europe

    Science.gov (United States)

    Schoenmaker, Annelie

    2014-07-01

    High-altitude balloons typically fly between 25 and 50 km in altitude, which, while below the Karman line of 100 km, is yet far above the altitudes typically flown by aircraft. For example, the highest-flying commercial aircraft - the Concorde - had a maximum cruising altitude of only 18 km. zero2infinity, a Spanish company, is currently developing a pressurized pod named “bloon” which will be capable of lifting six people, including two pilot crew members and four paying passengers, to an altitude of 36 km through the use of high-altitude balloons. The boundary between Airspace and Outer Space has never been legally defined, mostly because of the lack of activities taking place between the altitude where airplanes fly and the lowest orbiting spacecraft. High-altitude balloons do fly at these in-between altitudes and the prospect of commercializing access to these parts of the stratosphere poses some questions in a new light. Given the relatively low altitude at which they fly, it may well be that these types of balloons would be considered to operate exclusively within air space. However, given the technology involved in crewed high altitude balloon flights, which is more similar to spacecraft engineering than to traditional hot-air or gas ballooning, it is necessary to evaluate the various legal regimes, codes, and regulations that would apply to such flights, especially regarding licenses and liabilities. For high altitude balloon flights commencing in Europe, the European Aviation Safety Agency (EASA) would very likely be the competent certification or licensing agency for these flights, although there would likely be input from various national aviation authorities as well. However, because the European Commission (EC) has not yet issued regulations regarding commercial spaceflight, particularly the use of high altitude balloons, new rules and regulations governing such flights may still need to be drafted and promulgated. With the development of

  8. Balloon cells associated with granule cell dispersion in the dentate gyrus in hippocampal sclerosis.

    Science.gov (United States)

    Thom, M; Martinian, L; Caboclo, L O; McEvoy, A W; Sisodiya, S M

    2008-06-01

    Granule cell dispersion (GCD) is a common finding in hippocampal sclerosis in patients with intractable focal epilepsy. It is considered to be an acquired, post-developmental rather than a pre-existing abnormality, involving dispersion of either mature or newborn neurones, but the precise factors regulating it and its relationship to seizures are unknown. We present two cases of GCD with associated CD34-immunopositive balloon cells, a cell phenotype associated with focal cortical dysplasia type IIB, considered to be a developmental cortical lesion promoting epilepsy. This observation opens up the debate regarding the origin of balloon cells and CD34 expression and their temporal relationship to seizures.

  9. Pulmonary balloon angioplasty of chronic thromboembolic pulmonary hypertension (CTEPH) in surgically inaccessible cases

    International Nuclear Information System (INIS)

    Pitton, M.B.; Herber, S.; Thelen, M.; Mayer, E.

    2003-01-01

    The clinical course of patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) depends on the distribution pattern of the thromboembolic material. In patients with thromboembolic findings in the central pulmonary segments pulmonary thrombendarterectomy (PTE) has excellent results and acceptable operative risk. This paper presents two surgically inaccessable cases that were successfully treated with balloon pulmonary angioplasty. Balloon angioplasty improved parenchymal perfusion, increased cardiac index (ΔCI + 19.2% [Case 1], and + 15.4% [2]), reduced pulmonary vascular resistance during follow-up (ΔPVRI - 25.0% [1] and - 15.9% [2]), and is discussed as an alternative treatment option for cases not suited for surgery. (orig.) [de

  10. Promising results after balloon dilatation of the Eustachian tube for obstructive dysfunction

    DEFF Research Database (Denmark)

    Wanscher, Jens H; Svane-Knudsen, Viggo

    2014-01-01

    INTRODUCTION: As the first ear, nose and throat department in Denmark, we introduced balloon dilatation of the Eustachian tube as a treatment of obstructive dysfunction in the summer of 2012. We present our preliminary experiences with this new treatment in adults. MATERIAL AND METHODS: Preoperat......INTRODUCTION: As the first ear, nose and throat department in Denmark, we introduced balloon dilatation of the Eustachian tube as a treatment of obstructive dysfunction in the summer of 2012. We present our preliminary experiences with this new treatment in adults. MATERIAL AND METHODS...

  11. Measurements of Intra-Aortic Balloon Wall Movement During Inflation and Deflation: Effects of Angulation.

    Science.gov (United States)

    Bruti, Gianpaolo; Kolyva, Christina; Pepper, John R; Khir, Ashraf W

    2015-08-01

    The intra-aortic balloon pump (IABP) is a ventricular assist device that is used with a broad range of pre-, intra-, and postoperative patients undergoing cardiac surgery. Although the clinical efficacy of the IABP is well documented, the question of reduced efficacy when patients are nursed in the semi-recumbent position remains outstanding. The aim of the present work is therefore to investigate the underlying mechanics responsible for the loss of IABP performance when operated at an angle to the horizontal. Simultaneous recordings of balloon wall movement, providing an estimate of its diameter (D), and fluid pressure were taken at three sites along the intra-aortic balloon (IAB) at 0 and 45°. Flow rate, used for the calculation of displaced volume, was also recorded distal to the tip of the balloon. An in vitro experimental setup was used, featuring physiological impedances on either side of the IAB ends. IAB inflation at an angle of 45° showed that D increases at the tip of the IAB first, presenting a resistance to the flow displaced away from the tip of the balloon. The duration of inflation decreased by 15.5%, the inflation pressure pulse decreased by 9.6%, and volume decreased by 2.5%. Similarly, changing the position of the balloon from 0 to 45°, the balloon deflation became slower by 35%, deflation pressure pulse decreased by 14.7%, and volume suctioned was decreased by 15.2%. IAB wall movement showed that operating at 45° results in slower deflation compared with 0°. Slow wall movement, and changes in inflation and deflation onsets, result in a decreased volume displacement and pressure pulse generation. Operating the balloon at an angle to the horizontal, which is the preferred nursing position in intensive care units, results in reduced IAB inflation and deflation performance, possibly compromising its clinical benefits. Copyright © 2015 The Authors. Artificial Organs published by Wiley Periodicals, Inc. on behalf of International Center for

  12. A method for measuring mean wind velocities in a canyon with tracer balloons

    Science.gov (United States)

    Sheih, C. M.; Billman, B. J.; Depaul, F. T.

    1985-08-01

    A method using balloons as tracers for measuring mean wind velocity in street canyons or mountain valleys has been developed. Tests of the method with numerical experiments showed that the method reproduced an assumed wind field quite well provided that the buoyancy component of the balloon velocity was larger than the downward velocity component of the wind. Tests of the method with measurements of wind velocity in a street canyon of downtown Chicago showed that the method yielded flow patterns quite similar to photographic results of flow visualization of phisical simulations by other investigators. However, no direct measurements of wind velocity were available for quantitative comparison.

  13. Balloon observations of interstellar CII (158 microns) and OI (63 microns) forbidden lines

    Science.gov (United States)

    Shibai, H.; Okuda, H.; Nakagawa, T.; Maihara, T.; Mizutani, K.; Matsuhara, H.; Kobayashi, Y.; Hiromoto, N.; Low, F. J.; Nishimura, T.

    1993-01-01

    Interstellar CII and OI forbidden lines were observed by the Balloon-Borne Infrared Telescope (BIRT) with a Fabry-Perot spectrometer. Two balloon flights were successfully made. With a method of 'frequency switching', diffuse CII forbidden-line emission was efficiently detected and mapped in extended regions around HII/molecular cloud complexes and in a wide area of the Galactic plane. It has been shown that the CII forbidden-line emission is very strong and ubiquitously distributed in interstellar space in the Galaxy.

  14. Overview Of The Scientific Balloon Activity in Sweden 2014-2016

    Science.gov (United States)

    Abrahamsson, Mattias; Lockowandt, Christian; Andersson, Kent

    2016-07-01

    SSC, formerly known as Swedish Space Corporation, is a Swedish state-owned company working in several different space related fields, including scientific stratospheric balloon launches. Esrange Space Centre (Esrange in short) located in the north of Sweden is the launch facility of SSC, where both sounding rocket launches and stratospheric balloon launches are conducted. At Esrange there are also facilities for satellite communication, including one of the largest civilian satellite data reception stations in the world. Stratospheric balloons have been launched from Esrange since 1974, when the first flights were performed together with the French space agency CNES. These balloon flights have normally flown eastward either only over Sweden or into Finland. Some flights have also had permission to fly into Russia, as far as the Ural Mountains. Normal flight times are from 4 to 12 hours. These eastward flights are conducted during the winter months (September to May). Long duration flights have been flown from Esrange since 2005, when NASA flew the BLAST payload from Sweden to north Canada. The prevailing westerly wind pattern is very advantageous for trans-Atlantic flights during summer (late May to late July). The long flight times of 4-5 days are very beneficial for astronomical payloads, such as telescopes that need long observation times. Circumpolar flights of more than two weeks are possible if Russian overflight permission exists. Typical scientific balloon payload fields include atmospheric research, including research on ozone depletion, astronomical and cosmological research, and research in technical fields such as aerodynamics. Since last COSPAR a number of interesting balloon flights have been performed from Esrange. In late 2014 parachute tests for the ExoMars programme was performed by drop-test from balloons. This was followed up on in the summer of 2015 with full end-to-end dynamic stability tests of Earth re-entry capsule shapes. Several balloon

  15. Balloon Dilatation and Stenting for Aortic Coarctation: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Salcher, Maximilian; Naci, Huseyin; Law, Tyler J; Kuehne, Titus; Schubert, Stephan; Kelm, Marcus

    2016-06-01

    There is no systematic assessment of available evidence on effectiveness and comparative effectiveness of balloon dilatation and stenting for aortic coarctation. We systematically searched 4 online databases to identify and select relevant studies of balloon dilatation and stenting for aortic coarctation based on a priori criteria (PROSPERO 2014:CRD42014014418). We quantitatively synthesized results for each intervention from single-arm studies and obtained pooled estimates for relative effectiveness from pairwise and network meta-analysis of comparative studies. Our primary analysis included 15 stenting (423 participants) and 12 balloon dilatation studies (361 participants), including patients ≥10 years of age. Post-treatment blood pressure gradient reduction to ≤20 and ≤10 mm Hg was achieved in 89.5% (95% confidence interval, 83.7-95.3) and 66.5% (44.1-88.9%) of patients undergoing balloon dilatation, and in 99.5% (97.5-100.0%) and 93.8% (88.5-99.1%) of patients undergoing stenting, respectively. Odds of achieving ≤20 mm Hg were lower with balloon dilatation as compared with stenting (odds ratio, 0.105 [0.010-0.886]). Thirty-day survival rates were comparable. Numerically more patients undergoing balloon dilatation experienced severe complications during admission (6.4% [2.6-10.2%]) compared with stenting (2.6% [0.5-4.7%]). This was supported by meta-analysis of head-to-head studies (odds ratio, 9.617 [2.654-34.845]) and network meta-analysis (odds ratio, 16.23, 95% credible interval: 4.27-62.77) in a secondary analysis in patients ≥1 month of age, including 57 stenting (3397 participants) and 62 balloon dilatation studies (4331 participants). Despite the limitations of the evidence base consisting predominantly of single-arm studies, our review indicates that stenting achieves superior immediate relief of a relevant pressure gradient compared with balloon dilatation. © 2016 American Heart Association, Inc.

  16. Balloon Occlusion Types in the Treatment of Coronary Perforation during Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Xiangfei Wang

    2014-01-01

    Full Text Available Coronary artery perforation is an uncommon complication in patients with coronary heart disease undergoing percutaneous coronary intervention. However, pericardial tamponade following coronary artery perforation may be lethal, and prompt treatment is crucial in managing such patients. Balloon occlusion and the reversal of anticoagulant activity are the common methods used to prevent cardiac tamponade by reducing the amount of bleeding. Herein, we discuss the pros and cons of currently used occlusion types for coronary perforation. Optimal balloon occlusion methods should reduce the amount of bleeding and ameliorate subsequent myocardial ischemia injury, even during cardiac surgery.

  17. Trial of a Paclitaxel-Coated Balloon for Femoropopliteal Artery Disease.

    Science.gov (United States)

    Rosenfield, Kenneth; Jaff, Michael R; White, Christopher J; Rocha-Singh, Krishna; Mena-Hurtado, Carlos; Metzger, D Christopher; Brodmann, Marianne; Pilger, Ernst; Zeller, Thomas; Krishnan, Prakash; Gammon, Roger; Müller-Hülsbeck, Stefan; Nehler, Mark R; Benenati, James F; Scheinert, Dierk

    2015-07-09

    The treatment of peripheral artery disease with percutaneous transluminal angioplasty is limited by the occurrence of vessel recoil and restenosis. Drug-coated angioplasty balloons deliver antiproliferative agents directly to the artery, potentially improving vessel patency by reducing restenosis. In this single-blind, randomized trial conducted at 54 sites, we assigned, in a 2:1 ratio, 476 patients with symptomatic intermittent claudication or ischemic pain while at rest and angiographically significant atherosclerotic lesions to angioplasty with a paclitaxel-coated balloon or to standard angioplasty. The primary efficacy end point was primary patency of the target lesion at 12 months (defined as freedom from binary restenosis or from the need for target-lesion revascularization). The primary safety end point was a composite of freedom from perioperative death from any cause and freedom at 12 months from limb-related death (i.e., death from a medical complication related to a limb), amputation, and reintervention. The two groups were well matched at baseline; 42.9% of the patients had diabetes, and 34.7% were current smokers. At 12 months, the rate of primary patency among patients who had undergone angioplasty with the drug-coated balloon was superior to that among patients who had undergone conventional angioplasty (65.2% vs. 52.6%, P=0.02). The proportion of patients free from primary safety events was 83.9% with the drug-coated balloon and 79.0% with standard angioplasty (P=0.005 for noninferiority). There were no significant between-group differences in functional outcomes or in the rates of death, amputation, thrombosis, or reintervention. Among patients with symptomatic femoropopliteal peripheral artery disease, percutaneous transluminal angioplasty with a paclitaxel-coated balloon resulted in a rate of primary patency at 12 months that was higher than the rate with angioplasty with a standard balloon. The drug-coated balloon was noninferior to the standard

  18. Intragastric Balloon for Obesity Treatment: Safety, Tolerance, and Efficacy

    Directory of Open Access Journals (Sweden)

    Joana Ribeiro da Silva

    2017-12-01

    Full Text Available Background: Obesity is an increasing worldwide problem associated with a vast number of comorbidities. Decreasing body weight by only 5-10% has been shown to slow and even prevent the onset of obesity-related comorbidities. Between pharmacological therapy and bariatric surgery a great variety of endoscopic techniques are available, the most common being intragastric balloon (IGB. The purpose of this study was to assess the safety, tolerance, and kinetics of IGBs in weight loss. The kinetics of weight loss were evaluated in 2 different contexts and phases: after the IGB's removal and after follow-up that varied between 6 and 12 months. Successful weight loss was defined as ≥10% weight loss after 6-12 months. Methods: The study included 51 patients who had undergone Orbera® IGB placement between September 2014 and February 2016. Inclusion criteria were age between 18 and 65 years; body mass index (BMI 28-35 with severe obesity-related disorders; or BMI 35-40. The IGB was removed 6 months later. All patients were followed for a minimum period of 6-12 months. Results: Of 51 patients, 16 were excluded (7 due to intolerance and 35 patients entered the study, of which 83% were followed for more than 6-12 months. The average weight loss (WL and % excess WL (%EWL after 6 months of treatment were 11.94 kg and 42.16%, respectively. At 6-12 months, after removal of the IGB, the mean WL was 8.25 kg and %EWL was 30.27%. Nineteen patients attained a WL of ≥10% the baseline value at IGB removal and 12 maintained their weight below this threshold during the 6-12 following months. Conclusions: After temporary IGB implantation in overweight or obese individuals, a WL that was ≥10% of weight at baseline was achieved in 54.3% and sustained at 6-12 months in 41.4% of participants. IGBs are an attractive intermediate option between diet and exercise programs and bariatric surgery. In general, IGB placement is a safe and well-tolerated procedure.

  19. Balloon-based adjuvant radiotherapy in breast cancer: comparison between 99mTc and HDR 192Ir

    Directory of Open Access Journals (Sweden)

    Tarcísio Passos Ribeiro de Campos

    2016-04-01

    Full Text Available Abstract Objective: To perform a comparative dosimetric analysis, based on computer simulations, of temporary balloon implants with 99mTc and balloon brachytherapy with high-dose-rate (HDR 192Ir, as boosts to radiotherapy. We hypothesized that the two techniques would produce equivalent doses under pre-established conditions of activity and exposure time. Materials and Methods: Simulations of implants with 99mTc-filled and HDR 192Ir-filled balloons were performed with the Siscodes/MCNP5, modeling in voxels a magnetic resonance imaging set related to a young female. Spatial dose rate distributions were determined. In the dosimetric analysis of the protocols, the exposure time and the level of activity required were specified. Results: The 99mTc balloon presented a weighted dose rate in the tumor bed of 0.428 cGy.h-1.mCi-1 and 0.190 cGyh-1.mCi-1 at the balloon surface and at 8-10 mm from the surface, respectively, compared with 0.499 and 0.150 cGyh-1.mCi-1, respectively, for the HDR 192Ir balloon. An exposure time of 24 hours was required for the 99mTc balloon to produce a boost of 10.14 Gy with 1.0 Ci, whereas only 24 minutes with 10.0 Ci segments were required for the HDR 192Ir balloon to produce a boost of 5.14 Gy at the same reference point, or 10.28 Gy in two 24-minutes fractions. Conclusion: Temporary 99mTc balloon implantation is an attractive option for adjuvant radiotherapy in breast cancer, because of its availability, economic viability, and similar dosimetry in comparison with the use of HDR 192Ir balloon implantation, which is the current standard in clinical practice.

  20. Balloon-based adjuvant radiotherapy in breast cancer: comparison between {sup 99m}Tc and HDR {sup 192}Ir

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Tarcisio Passos Ribeiro de; Lima, Carla Flavia de; Cuperschmid, Ethel Mizrahy, E-mail: tprcampos@pq.cnpq.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2016-03-15

    Objective: To perform a comparative dosimetric analysis, based on computer simulations, of temporary balloon implants with {sup 99m}Tc and balloon brachytherapy with high-dose-rate (HDR) {sup 192}Ir, as boosts to radiotherapy. We hypothesized that the two techniques would produce equivalent doses under pre-established conditions of activity and exposure time. Materials and methods: simulations of implants with {sup 99m}Tc-filled and HDR {sup 192}Ir-filled balloons were performed with the Siscodes/MCNP5, modeling in voxels a magnetic resonance imaging set related to a young female. Spatial dose rate distributions were determined. In the dosimetric analysis of the protocols, the exposure time and the level of activity required were specified. Results: the {sup 99m}Tc balloon presented a weighted dose rate in the tumor bed of 0.428 cGy.h{sup -1}.mCi{sup -1} and 0.190 cGyh{sup -1} at the balloon surface and at 8-10 mm from the surface, respectively, compared with 0.499 and 0.150 cGyh{sup -1}.mCi{sup -1}, respectively, for the HDR {sup 192}Ir balloon. An exposure time of 24 hours was required for the {sup 99m}Tc balloon to produce a boost of 10.14 Gy with 1.0 Ci, whereas only 24 minutes with 10.0 Ci segments were required for the HDR {sup 192}Ir balloon to produce a boost of 5.14 Gy at the same reference point, or 10.28 Gy in two 24-minutes fractions. Conclusion: temporary {sup 99m}Tc balloon implantation is an attractive option for adjuvant radiotherapy in breast cancer, because of its availability, economic viability, and similar dosimetry in comparison with the use of HDR {sup 192}Ir balloon implantation, which is the current standard in clinical practice. (author)