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Sample records for bleed operating regions

  1. Predictors of re-operation due to post-surgical bleeding in breast cancer patients

    DEFF Research Database (Denmark)

    Winther Lietzen, L; Cronin-Fenton, Deirdre; Garne, Jens Peter;

    2012-01-01

    To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation.......To assess the risk of re-operation due to post-surgical bleeding after initial breast cancer surgery and to identify predictors of re-operation....

  2. Regional blood flow in brain and peripheral tissues during acute experimental arterial subdural bleeding.

    Science.gov (United States)

    Orlin, J R; Zwetnow, N N; Hall, C

    1993-01-01

    The effects of a large intracranial arterial subdural bleeding on regional blood flow in the brain (rCBF) and in other body organs were studied, using a porcine model. The bleeding was produced by leading blood through a catheter from the abdominal aorta via an electronic drop recorder into the subdural compartment (SDC) over the left cerebral hemisphere. Pressures in the right lateral cerebral ventricle and in the cisterna magna were recorded along with 15 other vital parameters. Measurements of rCBF were carried out using radioactive microspheres 1) before the start of bleeding, 2) during the early bleeding phase, and 3) during the late bleeding phase. When the bleeding was initiated, the intracranial pressures rose within one minute to a level approximately 40 mmHg below the systemic arterial pressure, whilst the latter usually decreased 30-40 mmHg. In the subsequent early bleeding phase the cerebral perfusion pressure and the bleeding pressure fluctuated at a level of approximately 40 mmHg for several minutes. In the late bleeding phase, the perfusion pressure decreased maximally, even when a Cushing reaction was activated. During the early bleeding phase the changes in rCBF varied between the cerebral regions. However, the mean flow remained largely constant in the presence of a decreasing cerebrovascular resistance, indicating that autoregulation of CBF was intact. Concomitantly, cardiac output and heart rate decreased, whilst regional blood flow in extracerebral organs tended to increase, possibly due to an intracranial effect on the autonomic nervous system. In the late bleeding phase, rCBF was critically reduced in all regions, in spite of a marked rise in systemic arterial pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8372718

  3. Comparison of local infiltration of adrenalized lidocaine with adrenaline alone in operative field bleeding in Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Mitra Yari

    2015-05-01

    Full Text Available Background: In many head and neck surgeries, operative field bleeding plays an important role in the success of surgery and reducing the time of operation. The current study was conducted to compare local infiltration of adrenalized lidocaine with adrenaline alone in operative field bleeding in Rhinoplasty. Methods: In this randomized clinical trial, 56 candidate patients aged15-45 years for Rhinoplasty with ASA class I and II were randomly divided into two groups of lidocaine and control. Group 1 was administered lidocaine 2% with adrenaline and group 2 was administered normal saline with adrenaline , Operative field bleeding was then recorded and compared between groups. Results: There was not a significant difference between groups in preoperative systolic BP and diastolic BP, postoperative (15 min systolic BP and diastolic BP , preoperative heart rate and postoperative (15 minheart rate , operative field bleeding and bleeding scale. Conclusion: the effect of lidocaine 2% in operative field bleeding is the same as that of normal saline. Hence, adrenaline along with normal saline can be used in Rhinoplasty.

  4. A Study on the Operator Decision Support for Feed-and-Bleed Operation

    International Nuclear Information System (INIS)

    In the case of a combined accident that includes a failure of the secondary cooling system, it is difficult for operators to recognize the necessity of an feed and bleed (F and B) operation because a lot of parameters and alarms should be checked before a decision, and operators may spend a considerable amount of time arriving at the entry for a proper emergency operating procedure that contains the procedure for an F and B operation. Therefore, a clear identification of the success boundary of an F and B operation would help operators in their decision-making when a combined accident that includes a secondary cooling system failure occurs. This study will provide a useful guideline for the initiation of an F and B operation for operators. Cooling the RCS after a scram is one of the most important safety functions for preventing core damage. To support the operator in decision making whether to initiate the F and B operation, plant conditions requiring the initiation of an F and B operation were identified. Plant conditions are affected by the steam generator inventory, RCS inventory, core inventory, and safety injection availability. The combination of accident types, component availabilities, and the initiation time of an F and B operation affect the success of the F and B operation. Operators need clear information about the RCS condition when the steam generators, the RCS's main residual heat removal mechanism, become unavailable. When this happens, the initiation of an F and B operation becomes necessary. As the number of the state increases, the necessity of an F and B operation increases. Especially, the operator should initiate an F and B operation when the RCS condition enters State 3 for Type 1 incidents or State 3-2 for Type 2 incidents. The results of this study may be useful in providing information regarding the necessity and effects of an F and B operation in a quantitative manner. In particular, in the case of a combined accident including a

  5. Dynamic sequence analysis for feed-and-bleed operation in an OPR1000

    International Nuclear Information System (INIS)

    Highlights: • An analysis of the necessity and effects of a feed-and-bleed operation is performed. • Plant conditions requiring an feed-and-bleed operation are identified. • Boundaries for each state are identified to support the operator’s decision. • A thermohydraulic analysis is performed to determine this success boundary. • Analysis results provide a useful guideline under complicated combined accident. - Abstract: A feed-and-bleed (F and B) operation in an OPR1000 provides residual heat removal when the secondary cooling system is not available. Operators may hesitate to initiate F and B operation if a clear cue is not provided because its initiation will result in the release of radioactive coolant into the containment structure. An analysis of the necessity and effects of F and B operation was performed systematically. The plant conditions requiring F and B operation were categorized as type of transients. The factors which affect the necessity and effects of F and B operation are water inventory in the primary and secondary cooling systems, break size and timing of the break-up in the case of loss-of-coolant accident, the availability of the safety injection system and safety depressurization system, and timing of the F and B operation initiation. The boundary of each state in an OPR1000 was identified and the effects of factors were investigated to support the operator’s decision to initiate F and B operation under various reactor conditions. A thermohydraulic analysis was performed using the MARS code to determine this success boundary. This study is expected to provide a useful guideline for the initiation of F and B operation for operators. In particular, in the case of a combined accident including a secondary cooling system failure, the provision of clear information will play a critical role in the operators’ decision to initiate F and B operation

  6. Comparative analysis of assessment methods for operational and anesthetic risks in ulcerative gastroduodenal bleeding

    Directory of Open Access Journals (Sweden)

    Potakhin S.N.

    2015-09-01

    Full Text Available Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK, proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

  7. Bleeding outcome during a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia: a prospective study.

    Science.gov (United States)

    Fariz-Safhan, M N; Tee, H P; Abu Dzarr, G A; Sapari, S; Lee, Y Y

    2014-06-01

    During a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia, one of the worst hit areas in the country at that time, we undertook a prospective study. We aimed to describe the bleeding outcome and changes in the liver and hematologic profiles that were associated with major bleeding outcome during the outbreak. All suspected cases of dengue admitted into the only referral hospital in the region during the outbreak were screened for WHO 2002 criteria and serology. Liver function, hematologic profile and severity of bleeding outcome were carefully documented. The association between symptoms, liver and hematologic impairments with the type of dengue infection (classical vs. hemorrhagic) and bleeding outcome (major vs. non-major) was tested. Dengue fever was confirmed in 183 cases (12.5/100,000 population) and 144 cases were analysed. 59.7% were dengue hemorrhagic fever, 3.5% were dengue shock syndrome and there were 3 in-hospital deaths. Major bleeding outcome (gastrointestinal bleeding, intracranial bleeding or haemoptysis) was present in 14.6%. Elevated AST, ALT and bilirubin were associated with increasing severity of bleeding outcome (all P profiles was seen in major bleeding outcome. PMID:25134895

  8. Association of blood products administration during cardiopulmonary bypass and excessive post-operative bleeding in pediatric cardiac surgery.

    Science.gov (United States)

    Agarwal, Hemant S; Barrett, Sarah S; Barry, Kristen; Xu, Meng; Saville, Benjamin R; Donahue, Brian S; Harris, Zena L; Bichell, David P

    2015-03-01

    Our objectives were to study risk factors and post-operative outcomes associated with excessive post-operative bleeding in pediatric cardiac surgeries performed using cardiopulmonary bypass (CPB) support. A retrospective observational study was undertaken, and all consecutive pediatric heart surgeries over 1 year period were studied. Excessive post-operative bleeding was defined as 10 ml/kg/h of chest tube output for 1 h or 5 ml/kg/h for three consecutive hours in the first 12 h of pediatric cardiac intensive care unit (PCICU) stay. Risk factors including demographics, complexity of cardiac defect, CPB parameters, hematological studies, and post-operative morbidity and mortality were evaluated for excessive bleeding. 253 patients were studied, and 107 (42 %) met the criteria for excessive bleeding. Bayesian model averaging revealed that greater volume of blood products transfusion during CPB was significantly associated with excessive bleeding. Multiple logistic regression analysis of blood products transfusion revealed that increased volume of packed red blood cells (PRBCs) administration for CPB prime and during CPB was significantly associated with excessive bleeding (p = 0.028 and p = 0.0012, respectively). Proportional odds logistic regression revealed that excessive bleeding was associated with greater time to achieve negative fluid balance, prolonged mechanical ventilation, and duration of PCICU stay (p < 0.001) after adjusting for multiple parameters. A greater volume of blood products administration, especially PRBCs transfusion for CPB prime, and during the CPB period is associated with excessive post-operative bleeding. Excessive bleeding is associated with worse post-operative outcomes.

  9. Transjugular Endovascular Recanalization of Splenic Vein in Patients with Regional Portal Hypertension Complicated by Gastrointestinal Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xuefeng; Nie, Ling; Wang, Zhu; Tsauo, Jiaywei; Tang, Chengwei; Li, Xiao, E-mail: simonlixiao@126.com [West China Hospital, Sichuan University, Department of Gastroenterology (China)

    2013-05-02

    PurposeRegional portal hypertension (RPH) is an uncommon clinical syndrome resulting from splenic vein stenosis/occlusion, which may cause gastrointestinal (GI) bleeding from the esophagogastric varices. The present study evaluated the safety and efficacy of transjugular endovascular recanalization of splenic vein in patients with GI bleeding secondary to RPH.MethodsFrom December 2008 to May 2011, 11 patients who were diagnosed with RPH complicated by GI bleeding and had undergone transjugular endovascular recanalization of splenic vein were reviewed retrospectively. Contrast-enhanced computed tomography revealed splenic vein stenosis in six cases and splenic vein occlusion in five. Etiology of RPH was chronic pancreatitis (n = 7), acute pancreatitis with pancreatic pseudocyst (n = 2), pancreatic injury (n = 1), and isolated pancreatic tuberculosis (n = 1).ResultsTechnical success was achieved in 8 of 11 patients via the transjugular approach, including six patients with splenic vein stenosis and two patients with splenic vein occlusion. Two patients underwent splenic vein venoplasty only, whereas four patients underwent bare stents deployment and two covered stents. Splenic vein pressure gradient (SPG) was reduced from 21.5 ± 7.3 to 2.9 ± 1.4 mmHg after the procedure (P < 0.01). For the remaining three patients who had technical failures, splenic artery embolization and subsequent splenectomy was performed. During a median follow-up time of 17.5 (range, 3–34) months, no recurrence of GI bleeding was observed.ConclusionsTransjugular endovascular recanalization of splenic vein is a safe and effective therapeutic option in patients with RPH complicated by GI bleeding and is not associated with an increased risk of procedure-related complications.

  10. Identification of Success Criteria for Automated Function Using Feed and Bleed Operation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Gyung; Kim, Sang Ho; Kang, Hyun Gook [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa Univ. of Science, Technology and Research, Abu Dhabi (United Arab Emirates)

    2013-10-15

    Since NPP has lots of functions and systems, operated procedure is much complicated and the chance of human error to operate the safety systems is quite high. In the case of large break loss of coolant accident (LBLOCA) and station black out (SBO), the dependency of operator is very low. However, when many mitigation systems are still available, operators have several choices to mitigate the accident and the human error can be increased more. To reduce the operator's workload and perform the operation accurate after the accident, automated function for safe cooldown based on the feed and bleed (F and B) operation was suggested. The automated function can predict whether the plant will be safe after the automated function is initiated, and perform the safety functions automatically. To expect the success of cooldown, success criteria should be identified. To perform the operation accurately after the accident, the automated function for safe cooldown based on the F and B operation is suggested. To expect the success of cooldown, sequence of RCS situation when heat removal by secondary system fails is identified. Based on the sequence of RCS situation, four levels of necessity of F and B operation are classified. To obtain the boundary of levels, the TH analysis will be performed.

  11. An Estimation of Operator's Diagnostic Time for Feed-And-Bleed Operation under Various Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Abu Dhabi (United Arab Emirates)

    2015-10-15

    In order to assess realistic safety of plant, effects of interactions between components, operator, and plant condition are needed to be considered in the PSA model. One of the important issues to estimate the CDF is the estimation of human error probability (HEP). When an accident occurs, operators follow the emergency operating procedure and check various alarm, parameters, and signals. In the conventional Korean PSA model, the Korean standard HRA (K-HRA) method is used. In this method, the HEP is the sum of diagnosis error probability and execution error probability. A diagnosis error probability is expressed by the available time for diagnosis and adjusting performance shaping factors, and an execution error probability is a function of task type and stress level. Available time for diagnosis is very important factor of HEP. If the available time for diagnosis is short, the HEP becomes high. In order to obtain the realistic risk assessment results, we first focus on the estimation of HEP considering the plant dynamics under various scenarios. Target operation and scenarios are feed-and bleed operation (F and B operation) and total loss of feedwater (TLOFW) accident with/without loss of coolant accident (LOCA). One of the highest HEP is HEP of FnB operation. In additional, Scenarios, which are related to combination secondary heat removal failure and primary heat removal failure, are most critical core damage scenario of the combined accident except scenarios related to station black out (SBO). In these scenarios, the FnB operation is last resort to prevent core damage. To estimate available operator diagnosis time, we identify the relationship between accidents, mitigation function, and plant condition. Distribution of available time of diagnosis was estimated using the MOSAIQUE. The variables are break size, break timing, trip timing of RCP, and availability of high pressure safety injection (HPSI) pump under the TLOFW accident with LOCA. For Type 1 accident

  12. Incidence of early pregnancy bleeding in the Eastern region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Wafaa Hassan

    2016-05-01

    Conclusions: The incidence of first trimester vaginal bleeding is high in our center when compared with figures from published literature. The incidence of threatened miscarriage is low, while the incidence of complete or incomplete miscarriage is relatively high. Similar to other reports from Asia, the incidence of molar pregnancy was very high. Further research is recommended to justify the detected high first trimester vaginal bleeding rates and to identify potentials of prevention or improvement of the outcomes of bleeding. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1392-1399

  13. Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany

    Directory of Open Access Journals (Sweden)

    Garbe Edeltraut

    2011-08-01

    Full Text Available Abstract Background Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM. Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. Methods We analysed hospitalisation diagnoses for oesophageal bleeding (OB and upper gastrointestinal bleeding (UGIB from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided or "unspecific" (origin of bleeding not provided coding. We studied regional (former East versus West Germany differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Results Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32 for specific and 0.67 (95% CI 0.60-0.74 for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51 for specific and 0.83 (95% CI 0.80-0.87 for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. Conclusions During the study

  14. 扁桃体剥离术后出血15例原因分析%Analysis of 15 Cases of Bleeding after Tonsillectomy Operation

    Institute of Scientific and Technical Information of China (English)

    张颖; 殷文斌; 王玲

    2014-01-01

    Objective To investigate the causes of bleeding after tonsil ectomy operation, prevention and treatment. Methods The undergraduate department in the past 10 years operation after tonsil ectomy bleeding were retrospectively analyzed. Results 429 cases of tonsil ectomy patients, 15 cases of bleeding, bleeding rate was 3.5%, hemorrhage patients were timely hemostasis, cured. Conclusion After tonsil operation bleeding and operation improvement before operation and operation operation examination, the patient's own factors, after care are related to improve before operation, check operation, careful operation, thorough hemostasis, prevention of infection after operation, strengthening the nursing guidance and other measures, reduce the incidence of bleeding after tonsil operation.%目的:探讨扁桃体剥离术后出血的原因、预防和治疗。方法对本科室近10年行扁桃体剥离术后出现出血的病例资料进行回顾性分析。结果429例扁桃体剥离术患者中,出血15例,出血率3.5%,出血患者均及时止血,痊愈出院。结论扁桃体术后出血与术前完善检查、患者自身因素、术中操作及术后护理均有关,要做到术前完善检查、术中仔细操作、彻底止血、术后预防感染、加强护理指导等各项措施,降低扁桃体术后出血发生率。

  15. Management of upper gastrointestinal bleeding from portal hypertension: Elective or emergency operation?

    OpenAIRE

    Liu, Sen

    2014-01-01

    Objective : To evaluate the clinical outcome of emergency and elective operation of splenectomy with periesophagogastric devascularization in treating upper gastrointestinal hemorrhage resulted from portal hypertension. Methods : We retrospectively reviewed 219 patients of upper gastrointestinal hemorrhage resulted from portal hypertension treated using emergency or elective operation between Jul 2002 and Aug 2010. The clinical data were collected and analyzed. Results : In the group of elect...

  16. Feed and Bleed Operation Analysis during Total Loss of Feedwater Accident for Supporting the PSA of APR+

    International Nuclear Information System (INIS)

    For estimating the safety of APR+ design, the probabilistic safety assessment (PSA) is performed. This paper discusses the minimum success criteria for successful feed and bleed procedure verified and decided when the secondary cooling is failed during Total loss of feedwater (TLOFW) accident. For verifying whether the equipment conditions proposed is enough to manage the transient event without core damage, the analysis is performed by RELAP5/MOD 3.3 code. During TLOFW event, the operator's action time is allowed for 80 minutes and the uncovered core could maintain the stable state for a long time, about a half or one hour by the positive effects given by the fast coolant circulation by RCP pump operation. In simulations considering test scenarios, the minimum required equipment for successful F and B managing during TLOFW without LOOP is verified that it is that F and B procedure could be performed successfully as if the operator would open at least one out of four POSRV within 80 minutes after secondary cooling failure for the RCS depressurization. These analysis results can be used for contribute more realistic and accurate performance of a APR+ PSA

  17. [Gastrointestinal bleeding].

    Science.gov (United States)

    Lanas, Ángel

    2015-09-01

    In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes. PMID:26520197

  18. Bleeding Disorders

    Science.gov (United States)

    ... times I'd miss work and skip the gym because I felt so lousy. So I decided ... cell called platelets. Your body also needs blood proteins called clotting factors. In people with bleeding disorders, ...

  19. Experiences in Reducing Intra-operative Bleeding during Laparoscopic Splenectomy%减少腹腔镜脾切除术出血初步体会

    Institute of Scientific and Technical Information of China (English)

    李巍; 董晓彤; 张学军; 李剑; 贺宇宏; 康建省

    2011-01-01

    目的 探讨预防和减少腹腔镜脾切除术出血的措施.方法 选取2008年1月-2010年3月我院行腹腔镜脾切除术患者40例,超声刀离断脾周韧带,胰腺上缘结扎脾动脉,离断脾门血管,切除脾脏.结果 本组40例患者均采用腹腔镜完成手术.术中发现3例副脾,一并切除.手术时间90~210 min,平均130 min.出血50~800 ml,平均160 ml.术后12~24 h胃肠蠕动恢复,术后24 h拔胃管并进流质饮食,术后住院5~9 d.全组无手术死亡,无术后出血、门静脉血栓形成、脏器意外损伤患者.结论 结扎脾动脉,避免脾包膜撕裂,妥善处理脾蒂血管可减少腹腔镜脾切除术出血.%Objective To explore measures that can effectively prevent and reduce intraoperative bleeding during laparoscopic splenectomy. Methods Totally 40 patients who underwent laparoscopic splenectomy from January 2008 to March 2010 were enrolled in this study. The splenic surrounding ligaments were cut by ultrasound knife, splenic artery above the pancreatic tail was ligated, the vessels of splenic hilum was cut, and the then the spleen was resected. Results All surgeries were completed under laparoscope. Three accessory spleens were found during the operation and were resected. The operation duration ranged 90- 210 min ( mean: 130 min ). The intra - operative blood loss ranged 50-800 ml ( mean: 160 ml ). Gastrointestinal motility was recovered 12 ~24 hours after surgery. Gastric tube was withdrawn 24 hours after surgery, and then liquid diet was provided. The post - operative hospital stay ranged 5~ 9 days. No surgery - related death was noted. No post - operative bleeding , portal vein thrombosis, incidental organ injury was noted. Conclusion Bleeding during laparoscopic splenectomy may be reduced by ligating splenic artery, avoiding the rupture of spleenic envelope, and proper handling of vessels of splenic hilum.

  20. Bleeding Disorders Treatment Options

    Science.gov (United States)

    ... Pictures Young Voices Compendium of Assessment Tools Educational Games Video Library Find a Treatment Centre Haemophilia Journal About Bleeding Disorders Bleeding Disorders The Clotting Process Drugs That Can Cause Bleeding Hemophilia How Do You ...

  1. EELA Operations: A standalone regional dashboard implementation

    OpenAIRE

    L'Orphelin, Cyril; Cordier, Hélène; Reynaud, Sylvain; Lins, Marcos; Loikkanen, Sinika; Lequeux, Olivier; Veyre, Pierre

    2013-01-01

    International audience Grid operators in EGEE use a dedicated dashboard as their central operational tool, stable and scalable for the last 5 years despite continuous upgrade from specifications by users, monitoring tools or data providers. In EGEE-III, regionalisation of operations led the tool developers to conceive a standalone instance of this tool. Hereby, we will present the concept and the EELA-II implementation. Indeed, there-engineering of this tool led to an easily deployable pac...

  2. [Diagnosis and therapy of bleeding in ENT].

    Science.gov (United States)

    Schulz, T; Eßer, D

    2013-12-01

    Bleeding in the oral cavity, nose or ear are common events in the daily routine of ENT specialists. Apart from trivial cases that often get outpatient treatment, there are numerous cases of serious bleeding that require stationary treatment and if necessary, an operative or interventional therapy. In the following section the most frequent types of bleeding, their diagnosis and therapy will be explained. PMID:24285208

  3. An Analysis of Effect of Break-up Timing on the Necessity of a Feed-and-Bleed Operation in the case of TLOFW with Local

    International Nuclear Information System (INIS)

    A Feed-and-bleed (F and B) operation is a process to cool the reactor by the primary side directly. If adequate residual heat removal through the secondary side is not available, the heat can be removed from the RCS by F and B operation. A total loss of feedwater (TLOFW) accident is used to represent an accident involving the failure of cooling by the secondary cooling system. Even if the secondary cooling system fails, the RCS can be cooled by F and B transients when a loss of coolant accident (LOCA) with a TLOFW accident occurs. During an F and B transient, the RCS has a residual heat removal mechanism. If the break size is large, an F and B transient continuously occurs if the SIS is available. If the break size is small to sufficiently decrease the RCS pressure, the SIS cannot inject the coolant, causing the F and B transient to terminate. After the termination of the F and B transient, the residual heat cannot be removed, and the necessity of an F and B operation increases. The operators may hesitate to initiate F and B operation if a clear cue is not provided, since its initiation implies the radioactive coolant releases into the containment. Therefore, the necessity of F and B operation is needed to be identified. The factors affected the necessity of F and B operation are the availability of the safety injection system and safety depressurization system, water inventory in the primary and secondary cooling systems, break size in a loss-of-coolant accident, and time of accident occurrence. The necessity of F and B operation can be changed according to different timing of break-up despite same break size. Moreover, different timing of break-up makes the operators more complicated. To identify effect of timing of break-up, a thermohydraulic analysis was performed using the MARS code. This study is expected to provide a useful guideline to identify the necessity of an F and B operation under combined accident

  4. The Massive Bleeding after the Operation of Hip Joint Surgery with the Acquired Haemorrhagic Coagulation Factor XIII(13) Deficiency: Two Case Reports.

    Science.gov (United States)

    Kanda, Akio; Kaneko, Kazuo; Obayashi, Osamu; Mogami, Atsuhiko

    2013-01-01

    Two women, aged 81 and 61, became haemorrhagic after surgery. Their previous surgeries were uneventful with no unexpected bleeding observed. Blood tests prior to the current surgeries indicated normal values including those related to coagulation. There were no problems with the current surgeries prior to leaving the operating room. At 3 hours after the surgery, the 81-year-old patient had an outflow of the drain at 1290 grams and her blood pressure decreased. She had disseminated intravascular coagulation (DIC). The 61-year-old woman had repeated haemorrhages after her current surgery for a long time. Their abnormal haemorrhages were caused by a deficiency of coagulation factor XIII(13). The mechanism of haemorrhagic coagulation factor XIII(13) deficiency is not understood, and it is a rare disorder. The only diagnostic method to detect this disorder is to measure factor XIII(13) activity in the blood. In this paper, we used Arabic and Roman numerals at the same time to avoid confusion of coagulation factor XIII(13) with coagulation factor VIII(8) that causes hemophilia A. PMID:23533879

  5. The Massive Bleeding after the Operation of Hip Joint Surgery with the Acquired Haemorrhagic Coagulation Factor XIII(13 Deficiency: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Akio Kanda

    2013-01-01

    Full Text Available Two women, aged 81 and 61, became haemorrhagic after surgery. Their previous surgeries were uneventful with no unexpected bleeding observed. Blood tests prior to the current surgeries indicated normal values including those related to coagulation. There were no problems with the current surgeries prior to leaving the operating room. At 3 hours after the surgery, the 81-year-old patient had an outflow of the drain at 1290 grams and her blood pressure decreased. She had disseminated intravascular coagulation (DIC. The 61-year-old woman had repeated haemorrhages after her current surgery for a long time. Their abnormal haemorrhages were caused by a deficiency of coagulation factor XIII(13. The mechanism of haemorrhagic coagulation factor XIII(13 deficiency is not understood, and it is a rare disorder. The only diagnostic method to detect this disorder is to measure factor XIII(13 activity in the blood. In this paper, we used Arabic and Roman numerals at the same time to avoid confusion of coagulation factor XIII(13 with coagulation factor VIII(8 that causes hemophilia A.

  6. Genome-wide association study identifies a region on chromosome 11q14.3 associated with late rectal bleeding following radiation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Background and purpose: Rectal bleeding can occur following radiotherapy for prostate cancer and negatively impacts quality of life for cancer survivors. Treatment and clinical factors do not fully predict rectal bleeding, and genetic factors may be important. Materials and methods: A genome-wide association study (GWAS) was performed to identify SNPs associated with the development of late rectal bleeding following radiotherapy for prostate cancer. Logistic regression was used to test the association between 614,453 SNPs and rectal bleeding in a discovery cohort (79 cases, 289 controls), and top-ranking SNPs were tested in a replication cohort (108 cases, 673 controls) from four independent sites. Results: rs7120482 and rs17630638, which tag a single locus on chromosome 11q14.3, reached genome-wide significance for association with rectal bleeding (combined p-values 5.4 × 10−8 and 6.9 × 10−7 respectively). Several other SNPs had p-values trending toward genome-wide significance, and a polygenic risk score including these SNPs shows a strong rank-correlation with rectal bleeding (Sommers’ d = 5.0 × 10−12 in the replication cohort). Conclusions: This GWAS identified novel genetic markers of rectal bleeding following prostate radiotherapy. These findings could lead to the development of a predictive assay to identify patients at risk for this adverse treatment outcome so that dose or treatment modality could be modified

  7. [Acute gastrointestinal bleeding].

    Science.gov (United States)

    Baumbach, Robert; Faiss, Siegbert; Cordruwisch, Wolfgang; Schrader, Carsten

    2016-04-01

    Acute gastrointestinal bleeding is a common major emergency (Internal medical or gastroenterological or medical), approximately 85 % of which occur in the upper GI tract. It is estimated that about a half of upper GI bleeds are caused by peptic ulcers. Upper GI bleeds are associated with more severe bleeding and poorer outcomes when compared to middle or lower GI bleeds. Prognostic determinants include bleeding intensity, patient age, comorbid conditions and the concomitant use of anticoagulants. A focused medical history can offer insight into the bleeding intensity, location and potential cause (along with early risk stratification). Initial measures should focus on rapid assessment and resuscitation of unstable patients. The oesophagogastroduodenoscopy (OGD) is the gold standard method for localizing the source of bleeding and for interventional therapy. Bleeding as a result of peptic ulcers is treated endoscopically with mechanical and / or thermal techniques in combination with proton pump inhibitor (PPI) therapy. When variceal bleeding is suspected, pre-interventional use of vasopressin analogues and antibiotic therapies are recommended. Endoscopically, the first line treatment of esophageal varices is endoscopic ligature therapy, whereas that for gastric varices is the use of Histoacryl injection sclerotherapy. When persistent and continued massive hemorrhage occurs in a patient with known or suspected aortic disease the possibility of an aorto-enteric fistula must be considered. PMID:27078246

  8. Operations of the Biblioteca Regional de Medicina (BIREME).

    Science.gov (United States)

    Neghme, A

    1975-04-01

    The operations and accomplishments of the Biblioteca Regional de Medicina (BIREME), the regional medical library of the Pan American Health Organization, are summarized. Aspects of BIREME's program which are described include: strengthening biomedical collections in Latin America, network organization, international cooperation, document and information delivery, bibliographic services, and educational efforts.

  9. Natural gas co-operation in the Baltic region

    International Nuclear Information System (INIS)

    Co-operation between the gas companies in the Baltic Region has been in place for several years. The overview given in this paper shows that the co-operation has been developed in trade, investments, privatisation and participation in the restructuring process. Finally, through a broad technical co-operation, significant efforts are made to establish common operational practices, codes and standards and the integrity of gas transmission pipelines. The Baltic Region, from a resource and gas interconnection point of view, enjoys a strategic position in the future development of the gas industry in Europe. The Baltic gas sector represents an interesting and growing gas market with the significant gas storage capacity. The region is also located strategically for planned gas interconnections and could serve as a transit corridor for the future gas supplies from western Siberia or the North Sea. This co-operation in the region is being supported by international regulations and agreements such as the Energy Charter between the European Union and the central and east European countries. However, at present the gas industry in the Baltic Region seems to be ahead of these international agreements. It may well be seen that trade arrangements such as Third Party Access are implemented directly by market forces rather than through international agreements. The regional development may thus be a driving force for the implementation of the Internal Energy Market for the gas industry

  10. Promoting regional energy co-operation in South Asia

    International Nuclear Information System (INIS)

    Energy is a key ingredient of the socio-economic development of any region. South Asia is not only one of the fastest growing regions in the world; it is also one of the poorest, which thus puts energy at the very heart of the development process in the region. This paper looks at the challenges faced by the South Asia sub-region for economic co-operation (SASEC) comprised of Bangladesh, Bhutan, India and Nepal, and also at the role of greater regional energy co-operation therein. The region is characterized by pressures of growing economies and increasing population. While the per capita energy consumption is one of the lowest in the world, energy intensity continues to be very high. A large portion of the population lacks access to modern sources of energy and depends on traditional sources that are not only inefficient but also have severe health and environmental problems associated with them. Increasing oil import dependency and huge investment needs for energy market development pose a further challenge. The region has a good resource potential and tremendous scope for energy co-operation, which can play a key role in addressing many of these energy security concerns and in putting it on the path of sustainable development. It is ironic that the record in the area has been so limited and that too in the most basic form of co-operation, i.e. bilateral arrangements between countries. This paper puts forth a multi-pronged strategy for sub-regional energy co-operation encompassing softer options aimed at confidence building to more substantial and larger scale co-operation efforts. Delays in decision making to ensure stronger and mutually beneficial co-operation efforts are associated with high costs not only to the energy sector but also for the entire development agenda. With the precarious energy situation in the region and unprecedented increases in international oil prices seen in recent times, it is high time for policy makers, financing institutions, NGOs

  11. Towards the Capacity Region of Multiplicative Linear Operator Broadcast Channels

    CERN Document Server

    Pang, Yimin

    2010-01-01

    Recent research indicates that packet multicasting employing random linear network coding can be regarded as transmitting subspaces as codewords over a linear operator channel (LOC). A LOC is normally viewed as a discrete memoryless unicast subspace channel over a finite field. In this paper we propose the framework of linear operator broadcast channels (LOBCs) and start initial work on determining their capacity region. LOBC correspond to a single-source multiple-recipients network, where every recipient's subchannel is a LOC having its own capacity. Our discussion concerns a class of constant-dimension multiplicative LOBCs (CMLOBCs), whose input subspaces have constant dimension and missing vectors of a subspace constitute the only possible channel interference. We first give a necessary and sufficient condition for a CMLOBC being stochastically degraded. Then we classify weakly and strongly degraded CMLOBCs. By numerically computing capacity regions with an Arimoto-Blahut type algorithm and discussing seve...

  12. Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries.

    Science.gov (United States)

    Kim, Ju Hyun; Joung, Eun-Ju; Lee, Soo-Jung; Kwack, Jae Young; Kwon, Yong Soon

    2015-11-01

    There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

  13. Operations plan for the Regional Seismic Test Network

    International Nuclear Information System (INIS)

    The Regional Seismic Test Network program was established to provide a capability for detection of extremely sensitive earth movements. Seismic signals from both natural and man-made earth motions will be analyzed with the ultimate objective of accurately locating underground nuclear explosions. The Sandia National Laboratories, Albuquerque, has designed an unattended seismic station capable of recording seismic information received at the location of the seismometers installed as part of that specific station. A network of stations is required to increase the capability of determining the source of the seismic signal and the location of the source. Current plans are to establish a five-station seismic network in the United States and Canada. The Department of Energy, Nevada Operations Office, has been assigned the responsibility for deploying, installing, and operating these remote stations. This Operation Plan provides the basic information and tasking to accomplish this assignment

  14. Bleeding during Pregnancy

    Science.gov (United States)

    ... have placenta accreta, you are at risk of life-threatening blood loss during delivery. Your ob-gyn will plan your ... to be done right after delivery to prevent life-threatening blood loss. Can bleeding be a sign of preterm labor? ...

  15. Laparoscopic resection of bleeding gastric polyps.

    Science.gov (United States)

    Siu, W T; Leong, H T; Li, M K

    1997-03-01

    Gastric polyps account for a small proportion of gastric neoplasms. Many of them presented with acute or chronic bleeding. Endoscopic polypectomy is the preferred treatment modality. However, endoscopic polypectomy is often incomplete and impossible for large polyps. Large and intramural polyps require laparotomy and excision. From June to October 1995, four patients with bleeding gastric polyps received laparoscopic resection in our unit. All were women, aged 40-78, with polyps 2-6 cm in diameter. One patient underwent emergency surgery for active bleeding. The others received elective operations. Operating time ranged from 90 to 120 min. There was no perioperative morbidity or mortality. Full diet was resumed by the 4th postoperative day. The average postoperative hospital stay was 5. 3 days (4-7). Laparoscopic resection of gastric polyp is a preferable treatment option when endoscopic treatment fails.

  16. Optimum bleeding rate of open loop ground source heat pump systems determined by hydrogeological modeling in Korea

    Science.gov (United States)

    Jeon, W. H.; Kim, N.; Lee, J. Y.

    2014-12-01

    This study aims to evaluate the influence of open loop ground source heat pump systems operation on hydrological conditions of aquifer. Test bed is located in Chuncheon, Korea. The step drawdown test was conducted in five stages for 300 minutes. The variation of groundwater levels by open loop ground source heat pump systems operation was estimated using Visual MODFLOW. Transmissivity ranged from 2.02×10-4 to 9.36×10-4, and storage coefficient ranged from 0.00067 to 0.021. The amount of optimum bleeding was calculated to be 240 m3/day. When bleeding will be 50, 90, 240 and 450 m3/day for 5 years, groundwater levels may decrease 1.84, 3.31, 8.89 and 17.0 m, respectively. If the amount of bleeding is 50 m3/day, the influence of bleeding will not reach the boundary regions of the Soyang River after 5 years. Regarding the open loop ground source heat pump system installed at the test bed, the amount of optimum bleeding in accordance with the stand are proposed by the government is 90 m3/day, which is 20% of the 450 m3/day circulation quantity of the system. However, if continuous bleeding of more than 90 m3/day occurs, then the radius of influence is expected to reach the boundary regions of the Soyang River after 5 years. These results indicate that amount of optimum bleeding differ in each open loop ground soured heat pump system. Therefore, the debate for the amount of optimum bleeding in open loop ground source heat pump systems is demanded. This work is supported by the Energy Efficiency and Resources of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) grant funded by the Korea government Ministry of Knowledge Economy (No.20123040110010).

  17. RF Regional Technical Centers for MPC and A Sustainability Operations

    International Nuclear Information System (INIS)

    The National Nuclear Security Administration (NNSA) programmatic vision to be a catalyst in Russia's assumption of responsibility for long-term system operation is exemplified in the sustainability cooperation with the RF Ministry of Defense (MOD). An identified goal for the MPC and A Program is to encourage the development of Russian Federation (RF) capabilities and commitments to operate and maintain safeguard improvements. The RF MOD Technical Support Center development fulfills the NNSA mission and MPC and A Program goal. The regional technical center concept involves a systematic approach to aid in the determination of the level of sustainability assistance required to transition operators, maintenance, training, and testing of MPC and A systems to the RF MOD. This paper describes the process used to create the RF MOD Technical support center. First are described the needs analyses conducted to determine the key system sustainability factors requiring support. These sustainability functions are then compiled to influence the form and ultimate physical design of the technical support center. Operational interfaces are described, in detail that show the benefit of the center to the individual sites. Finally, benefits relating to information accessibility and other economies of scale are described that highlight the central center concept's strengths

  18. Crew Factors in Flight Operations XIV: Alertness Management in Regional Flight Operations Education Module

    Science.gov (United States)

    Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.

    2002-01-01

    Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

  19. Evaluation Practice of Regional Operational Programmes in Poland

    Directory of Open Access Journals (Sweden)

    Tomasz Kupiec

    2014-09-01

    Full Text Available Purpose: The study concentrated on the process of evaluation of public programs currently implemented with the support of European Union funds in Poland. The aim was to show how the evaluation practice was adopted in the regional administration within programming and implementation of Regional Operational Programs 2007–2013 (ROP. The author analysed what types of decisions are primarily supported by evaluation and what functions evaluation serves. Methodology: The quantitative analysis was based on data drawn from documentation of the full population of ROP evaluations completed in 2007 to 2012, which was acquired from 16 ROP evaluation units. Findings: The practice of evaluation was well adopted in regional administration and has grown rapidly in recent years. 236 studies, costing more than 16 million PLN, were completed by the end of 2012. However, most studies were of limited value as they concentrated on the implementation process, not on the effects and justification of intervention. Implications: This study focused on quantitative aspects of the knowledge production process (evaluation reports. It omitted the question of actual evaluation use, which together with evaluation process quality and development of evaluation culture should be a subject of further investigation. Originality: This study was the fi rst review of ROP evaluations in Poland. It went far beyond the scope of data collected previously by the Ministry of Regional Development and proposed novel categorizations of evaluation subjects that may be useful for other than ROP evaluations.

  20. TREATMENT OF 100 CASES OF DYSFUNCTIONAL UTERINE BLEEDING BY SCRATCHING THERAPY

    Institute of Scientific and Technical Information of China (English)

    WANG Gui-qing

    2006-01-01

    @@ Dysfunctional uterine bleeding, a common gynecological disorder, is generally of two kinds, pubescent and climacteric, characterized by menorrhagia, menostaxis, irregular bleeding, associated with dysmenorrhea, soreness and bearing down sensation in the lumbosacral region.

  1. Training of tissue bank operators in Asia Pacific region

    International Nuclear Information System (INIS)

    To raise quality standards of Tissue Bank in Asia Pacific Region and to meet training needs of tissue bank operators. Singapore (NUH Tissue Bank) was officially appointed by IAEA on 18 September 1996 in Vienna to be the IAEA/NUS Regional Training Centre for RCA (Regional Co-operative Agreement). Member of States including Bangladesh, China, India, Indonesia, Korea, Malaysia, Myanmar, Pakistan, Philippines, Thailand, Sri Lanka and Vietnam. The Singapore Ministry of Environment gave a grant of $225,500 for setting up of this centre with National Science and Technology Board as funding agency, $100,000 being allocated for production of IAEA Developed Curriculum into Multi-Media. (authors being National Project Co-ordinators, Directors of Tissue Banks in the region). The Modules included Guide to Curriculum, Historical Background (0), Rules and Regulation (1), Organisation (2), Quality Assurance (3), Procurement (4), Processing (5), Distribution and Utilisation (6) and Future Developments (7). The Distance Learning Package included case studies from the region in text, in slides and videotapes. A new purpose-built NUH Tissue Bank with separate Wet and Dry Processing laboratories equipped with hands-on facilities was completed in July 1997. This was inaugurated as; IAEA/NUS Regional Training Centre for RCA; IAEA/NUS Interregional Training Centre; and NUS Diploma Course on Tissue Banking also launched by Deputy vice-chancellor, NUS, in conjunction with the IAEA/RCA Regional Training Course on 3 November 1997. One year NUS Open Distance Learning Diploma Course started with two weeks Intensive Course with Core Lectures on Modules (0-7) in the Curriculum and Practical Hands-on Demonstrations. One theory and two practical assessments were conducted. Nineteen participants registered for the Diploma Course. Production of IAEA Multi-Media Curriculum was completed and the Curriculum was distributed to member States during a 2-week-RCA 'Train the Trainers' Workshop on 27 April

  2. Operational flood forecasting system of Umbria Region "Functional Centre

    Science.gov (United States)

    Berni, N.; Pandolfo, C.; Stelluti, M.; Ponziani, F.; Viterbo, A.

    2009-04-01

    The hydrometeorological alert office (called "Decentrate Functional Centre" - CFD) of Umbria Region, in central Italy, is the office that provides technical tools able to support decisions when significant flood/landslide events occur, furnishing 24h support for the whole duration of the emergency period, according to the national directive DPCM 27 February 2004 concerning the "Operating concepts for functional management of national and regional alert system during flooding and landslide events for civil protection activities purposes" that designs, within the Italian Civil Defence Emergency Management System, a network of 21 regional Functional Centres coordinated by a central office at the National Civil Protection Department in Rome. Due to its "linking" role between Civil Protection "real time" activities and environmental/planning "deferred time" ones, the Centre is in charge to acquire and collect both real time and quasi-static data: quantitative data from monitoring networks (hydrometeorological stations, meteo radar, ...), meteorological forecasting models output, Earth Observation data, hydraulic and hydrological simulation models, cartographic and thematic GIS data (vectorial and raster type), planning studies related to flooding areas mapping, dam managing plans during flood events, non instrumental information from direct control of "territorial presidium". A detailed procedure for the management of critical events was planned, also in order to define the different role of various authorities and institutions involved. Tiber River catchment, of which Umbria region represents the main upper-medium portion, includes also regional trans-boundary issues very important to cope with, especially for what concerns large dam behavior and management during heavy rainfall. The alert system is referred to 6 different warning areas in which the territory has been divided into and based on a threshold system of three different increasing critical levels according

  3. AVO inversion based on inverse operator estimation in trust region

    Science.gov (United States)

    Yin, Xing-Yao; Deng, Wei; Zong, Zhao-Yun

    2016-04-01

    Amplitude variation with offset (AVO) inversion is widely utilized in exploration geophysics, especially for reservoir prediction and fluid identification. Inverse operator estimation in the trust region algorithm is applied for solving AVO inversion problems in which optimization and inversion directly are integrated. The L1 norm constraint is considered on the basis of reasonable initial model in order to improve effciency and stability during the AVO inversion process. In this study, high-order Zoeppritz approximation is utilized to establish the inversion objective function in which variation of {{v}\\text{p}}/{{v}\\text{s}} with time is taken into consideration. A model test indicates that the algorithm has a relatively higher stability and accuracy than the damp least-squares algorithm. Seismic data inversion is feasible and inversion values of three parameters ({{v}\\text{p}},{{v}\\text{s}},ρ ) maintain good consistency with logging curves.

  4. The selective bleed variable cycle engine

    OpenAIRE

    Nascimento, M. A. R.

    1992-01-01

    A new concept in aircraft propulsion is described in this work. In particular, variable jet engine is investigated for supersonic ASTOVL aircraft. This engine is a Selective Bleed Variable Cycle, twin shaft turbofan. At low flight speeds the engine operates as a medium bypass turbofan. At supersonic cruise it operates as low bypass turbofan without reheat. The performance of the engine and its components is analyzed using a novel matching procedure. Off-design engine performance characterist...

  5. Story: A Bleeding Watermelon

    Directory of Open Access Journals (Sweden)

    Nor bzang

    2010-12-01

    Full Text Available A Bleeding Watermelon was written by Norsang (Nor bzang;b. 1988, a native of Dpa ris (Rab rgyas (Huazangsi 华藏寺 Township, Tianzhu 天祝 Tibetan Autonomous County,Gansu 甘肃 Province. Norsang writes: I heard that a university student opened an elevator door in a campus building still under construction. The elevator shaft was empty and he fell to his death. Many people had questions about his death. This inspired me to write this story.

  6. EFECTO DE DOS DOSIS BAJAS DE ÁCIDO TRANEXÁMICO EN EL SANGRADO POSTOPERATORIO DE CIRUGÍA CARDÍACA / Effect of two low doses of tranexamic acid in post-operative bleeding after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Osvaldo González Alfonso

    2010-12-01

    circulation and to whom two doses of one gram of tranexamic acid was administered, was performed in the Cardiology Hospital of Santa Clara. The following variables were assessed: extracorporeal circulation times, number of reinterventions due to fibrinolysis, number of administered transfusions and extent of hematic loss within 24 hours after surgery. Results: Post-operative bleeding averaged 1272,9 ± 1148,8 ml; 52,9 % of the patients suffered blood loss of 1000 ml within 24 hours after surgery, 58.8% of the patients did not need allogenic blood transfusions, and only an average of 1,7 ± 3,4 of packed red blood cell units was administered to transfused patients. Only two patients needed reintervention due to exaggerated fibrinolysis. Conclusions: The low doses of tranexamic acid proved to be useful in reducing post-operative bleeding after cardiac surgery and at the same time they keep low the number of allogenic transfusions.

  7. The nursing effect of postoperative adenoid-tonsillectomy bleeding by low-temperature plasma in children

    OpenAIRE

    Chen, Xin

    2014-01-01

    To observe the nursing effect of postoperative adenoid tonsil bleeding by low-temperature plasma in children. 12 patients received the operation successfully without bleeding. The nursing methods include psychological nursing, observation, apnea prevention and diet nursing. Low-temperature plasma is an effective and safe way to cure postoperative bleeding without complications.

  8. Abnormal uterine bleeding.

    Science.gov (United States)

    Whitaker, Lucy; Critchley, Hilary O D

    2016-07-01

    Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life. PMID:26803558

  9. Regional Disparities in Romania. Contribution of the Regional Operational Program to Health Infrastructure

    Directory of Open Access Journals (Sweden)

    VICTOR PLATON

    2013-01-01

    Full Text Available Health infrastructure is one of the weaknesses of socio-economic development in Romania and in other European states. In order to get a better picture of the Romanian health system issues, this paper analyzes a number of statistical indicators considered representative for the national and European health infrastructure for a 20 years period, between 1990 and 2010. Our paper has three main objectives: (a to identify the main trends for health infrastructure in some of the European Union countries; (b to describe the evolution of the health system in Romania, the comparative situation at the European level as well as regional level indicators dynamics; (c to overview the Regional Operational Program in Romania, how much does it help the regional health infrastructure in our country. At the European level, there is a constant decrease in the number of hospital beds. For this indicator, Romania has slightly higher values than the European average. We must mention that the hospital beds indicator offers limited information on health infrastructure which also includes medical equipment and specific devices and practices. The number of hospitals in Romania increased with 18.9% during the last 20 years (1990-2010. During the observed timeline, the number of hospitals in Romania had a constant positive evolution at regional level. The number of doctors in hospitals has an increasing trend at the local as well as at the international level. Romania has a number of doctors twice lower than the European average (3.6 doctors for one thousand inhabitants. The Regional Operational Program (ROP has a limited influence in achieving the objectives stated in Applicants Guide for Priority Axis 3. Major Intervention Area 3.1. This happens because supporting infrastructure improvements will not create institutional modernization. The financial contribution through ROP will result in the modernization of 11% of the existing hospitals in Romania.

  10. Entrepreneurship in Tourism and Financing through the Regional Operational Programme

    Directory of Open Access Journals (Sweden)

    Mihaela Ana Pădurean

    2015-02-01

    Full Text Available The European Structural Funds have stood, as early as their very establishment back 1957, for a tool of economic and social harmonization of the Member States of the European Union. The comprehensive process of restructuring and reorganizing the process have led, in time, to emergence of new priority axis and key areas of intervention adapted to the real needs of the single European market. Whether aimed at developing the human resources, improving or creating the specific infrastructure or at fostering entrepreneurship, the Structural Funds have always pursued plugging in the development gaps at both regional and national level. In the depicted background, tourism appears as one of the priority areas for allocation of the European funding. Moreover, fostering entrepreneurship in tourism by allocating Structural Funds entails not only putting in place circumstances fostering establishment of new business entities, but also supporting any initiative which intends to enhance innovation and competitiveness of the existing companies. Further to the investigation of the current progress of the research in the industry, which relied on studies of both foreign and Romanian researchers, a niche has been articulated and become the topic of concern for this article. Thus, the main objective of the article is to determine the immediate effects of accessing the funds available under the Regional Operational Programme (ROP for the tourism business environment, as a catalyst for entrepreneurship in the respective industry. Subsequent to researching the current economic context of tourism in terms of the specific indicators, a closer look was taken into the use of the Structural Funds under the ROP throughout the recently ended reporting period: 2007- 2013. The data produced was correlated with the SPSS econometrics software. The key outputs include the degree and intensity of the influence of these financial instruments on the tourism business environment, in

  11. Use of selective serotonin reuptake inhibitors and risk of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study

    DEFF Research Database (Denmark)

    Gärtner, Rune; Cronin-Fenton, Deirdre; Hundborg, Heidi Holmager;

    2010-01-01

    Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association.......Selective serotonin reuptake inhibitors (SSRI) decrease platelet-function, which suggests that SSRI use may increase the risk of post-surgical bleeding. Few studies have investigated this potential association....

  12. Regional higher education co-operation: a research proposal to compare the Baltic Sea and the Black Sea regions

    Directory of Open Access Journals (Sweden)

    Stefan Ewert

    2011-12-01

    Full Text Available While the Baltic Sea Region is considered to be a pioneer region in the development of regional integration and identity, the Black Sea Region is regarded to be a laggard in terms of regionali¬zation and region building. My paper summarizes the role of regional higher education co-operation in the Baltic Sea regionalization process in theory and analyzes the empirical background of these assumptions. Yet, inasmuch an evaluation of the regions` status as a pioneer is possible only in a comparative perspective, I propose to compare the Black Sea and the Baltic Sea Region regarding their higher education networks systematically. My paper asks for the transferability of arguments in favor of a strong regional higher education co-operation in the Baltic Sea Region since the 1990s to today’s situation of the Black Sea Region. It concludes with some fundamental considerations on a comparative research project.

  13. Coronary interventions in patients with bleeding and bleeding tendency

    Institute of Scientific and Technical Information of China (English)

    Thach Nguyen; Lan Nguyen

    2007-01-01

    @@ In general, percutaneous coronary intervention (PCI)is contra-indicated in patients with bleeding and those that are easy to bleed because during PCI the patients need full anticoagulation to counter any thrombotic formation caused by introduction and manipulation of devices in the vascular system.

  14. Data report of ROSA/LSTF experiment TR-LF-07; Loss-of-feedwater transient with primary feed-and-bleed operation

    OpenAIRE

    竹田 武司

    2016-01-01

    The TR-LF-07 test simulated a loss-of-feedwater transient in a PWR. A SI signal was generated when steam generator (SG) secondary-side collapsed liquid level decreased to 3 m. Primary depressurization was initiated by fully opening a power-operated relief valve (PORV) of pressurizer (PZR) 30 min after the SI signal. High pressure injection (HPI) system was started in loop with PZR 12 s after the SI signal, while it was initiated in loop without PZR when the primary pressure decreased to 10.7 ...

  15. Gastrointestinal bleeding under dabigatran

    Directory of Open Access Journals (Sweden)

    C Stöllberger

    2014-01-01

    Full Text Available Dabigatran-absorption is dependent on the intestinal P-glycoprotein (P-gp-system, and P-gp activity is modulated by several drugs. We report an 83-old female with atrial fibrillation who developed gastrointestinal bleeding. She was under a therapy with non-steroidal anti-inflammatory drugs (NSAID and P-gp-modulating drugs and renal function was impaired. We conclude that NSAID and P-gp-modulating drugs should be avoided in dabigatran-treated patients. If renal function deteriorates the dabigatran-dosage should be reduced or the therapy should be stopped. There is an urgent need to increase knowledge about drug interactions with dabigatran.

  16. Linear operating region in the ozone dial photon counting system

    Science.gov (United States)

    Andrawis, Madeleine

    1995-01-01

    photocathode, however, at higher rates the limitations of the discrimination/counting system will cause the observed count rate to be non-linear with respect to the true count rate. Depending on the pulse height distribution and the discriminator level, the overlapping of pulses (pulse pile-up) can cause count loss or even an additional apparent count gain as the signal levels increase. Characterization of the system, including the pulse height distribution, the signal to noise ratio, and the effect of the discriminator threshold level, is critical in maximizing the linear operating region of the system, thus greatly increasing the useful dynamic range of the system.

  17. Splenic angiosarcoma metastasis to small bowel presented with gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Jun-Te Hsu; Chin-Yew Lin; Ting-Jun Wu; Han-Ming Chen; Tsann-Long Hwang; Yi-Yin Jan

    2005-01-01

    Primary splenic angiosarcoma is a very rare,aggressive neoplasm with a high metastatic rate and dismal prognosis. This neoplasm usually presents with abdominal pain, splenomegaly, anemia, and thrombocytopenia. Splenic angiosarcoma with bleeding gastrointestinal metastases is extremely rare. The literature contains only two case reports. This study reported a 44-year-old male patient with splenic angiosarcoma with sustained repeated gastrointestinal bleeding due to small bowel metastases. Salvage surgery was performed by splenectomy and resection of the metastatic small bowel tumors. The post-operative course was uneventful; the patient survived with the disease and had no GI bleeding, 7 mo after surgery.

  18. Vitamin K deficiency bleeding of the newborn

    Science.gov (United States)

    Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often ... A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting. Babies often ...

  19. PBO Operations in Alaska and Cascadia, Combining Regions and Collaborating with our Regional Partners

    Science.gov (United States)

    Austin, K. E.; Boyce, E. S.; Dausz, K.; Feaux, K.; Mattioli, G. S.; Pyatt, C.; Willoughby, H.; Woolace, A. C.

    2015-12-01

    During the last year, the Alaska and the Cascadia regions of the EarthScope Plate Boundary Observatory (PBO) network were combined into a single management unit. While both remain distinct regions with their own challenges and engineering staff, every effort has been made to operate as a single team to improve efficiency and provide the highest possible data quality and uptime. Over the last several years a concerted effort has been made to work collaboratively with other institutions and stakeholders to defray ongoing costs by sharing staff and resources. UNAVCO currently operates four integrated GPS/seismic stations in collaboration with the Alaska Earthquake Center, eight with the Alaska Volcano Observatory, and three with the EarthScope TA. By the end of 2015, PBO and TA plan to install another 3 integrated and/or co-located geodetic and seismic systems. While most of these are designed around existing PBO stations, the 2014 installation at Middleton Island is a new station for both groups, providing PBO with an opportunity to expand geodetic data in Alaska. There were two major joint maintenance efforts in 2015:, the largest was a 5 day mission among PBO, AVO, and TA, which shared boat, helicopter, and staff on and around Augustine Volcano; the second, was a 10 day helicopter mission shared between AVO and PBO on Unimak Island. PBO Pacific Northwest is working closely with University of Washington to co-locate at least 9 Earthquake Early Warning Systems, which include the addition of strong motion sensors and high speed RT telemetry at PBO sites. The project is managed by University of Washington but UNAVCO is providing land contact information and infrastructure support. Summer 2015 upgrades include a complete overhaul of aging radio technology at two major networks and several small radio networks in Cascadia. The upgrades will increase reliability and enhance the speed of existing telemetry infrastructure and will continue through summer 2018.

  20. Acute variceal bleeding: general management

    Institute of Scientific and Technical Information of China (English)

    David Patch; Lucy Dagher

    2001-01-01

    @@ TREATMENT STRATEGIES FOR ACUTE VARICEAL BLEEDING Backgound Acute variceal bleeding has a significant mortality which ranges form 5% to 50% in patients with cirrhosis[1].Overall survival is probably improving,because of new therapeutic approaches,and improved medical care.However,mortality is still closely related to failure to control hacmorrhage or carly rebleeding,which is a distinct characteristic of portal hypertensive bleeding and occures in as many as 50% of patients in the first days to 6 weeks after admission et al[2].

  1. Apoplexy in an intradural clival chordoma causing intraventricular bleed

    Science.gov (United States)

    Mohindra, Sandeep; Kapoor, Ankur; Kursa, Gopi Krishna; Mohindra, Satyawati; Saikia, Uma

    2016-01-01

    Background: A few cases depicting apoplexy in a chordoma have been reported. Rarely, this intratumoral bleed may spillover into intracerebral or intraventricular regions. Case Description: The authors report an intradural variety of clival chordoma presenting with apoplexy and spillover of blood into lateral ventricle. Clinical presentation, radiological scans, and relevant literature is also described. Conclusions: In a stable case of clival chordoma, intratumoral bleed or apoplexy may cause rapid neurological worsening and warranting urgent surgical intervention. PMID:26862453

  2. Phase-space-region operators and the Wigner function: Geometric constructions and tomography

    Science.gov (United States)

    Ellinas, Demosthenes; Bracken, Anthony J.

    2008-11-01

    Quasiprobability measures on a canonical phase space give rise through the action of Weyl’s quantization map to operator-valued measures and, in particular, to region operators. Spectral properties, transformations, and general construction methods of such operators are investigated. Geometric trace-increasing maps of density operators are introduced for the construction of region operators associated with one-dimensional domains, as well as with two-dimensional shapes (segments, canonical polygons, lattices, etc.). Operational methods are developed that implement such maps in terms of unitary operations by introducing extensions of the original quantum system with ancillary spaces (qubits). Tomographic methods of reconstruction of the Wigner function based on the radon transform technique are derived by the construction methods for region operators. A Hamiltonian realization of the region operator associated with the radon transform is provided, together with physical interpretations.

  3. Bleeding in the Digestive Tract

    Science.gov (United States)

    ... lining of the esophagus, stomach, or duodenum. The bacteria Helicobacter pylori (H. pylori) and use of nonsteroidal ... paleness shortness of breath vomit that looks like coffee grounds weakness A person with acute bleeding may ...

  4. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved...

  5. Fibrinogen concentrate in bleeding patients

    DEFF Research Database (Denmark)

    Wikkelsø, Anne; Lunde, Jens; Johansen, Mathias;

    2013-01-01

    Hypofibrinogenaemia is associated with increased morbidity and mortality, but the optimal treatment level, the use of preemptive treatment and the preferred source of fibrinogen remain disputed. Fibrinogen concentrate is increasingly used and recommended for bleeding with acquired haemostatic...

  6. Latin American regional co-operative programme on food irradiation

    International Nuclear Information System (INIS)

    The ''Latin American Regional Co-ordinated Research Programme on Food Irradiation'' was established in 1986 with the participation of research scientists from countries in the region to investigate the efficacy of food irradiation as a treatment to reduce post-harvest losses and improve the hygienic quality of food, to conduct techno-economic feasibility studies, and to disseminate knowledge about the scientific, health, legal and commercial aspects of food irradiation. This publication contains the final report of the Co-ordinated Research Programme and summaries of individual research reports presented by the participating scientists

  7. Financial Impacts of Regional Differences in Beef Cattle Operations

    OpenAIRE

    Sartwelle, James D.; Outlaw, Joe L.; Richardson, James W.

    2006-01-01

    The sensitivity of net cash farm income to changes in selected production variables, output prices, and input costs varies significantly across representative U.S. beef cattle operations. Larger changes in profitability result from changes in productivity and output prices than from changes in input costs.

  8. Null controllable region of delta operator systems subject to actuator saturation

    Science.gov (United States)

    Yang, Hongjiu; Yan, Ce; Xia, Yuanqing; Zhang, Jinhui

    2016-07-01

    In this paper, we give exact description of null controllable regions for delta operator systems subject to actuator saturation. The null controllable region is in terms of a set of extremal trajectories of anti-stable subsystems. For the delta operator system with real eigenvalues or complex eigenvalues, the description is simplified to an explicit formula which is used to characterise the boundary of a null controllable region. The relations of null controllable regions are shown separately for continuous-time systems, discrete-time systems and delta operator systems. Two numerical examples are given to illustrate the effectiveness of the proposed techniques on null controllable regions.

  9. Hydroturbine operating region partitioning based on analyses of unsteady flow field and dynamic response

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The operating states of hydroelectric generating units vary widely as the operating condition change. The details of the operating characteristics and the operating region partitioning method are discussed for two types of large Francis turbines in the Wanjiazhai Hydropower Plant and two same type large Kaplan turbines in the Shuikou Hydropower Plant. For the Wanjiazhai Hydropower units, the most critical factor affecting the operating stability is the hydraulic pressure fluctuations caused by the vortex rope in the draft tube. For Shuikou Hydropower units, the dynamic stresses as in the piston rod and the blade and the hydraulic thrust on the runner induced by the pressure fluctuations in the flow passage should be used to partition the operating regions. Analyzing the distribution cloud of operating characteristic factors which affects the operating stability in the hill-chart for each individual unit, the forbidden, stable and transient operating regions can be obtained.

  10. Production operation of small petroleum enterprises in Tomsk region

    Science.gov (United States)

    Sharf, I.; Filjushin, V.; Shenderova, I.; Kochetkova, O.

    2015-11-01

    Implementing resource-innovative strategy to develop Russian fuel-and-energy sector implies the promotion of small oil production enterprises developing fields with the reserves of less than 5 mln. tons. However, the efficiency of such enterprises, investigated on the example of Tomsk region (considering the indexes of oil extraction, growth of reserves, amount of capital expenditures and geological surveys), signifies the presence of definite tendencies. Consequently, management decisions concerning economic, organizational, financial and fiscal character should be taken in order to eliminate detrimental factors.

  11. The Kaarstoe gas terminal during operation - regional economic effects

    International Nuclear Information System (INIS)

    In the period 1981-1989 a comprehensive study was made of the impact on society of the establishment of Statoil's gas terminal at Kaarstoe, Norway. Some of this work is updated in the present report. The organization at Kaarstoe is Statoil's transport division for gas (GASS-T) and is described in Chapter 2. A survey is given in Chapter 3 of how the employees are associated with the local community, their distribution in age, sex and type of job. Chapter 4 treats the importance for the Haugesund region of the company's purchasing in the area, in particular from suppliers within the Tysvaer municipality. The development of the structure of industry in Tysvaer and the employment situation are described in Chapter 5. Population trends and housebuilding in Tysvaer are described in Chapter 6 and the impact of GASS-T on the municipal economy is described in Chapter 7. Finally, Chapter 8 discusses whether what is learned from Kaarstoe can be transferred to other regions where gas terminals have been established. 14 refs., 24 figs., 12 tabs

  12. [Direct oral anticoagulant associated bleeding].

    Science.gov (United States)

    Godier, A; Martin, A-C; Rosencher, N; Susen, S

    2016-07-01

    Direct oral anticoagulants (DOAC) are recommended for stroke prevention in atrial fibrillation and for the treatment of venous thromboembolism. However, they are associated with hemorrhagic complications. Management of DOAC-induced bleeding remains challenging. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. Therapeutic options also include antidotes: idarucizumab, antidote for dabigatran, has been approved for use whereas andexanet alpha, antidote for anti-Xa agents, and aripazine, antidote for all DOAC, are under development. Other options include hemodialysis for the treatment of dabigatran-associated bleeding and administration of oral charcoal if recent DOAC ingestion. DOAC plasma concentration measurement is necessary to guide DOAC reversal. We propose an update on DOAC-associated bleeding, integrating the availability of dabigatran antidote and the critical place of DOAC concentration measurements. PMID:27297642

  13. Endoscopic management of diverticular bleeding.

    Science.gov (United States)

    Rustagi, Tarun; McCarty, Thomas R

    2014-01-01

    Diverticular hemorrhage is the most common reason for lower gastrointestinal bleeding (LGIB) with substantial cost of hospitalization and a median length of hospital stay of 3 days. Bleeding usually is self-limited in 70-80% of cases but early rebleeding is not an uncommon problem that can be reduced with proper endoscopic therapies. Colonoscopy is recommended as first-line diagnostic and therapeutic approach. In the vast majority of patients diverticular hemorrhage can be readily managed by interventional endotherapy including injection, heat cautery, clip placement, and ligation to achieve endoscopic hemostasis. This review will serve to highlight the various interventions available to endoscopists with specific emphasis on superior modalities in the endoscopic management of diverticular bleeding.

  14. Endoscopic Management of Diverticular Bleeding

    Directory of Open Access Journals (Sweden)

    Tarun Rustagi

    2014-01-01

    Full Text Available Diverticular hemorrhage is the most common reason for lower gastrointestinal bleeding (LGIB with substantial cost of hospitalization and a median length of hospital stay of 3 days. Bleeding usually is self-limited in 70–80% of cases but early rebleeding is not an uncommon problem that can be reduced with proper endoscopic therapies. Colonoscopy is recommended as first-line diagnostic and therapeutic approach. In the vast majority of patients diverticular hemorrhage can be readily managed by interventional endotherapy including injection, heat cautery, clip placement, and ligation to achieve endoscopic hemostasis. This review will serve to highlight the various interventions available to endoscopists with specific emphasis on superior modalities in the endoscopic management of diverticular bleeding.

  15. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  16. Upper gastrointestinal bleeding etiology score for predicting variceal and non-variceal bleeding

    Institute of Scientific and Technical Information of China (English)

    Supot Pongprasobchai; Sireethorn Nimitvilai; Jaroon Chasawat; Sathaporn Manatsathit

    2009-01-01

    AIM: To identify clinical parameters, and develop an Upper Gastrointesinal Bleeding (UGIB) Etiology Score for predicting the types of UGIB and validate the score.METHODS: Patients with UGIB who underwent endoscopy within 72 h were enrolled. Clinical and basic laboratory parameters were prospectively collected.Predictive factors for the types of UGIB were identified by univariate and multivariate analyses and were used to generate the UGIB Etiology Score. The best cutoff of the score was defined from the receiver operating curve and prospectively validated in another set of patients with UGIB.RESULTS: Among 261 patients with UGIB, 47 (18%) had variceal and 214 (82%) had non-variceal bleeding.Univariate analysis identified 27 distinct parameters significantly associated with the types of UGIB. Logistic regression analysis identified only 3 independent factors for predicting variceal bleeding;previous diagnosis of cirrhosis or signs of chronic liver disease (OR 22.4, 95% CI 8.3-60.4, P < 0.001), red vomitus (OR4.6, 95% CI 1.8-11.9, P = 0.02), and red nasogastric (NG) aspirate (OR 3.3, 95% CI 1.3-8.3, P = 0.011).The UGIB Etiology Score was calculated from (3.1 x previous diagnosis of cirrhosis or signs of chronic liver disease) + (1.5 × red vornitus) + (1.2 × red NG aspirate), when 1 and 0 are used for the presence and absence of each factor, respectively. Using a cutoff ≥ 3.1, the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) in predicting variceal bleeding were 85%, 81%,82%, 50%, and 96%, respectively. The score was prospectively validated in another set of 195 UGIB cases (46 variceal and 149 non-variceal bleeding). The PPV and NPV of a score ≥3.1 for variceal bleeding were 79% and 97%, respectively.CONCLUSION: The UGIB Etiology Score, composed of 3 parameters, using a cutoff ≥ 3.1 accurately predicted variceal bleeding and may help to guide the choice of initial therapy for UGIB before endoscopy.

  17. Transcatheter embolization for treatment of acute lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries in an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation. (orig.)

  18. Superselective transarterial embolization for the management of acute gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Kyoung; Kim, Young Min; Kim, Jeong; Shin, Sang Soo; Yoon Woong; Kim, Jae Kyu; Park, Jin Gyoon [Chonnam National University Hospital, Gwangju (Korea, Republic of); Cho, Chol Kyoon; Kang, Heoung Keun [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2006-03-15

    We wanted to evaluate the safety and effectiveness of superselective transarterial embolization for the management of gastrointestinal bleeding. We evaluated 97 of 115 patients who had undergone diagnostic angiography and transarterial embolization for gastrointestinal bleeding from February 2001 to July 2004, and they subsequently underwent superselective transarterial embolization. Their ages ranged from 17 to 88 years (mean age: 58.5 years), and 73 were men and 24 were women. The etiologies were a postoperative condition (n=31), ulcer (n=23), Mallory-Weiss syndrome (n=3), trauma (n=3), pseudoaneurysm from pancreatitis (n=3), diverticula (n=2), inflammatory bowel disease (n=2), tumor (n=2), Behcet's disease (n=2), hemobilia (n=1), and unknown origin (n=25). The regions of bleeding were the esophagus (n=3), stomach and duodenum (n=41), small bowel (n=38) and colon (n=15). All the patients underwent superselective transarterial embolization using microcoils, gelfoam or a combination of microcoils and gelfoam. Technical success was defined as devascularization of targeted vascular lesion or the disappearance of extravasation of the contrast media, as noted on the angiography after embolization. Clinical success was defined as the disappearance of clinical symptoms and the reestablishment of normal cardiovascular hemodynamics after transarterial embolization without any operation or endoscopic management. The technical success rate was 100%. The primary clinical success rate was 67% (65 of 97 patients). Of the 32 primary failures, fourteen patients underwent repeat embolization; of these, clinical success was achieved in all the patients and so the secondary clinical success rate was 81% (79 of 97 patients). Of the 18 patients with primary failures, five patients underwent operation, one patient underwent endoscopic management and the others died during the observation period due to disseminated coagulopathy or complications of their underlying diseases. During

  19. Treatment of acute variceal bleeding

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Krag, Aleksander Ahm; Møller, Søren

    2008-01-01

    The management of variceal bleeding remains a clinical challenge with a high mortality. Standardisation in supportive and new therapeutic treatments seems to have improved survival within the last 25 years. Although overall survival has improved in recent years, mortality is still closely related...

  20. Efficacy of endoscopic therapy for gastrointestinal bleeding from Dieulafoy's lesion

    Institute of Scientific and Technical Information of China (English)

    Jun Cui; Liu-Ye Huang; Yun-Xiang Liu; Bo Song; Long-Zhi Yi; Ning Xu; Bo Zhang; Cheng-Rong Wu

    2011-01-01

    AIM: To investigate the endoscopic hemostasis for gastrointestinal bleeding due to Dieulafoy's lesion. METHODS: One hundred and seven patients with gastrointestinal bleeding due to Dieulafoy's lesion were treated with three endoscopic hemostasis methods: aethoxysklerol injection (46 cases), endoscopic hemoclip hemostasis (31 cases), and a combination of hemoclip hemostasis with aethoxysklerol injection (30 cases). RESULTS: The rates of successful hemostasis using the three methods were 71.7% (33/46), 77.4% (24/31) and 96.7% (29/30), respectively, with significant differences between the methods (P < 0.05). Among those who had unsuccessful treatment with aethoxysklerol injection, 13 were treated with hemoclip hemostasis and 4 underwent surgical operation; 9 cases were successful in the injection therapy. Among the cases with unsuccessful treatment with hemoclip hemostasis, 7 were treated with injection of aethoxysklerol and 3 cases underwent surgical operation; 4 cases were successful in the treatment with hemoclip hemostasis. Only 1 case had unsuccessful treatment with a combined therapy of hemoclip hemostasis and aethoxysklerol injection, and surgery was then performed. No serious complications of perforation occurred in the patients whose bleeding was treated with the endoscopic hemostasis, and no re-bleeding was found during a 1-year follow-up. CONCLUSION: The combined therapy of hemoclip hemostasis with aethoxysklerol injection is the most effective method for gastrointestinal bleeding due to Dieulafoy's lesion.

  1. Regional Comparative Unit Cost Studies for Maintenance and Operation of Physical Plants in Universities and Colleges in Central States Region and Rocky Mountain Region.

    Science.gov (United States)

    Association of Physical Plant Administrators, Corvallis, OR.

    Presented in this document are data pertaining to maintenance and operations costs at colleges and universities in the central states region and the Rocky Mountain region. The major accounts included in the cost analysis are: (1) physical plant administration, (2) building maintenance, (3) custodial services, (4) utilities, (5) landscape and…

  2. An unusual cause of gastrointestinal bleed

    Directory of Open Access Journals (Sweden)

    C K Adarsh

    2014-01-01

    Full Text Available Gastrointestinal (GI bleed often brings the patient to the emergency medical service with great anxiety. Known common causes of GI bleed include ulcers, varices, Mallory-Weiss among others. All causes of GI bleed should be considered however unusual during the evaluation. Aortoenteric fistula (AEF is one of the unusual causes of GI bleed, which has to be considered especially in patients with a history of abdominal surgery in general and aortic surgery in particular.

  3. Management of severe perioperative bleeding

    DEFF Research Database (Denmark)

    Kozek-Langenecker, Sibylle A; Afshari, Arash; Albaladejo, Pierre;

    2013-01-01

    The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia...... with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific subcommittees......-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA...

  4. [Gastric lipoma as an unusual cause of upper gastrointestinal bleeding].

    Science.gov (United States)

    Vogt, W; Allemann, J; Simeon, B; Fornaro, M; Rehli, V

    1995-04-18

    This is a case report of a gastric lipoma causing a severe upper gastrointestinal bleeding. About 200 cases of this very rare benign gastric tumor have been reported so far. Symptoms are not characteristic, but may also mimic malignancy when occurring with bleeding, obstruction or weight loss. Malignant transformation is possible, but extremely rare. Because the tumor is situated under the submucosal layer in 90%, preoperative diagnosis by endoscopic biopsy is almost never possible. The tumor has to be treated by resection. A diagnosis by frozen section during the operation is recommended.

  5. Guangxi Shanglin Aluminum Plant cross-regional technical upgrade project(phase 1)put into operation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    <正>The project(Phase 1)of cross-regional techni- cal upgrade of the aluminum plant of Guangxi Shanglin Nannan Industrial Co.was completed and put into operation on June 8,2007.The plant is a cross-regional technical upgrade pro- ject of Nanning Aluminum Plant,featuring the integration of coal,electricity and aluminum.

  6. The effect of prostate specific antigen on the effect of epristeride in preventing operative bleeding during transurethral prostatic resection%前列腺特异性抗原对爱普列特预防前列腺电切术中出血的效果的影响

    Institute of Scientific and Technical Information of China (English)

    李涛

    2015-01-01

    目的 研究前列腺特异性抗原对爱普列特预防前列腺电切术中出血的效果的影响.方法 189例经尿道前列腺电切术患者按照前列腺特异抗原水平分为A组87例(前列腺特异性抗原<4 ng/ml)和B组102例(前列腺特异性抗原4~10 ng/ml),两组患者均给予爱普列特和前列腺电切术进行治疗,观察两组患者的出血情况及临床疗效.结果 A组患者手术中出血量、手术操作时间、手术中灌洗量、术后冲洗量、血红蛋白的差值均明显少于B组,差异有统计学意义(P<0.01);两组患者发生尿道狭窄、暂时性尿失禁、膀胱颈痉挛、逆行射精、电切综合征的比率比较差异无统计学意义(P>0.05).结论 前列腺特异性抗原对爱普列特预防前列腺电切术中出血的效果具有明显的影响.%Objective To study the effect of prostate specific antigen (PSA) on the effect of epristeride in preventing operative bleeding during transurethral prostatic resection.Methods 189 patients undergoing transurethral prostatic resection were divided into group A (87 cases,PSA<4 ng/ml) and group B (102 cases,PSA 4-10 ng/ml).Both two groups received epristeride treatment.Observed operative bleeding and clinical efficacy of two groups.Results Operative bleeding,operative time,intraoperative lavage,postoperative flush volume,the difference of hemoglobin of group A were significantly less than those of group B,with statistically significant differences (P<0.01).There were no statistically significant differences in the incidences of urethrostenosis,transient uracratia,bladder neck spasm,retrograde ejaculation,transurethral resection syndrome between two groups (P>0.05).Conclusion PSA has obvious effect on the effect of epristeride in preventing operative bleeding during transurethral prostatic resection.

  7. Role of videocapsule endoscopy for gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Cristina Carretero; Ignacio Fernandez-Urien; Maite Betes; Miguel Mu(n)oz-Navas

    2008-01-01

    Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of an unknown origin that persists or recurs after negative initial upper and lower endoscopies.Several techniques,such as endoscopy,arteriography,scintigraphy and barium radiology are helpful for recognizing the bleeding source;nevertheless,in about 5%-10% of cases the bleeding lesion cannot be determined.The development of videocapsule endoscopy (VCE) has permitted a direct visualization of the small intestine mucosa.We will analyze those techniques in more detail.The diagnostic yield of CE for OGIB varies from 38% to 93%,being in the higher range in those cases with obscure-overt bleeding.

  8. Scintigraphic diagnosis of lower GI bleeding

    International Nuclear Information System (INIS)

    Abdominal scintigraphy with 99mTc HSA, 99mTc Sn colloid, or 99mTc RBC was performed in 28 patients with melena to detect bleeding and determine the bleeding site in the lower gastrointestinal tract. Active bleedings and/or vascular lesions were identified in 16 patients. They were proved by antiography, endoscopy or barium enema in 14. We concluded that scintigraphy was an accurate and effective method to detect the bleeding and determine the bleeding site in the lower gastrointestinal tract. (author)

  9. Otorrhagia bleeding due to leech bite

    Directory of Open Access Journals (Sweden)

    Narges Askari

    2012-01-01

    Full Text Available Leeches are blood-sucking hermaphroditic parasites that attach to vertebrate hosts, bite through the skin, and suck out blood. When leeches feed, they secrete an anticoagulant (hirudin, which helps them get a full meal of blood. This is the first report of leech removal from external auditory canal. Previous leech involvement cases were explained in nasopharynx, larynx, pharynx, eye, and gastrointestinal tract. Prominent sign of all cases was active bleeding from the leech attachment site; that stopped with leech removal. A 24-year-old man was presented to Al-Zahra hospital with left otorrhagia and otalgia from 2 days ago. After suction of ear a small soft foreign body was seen in the external ear near the tympanic membrane, then the ear filled with glycerine phenice, the patient explained decreased movement of foreign body. Four hours later the bloody discharge stopped and otalgia decreased. After suction of clots, a leech was extruded from external auditory canal by alligator. Leech infestation is a rare cause of otorrhagia and should be suspected in the endemic region in all of unusual bleeding; it can be diagnosed and treated by exact inspection and removal.

  10. Bleeding

    Science.gov (United States)

    ... NY: McGraw-Hill; 2004:chap 251. Lammers RL. Principles of wound management. In: Roberts JR, Hedges JR, eds. Roberts: Clinical ... 2009:chap 39. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et ...

  11. /sup 99m/Tc-labeled RBC scan. Diagnostic method for lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    The experience with 62 /sub 99m/Tc-labeled in vivo scans performed for lower gastrointestinal bleeding is discussed. Thirty-seven scans were deemed positive. The tendency of scans to become positive correlated with observations of active bleeding. Five patients had fulminant hemorrhage, necessitating emergency operation. In this group, scanning accurately located the bleeding sources prior to intervention. Seven other patients having later operations bled less rapidly. The bleeding site was localized accurately by scanning in three of these patients. Two studies were falsely positive and two were negative, whereas angiography was positive in two patients studied. Labeled RBC scanning is a useful technique in the early evaluation of patients with lower gastrointestinal bleeding, obviating the need of arteriography in some cases

  12. Operational concepts for maglev railways in regional traffic; Betriebskonzepte fuer Magnetschwebebahnen im Regionalverkehr

    Energy Technology Data Exchange (ETDEWEB)

    Anders, J.; Fritz, E. [Institut fuer Bahntechnik GmbH, Berlin (Germany); Witt, M. [Dornier Consulting GmbH, Friedrichshafen (Germany)

    2002-07-01

    By order of the Federal Ministry of Transport, Construction and Housing, various model lines have been technically and operationally designed for operation of Maglev railways in regional transport systems. For this purpose, different operational concepts have been compared with regard to their effects on vehicle configurations, propulsion, operations control and power supply systems. (orig.) [German] Im Auftrag des Bundesministeriums fuer Verkehr, Bau und Wohnungswesen wurden verschiedene Modellstrecken fuer den Betrieb von Magnetschwebebahnsystemen im Regionalverkehr technisch und betrieblich ausgelegt. Anlass war der Vergleich unterschiedlicher Betriebskonzepte, mit ihren Auswirkungen auf Fahrzeugkonfigurationen, Antrieb, Betriebsleittechnik und Energieversorgung. (orig.)

  13. [The changes of intraabdominal pressure in patients with retroperitoneal bleeding].

    Science.gov (United States)

    Smoliar, A N; Abakumov, M M

    2012-01-01

    The linear dependence of the intraabdominal pressure and the volume of retroperitoneal bleeding was revealed in 34 patients with the aortic aneurism rupture. In patients with the blunt abdominal trauma, treated conservatively and laparotomized (each group consisted of 26 patients), the intraabdominal pressure is higher in the operated group during the first day after the operation. The main factors of the intraabdominal hypertension seem to be shock and massive infusion and transfusion therapy. PMID:22951607

  14. Development of an operational tool for oil spill forecast: application to oil exposed regions

    OpenAIRE

    Janeiro, João Miguel Leitão

    2014-01-01

    Tese de doutoramento, Ciências do Mar, da Terra e do Ambiente (Modelação), Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2014 The objective of the following thesis is to present a modelling methodology, based on the MOHID system, which allows the development of coastal operational models by taking advantage of already implemented regional operational models using a dow...

  15. Sandostatin therapy of acute oesophageal variceal bleeding.

    Science.gov (United States)

    McKee, R F

    1993-01-01

    This communication deals with the emergency control of variceal bleeding rather than the prevention of rebleeding. The current main options of oesophageal tamponade, emergency sclerotherapy and drug therapy are discussed, with particular reference to the use of somatostatin. Sandostatin (Sandoz, Basel), a synthetic long-acting somatostatin analogue, was found to reduce transhepatic venous gradient by 30% with no effect on systemic haemodynamics in a study of 16 stable cirrhotic patients. In a trial comparing intravenous infusion of Sandostatin (SMS) to oesophageal tamponade (OT) in active variceal bleeding, 18 of 20 bleeds in the SMS group and 19 of 20 bleeds in the OT group were controlled at 4 h. Ten in the SMS group and 14 in the OT group had no further bleeding during the 48-hour study period. Thus SMS may be useful in the temporary control of active variceal bleeding. PMID:8359565

  16. THE FINANCING OF THE ADMINISTRATIVE TERRITORIAL UNITS IN THE WEST DEVELOPMENT REGION THROUGH THE REGIONAL OPERATIONAL PROGRAMME 2007 - 2013

    Directory of Open Access Journals (Sweden)

    Munteanu Nicolae-Eugen

    2011-07-01

    Full Text Available It is very important to be found methods to increase the competitiveness between the Romanian administrative-territorial units, under the current conditions of the economic crisis, by means of the existing economic levers successfully used within the European Union regions. The development regions of Romania do not have the statute of administrative units, but they represent territorial units large enough to constitute a good basis for the elaboration and implementation of regional development strategies, allowing an efficient use of the financial and human resources. The scope for which these development regions were created had in view the support granted for the larger communities in their action to settle the problems which go beyond the administrative borders and which surpass the financial possibilities of one county. In Romania, the communes, towns, municipalities and counties are defined as administrative-territorial units within which the local autonomy is exercised and the authorities of the local public administration are organized and operate. The local, communal, town, municipality and county councils, as deliberative authorities, and also the mayors and the presidents of county councils as executive authorities have the duties to solve the public matters of the community, acting as authorities of the Romanian public administration. In Romania, the local autonomy is only administrative and financial, having as objective the organization, operation, competencies and tasks, and also the management of the inland resources. The principle of the local financial autonomy implies the fact that the administrative-territorial units have the right to financial resources, which can be used by the authorities of the local public administration when exercising their tasks. According to the Law of the local public finances, the local budget incomes could be made also of the non-reimbursable funds granted by the European Union. Based on the

  17. Cyclical rectal bleeding in colorectal endometriosis.

    Science.gov (United States)

    Levitt, M D; Hodby, K J; van Merwyk, A J; Glancy, R J

    1989-12-01

    Three case reports of cyclical rectal bleeding in endometriosis affecting rectum and sigmoid colon emphasize the close relationship between such cyclical bleeding and intestinal endometriosis. The cause of bleeding, however, is still unclear. The predilection of endometriotic deposits for the outer layers of the bowel wall suggests that mucosal involvement is not a prerequisite for rectal bleeding. The frequent absence of identifiable intramural haemorrhage casts doubt on the premise that intestinal endometriotic deposits 'menstruate'. The cause may simply be a transient tear in normal mucosa due to swelling of an underlying endometriotic deposit at the time of menstruation. PMID:2597100

  18. A diagnostic approach to mild bleeding disorders.

    Science.gov (United States)

    Boender, J; Kruip, M J H A; Leebeek, F W G

    2016-08-01

    Mild inherited bleeding disorders are relatively common in the general population. Despite recent advances in diagnostic approaches, mild inherited bleeding disorders still pose a significant diagnostic challenge. Hemorrhagic diathesis can be caused by disorders in primary hemostasis (von Willebrand disease, inherited platelet function disorders), secondary hemostasis (hemophilia A and B, other (rare) coagulant factor deficiencies) and fibrinolysis, and in connective tissue or vascular formation. This review summarizes the currently available diagnostic methods for mild bleeding disorders and their pitfalls, from structured patient history to highly specialized laboratory diagnosis. A comprehensive framework for a diagnostic approach to mild inherited bleeding disorders is proposed. PMID:27208505

  19. Researches on operating region of Tokamak device with soft X-ray tomography

    Institute of Scientific and Technical Information of China (English)

    李林忠; 梁荣庆; 尹协锦; 邱励俭

    1997-01-01

    The structures of three operating regions in HT-6B Tokamak have been studied by soft X-ray tomo-graphic system with high sensibility and high time-space resolution. One of the requisites for forming sawtooth discharge is the effective heating action in the central region. In the sawtooth region there are five evolutional phases and five types of magnetic surface structures correspondingly; that is, the concentric, the eccentric, the double-core, the "MHD-type" and the "ultra-MHD type" magnetic surface structures. In the MHD oscillation region, there is a stable "MHD-type" magnetic surface structure. It consists of a crescent "hot core" and a circular "cold bubble" and rotates in the diamagnetic direction of electrons. In the resonant region, the resonant helical field improves the heating status and suppresses the MHD disturbances; therefore the single "MHD-type" magnetic surface changes into a sawtooth type one

  20. The Texts of the Agency's Co-operation Agreements with Regional Intergovernmental Organizations

    International Nuclear Information System (INIS)

    The texts of the Agency's agreements for co-operation with the regional inter-governmental organizations listed below, together with the respective protocols authenticating them, are reproduced in this document in the order in which the agreements entered into force, for the information of all Members of the Agency

  1. Factors Associated With Major Bleeding Events

    Science.gov (United States)

    Goodman, Shaun G.; Wojdyla, Daniel M.; Piccini, Jonathan P.; White, Harvey D.; Paolini, John F.; Nessel, Christopher C.; Berkowitz, Scott D.; Mahaffey, Kenneth W.; Patel, Manesh R.; Sherwood, Matthew W.; Becker, Richard C.; Halperin, Jonathan L.; Hacke, Werner; Singer, Daniel E.; Hankey, Graeme J.; Breithardt, Gunter; Fox, Keith A. A.; Califf, Robert M.

    2014-01-01

    Objectives This study sought to report additional safety results from the ROCKET AF (Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation). Background The ROCKET AF trial demonstrated similar risks of stroke/systemic embolism and major/nonmajor clinically relevant bleeding (principal safety endpoint) with rivaroxaban and warfarin. Methods The risk of the principal safety and component bleeding endpoints with rivaroxaban versus warfarin were compared, and factors associated with major bleeding were examined in a multivariable model. Results The principal safety endpoint was similar in the rivaroxaban and warfarin groups (14.9 vs. 14.5 events/100 patient-years; hazard ratio: 1.03; 95% confidence interval: 0.96 to 1.11). Major bleeding risk increased with age, but there were no differences between treatments in each age category (<65, 65 to 74, ≥75 years; pinteraction = 0.59). Compared with those without (n = 13,455), patients with a major bleed (n = 781) were more likely to be older, current/prior smokers, have prior gastrointestinal (GI) bleeding, mild anemia, and a lower calculated creatinine clearance and less likely to be female or have a prior stroke/transient ischemic attack. Increasing age, baseline diastolic blood pressure (DBP) ≥90 mm Hg, history of chronic obstructive pulmonary disease or GI bleeding, prior acetylsalicylic acid use, and anemia were independently associated with major bleeding risk; female sex and DBP <90 mm Hg were associated with a decreased risk. Conclusions Rivaroxaban and warfarin had similar risk for major/nonmajor clinically relevant bleeding. Age, sex, DBP, prior GI bleeding, prior acetylsalicylic acid use, and anemia were associated with the risk of major bleeding. (An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non

  2. Diagnostic Strategies for Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    M. C. Breijer

    2010-01-01

    Full Text Available Postmenopausal bleeding (PMB is a common clinical problem. Patients with PMB have 10%–15% chance of having endometrial carcinoma and therefore the diagnostic workup is aimed at excluding malignancy. Patient characteristics can alter the probability of having endometrial carcinoma in patients with PMB; in certain groups of patients the incidence has been reported to be as high as 29%. Transvaginal sonography (TVS is used as a first step in the diagnostic workup, but different authors have come to different conclusions assessing the accuracy of TVS for excluding endometrial carcinoma. Diagnostic procedures obtaining material for histological assessment (e.g., dilatation and curettage, hysteroscopy, and endometrial biopsy can be more accurate but are also more invasive. The best diagnostic strategy for diagnosing endometrial carcinoma in patients with PMB still remains controversial. Future research should be focussed on achieving a higher accuracy of different diagnostic strategies.

  3. MBE growth of active regions for electrically pumped, cw-operating GaSb-based VCSELs

    Science.gov (United States)

    Kashani-Shirazi, K.; Bachmann, A.; Boehm, G.; Ziegler, S.; Amann, M.-C.

    2009-03-01

    Electrically pumped, cw-operating, single-mode GaSb-based VCSELs are attractive light sources for trace-gas sensing systems using tunable diode laser absorption spectroscopy (TDLAS) [A. Vicet, D.A. Yarekha, A. Pérona, Y. Rouillard, S. Gaillard, Spectrochimica Acta Part A 58 (2002) 2405-2412]. Only recently, the first electrically pumped (EP) devices emitting at 2.325 μm in cw-mode at room temperature have been reported [A. Bachmann, T. Lim, K. Kashani-Shirazi, O. Dier, C. Lauer, M.-C. Amann, Electronics Letters 44(3) (2008) 202-203]. The fabrication of these devices employs the molecular beam epitaxy (MBE) growth of GaSb/AlAsSb-distributed Bragg mirrors, a multi-quantum-well active region made of AlGaAsSb/InGaAsSb and an InAsSb/GaSb-buried-tunnel junction. As VCSELs are usually driven under high injection rates, an optimum electrical design of active regions is essential for high-performance devices. In this paper we present an enhanced simulation of current flow in the active region under operation conditions. The calculation includes carrier transport by drift, diffusion and tunneling. We discuss different design criteria and material compositions for active regions. Active regions with various barrier materials were incorporated into edge emitter samples to evaluate their performance. Aluminum-containing barriers show better internal efficiency compared to active regions with GaSb as the barrier material.

  4. Peri-operative nursing of infants with cavernous transformation of the portal vein and gastrointestinal bleeding undergoing distal splenorenal shunt%小儿门静脉海绵样变并消化道出血行远端脾肾分流术的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    刘新文; 何小琼; 甘红霞

    2014-01-01

    Objective To summarize the nursing of infants with cavernous transformation of the portal vein (CTPV) and gastrointestinal bleeding undergoing distal splenorenal shunt.Methods 3 cases of infants with CTPV and gastrointestinal bleeding were given with preoperative nursing for upper gastrointestinal bleeding,strengthening nutritional support; strengthening prevention measures of thrombosis and bleeding complications,monitoring of urine and urine gravity,completing the artery piezometer tube care,paying attention to the discharge guidance and follow-up work.Results The platelet increased in 3 cases post-operation.1 cases occurred abdominal bleeding,but improved after symptomatic treatment.1 case occurred leakage on the site of venous indwelling needle during intravenous infusion of high nutrient solution.3 cases of children received 3 months to 3 years follow-up after discharge,no complications such as liver,kidney and blood clots occurred.Conclusions Infants with CTPV and gastrointestinal bleeding undergoing distal splenorenal shunt is very rare in clinic.Good perioperative care and strengthening the observation of the postoperative complications,attaching great importance to the discharge guidance and follow-up work,are the assurances of successful treatment.%目的 总结门静脉海绵样变并消化道出血患儿行远端脾肾分流术的护理要点.方法 对3例门静脉海绵样变并消化道出血患儿术前做好上消化道出血的护理,加强营养支持;术后加强血栓和出血等并发症的防范工作,监测尿量和尿密度,做好动脉测压管的护理,重视出院指导和随访工作.结果 本组3例患儿术后均出现不同程度的血小板增高,1例患儿出现腹腔少量出血,经对症处理后好转,1例患儿输注静脉高营养液发生静脉留置针处渗漏;3例患儿出院后跟踪随访3个月~3年,无肝、肾功能异常及血栓等并发症发生.结论 小儿门静脉海绵样变脾肾分流术临床非常少

  5. Obstetric management of adolescents with bleeding disorders.

    Science.gov (United States)

    James, Andra H

    2010-12-01

    Adolescents with bleeding disorders who become pregnant must contend with the dual challenges of their bleeding disorder and their pregnancy. Adolescents are more likely to terminate a pregnancy than adult women, and when they do carry a pregnancy, they are more likely to deliver prematurely. Otherwise, they are at risk for the same complications that adult women with bleeding disorders experience, particularly bleeding complications postpartum. Since one half to two thirds of adolescent pregnancies are unplanned, issues related to reproduction should be addressed during routine visits with the pediatrician, hematologist or gynecologist. Girls who are at risk of being carriers for hemophilia A and B, severe von Willebrand disease, and other severe bleeding disorders should have their bleeding disorder status determined before they become pregnant. During pregnancy, a plan should be established to ensure that both mother and fetus deliver safely. Young women at risk for severe bleeding or at risk of having a severely affected infant should be referred for prenatal care and delivery to a center where, in addition to specialists in high-risk obstetrics, there is a hemophilia treatment center or a hematologist with expertise in hemostasis. Prior to delivery or any invasive procedures, young women at risk for severe bleeding should receive prophylaxis. Since administration of desmopressin may result in hyponatremia, whenever available, virally inactivated or recombinant clotting factor concentrates should be used for replacement as opposed to fresh frozen plasma or cryoprecipitate. PMID:20934895

  6. First trimester bleeding and maternal cardiovascular morbidity

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens

    2012-01-01

    First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...... to and subsequent to first trimester bleeding without miscarriage....

  7. Transarterial embolization of acute intercostal artery bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ik; Park, Auh Whan; Lee, Seon Joo [Inje University College of Medicine, Busan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Shin, Tae Beom [Donga University College of Medicine, Busan (Korea, Republic of); Kim, Young Hwan [Kyimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-09-15

    To report our experiences of transarterial embolization for acute intercostal artery bleeding. A retrospectively analysis of the causes, clinical manifestations, angiographic findings and transarterial embolization technique in 8 patients with acute intercostal artery bleeding, with a review of the anatomical basis. The causes of intercostal artery bleeding were iatrogenic and traumatic in 88 and 12% of cases, respectively. Active bleeding from the collateral intercostal or posterior intercostal arteries was angiographically demonstrated in 75 and 25% of cases, respectively. Transarterial embolization successfully achieved hemostasis in all cases. However, two patient with hypovolemic shock expired due to a massive hemothorax, despite successful transarterial embolization. Intercostal access should be performed through the middle of the intercostal space to avoid injury to the collateral intercostal artery. Transarterial embolization is an effective method for the control of intercostal artery bleeding.

  8. Extending the Operational Envelope of a Turbofan Engine Simulation into the Sub-Idle Region

    Science.gov (United States)

    Chapman, Jeffryes Walter; Hamley, Andrew J.; Guo, Ten-Huei; Litt, Jonathan S.

    2016-01-01

    In many non-linear gas turbine simulations, operation in the sub-idle region can lead to model instability. This paper lays out a method for extending the operational envelope of a map based gas turbine simulation to include the sub-idle region. This method develops a multi-simulation solution where the baseline component maps are extrapolated below the idle level and an alternate model is developed to serve as a safety net when the baseline model becomes unstable or unreliable. Sub-idle model development takes place in two distinct operational areas, windmilling/shutdown and purge/cranking/startup. These models are based on derived steady state operating points with transient values extrapolated between initial (known) and final (assumed) states. Model transitioning logic is developed to predict baseline model sub-idle instability, and transition smoothly and stably to the backup sub-idle model. Results from the simulation show a realistic approximation of sub-idle behavior as compared to generic sub-idle engine performance that allows the engine to operate continuously and stably from shutdown to full power.

  9. High duty cycle operation of quantum cascade lasers based on graded superlattice active regions

    International Nuclear Information System (INIS)

    High duty cycle operation of quantum cascade superlattice lasers with graded superlattice active regions is investigated with the goal of achieving high average optical power. The optical output power increases with pulse width and decreases with heat sink temperature. This behavior is explained on the basis of the laser core temperature oscillations during the pulsed, high duty cycle operation. Between 175 and 325 K heat sink temperature, optimum duty cycles vary from 10% to 1% and average power levels vary from 50 to 1 mW for various lasers used in this study. [copyright] 2001 American Institute of Physics

  10. To observe the clinical effect of vaginal bleeding of medroxyprogesterone acetate combined with gynecologic Qianjin tablets in the treatment of medicine after operation%安宫黄体酮联合妇科千金片治疗药流术后阴道出血的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    张瑞瑞

    2014-01-01

    Objective To further study the actual effect of the treatment of clinical vaginal bleeding clinical medicine after operation is adopted in the process of medroxyprogesterone acetate combined with gynecologic Qianjin tablets treatment,so as to provide reference for clinical practice.Methods The period in our hospital from 2010 December to 2013 January,196 patients with uterine hemorrhage after vaginal bleeding patients as the research object,the clinical data of the patients were analyzed retrospectively.Results The two groups of patients with different treatment methods after the total efficiency comparison between groups,the observation group than in the control group(96.94%VS79.59%)and compared with P<0.05 group,the difference was statistically significant;com-pare the hemostatic effect between group,vaginal bleeding time is less than 4D the proportion of patients,the observation group was significantly higher than the control group(83.67%VS50.00%),P<0.05 and group,the difference was statistically significant.Conclusion In the clinical practice of vaginal bleeding af-ter operation in clinical medicine,clinical therapeutic effect of the treatment of medroxyprogesterone acetate combined with gynecologic Qianjin tablets is remarka-ble,is safe and reliable choice of vaginal bleeding after drug treatment.%目的:为了进一步研究临床治疗药流术后阴道出血过程中采用安宫黄体酮联合妇科千金片治疗的临床实际治疗效果,从而为临床实践提供借鉴和参考。方法本文以我院2010年12月~2013年1月期间入院治疗的196例药流术后阴道出血患者为研究对象,对患者的临床资料进行了回顾性分析。结果两组患者采用不同治疗方法后总有效率组间比较,观察组优于对照组(96.94%VS79.59%)且组间比较P<0.05,差异具有统计学意义;止血效果组间比较,阴道出血时间小于4d患者的比例,观察组明显高于对照组(83.67%VS50

  11. Experimental and clinical application of laser doppler flowmetry in gastric and duodenal ulcerative bleedings

    Directory of Open Access Journals (Sweden)

    Afanasieva G.A.

    2011-12-01

    Full Text Available The research goal is to develop a new objective diagnostic method of prerecurrence syndrome that will prognose bleeding recurrence from gastroduodenal ulcers. Materials and methods. Method of laser Doppler flowmetry (LDF of the regional perfusion of tissue has been used. The experimental part has been done on 30 white laboratory rats. Characteristics of regional tissue perfusion in the simulation and laser hemostasis of bleeding have been studied. Gastroduodenal endoscopy has been performed with laser Doppler flowmetry (ELDF in clinical conditions to predict the recurrence of ulcerative bleeding. The prognostic method of gastroduodenal ulcerative bleeding was used in 58 patients hospitalized with such pathology and activity of bleeding Forrest II. Results. The study of microcirculation parameters and experimental hemostasis has showed the possibility of using LDF to measure its performance. Effective hemostasis has been accompanied by a significant decrease in perfusion. On the basis of microcirculation parameters in ulcerative bleeding, medical adrenaline test has been proposed for an objective verification pre-recurrence syndrome. To evaluate the effectiveness of endoscopic hemostasis perfusion has been measured before and after its implementation. Conclusion. ELDF has objectified the prognosis of ulcerative bleeding recurrence, verified pre-recurrence syndrome and evaluated the efficacy of endoscopic hemostasis

  12. Ultra-Low-Voltage CMOS-Based Current Bleeding Mixer with High LO-RF Isolation

    OpenAIRE

    Gim Heng Tan; Roslina Mohd Sidek; Harikrishnan Ramiah; Wei Keat Chong; De Xing Lioe

    2014-01-01

    This journal presents an ultra-low-voltage current bleeding mixer with high LO-RF port-to-port isolation, implemented on 0.13 μm standard CMOS technology for ZigBee application. The architecture compliments a modified current bleeding topology, consisting of NMOS-based current bleeding transistor, PMOS-based switching stage, and integrated inductors achieving low-voltage operation and high LO-RF isolation. The mixer exhibits a conversion gain of 7.5 dB at the radio frequency (RF) of 2.4 GHz, ...

  13. Primary evaluation of 99mTc-RBC imaging for the diagnosis of lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    99mTc-RBC gastrointestinal (GI) scintigraphy was performed in 10 patients with lower GI bleeding which was confirmed by operation later. The results suggested that 99mTc-RBC imaging was an effective method for the diagnosis of intestinal hemorrhage, especially the small intestine. However, there was some difficulty in accurately localizing the bleeding site due to the movement of the blood containing labelled RBC from original bleeding site to lower portion during intestinal peristalsis and also displacement of the moving colon. Therefore it is necessary to completely explore the intestine carefully and awareness of the possibility of biliary hemorrhage

  14. Asian regional co-operative project on food irradiation: Technology transfer

    International Nuclear Information System (INIS)

    These Proceedings include the final reports of work performed by different institutions under the scope of Phase II of the Asian Regional Co-operative Project on Food Irradiation. The topics covered include the disinfestation and decontamination of stored products; improvements in the hygiene of processed seafood; insect disinfestation of fruits; and sprout inhibition of root crops. The individual presentations are indexed separately. Refs, figs and tabs

  15. Particulate Matter Contributions from Agricultural Tilling Operations in an Irrigated Desert Region.

    Directory of Open Access Journals (Sweden)

    Meilan Qi

    Full Text Available Sources of regional particulate matter (PM, particularly agricultural operations, must be understood in order to manage the air quality in irrigated dry climates. Direct monitoring measurements alone are useful, but not sufficient, to estimate regional PM source concentrations. This paper combines modeling with ground (point and airplane (spatial measurement methods to estimate regional PM10 (PM diameter≤10 μm contributions from agricultural operations. Hourly data from three air quality monitoring stations positioned at a 2-m height located on the west and east mesas of New Mexico's Mesilla Valley and in the valley at Anthony, NM were acquired from the New Mexico Air Quality Bureau. The study spanned the agricultural tilling season, March 1 to April 30, for the years 2008 to 2012. One- second spatial PM10 concentrations at 200 m above the valley floor were measured during a two-hour controlled field tilling operation on April 1, 2008. The HYSPLIT 4.0 (Hybrid Single-Particle Lagrangian Integrated Trajectory version 4 model was run at the corresponding times and heights, outputting PM10 concentrations from all potential agricultural tilling operations. The calculated percentage contribution (modeled PM10 concentration/measured PM10 concentration indicated that the near-surface (2-m height proportion from the agricultural operations for five seasonal averages ranged from 0.7% to 1.5% on the west and east mesas and 1.3% for the valley site at Anthony. There were 71 hourly high values of contribution ratios ranging from 30 to 100% at the three sites, depending on the wind speed and direction.

  16. Preventive effect of carboprost tromethamine on intra-operative and postoperative bleeding%卡前列素氨丁三醇预防剖宫产术中及术后出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    朱群飞; 陈健

    2013-01-01

    Objectives:To explore the preventive effect of carboprost tromethamine on intraoperative and postoperative bleeding.Methods:120 hospitalized patients who had indication of caesarean section were divided into the observing group and the control group randomly.All the puerperae got caesarean section by intrafacial transverse incision under continuous epidural anesthesia.Puerperae in the control group were injected in ureters with oxytocin 20U after birth immediately,and got another 20U by intramuscular injection 2h after surgery.The drug used for puerperae of the observing group was carboprost tromethamine corresponding to that used in the control group.We observed the blood loss of intraoperation,2h and 24h postoperation,and observed the adverse reaction during treatment.Results:The blood loss of intraoperation,2h and 24h postoperation of the observing group were significantly less than those of the control group (P < 0.05).Nine cases of adverse reaction were found during treatment in the observing group with slight symptoms,and these symptoms disappeared without treatment,and none was found in the control group.Conclusion:Carboprost tromethamine can reduce and prevent intraoperative and postoperative bleeding effectively and safely,with slight symptom of adverse reaction.It is especially suitable for popularization and application in primary care hospitals.%目的:对卡前列素氨丁三醇预防剖宫产术中及术后出血的疗效观察.方法:选择住院并有指征行剖宫产手术的产妇120例,随机分为观察组和对照组.两组产妇均采用连续硬膜外麻醉下行常规的筋膜内子宫下段横切口剖宫产术.对照组产妇在术中胎儿娩出后宫体注射缩宫素20U,术后2h肌肉注射缩宫素20U.观察组产妇在术中胎儿娩出后宫体注射卡前列素氨丁三醇250ug,术后2h肌肉注射卡前列素氨丁三醇250ug.观察两组产妇术中、产后2h、产后24h出血量,并观察治疗期间的不良反应.结果:

  17. Use of tranexamic acid for controlling bleeding in thoracolumbar scoliosis surgery with posterior instrumentation

    Directory of Open Access Journals (Sweden)

    Vinícius Magno da Rocha

    2015-04-01

    Full Text Available OBJECTIVE: Scoliosis surgery involves major blood loss and frequently requires blood transfusion. The cost and risks involved in using allogeneic blood have motivated investigation of methods capable of reducing patients' bleeding during operations. One of these methods is to use antifibrinolytic drugs, and tranexamic acid is among these. The aim of this study was to assess the use of this drug for controlling bleeding in surgery to treat idiopathic scoliosis.METHODS: This was a retrospective study in which the medical files of 40 patients who underwent thoracolumbar arthrodesis by means of a posterior route were analyzed. Of these cases, 21 used tranexamic acid and were placed in the test group. The others were placed in the control group. The mean volumes of bleeding during and after the operation and the need for blood transfusion were compared between the two groups.RESULTS: The group that used tranexamic acid had significantly less bleeding during the operation than the control group. There was no significant difference between the groups regarding postoperative bleeding and the need for blood transfusion.CONCLUSIONS: Tranexamic acid was effective in reducing bleeding during the operation, as demonstrated in other studies. The correlation between its use and the reduction in the need for blood transfusion is multifactorial and could not be established in this study. We believe that tranexamic acid may be a useful resource and that it deserves greater attention in randomized double-blind prospective series, with proper control over variables that directly influence blood loss.

  18. Adaptive Control of a Utility-Scale Wind Turbine Operating in Region 3

    Science.gov (United States)

    Frost, Susan A.; Balas, Mark J.; Wright, Alan D.

    2009-01-01

    Adaptive control techniques are well suited to nonlinear applications, such as wind turbines, which are difficult to accurately model and which have effects from poorly known operating environments. The turbulent and unpredictable conditions in which wind turbines operate create many challenges for their operation. In this paper, we design an adaptive collective pitch controller for a high-fidelity simulation of a utility scale, variable-speed horizontal axis wind turbine. The objective of the adaptive pitch controller in Region 3 is to regulate generator speed and reject step disturbances. The control objective is accomplished by collectively pitching the turbine blades. We use an extension of the Direct Model Reference Adaptive Control (DMRAC) approach to track a reference point and to reject persistent disturbances. The turbine simulation models the Controls Advanced Research Turbine (CART) of the National Renewable Energy Laboratory in Golden, Colorado. The CART is a utility-scale wind turbine which has a well-developed and extensively verified simulator. The adaptive collective pitch controller for Region 3 was compared in simulations with a bas celliansesical Proportional Integrator (PI) collective pitch controller. In the simulations, the adaptive pitch controller showed improved speed regulation in Region 3 when compared with the baseline PI pitch controller and it demonstrated robustness to modeling errors.

  19. Modified Adaptive Control for Region 3 Operation in the Presence of Wind Turbine Structural Modes

    Science.gov (United States)

    Frost, Susan Alane; Balas, Mark J.; Wright, Alan D.

    2010-01-01

    Many challenges exist for the operation of wind turbines in an efficient manner that is reliable and avoids component fatigue and failure. Turbines operate in highly turbulent environments resulting in aerodynamic loads that can easily excite turbine structural modes, possibly causing component fatigue and failure. Wind turbine manufacturers are highly motivated to reduce component fatigue and failure that can lead to loss of revenue due to turbine down time and maintenance costs. The trend in wind turbine design is toward larger, more flexible turbines that are ideally suited to adaptive control methods due to the complexity and expense required to create accurate models of their dynamic characteristics. In this paper, we design an adaptive collective pitch controller for a high-fidelity simulation of a utility-scale, variable-speed horizontal axis wind turbine operating in Region 3. The objective of the adaptive pitch controller is to regulate generator speed, accommodate wind gusts, and reduce the excitation of structural modes in the wind turbine. The control objective is accomplished by collectively pitching the turbine blades. The adaptive collective pitch controller for Region 3 was compared in simulations with a baseline classical Proportional Integrator (PI) collective pitch controller. The adaptive controller will demonstrate the ability to regulate generator speed in Region 3, while accommodating gusts, and reducing the excitation of certain structural modes in the wind turbine.

  20. A Coupled Snow Operations-Skier Demand Model for the Ontario (Canada) Ski Region

    Science.gov (United States)

    Pons, Marc; Scott, Daniel; Steiger, Robert; Rutty, Michelle; Johnson, Peter; Vilella, Marc

    2016-04-01

    The multi-billion dollar global ski industry is one of the tourism subsectors most directly impacted by climate variability and change. In the decades ahead, the scholarly literature consistently projects decreased reliability of natural snow cover, shortened and more variable ski seasons, as well as increased reliance on snowmaking with associated increases in operational costs. In order to develop the coupled snow, ski operations and demand model for the Ontario ski region (which represents approximately 18% of Canada's ski market), the research utilized multiple methods, including: a in situ survey of over 2400 skiers, daily operations data from ski resorts over the last 10 years, climate station data (1981-2013), climate change scenario ensemble (AR5 - RCP 8.5), an updated SkiSim model (building on Scott et al. 2003; Steiger 2010), and an agent-based model (building on Pons et al. 2014). Daily snow and ski operations for all ski areas in southern Ontario were modeled with the updated SkiSim model, which utilized current differential snowmaking capacity of individual resorts, as determined from daily ski area operations data. Snowmaking capacities and decision rules were informed by interviews with ski area managers and daily operations data. Model outputs were validated with local climate station and ski operations data. The coupled SkiSim-ABM model was run with historical weather data for seasons representative of an average winter for the 1981-2010 period, as well as an anomalously cold winter (2012-13) and the record warm winter in the region (2011-12). The impact on total skier visits and revenues, and the geographic and temporal distribution of skier visits were compared. The implications of further climate adaptation (i.e., improving the snowmaking capacity of all ski areas to the level of leading resorts in the region) were also explored. This research advances system modelling, especially improving the integration of snow and ski operations models with

  1. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. Technical background and guidance for deployment in EU regions

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Le Pierres, S. [Energies Demain, Montreuil Sous Bois (France); Del Ciello, R. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Harnych, J. [ENVIROS, Prague (Czech Republic)

    2013-03-15

    The CO2MPARE model enables national and regional authorities to assess the carbon impacts of Operational Programmes co-financed through the European Regional Development Fund (ERDF). This document provides technical background information and guidance for deploying the model in additional EU regions.

  2. Wintertime Air Quality Impacts from Oil and Natural Gas Drilling Operations in the Bakken Formation Region

    Science.gov (United States)

    Evanoski-Cole, Ashley; Sive, Barkley; Zhou, Yong; Prenni, Anthony; Schurman, Misha; Day, Derek; Sullivan, Amy; Li, Yi; Hand, Jenny; Gebhart, Kristi; Schichtel, Bret; Collett, Jeffrey

    2016-04-01

    Oil and natural gas extraction has dramatically increased in the last decade in the United States due to the increased use of unconventional drilling techniques which include horizontal drilling and hydraulic fracturing. The impact of these drilling activities on local and regional air quality in oil and gas basins across the country are still relatively unknown, especially in recently developed basins such as the Bakken shale formation. This study is the first to conduct a comprehensive characterization of the regional air quality in the Bakken region. The Bakken shale formation, part of the Williston basin, is located in North Dakota and Montana in the United States and Saskatchewan and Manitoba in Canada. Oil and gas drilling operations can impact air quality in a variety of ways, including the generation of atmospheric particulate matter (PM), hazardous air pollutants, ozone, and greenhouse gas emissions. During the winter especially, PM formation can be enhanced and meteorological conditions can favor increased concentrations of PM and other pollutants. In this study, ground-based measurements throughout the Bakken region in North Dakota and Montana were collected over two consecutive winters to gain regional trends of air quality impacts from the oil and gas drilling activities. Additionally, one field site had a comprehensive suite of instrumentation operating at high time resolution to gain detailed characterization of the atmospheric composition. Measurements included organic carbon and black carbon concentrations in PM, the characterization of inorganic PM, inorganic gases, volatile organic compounds (VOCs), precipitation and meteorology. These elevated PM episodes were further investigated using the local meteorological conditions and regional transport patterns. Episodes of elevated concentrations of nitrogen oxides and sulfur dioxide were also detected. The VOC concentrations were analyzed and specific VOCs that are known oil and gas tracers were used

  3. [Historical schedule of management of bleeding from the upper part of gastrointestinal tract].

    Science.gov (United States)

    Wójtowicz, Jacek; Wojtuń, Stanisław; Gil, Jerzy

    2009-05-01

    Treatment of bleeding from the upper part of gastrointestinal tract were changed many times. First there were waiting (Hipocrates, Sydenham, Stahl), next transfusion of the blood were initiated (Denis, Blundell, Dieffenbach, Bierkowski, Dungren, Hirszfeld). Big (Rydygier) and small (Dragstedt) operations procedures were attempted. Discovery of endoscopy of gastrointestinal tract (Mikulicz) and initiation of elastic scopes (Hirschowitz) and exploration inhibitor of histamine receptors (H2) and proton pump inhibitors with recognition of role Helicobacter pylori in bleeding were permitted elaborate actual schemas of proceedings.

  4. Compressor bleed cooling fluid feed system

    Science.gov (United States)

    Donahoo, Eric E; Ross, Christopher W

    2014-11-25

    A compressor bleed cooling fluid feed system for a turbine engine for directing cooling fluids from a compressor to a turbine airfoil cooling system to supply cooling fluids to one or more airfoils of a rotor assembly is disclosed. The compressor bleed cooling fluid feed system may enable cooling fluids to be exhausted from a compressor exhaust plenum through a downstream compressor bleed collection chamber and into the turbine airfoil cooling system. As such, the suction created in the compressor exhaust plenum mitigates boundary layer growth along the inner surface while providing flow of cooling fluids to the turbine airfoils.

  5. Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Fahad Saeed

    2011-01-01

    Full Text Available Gastrointestinal (GI bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI in chronic kidney disease (CKD and end-stage renal disease (ESRD patients. We suggest an approach to diagnosis and management of this problem.

  6. Carcinoma of the pancreas and periampullary region: Palliation versus cure

    NARCIS (Netherlands)

    J.H. Klinkenbijl (Jean); J. Jeekel (Hans); P.I.M. Schmitz (Paul); P.A.R. Rombout (P. A R); G.A.J.J. Nix (Gerard); H.A. Bruining (Hajo); M. van Blankenstein (Mark)

    1993-01-01

    textabstractA retrospective study of 310 patients with carcinoma of the head of the pancreas or periampullary region was performed. Preoperative bile drainage by placement of a stent reduced the number of postoperative complications, especially bleeding (P = 0·03). The operative mortality rate was n

  7. Improving reservoir operations modeling for integration in a regional Earth system model

    Science.gov (United States)

    Voisin, N.; Li, H.; Ward, D. L.; Huang, M.; Leung, L.; Wigmosta, M. S.

    2012-12-01

    In integrated Earth system models (EaSMs), accurate hydrologic information in all of its components including socio-economy, atmosphere, land, and energy infrastructure is needed to represent the interactions between human and Earth system processes. The hydrology processes regulate the water, energy and carbon fluxes in this integrated framework. Human influence on the hydrologic cycle includes regulation and storage, consumptive use and overall redistribution of water resources in space and time. Representing these processes is essential for applications of EaSMs in hydrologic and climate predictions, as well as impact studies such as integrated assessment activities at regional to global scales. Dynamic programming approaches to optimize operations of reservoir systems have been widely used for water resources management planning at local and regional scales and recently have emerged in global-scale applications; albeit they are performed offline from the EaSMs , and require accurate knowledge of future flow for the upcoming water year. Other emerging large-scale research reservoir models use generic operating rules that are more flexible for coupling with EaSMs. Those generic operating rules have been successful in reproducing overall regulated flow at large basin scales. Improved generic operating rules are presented and evaluated across multiple spatial scales and objectives (flow but also storage and supply) over the complex multi-objective Columbia River Regulation System, which is representative of large river systems with increasing competitive reservoir purposes in the future. Challenges due to the difference in time and spatial scales between the physical processes versus reservoir operations and targets (irrigation, flood control, hydropower, environmental flow, navigation) are then discussed in the context of improving hydrology and evapotranspiration fluxes within an integrated EaSM.

  8. The Impact of Reverse Trendelenburg Versus Head-up Position on Intraoperative Bleeding of Elective Rhinoplasty

    Science.gov (United States)

    Nooraei, Navid; Dabbagh, Ali; Niazi, Feizolah; Mohammadi, Siamak; Mohajerani, Seyed Amir; Radmand, Golnar; Hashemian, Seyed Mohammad Reza

    2013-01-01

    Background: In spite of several efforts for decreasing blood loss, our experience sometimes shows that some patients bleed more profusely during rhinoplasty. Patient position could have deep impact on bleeding amount during surgical procedures. Objective: In this study, we aimed to compare reverse trendelenburg position and head-up position on intra-operative bleeding of elective rhinoplasty. This was to check the effects of reverse trendelenburg position and head up position on the intraoperative bleeding of elective rhinoplasty. Methods: In this study, 30 ASA I (American Society of Anesthesiology physical condition classification) patients between 18 and 40 years of age who were candidate to rhinoplasty operations for first time were included. Patients were randomly assigned to reverse trendelenburg or head-up position. Exclusion criteria was any history or lab indicating coagulation problems or using any drug. All gauzes used and the blood that accumulated in the aspirator throughout the operation were calculated. Results: Our results showed that the mean amount of blood loss in reverse trendelenburg was lower (77.00 ± 13.20 ml) than head-up position (83.33 ± 21.18 ml), although, there was no statistical difference between two groups. However, there was no significant differences among two groups in different aspects of hemodynamic determinants and bleeding amount during and after rhinoplasty. Conclusions: Our results showed that patient bleeding is not increased because of positioning per se. In conclusion, perhaps in the future reverse trendelenburg will be given more often during rhinoplasry. PMID:24498500

  9. The impact of reverse trendelenburg versus head-up position on intraoperative bleeding of elective rhinoplasty

    Directory of Open Access Journals (Sweden)

    Navid Nooraei

    2013-01-01

    Full Text Available Background: In spite of several efforts for decreasing blood loss, our experience sometimes shows that some patients bleed more profusely during rhinoplasty. Patient position could have deep impact on bleeding amount during surgical procedures. Objective: In this study, we aimed to compare reverse trendelenburg position and head-up position on intra-operative bleeding of elective rhinoplasty. This was to check the effects of reverse trendelenburg position and head up position on the intraoperative bleeding of elective rhinoplasty. Methods: In this study, 30 ASA I (American Society of Anesthesiology physical condition classification patients between 18 and 40 years of age who were candidate to rhinoplasty operations for first time were included. Patients were randomly assigned to reverse trendelenburg or head-up position. Exclusion criteria was any history or lab indicating coagulation problems or using any drug. All gauzes used and the blood that accumulated in the aspirator throughout the operation were calculated. Results: Our results showed that the mean amount of blood loss in reverse trendelenburg was lower (77.00 ΁ 13.20 ml than head-up position (83.33 ΁ 21.18 ml, although, there was no statistical difference between two groups. However, there was no significant differences among two groups in different aspects of hemodynamic determinants and bleeding amount during and after rhinoplasty. Conclusions: Our results showed that patient bleeding is not increased because of positioning per se. In conclusion, perhaps in the future reverse trendelenburg will be given more often during rhinoplasry.

  10. Genetic analysis of bleeding disorders.

    Science.gov (United States)

    Edison, E; Konkle, B A; Goodeve, A C

    2016-07-01

    Molecular genetic analysis of inherited bleeding disorders has been practised for over 30 years. Technological changes have enabled advances, from analyses using extragenic linked markers to next-generation DNA sequencing and microarray analysis. Two approaches for genetic analysis are described, each suiting their environment. The Christian Medical Centre in Vellore, India, uses conformation-sensitive gel electrophoresis mutation screening of multiplexed PCR products to identify candidate mutations, followed by Sanger sequencing confirmation of variants identified. Specific analyses for F8 intron 1 and 22 inversions are also undertaken. The MyLifeOurFuture US project between the American Thrombosis and Hemostasis Network, the National Hemophilia Foundation, Bloodworks Northwest and Biogen uses molecular inversion probes (MIP) to capture target exons, splice sites plus 5' and 3' sequences and to detect F8 intron 1 and 22 inversions. This allows screening for all F8 and F9 variants in one sequencing run of multiple samples (196 or 392). Sequence variants identified are subsequently confirmed by a diagnostic laboratory. After having identified variants in genes of interest through these processes, a systematic procedure determining their likely pathogenicity should be applied. Several scientific societies have prepared guidelines. Systematic analysis of the available evidence facilitates reproducible scoring of likely pathogenicity. Documentation of frequency in population databases of variant prevalence and in locus-specific mutation databases can provide initial information on likely pathogenicity. Whereas null mutations are often pathogenic, missense and splice site variants often require in silico analyses to predict likely pathogenicity and using an accepted suite of tools can help standardize their documentation.

  11. Genetic analysis of bleeding disorders.

    Science.gov (United States)

    Edison, E; Konkle, B A; Goodeve, A C

    2016-07-01

    Molecular genetic analysis of inherited bleeding disorders has been practised for over 30 years. Technological changes have enabled advances, from analyses using extragenic linked markers to next-generation DNA sequencing and microarray analysis. Two approaches for genetic analysis are described, each suiting their environment. The Christian Medical Centre in Vellore, India, uses conformation-sensitive gel electrophoresis mutation screening of multiplexed PCR products to identify candidate mutations, followed by Sanger sequencing confirmation of variants identified. Specific analyses for F8 intron 1 and 22 inversions are also undertaken. The MyLifeOurFuture US project between the American Thrombosis and Hemostasis Network, the National Hemophilia Foundation, Bloodworks Northwest and Biogen uses molecular inversion probes (MIP) to capture target exons, splice sites plus 5' and 3' sequences and to detect F8 intron 1 and 22 inversions. This allows screening for all F8 and F9 variants in one sequencing run of multiple samples (196 or 392). Sequence variants identified are subsequently confirmed by a diagnostic laboratory. After having identified variants in genes of interest through these processes, a systematic procedure determining their likely pathogenicity should be applied. Several scientific societies have prepared guidelines. Systematic analysis of the available evidence facilitates reproducible scoring of likely pathogenicity. Documentation of frequency in population databases of variant prevalence and in locus-specific mutation databases can provide initial information on likely pathogenicity. Whereas null mutations are often pathogenic, missense and splice site variants often require in silico analyses to predict likely pathogenicity and using an accepted suite of tools can help standardize their documentation. PMID:27405681

  12. LPV control for the full region operation of a wind turbine integrated with synchronous generator.

    Science.gov (United States)

    Cao, Guoyan; Grigoriadis, Karolos M; Nyanteh, Yaw D

    2015-01-01

    Wind turbine conversion systems require feedback control to achieve reliable wind turbine operation and stable current supply. A robust linear parameter varying (LPV) controller is proposed to reduce the structural loads and improve the power extraction of a horizontal axis wind turbine operating in both the partial load and the full load regions. The LPV model is derived from the wind turbine state space models extracted by FAST (fatigue, aerodynamics, structural, and turbulence) code linearization at different operating points. In order to assure a smooth transition between the two regions, appropriate frequency-dependent varying scaling parametric weighting functions are designed in the LPV control structure. The solution of a set of linear matrix inequalities (LMIs) leads to the LPV controller. A synchronous generator model is connected with the closed LPV control loop for examining the electrical subsystem performance obtained by an inner speed control loop. Simulation results of a 1.5 MW horizontal axis wind turbine model on the FAST platform illustrates the benefit of the LPV control and demonstrates the advantages of this proposed LPV controller, when compared with a traditional gain scheduling PI control and prior LPV control configurations. Enhanced structural load mitigation, improved power extraction, and good current performance were obtained from the proposed LPV control. PMID:25884036

  13. LPV Control for the Full Region Operation of a Wind Turbine Integrated with Synchronous Generator

    Directory of Open Access Journals (Sweden)

    Guoyan Cao

    2015-01-01

    Full Text Available Wind turbine conversion systems require feedback control to achieve reliable wind turbine operation and stable current supply. A robust linear parameter varying (LPV controller is proposed to reduce the structural loads and improve the power extraction of a horizontal axis wind turbine operating in both the partial load and the full load regions. The LPV model is derived from the wind turbine state space models extracted by FAST (fatigue, aerodynamics, structural, and turbulence code linearization at different operating points. In order to assure a smooth transition between the two regions, appropriate frequency-dependent varying scaling parametric weighting functions are designed in the LPV control structure. The solution of a set of linear matrix inequalities (LMIs leads to the LPV controller. A synchronous generator model is connected with the closed LPV control loop for examining the electrical subsystem performance obtained by an inner speed control loop. Simulation results of a 1.5 MW horizontal axis wind turbine model on the FAST platform illustrates the benefit of the LPV control and demonstrates the advantages of this proposed LPV controller, when compared with a traditional gain scheduling PI control and prior LPV control configurations. Enhanced structural load mitigation, improved power extraction, and good current performance were obtained from the proposed LPV control.

  14. Tennessee Valley region study: potential year 2000 radiological dose to population resulting from nuclear facility operations

    International Nuclear Information System (INIS)

    A companion report, DOE/ET-0064/1, presents a geographic, cultural, and demographic profile of the Tennessee Valley Region study area. This report describes the calculations of radionuclide release and transport and of the resultant dose to the regional population, assuming a projected installed capacity of 220,000 MW in the year 2000, of which 144,000 MW would be nuclear. All elements of the fuel cycle were assumed to be in operation. The radiological dose was calculated as a one-year dose based on ingestion of 35 different food types as well as for nine non-food pathways, and was reported as dose to the total body and for six specific organs for each of four age groups (infant, child, teen, and adult). Results indicate that the average individual would receive an incremental dose of 7 x 10-4 millirems in the year 2000 from the operation of nuclear facilities within and adjacent to the region, five orders of magnitude smaller than the dose from naturally occurring radiation in the area. The major contributor to dose was found to be tritium, and the most significant pathways were immersion in air, inhalation of air, transpiration of tritium (absorption through the skin), and exposure radionuclide-containing soil. 60 references

  15. Dysfunctional Uterine Bleeding (DUB) (For Teens)

    Science.gov (United States)

    ... the body's hormones. Problems like compulsive exercise , not eating healthy foods, or too much stress can cause hormone changes. Some severe cases of AUB are caused by bleeding disorders such as von Willebrand disease . What Are the ...

  16. Fibrinogen concentrate for bleeding - a systematic review

    DEFF Research Database (Denmark)

    Lunde, J; Stensballe, J; Wikkelsø, A;

    2014-01-01

    Fibrinogen concentrate as part of treatment protocols increasingly draws attention. Fibrinogen substitution in cases of hypofibrinogenaemia has the potential to reduce bleeding, transfusion requirement and subsequently reduce morbidity and mortality. A systematic search for randomised controlled...

  17. Cough-induced Tracheobronchial Mucosal Bleeding.

    Science.gov (United States)

    Hira, Harmanjit Singh

    2011-01-01

    A 56-year-old man presented with moderate hemoptysis. It was preceded by a severe bout of cough. Flexible bronchoscopy showed diffuse tracheobronchial mucosal petechiae and bleeding. The patient was not suffering with any coagulopathies. He did not receive antiplatelet drugs. Hemoptysis resolved with cough suppressant. Subsequent bronchoscopy revealed the complete resolution of petechiae. The mechanism of bleeding after the bout of coughing is discussed. PMID:23169019

  18. Management of patients with ulcer bleeding.

    Science.gov (United States)

    Laine, Loren; Jensen, Dennis M

    2012-03-01

    This guideline presents recommendations for the step-wise management of patients with overt upper gastrointestinal bleeding. Hemodynamic status is first assessed, and resuscitation initiated as needed. Patients are risk-stratified based on features such as hemodynamic status, comorbidities, age, and laboratory tests. Pre-endoscopic erythromycin is considered to increase diagnostic yield at first endoscopy. Pre-endoscopic proton pump inhibitor (PPI) may be considered to decrease the need for endoscopic therapy but does not improve clinical outcomes. Upper endoscopy is generally performed within 24h. The endoscopic features of ulcers direct further management. Patients with active bleeding or non-bleeding visible vessels receive endoscopic therapy (e.g., bipolar electrocoagulation, heater probe, sclerosant, clips) and those with an adherent clot may receive endoscopic therapy; these patients then receive intravenous PPI with a bolus followed by continuous infusion. Patients with flat spots or clean-based ulcers do not require endoscopic therapy or intensive PPI therapy. Recurrent bleeding after endoscopic therapy is treated with a second endoscopic treatment; if bleeding persists or recurs, treatment with surgery or interventional radiology is undertaken. Prevention of recurrent bleeding is based on the etiology of the bleeding ulcer. H. pylori is eradicated and after cure is documented anti-ulcer therapy is generally not given. Nonsteroidal anti-inflammatory drugs (NSAIDs) are stopped; if they must be resumed low-dose COX-2-selective NSAID plus PPI is used. Patients with established cardiovascular disease who require aspirin should start PPI and generally re-institute aspirin soon after bleeding ceases (within 7 days and ideally 1-3 days). Patients with idiopathic ulcers receive long-term anti-ulcer therapy. PMID:22310222

  19. Abnormal uterine bleeding: a clinicohistopathological analysis

    OpenAIRE

    Anupamasuresh Y; Suresh YV; Prachi Jain*,

    2014-01-01

    Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. It adversely effects on the quality of life and psychology of women. It is of special concern in developing country as it adds to the causes of anemia. Management of Abnormal Uterine Bleeding (AUB) is not complete without tissue diagnosis especially in perimenopausal and post-menopausal women. Histological characteristics of endometrial biopsy material as assessed by light mic...

  20. Facing operational problems in a biodigester in Yuvientsa - Amazonian region of Ecuador

    Energy Technology Data Exchange (ETDEWEB)

    Aragundy, J.

    2007-07-01

    Yuvientsa is a Shuar indigenous community located in the Morona Santiago Province in the southwestern part of the Amazonian region of Ecuador. Two types of alternative energies have being implemented in Yuvientsa to satisfy people's needs. Solar panels provide electricity to the community. A biodigester to treat the school lavatories' brown-water (fecal water) and to provide gas for cooking to the communal kitchen was built as well. During the operational phase the biodigester faced some difficulties as: being perforated by people of the community as started inflating, being fumigated against malaria, and not having enough organic matter to produce biogas. As a result in this time the biodigester did not operate satisfactorily and the community did not believe that it could work and produce biogas. A biodigester should not be built without an awareness campaign or showing a direct benefit to the community that ensures its adequate operation and maintenance. Before constructing the reactor the organic matter source to operate the biodigester should be clearly identified and its amount should be enough. (orig.)

  1. PRESSCA: A regional operative Early Warning System for landslides risk scenario assessment

    Science.gov (United States)

    Ponziani, Francesco; Stelluti, Marco; Berni, Nicola; Brocca, Luca; Moramarco, Tommaso

    2013-04-01

    The Italian national alert system for the hydraulic and hydrogeological risk is ensured by the National Civil Protection Department, through the "Functional Centres" Network, together with scientific/technical Support Centres, named "Competence Centres". The role of the Functional Centres is to alert regional/national civil protection network, to manage the prediction and the monitoring phases, thus ensuring the flow of data for the management of the emergency. The Umbria regional alerting procedure is based on three increasing warning levels of criticality for 6 sub-areas (~1200 km²). Specifically, for each duration (from 1 to 48 hours), three criticality levels are assigned to the rainfall values corresponding to a recurrence interval of 2, 5, and 10 years. In order to improve confidence on the daily work for hydrogeological risk assessment and management, a simple and operational early warning system for the prediction of shallow landslide triggering on regional scale was implemented. The system is primarily based on rainfall thresholds, which represent the main element of evaluation for the early-warning procedures of the Italian Civil Protection system. Following previous studies highlighting that soil moisture conditions play a key role on landslide triggering, a continuous physically-based soil water balance model was implemented for the estimation of soil moisture conditions over the whole regional territory. In fact, a decreasing trend between the cumulated rainfall values over 24, 36 and 48 hours and the soil moisture conditions prior to past landslide events was observed. This trend provides an easy-to-use tool to dynamically adjust the operational rainfall thresholds with the soil moisture conditions simulated by the soil water balance model prior to rainfall events. The application of this procedure allowed decreasing the uncertainties tied to the application of the rainfall thresholds only. The system is actually operational in real-time and it was

  2. Reasons of bleeding complications and prevention methods in endovascular stenting for intracranial artery stenosis

    International Nuclear Information System (INIS)

    Objective: To summarize the reasons of bleeding complications and the prevention methods in stenting for intracranial arterial stenosis. Methods: The clinical data of 366 patients underwent stent-assistant angioplasty of intracranial artery stenosis from July 2006 to December 2011 were analyzed retrospectively. Among them, 14 patients with bleeding complications were found. The initial 100 patients were categorized as early stage group and the rest as mature stage group. The reasons of bleeding and the methods for preventing this complication were summarized. Results: The overall incidence of bleeding complication was 3.8% (14/366). In the early stage group and mature stage group,the rates was 10%(10/100) and 1.5% (4/266). Six cases were related to the operational manipulation and 8 cases secondary to hyperperfusion injury. Death was found in 6 patients,severe disability in 3, mild paralysis in 2, and no neurological deficits in 3. Conclusions: The bleeding complications in stent-assisted angioplasty of intracranial artery stenosis have a high disability and mortality. The improvement of operative techniques and the more strict indications decrease the bleeding complications rate effectively. (authors)

  3. Duration of increased bleeding tendency after cessation of aspirin therapy.

    LENUS (Irish Health Repository)

    Cahill, Ronan A

    2012-02-03

    BACKGROUND: Aspirin has a significant effect on hemostasis, so it is often recommended that patients taking aspirin discontinue treatment before elective surgery. While off aspirin, these patients may be at risk of thrombosis. The optimum period of time that aspirin should be withheld is controversial. The aim of this study was to establish the duration of the antihemostatic effect of prolonged aspirin therapy. STUDY DESIGN: In a prospective study, 51 healthy volunteers were randomly assigned into 3 groups, each receiving an identical tablet for 14 days. One group received a placebo tablet; individuals in the other two groups received either 75 mg or 300 mg of aspirin once a day. Template bleeding times and specific platelet function testing (using the PFA-100; Dade Behring) were carried out on subjects before therapy and again after its completion until they returned to baseline. RESULTS: Thirty-eight volunteers complied sufficiently with the protocol to provide useful results. All bleeding times normalized within 96 hours and all platelet function tests within 144 hours after stopping aspirin. There was no demonstrable hemostatic defect in any volunteer persisting by or beyond the sixth day after treatment cessation. There was no apparent difference in duration of effect between those taking either 75 mg or 300 mg of aspirin. CONCLUSIONS: This study uses sensitive measures of platelet function to demonstrate the duration of increased bleeding tendency after withdrawal of aspirin therapy. It supports discontinuation of aspirin therapy 5 days before elective surgery (with the operation being performed on the sixth day).

  4. Critical gastrointestinal bleed due to secondary aortoenteric fistula.

    Science.gov (United States)

    Malik, Mohammad U; Ucbilek, Enver; Sherwal, Amanpreet S

    2015-01-01

    Secondary aortoenteric fistula (SAEF) is a rare yet lethal cause of gastrointestinal bleeding and occurs as a complication of an abdominal aortic aneurysm repair. Clinical presentation may vary from herald bleeding to overt sepsis and requires high index of suspicion and clinical judgment to establish diagnosis. Initial diagnostic tests may include computerized tomography scan and esophagogastroduodenoscopy. Each test has variable sensitivity and specificity. Maintaining the hemodynamic status, control of bleeding, removal of the infected graft, and infection control may improve clinical outcomes. This review entails the updated literature on diagnosis and management of SAEF. A literature search was conducted for articles published in English, on PubMed and Scopus using the following search terms: secondary, aortoenteric, aorto-enteric, aortoduodenal, aorto-duodenal, aortoesophageal, and aorto-esophageal. A combination of MeSH terms and Boolean operators were used to device search strategy. In addition, a bibliography of clinically relevant articles was searched to find additional articles (Appendix A). The aim of this review is to provide a comprehensive update on the diagnosis, management, and prognosis of SAEF. PMID:26653698

  5. Critical gastrointestinal bleed due to secondary aortoenteric fistula

    Directory of Open Access Journals (Sweden)

    Mohammad U. Malik

    2015-12-01

    Full Text Available Secondary aortoenteric fistula (SAEF is a rare yet lethal cause of gastrointestinal bleeding and occurs as a complication of an abdominal aortic aneurysm repair. Clinical presentation may vary from herald bleeding to overt sepsis and requires high index of suspicion and clinical judgment to establish diagnosis. Initial diagnostic tests may include computerized tomography scan and esophagogastroduodenoscopy. Each test has variable sensitivity and specificity. Maintaining the hemodynamic status, control of bleeding, removal of the infected graft, and infection control may improve clinical outcomes. This review entails the updated literature on diagnosis and management of SAEF. A literature search was conducted for articles published in English, on PubMed and Scopus using the following search terms: secondary, aortoenteric, aorto-enteric, aortoduodenal, aorto-duodenal, aortoesophageal, and aorto-esophageal. A combination of MeSH terms and Boolean operators were used to device search strategy. In addition, a bibliography of clinically relevant articles was searched to find additional articles (Appendix A. The aim of this review is to provide a comprehensive update on the diagnosis, management, and prognosis of SAEF.

  6. Assessment of the Water Balance Over France Using Regionalized Turc-Pike Formula for Operational Hydrology

    Science.gov (United States)

    LE Lay, M.; Garcon, R.; Gailhard, J.; Garavaglia, F.

    2015-12-01

    With extensive use of hydrological models over a wide range of hydro-climatic contexts, bias in hydro-climatic data may lead to unreliable models and thus hydrological forecasts and projections. This issue is particularly pregnant when considering mountainous areas with great uncertainties on precipitations, or when considering complex unconservative catchments (e.g. karstic systems). The Turc-Pike water balance formula, analogous to the classical Budyko formula, is a simple and efficient mathematical formulation relating long-term average streamflow to long-term average precipitation and potential evaporation. In this study, we propose to apply this framework to assess and eventually adjust the water-balance before calibrating an operational hydrologic model (MORDOR model). Considering a large set of 350 french catchments, the Turc-Pike formula is regionalized based on ecohydrologic criterions to handle various hydro-climatic contexts. This interannual regional model is then applied to assess the water-balance over numerous catchments and various conditions, such as karstic, snow-driven or glaciarized and even anthropized catchments. Results show that it is possible to obtain pretty realistic corrections of meteorological inputs (precipitations, temperature or potential evaporation) or hydrologic surface (or runoff). These corrections can often be confirmed a posteriori by exogenous information. Positive impacts on hydrologic model's calibration are also demonstrated. This methodology is now operational for hydrologic applications at EDF (Electricité de France, French electric utility company), and therefore applied on hundreds of catchments.

  7. Implementation and modeling of a Regional Hub Reception Center during mass evacuation operations.

    Science.gov (United States)

    Wojtalewicz, Cliff; Kirby, Adam; Dietz, J Eric

    2014-01-01

    When developing response plans in the aftermath of a catastrophic incident, jurisdictions often fail to conduct the necessary interdisciplinary planning needed to fully address the needs across jurisdictional borders. The Purdue Homeland Security Institute (PHSI) was selected by the City of Chicago Office of Emergency Management and Communications (OEMC) in 2010 to lead an effort to address planning across jurisdictional borders during mass evacuations following a catastrophic incident. Specifically, PHSI was chosen to lead the effort in developing a planning and implementation guide for standing up a conceptual Regional Hub Reception Center (RHRC). A major component within the mass evacuation and sheltering continuum, the RHRC is designed to provide evacuees with quickresponse mass care and emergency assistance while their other needs are assessed and appropriate shelter locations are identified. The RHRC also provides a central location to leverage governmental, nongovernmental, and private sector resources and is the first point in the evacuation, mass care, and sheltering concept of operations where more comprehensive support (food, shelter, medical, psychological, household pet sheltering, reunification, etc) can be expected. PHSI undertook this lead role working within the Illinois-Indiana-Wisconsin (IL-IN-WI) Combined Statistical Area (CSA) as part of the US Department of Homeland Security Regional Catastrophic Planning Grant Program. Coordinating closely with the City of Chicago OEMC and IL-IN-WI CSA Regional Catastrophic Planning Team, PHSI lead the research effort using resource and capability data compiled from all 17 jurisdictions within the IL-IN-WI CSA and validated the RHRC concept using three tabletop exercises. Upon completion, the PHSI team published the RHRC planning guide complete with procedures and processes that define the roles and responsibilities of government, nongovernment organizations, and private sector for providing RHRC mass care

  8. MODELING ON THE CYCLIC OPERATION OF STANDING COLUMN WELLS UNDER REGIONAL GROUNDWATER FLOW*

    Institute of Scientific and Technical Information of China (English)

    LEE Kun Sang

    2011-01-01

    Coupled hydrogeological-thermal simulation of the Standing Column Well (SCW) system is essential to provide an optimized configuration and operation schedule for boreholes on the site.This paper presents numerical investigations and thermo-hydraulic evaluation of standing column well system operating under cyclic flow regime.A three-dimensional numerical model for groundwater flow and heat transport is used to analyze the heat exchange in the ground.The model includes the effects of convective and conductive heat transfer, heat loss to the adjacent confining strata, and hydraulic anisotropy.The operation scenario consists of cyclic injection and recovery and four periods per year to simulate the seasonal temperature conditions.For different parameters of the system, performances have been evaluated in terms of variations in recovery temperature.The calculated temperatures at the producing pipe are relatively constant within a certain range through the year and fluctuating quarterly a year.Pipe-to-pipe distance, injection/production rate, ground thickness, and permeability considered in the model are shown to impact the predicted temperature profiles at each stage and the recovery water temperature.The influence of pressure gradient, which determines the velocity of regional groundwater flow, is most substantial.

  9. Immediate bleeding complications in dental implants: A systematic review

    OpenAIRE

    Balaguer Martí, José Carlos; Peñarrocha Oltra, David; Balaguer Martínez, José; Peñarrocha Diago, Miguel

    2014-01-01

    Objective: A review is made of the immediate or immediate postoperative bleeding complications in dental implants, with a view to identifying the areas of greatest bleeding risk, the causes of bleeding, the length of the implants associated with bleeding, the most frequently implicated blood vessels, and the treatments used to resolve these complications. Material and Methods: A Medline (PubMed) and Embase search was made of articles on immediate bleeding complications in dental implants publ...

  10. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. Improved carbon management with EU Regional Policy. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Schram, J. [Energies Demain, Montreuil Sous Bois (France); Amerighi, O. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Ten Donkelaar, M. [ENVIROS, Prague (Czech Republic)

    2013-03-15

    The CO2MPARE model supports national and regional authorities in making balanced decisions for their investment portfolio under their regional development programmes, in particular under their Operational Programmes of EU Regional Policy. The EU's climate objectives require that investments across the EU are channeled towards low-carbon development. The carbon impacts of investments should therefore be seriously considered in the decision making process of regional development programmes. The CO2MPARE model informs national and regional authorities on the impacts that the investments under various Operational Programmes can have in terms of CO2 emissions. Knowing which investments lead either to additional emissions or rather to emission reductions, and what the overall impact of a programme is, represents the first step towards investment decisions that have decarbonisation co-benefits. CO2MPARE estimates the combined carbon impact of all activities that take place under a programme, and provides insights into the relative contributions of the different themes. Through its high aggregation level, it allows comparison of investment scenarios rather than individual projects. As such, it aims to support informed decisions on investment strategies rather than project investment decisions. In doing so, it also helps to build and develop a 'carbon culture' within the authorities directly or indirectly in charge of managing Regional Policy Operational Programmes. The model is primarily aimed at Operational Programmes co-financed by the European Regional Development Fund (ERDF)

  11. Radiation protection activities under a Regional Co-operative Agreement (RCA)

    International Nuclear Information System (INIS)

    The current status of a Regional Co-operative Agreement (RCA) project on 'strengthening of radiation protection' is described. All the RCA Member States, i.e. Australia, Bangladesh, China, India, Indonesia, Japan, the Republic of Korea, Malaysia, Pakistan, the Philippines, Singapore, Sri Lanka, Thailand and Viet Nam are participating in the project and providing the financial and human resources necessary for its implementation. The objective of the project is to strengthen radiation protection capabilities in the RCA region with emphasis on the establishment and development of the infrastructure, in particular, manpower development in dosimetry, dose and risk assessment, protection practices, emergency countermeasures, regulatory provisions, and educational and training systems. The activities include practical training, the acquisition of fundamental knowledge and techniques; workshop and study tours at an advanced level; a co-ordinated research programme to obtain data essential for radiation protection measures in the region; assignment of experts to address specific problems; provision of long term fellowships to supplement short term training; provision of instruments and equipment; participation in the radiation protection advisory team (RAPAT) programme of the IAEA; and periodic evaluation of the project. These activities are applied in a concerted way to industrial applications, including nuclear energy and medical and biological applications. In the field of industrial applications, two training courses and two workshops including study tours were implemented in 1988 and 1989, and one training course and two workshops are envisaged for 1990. In the medical and biological field, efforts have been concentrated on the co-ordinated research programme which aims at compiling essential data of the region for setting Reference Asian Man. 1 tab

  12. Accuracy of rockall score for in hospital re bleeding among cirrhotic patients with variceal bleed

    International Nuclear Information System (INIS)

    To assess the diagnostic accuracy of Roc kall scoring system for predicting in-hospital re-ble- eding in cirrhotic patients presenting with variceal bleed. Material and Methods: This descriptive case series study was conducted at Department of Medicine Combined Military Hospital Lahore from December 2013 to May 2014. We included patients with liver cirrhosis who presented with upper GI bleeding and showed varices as the cause of bleeding on endoscopy. Clinical and endoscopic features were noted to calculate Rockall score. Patients with score < 2 and > 8 were included. After treating with appropriate pharmacological and endoscopic therapy, patients were followed for re-bleeding for 10 days. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive values using 2 x 2 tables. Results: In the study, 175 patients were included. Mean age was 51.5 ± 1.22 years. Male to female ratio was 1.5 to 1.0 out of 175 patients, 157 patients (89.7%) were of low risk group (score = 2) while 18 patients (10.3%) were in high risk group (score > 8). In low risk group, re-bleeding occurred only in 2 patients (1.2%) while in high risk group, re-bleeding occurred in 14 patients (78%). Rockall score was found to have good diagnostic accuracy with sensitivity of 87.5%, specificity of 97.48%, positive predictive value of 77.8% and negative predictive value of 98.7%. Conclusion: In cases of variceal bleed, frequency of re-bleed is less in patients who are in low risk category with lower Rockall score and high in high risk patients with higher rockall score. The Rockall score has a good diagnostic accuracy in prediction of re-bleed in variceal bleeding. (author)

  13. THE FINANCING OF THE ADMINISTRATIVE TERRITORIAL UNITS IN THE WEST DEVELOPMENT REGION THROUGH THE REGIONAL OPERATIONAL PROGRAMME 2007 - 2013

    OpenAIRE

    Munteanu Nicolae-Eugen

    2011-01-01

    It is very important to be found methods to increase the competitiveness between the Romanian administrative-territorial units, under the current conditions of the economic crisis, by means of the existing economic levers successfully used within the European Union regions. The development regions of Romania do not have the statute of administrative units, but they represent territorial units large enough to constitute a good basis for the elaboration and implementation of regional developmen...

  14. Airport operations management- aplikace na regionální letiště

    OpenAIRE

    Adamová, Eva

    2011-01-01

    Záverečná diplomová práca sa zaoberá problematikou Airport Operations Management a jej aplikáciou na regionálne letisko Brno – Tuřany. Rozoberá všeobecné prevádzkové procesy letísk a porovnáva ich so súčasnou situáciou v Tuřanoch. Na základe porovnania sú navrhnuté zlepšenia, alebo návrhy pre zefektívnenie prevádzky. Súčasťou práce je tiež priblíženie súčasnej problematiky ekologizácie letísk a leteckej dopravy.

  15. Radionuclide detection of lower gastrointestinal bleeding sites

    International Nuclear Information System (INIS)

    A retrospective review of two years' experience with radionuclide screening to detect lower gastrointestinal bleeding sites was conducted at New York's Montefiore Medical Center. Of 82 studies performed in 63 patients, 13 identified active bleeding sites. Only three of eight angiograms obtained in these 13 patients were positive. Thirteen contrast angiograms were performed in the group of 50 patients with negative radionuclide studies of which ten were negative and one was equivocal. The results of this study suggest that the Tc-99m sulfur colloid study for active lower gastrointestinal (GI) bleeding is an effective screening procedure. Positive studies help determine which vessel to catheterize selectively if an angiogram is to be performed. If vascular ectasis is still suspected following a negative radionuclide study, contrast angiography can be more efficaciously performed on a nonemergent basis

  16. Somatostatin analogues for acute bleeding oesophageal varices

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C.; Hrobjartsson, A.

    2008-01-01

    BACKGROUND: Somatostatin and its derivatives are sometimes used for emergency treatment of bleeding oesophageal varices in patients with cirrhosis of the liver. OBJECTIVES: To study whether somatostatin or its analogues improve survival or reduce the need for blood transfusions in patients...... with bleeding oesophageal varices. SEARCH STRATEGY: PubMed and The Cochrane Library were searched (November 2007). Reference lists of publications, contacts with authors. SELECTION CRITERIA: All randomised trials comparing somatostatin or analogues with placebo or no treatment in patients suspected of acute...... or recent bleeding from oesophageal varices. DATA COLLECTION AND ANALYSIS: The outcome measures extracted were: mortality, blood transfusions, use of balloon tamponade, initial haemostasis and rebleeding. Intention-to-treat analyses including all randomised patients were conducted if possible; a random...

  17. Change ratio of hemoglobin has predictive value for upper gastrointestinal bleeding

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-01-01

    The present study aimed to identify novel predictors of upper gastrointestinal (GI) bleeding by assessing change ratios of blood test variables. Records of 1,023 patients (431 men and 592 women) who underwent endoscopy between October 2014 and September 2015 at the National Hospital Organization Shimoshizu Hospital (Yotsukaido, Japan) were retrospectively analyzed. Patients whose blood test variables for the time-point of endoscopy and three months previously were available were enrolled and subsequently categorized into a group with and another one without upper GI bleeding (n=32 and 84, respectively), and the respective change ratios were calculated for each group. One-way analysis of variance revealed that in patients with upper GI bleeding, change ratios of white blood cell count and alkaline phosphatase were significantly higher than those in patients without, while change ratios of hemoglobin (Hb), total protein and albumin were significantly reduced. Logistic regression analysis demonstrated that the change ratio of Hb was significantly correlated with upper GI bleeding. Receiver-operator characteristic analysis revealed that an 18.7% reduction of Hb was the threshold value for the prediction of upper GI bleeding. In conclusion, the present study revealed that a ≥18.7% reduction in Hb over three months has predictive value for upper GI bleeding.

  18. Per rectal portal scintigraphy as a useful tool for predicting esophageal variceal bleeding in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Taned Chitapanarux; Ong-ard Praisontarangkul; Satawat Thongsawat; Pises Pisespongsa; Apinya Leerapun

    2007-01-01

    AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using 99mTechnetium pertechnetate.The shunt index was calculated from the ratio of 99mTechnetium pertechnetate in the heart and the liver.Data were analyzed using Student's t-test and receiver operating characteristics.RESULTS: Cirrhotic patients showed a higher shunt index than normal subjects (63.80 ± 25.21 vs 13.54 ± 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 ± 9.40 vs 49.35 ± 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.CONCLUSION: In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.

  19. A review of operational, regional-scale, chemical weather forecasting models in Europe

    Directory of Open Access Journals (Sweden)

    J. Kukkonen

    2012-01-01

    Full Text Available Numerical models that combine weather forecasting and atmospheric chemistry are here referred to as chemical weather forecasting models. Eighteen operational chemical weather forecasting models on regional and continental scales in Europe are described and compared in this article. Topics discussed in this article include how weather forecasting and atmospheric chemistry models are integrated into chemical weather forecasting systems, how physical processes are incorporated into the models through parameterization schemes, how the model architecture affects the predicted variables, and how air chemistry and aerosol processes are formulated. In addition, we discuss sensitivity analysis and evaluation of the models, user operational requirements, such as model availability and documentation, and output availability and dissemination. In this manner, this article allows for the evaluation of the relative strengths and weaknesses of the various modelling systems and modelling approaches. Finally, this article highlights the most prominent gaps of knowledge for chemical weather forecasting models and suggests potential priorities for future research directions, for the following selected focus areas: emission inventories, the integration of numerical weather prediction and atmospheric chemical transport models, boundary conditions and nesting of models, data assimilation of the various chemical species, improved understanding and parameterization of physical processes, better evaluation of models against data and the construction of model ensembles.

  20. The Approach to Occult Gastrointestinal Bleed.

    Science.gov (United States)

    Naut, Edgar R

    2016-09-01

    Occult gastrointestinal bleeding is not visible and may present with a positive fecal occult blood test or iron deficiency anemia. Obscure bleeding can be overt or occult, with no source identified despite an appropriate diagnostic workup. A stepwise approach to this evaluation after negative upper and lower endoscopy has been shown to be cost effective. This includes repeat endoscopies if warranted, followed by video capsule endoscopy (VCE) if no obstruction is present. If the VCE is positive then specific endoscopic intervention may be possible. If negative, patients may undergo either repeat testing or watchful waiting with iron supplements.

  1. [Jejunal GIST with obscure gastrointestinal bleeding].

    Science.gov (United States)

    Nelly Manrique, María; Frisancho, Oscar; Rivas Wong, Luz; Palomino, Américo

    2011-01-01

    We report the case of a woman of 84 years with a history of cardiac arrhythmia and hemorrhoids. She had multiple hospitalizations and transfusions for symptomatic iron deficiency anemia, endoscopic studies showed only small diverticula and colon polyps. He was later hospitalized with bloody stools red wines, upper endoscopy and colonoscopy showed gastritis, small colonic ulcers, colonic polyp and multiple diverticula. Readmitted with bleeding of obscure origin, on that occasion showed gastritis, antral erosions, small ulcers, colon polyps and colon ulcers in the process of healing, capsule endoscopy showed angiodysplasia in jejunum, anterograde enteroscopy detected some erythematous lesions in proximal jejunum without evidence of bleeding. Again hospitalized for melena and abdominal. PMID:22086325

  2. [Epidemiology of upper gastrointestinal bleeding in Gabon].

    Science.gov (United States)

    Gaudong Mbethe, G L; Mounguengui, D; Ondounda, M; Magne, C; Bignoumbra, R; Ntsoumou, S; Moussavou Kombila, J-B; Nzenze, J R

    2014-01-01

    The department of internal medicine of the military hospital of Gabon managed 92 cases of upper gastrointestinal bleeding from April 2009 to November 2011. The frequency of these hemorrhages in the department was 8.2%; they occurred most often in adults aged 30-40 years and 50-60 years, and mainly men (74%). Erosive-ulcerative lesions (65.2%) were the leading causes of hemorrhage, followed by esophageal varices (15.2%). These results underline the importance of preventive measures for the control of this bleeding.

  3. Impact of Water Availability on Regional Power System Operations - A Case Study of ERCOT

    Science.gov (United States)

    Levin, T.; Zhou, Z.

    2015-12-01

    Impact of water availability on regional power system operations - A case study of ERCOT Thermal power plants are the largest single source of water withdrawals in the United States, mainly for cooling purposes. The amount of water that is required for cooling is highly dependent on a number of factors including the generation technologies being used, the temperature of the input water, and the total electricity load in the system. During summer months, many of these factors coincide to greatly increase the demand for water in a power system. Electricity demand typically reaches its annual peak when temperatures are high due to increased air conditioning loads. Ambient water temperatures also increase, meaning that greater quantities of water are required to provide the same amount of cooling at thermal generation plants. Finally, water availability is generally constrained due to seasonal effects and potential droughts. This raises concerns that water scarcity may lead to forced de-rating at some power plants during periods of peak demand, resulting in a more vulnerable and less reliable energy system. While increasing attention has recently been given to the inexorable link between water and energy, most commercial power models do not explicitly account for water use when optimizing system operation. We apply the AURORAxmp power modeling software to a case study analysis of the ERCOT power system to determine the water requirements of the system during periods of peak power demand. We then analyze water availability by location and time to identify potential supply shortages, which may reduce actual power generation availability. These data are fed back into the power systems model and specific generation units are de-rated as necessitated by water constraints. We then analyze these results to determine how the optimal generation mix, system reliability, and wholesale electricity prices may be affected by when the ERCOT power system is operated under water

  4. AROME-Arctic: New operational NWP model for the Arctic region

    Science.gov (United States)

    Süld, Jakob; Dale, Knut S.; Myrland, Espen; Batrak, Yurii; Homleid, Mariken; Valkonen, Teresa; Seierstad, Ivar A.; Randriamampianina, Roger

    2016-04-01

    substitute our actual operational Arctic mesoscale HIRLAM (High Resolution Limited Area Model) NWP model. This presentation will discuss in detail the operational implementation of the AROME-Arctic model together with post-processing methods. Aimed services in the Arctic region covered by the model, such as online weather forecasting (yr.no) and tracking of polar lows (barentswatch.no), is also included.

  5. Whipple's operation for carcinoma of the pancreatic head and the ampullary region. Short-and long-term results

    DEFF Research Database (Denmark)

    Sørensen, M B; Banner, Jytte; Rokkjaer, M;

    1998-01-01

    In this retrospective review short- and long-term perspectives have been evaluated for 108 patients who, during 1982 through 1992, had Whipple's operation performed for carcinoma of the pancreatic head (PC, n=63) or the ampullary region (AC, n=45). In 24 patients the operation was not radical (21...

  6. Assessment of a water hydraulics joint for RH operations in the divertor region

    International Nuclear Information System (INIS)

    Due to the high level of radiations, all the nominal maintenance in the divertor region of ITER will be carried out with help of robotic means. In reduced volumes, hydraulic applications can provide powerful actuators. They become an interesting technology to build a heavy duty manipulator for operations in space constrained areas. Oil hydraulics can not ensure the cleanliness level required for all maintenance operations in the vacuum vessel. Therefore, pure water hydraulics proposes a good alternative to oil and developments are today focusing on that direction. Although basic hydraulic elements like pumps, on-off valves, filters running with pure water are already available on the market, actuators are not so many and generally limited to linear motions. Fine control of the joint is achieved with help of servovalves. Today's off the shelf products are only adaptations from standard oil servovalves and are not specifically designed for water use. Operational experience for these products shows short lifetime expectancy and could not last a complete shutdown. Starting from the oil hydraulic version CEA with help of Cybernetix redesigned for water applications the elbow vane actuator of a Maestro arm, a six-degrees-of-freedom hydraulic manipulator used in decommissioning activities. In parallel with help of In-LHC, CEA developed a servovalve for water hydraulic applications that fits the space constraints of a Maestro manipulator. This prototype is a pressure-control valve. To a current input this servovalve supplies a very accurate pressure difference output instead of a flow rate in the case of flow control servovalve that are generally used in that kind of applications. The advantage is the improvement of the performances and stability of the force control loop. This paper presents the performances of the modified vane actuator and its servovalve. Both static and dynamic responses of the servovalve prototype with and without actuator are presented. Position and

  7. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. User Tutorial

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Vincent-Genod, C. [Energies Demain, Montreuil Sous Bois (France); Regina, P. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Harnych, J. [ENVIROS, Prague (Czech Republic)

    2013-03-15

    The CO2MPARE model supports national and regional authorities in making balanced decisions for their investment portfolio under their regional development programmes, in particular under their Operational Programmes of EU Regional Policy. This document is a tutorial for users of the CO2MPARE model and provides step by step guidance on the different functionalities of the model for both basic and expert users.

  8. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    Institute of Scientific and Technical Information of China (English)

    Bong; Sik; Matthew; Kim; Bob; T; Li; Alexander; Engel; Jaswinder; S; Samra; Stephen; Clarke; Ian; D; Norton; Angela; E; Li

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is notapparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

  9. Experience with WASP and MAED among IAEA Member States participating in the Regional Co-operative Agreement (RCA) in Asia and the Pacific Region

    International Nuclear Information System (INIS)

    The report includes the proceedings and papers presented during the workshop on the experience with WASP/MAED computer programs among IAEA Member States participating in the regional co-operative agreement (RCA) in Asia and the Pacific Region, organized by the IAEA and held in Kuala Lumpur (Malaysia) between 5-9 December 1988. A separate abstract was prepared for each of the 14 papers presented. Refs, figs and tabs

  10. [OMEPRAZOL VS RANITIDINE IN UPPER DIGESTIVE BLEEDING

    Science.gov (United States)

    Regis R, Regina; Bisso A, Aland; Rebaza, Segundo

    1999-01-01

    Pectic ulcer is the most frequent cause of gastrointestinal bleeding. The homeostatic mechanism of bleeding, and coagulation, does not happen with values of pH less than 5,0. Therefore neutralization of gastric acidity (pH more than 5,0) is a recourse of control, improve the evolution and healing of peptic ulcer and to avoid a new bleeding. The aim of this study was to compare the results of treatment with omeprazole and ranitidine, in 57 patients admitted at emergency room of the Hospital Central de la Polic a Nacional del Per with endoscopic diagnosis of peptic ulcer, using Forrest classification. Patients received omeprazole 40 mg in bolus IV, followed by continuos infusion of 8 mg/hour for 72 hours (group A) or ranitidine 50 mg IV each 8 hours for 72 hours (group B). A new endoscopy was made 72 hours after admission demostrated a succesful therapy in both group. Bleeding stopped in 26/27 patients in group A (96,2%) and in 23/30 patients in group B (76,6%) (pomeprazole IV is more effective than ranitidine IV in the control of UGB because of peptic ulcer and provides a faster healing. PMID:12181579

  11. Fatiguing effect of multiple take-offs and landings in regional airline operations.

    Science.gov (United States)

    Honn, Kimberly A; Satterfield, Brieann C; McCauley, Peter; Caldwell, J Lynn; Van Dongen, Hans P A

    2016-01-01

    Fatigue is a risk factor for flight performance and safety in commercial aviation. In US commercial aviation, to help to curb fatigue, the maximum duration of flight duty periods is regulated based on the scheduled start time and the number of flight segments to be flown. There is scientific support for regulating maximum duty duration based on scheduled start time; fatigue is well established to be modulated by circadian rhythms. However, it has not been established scientifically whether the number of flight segments, per se, affects fatigue. To address this science gap, we conducted a randomized, counterbalanced, cross-over study with 24 active-duty regional airline pilots. Objective and subjective fatigue was compared between a 9-hour duty day with multiple take-offs and landings versus a duty day of equal duration with a single take-off and landing. To standardize experimental conditions and isolate the fatiguing effect of the number of segments flown, the entire duty schedules were carried out in a high-fidelity, moving-base, full-flight, regional jet flight simulator. Steps were taken to maintain operational realism, including simulated airplane inspections and acceptance checks, use of realistic dispatch releases and airport charts, real-world air traffic control interactions, etc. During each of the two duty days, 10 fatigue test bouts were administered, which included a 10-minute Psychomotor Vigilance Test (PVT) assessment of objective fatigue and Samn-Perelli (SP) and Karolinska Sleepiness Scale (KSS) assessments of subjective sleepiness/fatigue. Results showed a greater build-up of objective and subjective fatigue in the multi-segment duty day than in the single-segment duty day. With duty start time and duration and other variables that could impact fatigue levels held constant, the greater build-up of fatigue in the multi-segment duty day was attributable specifically to the difference in the number of flight segments flown. Compared to findings in

  12. Applying micro scales of horizontal axis wind turbines for operation in low wind speed regions

    International Nuclear Information System (INIS)

    Highlights: • Three micro-turbines with output power less than 1 kW were designed for operation in low wind speed regions. • In addition to the output power, starting time was considered as a key parameter during the design. • The effects of generator resistive torque and number of blades on the performance of the turbines were investigated. - Abstract: Utilizing the micro scales of wind turbines could noticeably supply the demand for the electricity in low wind speed regions. Aerodynamic design and optimization of the blade, as a main part of a wind turbine, were addressed in the study. Three micro scales of horizontal axis wind turbines with output power of 0.5, 0.75 and 1 kW were considered and the geometric optimization of the blades in terms of the two involved parameters, chord and twist, was undertaken. In order to improve the performance of the turbines at low wind speeds, starting time was included in an objective function in addition to the output power – the main and desirable goal of the wind turbine blade design. A purpose-built genetic algorithm was employed to maximize both the output power and the starting performance which were calculated by the blade-element momentum theory. The results emphasize that the larger values of the chord and twist at the root part of the blades are indispensable for the better performance when the wind speed is low. However, the noticeable value of the generator resistive torque could largely delay the starting of the micro-turbines especially for the considered smaller size, 0.5 kW, where the starting aerodynamic torque could not overcome the generator resistive torque. For that size, an increase in the number of blades improved both the starting performance and also output power

  13. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    International Nuclear Information System (INIS)

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered

  14. Correlation of bleeding pattern with endometrial histopathologic results in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Zehra Yilmaz

    2015-06-01

    Full Text Available Background: Abnormal Uterine Bleeding (AUB is referred as bleeding outside of normal menstruation pattern and it is the most common gynecological problem for women of all ages. This study was evaluated the correlation of menstrual bleeding patterns and endometrial histopathological findings in perimenopausal women. Methods: This study was done on perimenopausal aged women presented with AUB for the last 6 months at a gynecology clinic of a tertiary medical center. Only the patients with isolated endometrial causes of AUB were selected for study. A total of 313 cases were included in the study. Abnormal bleeding patterns of the patients were recorded and endometrial sampling was performed to all women. AUB was classified as menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, intermenstrual bleeding, and histopathological findings were classified as Proliferative Endometrium (PE, Secretory Endometrium (SE, Disordered Proliferative Pattern (DPP, Endometrial Polyp (EP, Chronic Endometritis (CE, Endometrial Hyperplasia (EH, and Endometrial Adenocarcinoma (CA. Results: The most common bleeding pattern was menorrhagia (45.0% and the most common histopathological finding was PE+SE (52.0% in our study. PE+SE and endometrial hyperplasia without atypia were found more common in menorrhagia group. The most histopathological findings were found PE+SE in menometrorrhagia and polymenorrhea group (P 0.05. Conclusions: We concluded that although menometrorrhagia and polymenorrhea were significantly more associated with PE+SE, intermenstrual bleeding was significantly more associated with EP and CE. It is noteworthy that endometrial hyperplasia without atypia is significantly higher in patients with menorrhagia which is the most common abnormal bleeding pattern in perimenopausal aged women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 547-550

  15. Experience with WASP among IAEA Member States participating in the Regional Co-operative Agreement (RCA) in Asia and the Pacific Region

    International Nuclear Information System (INIS)

    The document contains the proceedings and the 15 papers presented during the Regional Co-operative Agreement (RCA) Workshop on the WASP Computer Program held in Jakarta, Indonesia, 7-11 December 1987. A separate abstract was prepared for each paper. Refs, figs and tabs

  16. IMPACT ANALYSIS OF LEGISLATIVE AND INSTITUTIONAL FRAMEWORK ON THE POLICY FOR REGIONAL DEVELOPMENT IN THE LIGHT OF THE REGIONAL OPERATIONAL PROGRAMME

    Directory of Open Access Journals (Sweden)

    Popescu (Stîngaciu Ana-Maria

    2012-12-01

    Full Text Available The analysis of the administrative capacity of institutions in the regional development starts from the analysis of the existing framework for the implementation of regional politics in Romania and studies the extent to what the structures and competencies were regionally enlarged as to contribute in the regional development. The basic hypothesis considered for such analysis had in view the fact that the differences recorded with respect to the implementation capacity of the regional development policy are caused by the various levels of the administrative capacity of the national, regional and local institutions existent in Romania. Although the regional development activity is, both centrally and regionally, dominated by the Regional Operational Programmme 2007-2013 (ROP implementation, significant activity also exists outside the ROP, but only regionally. The regional strategies incorporate to a great extent the strategic objectives established nationally, being coordinated with the national financing instruments for economic, social and territorial development. The undertaking degree of responsibilities regarding the objectives fulfillment of the regional development policy is relatively low both regionally and locally, and the main indicator which contributes in sustaining this conclusion is the absence of an adequate level regarding the property holding on certain strategies and also the methodological lack of strategies. Nationally, the current activity of Ministry of Regional Development and Tourism in the field of regional development totally overlaps the management activity of ROP. The management of structural funds 2007-2013 granted through ROP deals with various situations in which, due to the fact that the Law of regional development remained behind the legislation for the structural instruments implementation in Romania, additional resources are necessary to be granted in order to be found solutions through other types of

  17. Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Bindushree Kadakola

    2015-02-01

    Full Text Available Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB in postmenopausal women (PMW and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS and transvaginal scan (TVS where ever necessary. Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%, endometrial polyp (22%, followed by malignancy (14%, and hyperplastic endometrium (6%. At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% and 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity and accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly and good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D and C, hysteroscopy in evaluating endometrial disorders. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 229-234

  18. Vivax malaria:a rare cause of thalamic bleed

    Institute of Scientific and Technical Information of China (English)

    Jaydeep Sarkar; Biku Naik; Atul Gawande; Atul Goel

    2012-01-01

    Most common cause of thalamic bleed is hypertension; other causes are arteriovenous malformation, aneurysm, bleeding diathesis, drugs, amyloid angiopathy, tumor etc.We present a case ofPlasmodium vivax (P. vivax) malaria with unusual site of bleeding i.e. left thalamus of brain.To the best of our knowledge, this is the first reported case of thalamic bleed caused by vivax malaria in absence of severe thrombocytopenia/disseminated intravascular coagulation (DIC).

  19. Bleeding from the pancreas - a comparison of imaging methods

    Energy Technology Data Exchange (ETDEWEB)

    Roedl, W.; Nebel, G.; Englehard, K.

    1984-05-01

    Four patients with spontaneous bleeding from the pancreas are described. Transpapillary bleeding is diagnosed endoscopically. Angiography can demonstrate the eroded vessel directly. Ultrasound, CT and ERCP demonstrate the underlying abnormality in the pancreas. Bleeding into a cyst produces characteristic echoes, or an increase in density. NMR is able to demonstrate pancreatitis and pancreatic pseudo-cysts. Early diagnosis is extremely important, since without appropriate surgery, pancreatic bleeding is frequently fatal. 7 figs.

  20. Capsule endoscopy: Current status in obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    R Gupta; Nageshwar Duvvuru Reddy

    2007-01-01

    Capsule endoscopy (CE) is a safe, non invasive diagnostic modality for the evaluation of small bowel lesions. Obscure gastrointestinal bleeding (OGIB) is one of the most important indications of capsule endoscopy.Capsule endoscopy has a very high diagnostic yield especially if the bleeding is ongoing. This technique appears to be superior to other techniques for the detection of suspected lesions and the source of bleeding. Capsule endoscopy has been shown to change the outcome in patients with obscure gastrointestinal (GI)bleed.

  1. Bleeding from gums: Can it be a dengue

    OpenAIRE

    Rajat Bansal; Purnita Goyel; Dinesh. C. Agarwal

    2014-01-01

    Introduction: Bleeding from gums is a common feature in periodontitis patient. But abnormal bleeding from the gingiva or other areas of the oral mucosa that is difficult to control is an important clinical sign suggesting a hematological disorder. Case Report: A-40-year old male patient reported to our clinic with the chief complaint of acute gingival bleeding. There was continuous bleeding, fever since 3-4 days with weakness, retro orbital pain, and severe backache. Patient gave a history of...

  2. Australia's co-operation under the framework of the Asian Regional Co-operative Project on Food Irradiation

    International Nuclear Information System (INIS)

    The second phase of the Asian Regional Project on Food Irradiation (RPFI) became effective on 11 April 1985, and will last for three years, with Australia as the funding country. The first major activity was a two-week Workshop on the Commercialization of Ionising Energy Treatments of Food, held at the Australian School of Nuclear Technology from 29 April to 10 May, 1985, attended by representatives from eight RPFI countries and two observers from New Zealand. Studies of the transportation irradiated foods under commercial conditions are an integral part of the Project. Results of shipping/airfreight trials between Thailand and Australia of Nan Klang Won mangoes and frozen shrimps are presented. These trials were successful as irradiated produce shipped under commercial conditions reached its destination in good, marketable condition. (author). 3 refs

  3. Methods of Nuclear Medicine in gastrointestinal bleeding detection

    International Nuclear Information System (INIS)

    Several methods used in the diagnostic of gastrointestinal bleeding are presented. Two radioisotopic methods are considered the main ones: coloidal sulphur labeled with technetium-99m, more useful for low and acute bleeding and red blood cells labeled with technetium-99m, adequate for high and intermitent bleeding. (Author)

  4. Scintigraphic detection and localization of gastrointestinal bleeding sites

    International Nuclear Information System (INIS)

    Successful management of acute gastrointestinal (GI) bleeding usually depends on accurate localization of the bleeding site. History and clinical findings are often misleading in determination of the site of hemorrhage. The widespread application of flexible endoscopy and selective arteriography now provide accurate diagnoses for the majority of patients bleeding from the upper GI tract, but lower GI bleeding still poses a serious diagnostic challenge. Endoscopy and barium studies are of limited value in examining the small bowel and colon in the face of active hemorrhage. Arteriography, although successful in many cases (3-5), has limitations. The angiographic demonstration of bleeding is possible only when the injection of contrast material coincides with active bleeding at a rate greater than 0.5 ml/min, and since lower GI bleeding is commonly intermittent rather than continuous, a high rate of negative angiographic examinations has been reported. The diagnosis of lower GI bleeding is usually easy to make. In contrast, localizing the site of bleeding may be extremely difficult. Using the techniques described the nuclear physician may be able to detect the bleeding site precisely. However, if the cautions detailed are not observed, the tracer studies will show GI bleeding, but not at the true bleeding site. This must be carefully understood and avoided. Done correctly, these tests can have a major impact on patient care

  5. 14 CFR 23.1109 - Turbocharger bleed air system.

    Science.gov (United States)

    2010-01-01

    ... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to hazardous... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbocharger bleed air system....

  6. Obesity and risk of bleeding : The SMART study

    NARCIS (Netherlands)

    Braekkan, S. K.; van der Graaf, Y.; Visseren, F. L J; Algra, A.

    2016-01-01

    Essentials: Whether obesity protects against clinically relevant bleeding is unclear. We investigated the risk of bleeding according to various measures of obesity in a cohort of 9736 patients. Obesity was not associated with a lower risk of bleeding. The procoagulant profile in obese subjects may n

  7. 14 CFR 23.1111 - Turbine engine bleed air system.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  8. Endoscopic Management of Bleeding Ectopic Varices With Histoacryl

    OpenAIRE

    1999-01-01

    Bleeding from antral and duodenal varices is an uncommon feature in patients with portal hypertension. We report a patient with cirrhosis and portal vein thrombosis, who had a massive bleed from antral and duodenal varices. Bleeding was controlled with endoscopic injection of varices using histoacryl. Endoscopic treatment and the relatively uncommon occurrence of antral and duodenal varices are highlighted.

  9. Effect of Desmopressin in Reducing Bleeding after Cardiac Surgery in Patients Receiving Anti-Platelet Agents

    Directory of Open Access Journals (Sweden)

    Kamran Shadvar

    2016-07-01

    Full Text Available Background: Severe bleeding is an important cause of morbidity and mortality in cardiac surgery using the cardiopulmonary bypass (CPB pump. Desmopressin, a synthetic analogue of vasopressin, is used to prevent postoperative bleeding in patients with renal insufficiency. The aim of the present study was to evaluate the effect of desmopressin in reducing blood loss after cardiac surgery in patients receiving antiplatelet drugs. Methods: In this prospective clinical trial, 40 patients undergoing coronary artery bypass grafting (CABG surgery with CPB, aged over 18 years, and on antiplatelet therapy for a week before surgery were divided in two groups. Case and control groups received nasal desmopressin spray and nasal normal saline spray, respectively. Patient vital signs, blood loss, administration of blood products, prescription drugs to improve the coagulation status, serum and whole intake and output of patients, need for a second surgery to control the bleeding, remaining sternum open, mortality due to bleeding, duration of intensive care unit (ICU stay and mechanical ventilation were recorded. Results: In the case and control groups there were no differences in duration of operation, mechanical ventilation and length of ICU stay. There was no significant difference in terms of postoperative bleeding and intake of blood products between two groups (P>0.05. Reoperation due to bleeding in the case and control groups was observed in 3 (15%, and 1 (5% patient(s, respectively (P=0.3. Conclusion: Desmopressin has no significant effect on reducing the amount of bleeding after cardiac surgery in patients receiving anti-platelet agents. Keywords: CABG; cardio pulmonary bypass pump; hemorrhage; desmopressin 

  10. Plate Boundary Observatory Southwest Region Network Operations, Expansion and Communications Hardening

    Science.gov (United States)

    Mann, D.; Walls, C. P.; Basset, A.; Turner, R.; Lawrence, S.; Feaux, K.; Mattioli, G. S.

    2014-12-01

    The Southwest Region of the Plate Boundary Observatory manages 480 continuously operating GPS stations located principally along the transform system of the San Andreas fault, Eastern California Shear Zone and the northern Baja peninsula. In the past year, network uptime averaged 98% with greater than 99% data acquisition. In an effort to modernize the network, we have started to replace Trimble NETRS receivers with GNSS capable NETR9 receivers. Currently, we have 431 NetRS receivers deployed in the region, and 48 NetR9 receivers. In addition, 82 stations (17%) stream 1 Hz data over the VRS3Net typically with 92%. Based on their typical data download rates, approximately 252 (53%) of all stations are capable of streaming 1 Hz, but have not yet been added to the real time network because of lack of resources. In the immediate aftermath of the M8.2 Chile earthquake in April 2014, high rate data downloads from the entire SW network had a success rate of 95% and 71% for 1 Hz and 5 Hz data downloads respectively. We have continued to upgrade critical radio networks, including the San Francisco Bay Area, Anza Borrego, and Santa Barbara networks. These efforts are ongoing, but they have already significantly improved data download rates and dependability. We are also converting cell modem to radio communications whenever possible for increased reliability and cost savings. In December 2013 the 13-station Edison network expansion was completed through cost recovery contracts. These stations span coastal southern California in Orange, San Diego and Los Angeles counties including a hybrid site on the Elly oil platform. The primary purpose of the stations is to aid in the seismic source characterization of the San Onofre Nuclear Generating Station and assess the strain field associated with the Oceanside Blind Thrust and Newport Inglewood fault. The new stations fill a gap between SCIGN and PBO. Three sites have WXT520 Vaisala metpacks and twelve stations stream 1Hz data via

  11. Co-operation and Competition in Regional Economic Development Associated with Radioactive Waste Management

    International Nuclear Information System (INIS)

    Competition and co-operation appear in many different social venues. The author gives a variety of examples of co-operative behaviour in economics, politics, research, and everyday life activities such as sports. These four diverse examples illustrate the variety of forms that co-operation may take such as tacit co-operation, incremental co-operation, deep co-operation, etc. The links with the form of democracy (adversary democracy or consensual democracy) are also pointed. However, as with so many other things in life, the key is to the question of co-operation or competition is balance. Co-operation and competition are dialectical opposites. They create and maintain and define each other; they each are incomplete without the other

  12. Organisation of personal security in foreign operations : Cases: Export companies from Capital Region

    OpenAIRE

    Hookana, Risto

    2016-01-01

    The purpose of this thesis is to study what Finnish companies are doing in order to safeguard the personal security of their employees in foreign operations. The studied companies are examined in three different themes: what are the current issues and trends regarding personal security in foreign operations, how companies feel about using external security services in foreign operations and what aspects in companies build the personal security in foreign operations. This thesis was ...

  13. Demographic Characteristics of 796 Patients Operated for Lumbar Disc Herniation in Thrace Region, Turkey

    Directory of Open Access Journals (Sweden)

    Emre Delen

    2014-12-01

    Full Text Available Aim: This study was designed was to determine the demographic characteristics of patients operated for lumbar disc herniation in Thrace Region, Turkey. Material and Method: We retrospectively searched our data to find out patients who had one sided, one level and only one spinal surgical intervention for herniated lumbar disc. Results: Among 796 cases, 336 (42% were men and 460 (58% were women. The level of the pathology is determined as L1 - 2 for 4 cases (0.5%, L2 - 3 for 15 cases (1.9%, L3 - 4 for 51 cases (6.4%, L4 - 5 for 412 cases (51.8% and as L5 - S1 on 314 cases (39.4%. While a total of 70 cases (8.9% were identified on upper-levels ( L1 %u2013 2, L2 %u2013 3, L3 %u2013 4; 726 cases (91.1% were found to be on lower-levels ( L4 %u2013 5, L5 - S1. A mild positive correlation between the pathology level and physical activity intensity (P < 0.05, P = 0.103 has been demonstrated; as well as a strong negative correlation between pathology level and mean age (P < 0.05, P = -0.404. Discussion: The demographic characteristics are consistent with the literature. Physical activity intensity influence on lower-level herniations might have significance due to the large sample size. The strong negative correlation between pathology level and mean age suggests that the degeneration raises the frequency of upper-level herniations.

  14. Duodenal Bleeding from Metastatic Renal Cell Carcinoma

    Science.gov (United States)

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-01-01

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested. PMID:21577373

  15. Duodenal Bleeding from Metastatic Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Tarun Rustagi

    2011-04-01

    Full Text Available Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

  16. Endovascular management of acute bleeding arterioenteric fistulas

    DEFF Research Database (Denmark)

    Leonhardt, H.; Mellander, S.; Snygg, J.;

    2008-01-01

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed....... All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean...... reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding...

  17. Duodenal bleeding from metastatic renal cell carcinoma.

    Science.gov (United States)

    Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

    2011-04-20

    Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

  18. Prospects of Socio-economic Development of Frontier Territories within the Framework of International Co-operation Donbass Euro Region

    Directory of Open Access Journals (Sweden)

    Evtishina Kseniya A.

    2014-01-01

    Full Text Available The article studies potential and prospects of international co-operation within the framework of a special frontier formation – Donbass Euro Region, which includes Rostov oblast of Russian Federation and Donetsk and Lugansk oblasts of Ukraine. The article lists a complex of socio-economic tasks of Donbass Euro Region for the period until 2020, specifies priority economic directions of long-term development of frontier territorial and economic complex and priority zones of Russian-Ukrainian frontier economic co-operation. It also justifies expediency of creation of the Corporation of development of Donbass Euro Region, which could take functions of ensuring mutually beneficial interaction and inter-assistance between Russian and (or foreign (including Ukrainian investors, frontier municipal administrations and branch and departmental structures of regional governments.

  19. Neurenteric Cyst Presenting with Bleeding Per Rectum.

    Science.gov (United States)

    Yadav, Taruna; Parmar, Padam; Rattan, Kamal Nain

    2016-01-01

    Neurenteric cyst in the thoracic cavity may produce a myriad of clinical features. We report a 7-month-old girl who presented with significant bleeding per rectum. On imaging, a mediastinal cystic structure with air-fluid levels was evident with cervico-thoracic vertebral anomalies. The cyst was excised and histopathology showed intestinal mucosal lining with heterotopic pancreatic tissue confirming the diagnosis of neurenteric cyst.

  20. Bleeding gums: Duloxetine may be the cause

    Directory of Open Access Journals (Sweden)

    Balhara YPS

    2007-01-01

    Full Text Available Duloxetine is a newly introduced drug. It is being prescribed for the management of diabetic neuropathic pain and major depressive disorder. The most frequently observed adverse events with duloxetine are nausea, dry mouth and somnolence, constipation, diarrhea, decreased appetite, weight loss, feeling of fatigue, dizziness, somnolence, hypohidrosis, decreased libido and erectile dysfunction. One of the patients being prescribed the drug developed bleeding gums on being started with the drug which resolved on stopping it. We hereby report this case.

  1. Otorrhagia bleeding due to leech bite

    OpenAIRE

    Narges Askari; Afrooz Eshaghian

    2012-01-01

    Leeches are blood-sucking hermaphroditic parasites that attach to vertebrate hosts, bite through the skin, and suck out blood. When leeches feed, they secrete an anticoagulant (hirudin), which helps them get a full meal of blood. This is the first report of leech removal from external auditory canal. Previous leech involvement cases were explained in nasopharynx, larynx, pharynx, eye, and gastrointestinal tract. Prominent sign of all cases was active bleeding from the leech attachment site; t...

  2. The role of endoscopy in pediatric gastrointestinal bleeding

    Science.gov (United States)

    Franke, Markus; Geiß, Andrea; Greiner, Peter; Wellner, Ulrich; Richter-Schrag, Hans-Jürgen; Bausch, Dirk; Fischer, Andreas

    2016-01-01

    Background and study aims: Gastrointestinal bleeding in children and adolescents accounts for up to 20 % of referrals to gastroenterologists. Detailed management guidelines exist for gastrointestinal bleeding in adults, but they do not encompass children and adolescents. The aim of this study was to assess gastrointestinal bleeding in pediatric patients and to determine an investigative management algorithm accounting for the specifics of children and adolescents. Patients and methods: Pediatric patients with gastrointestinal bleeding admitted to our endoscopy unit from 2001 to 2009 (n = 154) were identified. Retrospective statistical and neural network analysis was used to assess outcome and to determine an investigative management algorithm. Results: The source of bleeding could be identified in 81 % (n = 124/154). Gastrointestinal bleeding was predominantly lower gastrointestinal bleeding (66 %, n = 101); upper gastrointestinal bleeding was much less common (14 %, n = 21). Hematochezia was observed in 94 % of the patients with lower gastrointestinal bleeding (n = 95 of 101). Hematemesis (67 %, n = 14 of 21) and melena (48 %, n = 10 of 21) were associated with upper gastrointestinal bleeding. The sensitivity and specificity of a neural network to predict lower gastrointestinal bleeding were 98 % and 63.6 %, respectively and to predict upper gastrointestinal bleeding were 75 % and 96 % respectively. The sensitivity and specifity of hematochezia alone to predict lower gastrointestinal bleeding were 94.2 % and 85.7 %, respectively. The sensitivity and specificity for hematemesis and melena to predict upper gastrointestinal bleeding were 82.6 % and 94 %, respectively. We then developed an investigative management algorithm based on the presence of hematochezia and hematemesis or melena. Conclusions: Hematochezia should prompt colonoscopy and hematemesis or melena should prompt esophagogastroduodenoscopy. If no

  3. Consideration of Regional Informatization Practices in Japan: A Case Study on a Civic Organization Operating Community Media

    OpenAIRE

    Togo, Hiroshi; Enomoto, Kosei

    2011-01-01

    [Abstract] The aim of this article is to investigate Japanese regional informatization from the viewpoint of practices with use of a progressive case study. This article focuses attention on a civic organization that has been taking the lead in promoting regional informatization in city A, and elucidates how the civic organization of a community media operator reconsidered its own practices, and then transformed both its own organizational structure and practices. This article starts with a ...

  4. Bleeding risk in 'real world' patients with atrial fibrillation: comparison of two established bleeding prediction schemes in a nationwide cohort

    DEFF Research Database (Denmark)

    Olesen, J B; Lip, G Y H; Hansen, P R;

    2011-01-01

    Oral anticoagulation (OAC) in patients with atrial fibrillation (AF) is a double-edged sword, because it decreases the risk of stroke at the cost of an increased risk of bleeding. We compared the performance of a new bleeding prediction scheme, HAS-BLED, with an older bleeding prediction scheme, ......, HEMORR(2)HAGES, in a cohort of 'real-world' AF patients....

  5. Endoscopic hemoclip treatment for bleeding peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Yung Chih Lai; Sien Sing Yang; Chi Hwa Wu; Tzen Kwan Chen

    2000-01-01

    AIM To evaluate the efficacy of endoscopic hemoclip in the treatment of bleeding peptic ulcer.METHODS Totally, 40 patients with F1a and F1b hemorrhagic activity of peptic ulcers were enrolled in this uncontrolled prospective study for endoscopic hemoclip treatment. We used a newly developed rotatable clip-device for the application of hemoclip (MD850) to stop bleeding. Endoscopy was repeated if there was any sign or suspicion of rebleeding, and reclipping was performed if necessary and feasible.RESULTS Initial hemostatic rate by clipping was 95%, and rebleeding rate was only 8%.Ultimate hemostatic rates were 87%, 96%, and 93% in the F1a and F1b subgroups, and total cases, respectively. In patients with shock on admission, hemoclipping achieved ultimate hemostasis of 71% and 83% in F1a and F1b subgroups, respectively. Hemostasis reached 100% in patients without shock regardless of hemorrhagic activity being F1a or F1b. The average number of clips used per case was 3.0 (range 2- 5). Spurting bleeders required more clips on average than did oozing bleeders (3.4 versus 2.8 ). We observed no obvious complications, no tissue injury, or impairment of ulcer healing related to hemoclipping.CONCLUSION Endoscopic hemoclip placement is an effective and safe method. With the improvement of the clip and application device,the procedure has become easier and much more efficient. Endoscopic hemoclipping deserves further study in the treatment of bleeding peptic ulcers.

  6. [Obscure digestive bleeding by ileal carcinoid tumor].

    Science.gov (United States)

    Nelly Manrique, María; Frisancho, Oscar; Zumaeta, Eduardo; Palomino, Américo; Rodriguez, César

    2011-01-01

    The patient is an 82 year-old female with a history of osteoarthritis, hypothyroidism and anemia for 14 years (receiving blood transfusions). She was admited to our hospital with a nine months history of malaise, anorexia, fatigue and weakness, associated with intermitten episodes of abdominal pain. She was diagnosed anemia and occult blood positive stools. Physical examination revealed a patient in generally fair condition, obese, with mild edema of lower limbs, no changes in the evaluation of chest, cardiovascular, abdomen, etc. Laboratory data was unremarkable, except for iron deficiency anemia. The upper endoscopy showed duodenal ulcer scar, fundic polyposis and chronic gastritis. Colonoscopy revealed some diverticula, a small sessile polyp and internal hemorrhoids. The diagnosis of obscure gastrointestinal bleeding was made. The CT scan of the abdomen showed gallstones and fatty liver; a radiograph of intestinal transit detected a lesion apparently protruded intestinal loop for distal jejunum; enteroscopy was performed (with one team ball) anterograde and retrograde achieving assess distal jejunum and distal ileum without observing any injuries. The study of capsule endoscopy showed a polypoid tumor intestinal with evidence of having bleeding. Surgery detected the tumor in proximal ileum. The surgical specimen findings showed three tumors 0.7 mm, 10 mm and 15 mm on the proximal ileum. The microscopic examination revealed that these lesions were neuroendocrine tumors (carcinoid). The Ileal carcinoid tumor may rarely presented with obscure gastrointestinal bleeding. PMID:21544161

  7. Rare bleeding disorders: diagnosis and treatment.

    Science.gov (United States)

    Palla, Roberta; Peyvandi, Flora; Shapiro, Amy D

    2015-03-26

    Despite the worldwide prevalence of rare bleeding disorders (RBDs), knowledge of these conditions and their management is suboptimal; health care professionals often have little diagnostic and treatment experience with variable access to diagnostic modalities required for accurate identification. Therefore, patients often experience morbidity and mortality due to delayed diagnosis. As RBDs represent a small potential commercial market, few, if any, specific therapies exist for these conditions. As a result, affected individuals commonly face delayed diagnosis, incomplete laboratory evaluation, and limited treatment options. Standardization and customization of coagulation assays, full genome sequencing, and global clotting assays will significantly improve diagnosis of patients with RBDs. In addition, new therapeutic modalities, both recombinant and plasma derived, are emerging, at least in developed countries. Registries and clinical trials have demonstrated decreased bleeding and improved outcomes when patients are appropriately diagnosed and properly treated. Expansion and harmonization of international registries has been initiated to correlate genotype, laboratory, and clinical phenotypes including bleeding severity to improve the diagnosis and therapeutic approach. This review focuses on the latest advances in our understanding, diagnosis, and treatment of RBDs. PMID:25712993

  8. Arterial embolization for iatrogenic life-threatening bleeding from subcutaneous hypervascular tumor in prone position

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Toru Sawamoto; Hiromichi Aoki; Naoya Miura; Hiroyuki Otsuka; Sadaki Inokuchi

    2010-01-01

    Performing angiography in the prone position is a difficult technique; however it is useful in some emergency situation. We experienced a 60 years old male who was performed lipoma excision on his back in his family doctor's clinic. Since massive arterial bleeding could not be controlled with manual astriction, he transferred to our hospital in prone position with hemodynamic instability. Operating field was not kept because of massive bleeding; there-fore surgical treatment was impossible. We planed emer-gency arterial embolization (AE) in prone position. Hence we chose the left radial artery for vascular access. The left subclavicle arteriography showed many major and minor feeding arteries from left subclavicular and axillary arteries and a massive extravasation of the contrast medium. Three major feeding arteries were performed AE with gelatin sponge and steel coils. After AE, massive bleeding was controlled.He could discharge from our hospital on the 5th hospital day without any complication. Arterial embolization for lifethreatening bleeding from subcutaneous hypervascular tumor in the prone position is first report to our knowledge,and it is extremely rare. However we thought that this tech-nique is useful for patients who could not turn in the supine position, e.g. massive bleeding during renal biopsy and penetrating trauma from back.

  9. Clinical application of Hawkeye VG SPECT/CT imaging in the bleeding position of lower gastrointestinal

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tcm-RBC. Methods: Fifty-six patients (42 males, 14 females, age ranging from 10 to 76 years) who had definite lower gastrointestinal bleeding were studied retrospectively. All patients had intravenous injection with 370 MBq 99Tcm-RBC and then underwent planar, SPECT, and CT imaging respectively in the abdomen before exploratory laparotomy. Images from SPECT and CT were fused thereafter to locate the active bleeder, if any. χ2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging. Results: In 56 patients with lower gastrointestinal bleeding, 50 patients showed abnormally concentrated radionuclide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT. Among these patients, concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images. The sensitivity and accuracy were 89.3% (50/56) and 73.8% (31/42) in planar images, and 92.9% (52/56) and 92.3% (48/52) in SPECT/CT images (χ2=0.11, P>0.05; χ2=4.63, P<0.05). Conclusion: Hawkeye VG SPECT/CT imaging shows an effective, simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding. (authors)

  10. Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report

    Directory of Open Access Journals (Sweden)

    Miettinen Simo

    2012-09-01

    Full Text Available Abstract Introduction A blunt thoracic trauma may cause arterial bleeding requiring operative treatment or endovascular embolization or endovascular aortic stenting. A novel damage control technique to stop such bleeding is presented. Case presentation We present the case of an 82-year-old Caucasian man who experienced rib fractures I-VII on the left side and bleeding from damaged intercostal arteries after a blunt thoracic trauma. Emergency thoracotomy was performed. Conclusions Effective hemostasis was achieved by using a rolled surgical swab and inserting it against the chest wall next to the aorta with sutures pulled through the intercostal muscles and then sutured to the back side of the patient. The patient died four days after the surgery due to a head injury sustained in the car crash.

  11. National consensus on management of peptic ulcer bleeding in Denmark 2014

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2014-01-01

    stable patients without serious ischaemic disease. Endoscopy should generally be performed within 24 hours, reducing operation rate, rebleeding rate and duration of in-patient stay. When serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result......DESCRIPTION: The Danish Society of Gastroenterology and Hepatology have compiled a national guideline for the management of peptic ulcer bleeding. Sources of data included published studies up to June 2014. Quality of evidence and strength of recommendations have been graded. The guideline...... endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA) within 24 hours from primary endoscopy. Patients in need of continued treatment with ASA or a nonsteroidal anti-inflammatory drug should be put...

  12. Treatment of bleeding gastroesophageal varices: a report of forty-four cases.

    Science.gov (United States)

    Tay, S K; Leong, Y P; Meah, F A; Abdullah, T; Zain, A R

    1992-12-01

    Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients. Five patients had associated hepatoma. Thirty-four percent had gastric fundal varices and a third of these bled from them. A total of 179 endoscopic injection sclerotherapy sessions were performed averaging 4 per person. Rebleeding rate was 4% and mortality was high (50%) in these cases. It was concluded that injection sclerotherapy is a safe and effective means of controlling bleeding oesophageal varices. Operative surgery was employed in those who rebled after injection and would be considered in those in Child's A. PMID:1303478

  13. Endoscopic laser Doppler flowmetry in the experiment and in the bleeding gastric and duodenal ulcer clinic

    Science.gov (United States)

    Kapralov, S. V.; Shapkin, Y. G.; Lychagov, V. V.; Tuchin, V. V.

    2007-05-01

    One of the most complex problems of emergency surgery is the choice of surgical tactics to deal with bleeding peptic ulcer. Endoscopic hemostasis is prescribed to patients with continuing bleedings and prerelapse syndrome. But till nowdays the objective verification of the prerelapse condition had not been worked out. What is more there are no objective criteria to judge the effectiveness of the carried endohemostasis. The aim of the study was to work out a new objective diagnostic method of pre-recurrence syndrome that can be able to make prognosis for possible gastroduodenal ulcer bleeding recurrence more precise. Laser Doppler flowmetry was the method of studies the regional perfusion. The device used in this work was made at the Optics and Biophysics Department of Saratov State University.

  14. Scintigraphic localisation of colonic bleeding; Scintigrafisk lokalisasjon av colonbloedning

    Energy Technology Data Exchange (ETDEWEB)

    Aspevik, Ranveig K.; Miskowiak, Jerzy; I Bud, Margreta

    2001-07-01

    Background. Endoscopy and occasionally X-ray studies are used to discover the focus of a gastrointestinal bleeding. Material and methods. We describe a case of severe gastrointestinal bleeding where these methods failed. Scintigraphy after labelling of erythrocytes with 99m technetium was performed in a continuos manner for 60 minutes. Scintigrams were also taken three, ten and 23 hours after the injection. Results. No bleeding was revealed after 60 minutes but two hours later a slight radioactivity was encountered in the right part of the abdomen and the later images localised the bleeding in the right colon. The bleeding ceased after right-sided hemicolectomy. Interpretation. Scintigraphy is of value in localisation of gastrointestinal bleeding and should be performed in a continuos manner until the bleeding focus is localised. Secretion of unbound technetium through the mucosa of the stomach and its presence in the urinary tract should be taken in account.

  15. Development of a Remotely Operated NDE System for Inspection of Hanford's Double Shell Waste Tank Knuckle Regions

    Energy Technology Data Exchange (ETDEWEB)

    Pardini, Allan F.; Alzheimer, James M.; Crawford, Susan L.; Diaz, Aaron A.; Gervais, Kevin L.; Harris, Robert V.; Riechers, Douglas M.; Samuel, Todd J.; Schuster, George J.; Tucker, Joseph C.; Roberts, R. A.

    2001-09-28

    This report documents work performed at the PNNL in FY01 to support development of a Remotely Operated NDE (RONDE) system capable of inspecting the knuckle region of Hanford's DSTs. The development effort utilized commercial off-the-shelf (COTS) technology wherever possible and provided a transport and scanning device for implementing the SAFT and T-SAFT techniques.

  16. Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population.

    Science.gov (United States)

    Lee, Yeong Yeh; Noridah, Nordin; Syed Hassan, Syed Abdul Aziz; Menon, Jayaram

    2014-01-01

    Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (GI) bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score > 5 was considered high risk for bleeding and primary outcomes studied were in-hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person-years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person-years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score ≤5). Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01) especially in the presence of duodenal ulcers (P = 0.04) despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

  17. Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

    Directory of Open Access Journals (Sweden)

    Yeong Yeh Lee

    2014-02-01

    Full Text Available Aim. Helicobacter pylori (H. pylori infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (GI bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score > 5 was considered high risk for bleeding and primary outcomes studied were in-hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person-years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person-years. In-hospital mortality (3.6%, recurrent bleeding (9.6% and need for surgery (4.0% were uncommon in this population with a largely low risk score (85.2% with score ≤5. Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01 especially in the presence of duodenal ulcers (P = 0.04 despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

  18. From cities and towns to urban networks in Germany – intra regional competition versus regional co-operation and inter regional competitiveness

    Directory of Open Access Journals (Sweden)

    Bernhard Mueller

    2000-01-01

    Full Text Available For many decades of the 20th century particular cities and towns were understood as integral parts of national and international urban systems. For many years the theory on central places and hierarchy of central places, first developed by Christaller and amended by Loesch, had a decisive influence on spatial research and regional development policies with guiding principles for urbanisation and the development of settlement patterns. However it is becoming ever more evident, that the planned effects of concepts for harmonising intra- and inter-regional differences were not reached. Moreover, inter-regional competition between neighbouring municipalities, as well as modern life styles and residential choices have caused the emergence of new settlement structures with dispersed spatial patterns and string functional ties. It is also true, that urban networking isn’t an easy task and that it inherently carries numerous obstacles.

  19. Comparison of detectable bleeding rates of radiopharmaceuticals for localization of gastrointestinal bleeding in sheep using a closed system

    Energy Technology Data Exchange (ETDEWEB)

    Owunwanne, A.; Sadek, S.; Yacoub, T.; Awdeh, M.; Abdel-Dayem, H.M. (Kuwait Univ. (Kuwait). Dept. of Nuclear Medicine); Al-Wafai, I.; Vallgren, S. (Kuwait Univ. (Kuwait). Dept. of Surgery)

    1989-06-01

    The closed experimental animal model system was used to compare the detectable gastrointestinal (GI) bleeding rates of {sup 99m}Tc-DTPA, {sup 99m}Tc-RBCs and {sup 99m}Tc tin colloid in sheep. The three radiopharmaceuticals were used to detect the upper GI bleeding sites at rates of 0.57 and 0.25 ml/min. At the lower bleeding rate of 0.1 ml/min, both {sup 99m}Tc-DTPA and {sup 99m}Tc-RBCs were successful in detecting the bleeding site. At the lowest rate of 0.07 ml/min only {sup 99m}Tc-DTPA was successful in detecting the bleeding site. The results indicate that {sup 99m}Tc-DTPA is the most useful {sup 99m}Tc radiopharmaceutical for detecting the upper GI bleeding site at the slowest bleeding rate studied. (orig.).

  20. Utah Southwest Regional Geothermal Development Operations Research Project. Appendix 10 of regional operations research program for development of geothermal energy in the Southeast United States. Final technical report, June 1977--August 1978

    Energy Technology Data Exchange (ETDEWEB)

    Green, Stanley; Wagstaff, Lyle W.

    1979-01-01

    The Southwest Regional Geothermal Operations/Research project was initiated to investigate geothermal development in the five states within the region: Arizona, Colorado, Nevada, New Mexico, and Utah. Although the region changed during the first year to include Idaho, Montana, North Dakota, South Dakota, and Wyoming, the project objectives and procedures remained unchanged. The project was funded by the DOE/DGE and the Four Corners Regional Commission with participation by the New Mexico Energy Resources Board. The study was coordinated by the New Mexico Energy Institute at New Mexico State University, acting through a 'Core Team'. A 'state' team, assigned by the states, conducted the project within each state. This report details most of the findings of the first year's efforts by the Utah Operations/Research team. It is a conscientious effort to report the findings and activities of the Utah team, either explicitly or by reference. The results are neither comprehensive nor final, and should be regarded as preliminary efforts to much of what the Operations/Research project was envisioned to accomplish. In some cases the report is probably too detailed, in other cases too vague; hopefully, however, the material in the report, combined with the Appendices, will be able to serve as source material for others interested in geothermal development in Utah.

  1. Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Arpad; Ivanecz; Marko; Sremec; Davorin; ?erani?; Stojan; Potr?; Pavel; Skok

    2014-01-01

    Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidenceof bariatric operations and coherently possible complications after such procedures, which modify patient’s anatomy and physiology.

  2. The effect of Tranexamic acid on cardiac surgery bleeding

    Directory of Open Access Journals (Sweden)

    Mohammad Esmaeelzadeh

    2014-02-01

    Full Text Available Serious bleeding in cardiac surgery leads to re-exploration, blood transfusion and increases the risks of mortality and morbidity. Using the lysine analogous of antifibrionlytic agents are the preferred strategy to suppress the need for transfusion procedures and blood products. Although tranexamic acid has been very influential in reducing the transfusion requirement after operation, tranexamic acid induced seizures is one of the common side effects of this drug. Due to inhibiting the fibrinolysis, thrombotic events are other possible side effects of using tranexamic acid. There are no certain results regarding decreasing the mortality rate by using the drug but it is identified that tranexamic acid does not increase the mortality. In this article, we aimed to review the literature on using tranexamic acid in cardiac surgeries.

  3. Gas Bearing Control for Safe Operation in Critical Speed Regions - Experimental Verification

    DEFF Research Database (Denmark)

    Theisen, Lukas R. S.; Niemann, Hans H.; Galeazzi, Roberto;

    2015-01-01

    and deceleration patterns and avoidance of operation near the critical speeds, which is a limiting factor during operation, specially during run-downs. An approach for reducing the vibrations is by feedback controlled lubrication. This paper addresses the challenge of reducing vibrations in rotating machines......Gas bearings are popular for their high speed capabilities, low friction and clean operation, but require low clearances and suffer from poor damping properties. The poor damping properties cause high disturbance amplification near the natural frequencies. These become critical when the rotation...... supported by gas bearings to extend their operating range. Using H∞-design methods, active lubrication techniques are proposed to enhance the damping, which in turn reduces the vibrations to a desired safe level. The control design is validated experimentally on a laboratory test rig, and shown to allow...

  4. New Mexico Southwest Regional Geothermal Development Operations Research Project. Appendix 9 of regional operations research program for development of geothermal energy in the Southwest United States. Final technical report, June 1977--August 1978

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, Thomas A.; Fedor, Dennis

    1979-01-01

    This final report describes the findings and conclusions of the New Mexico Team during the first project year of the Southwest Regional Geothermal Development Operations Research Project. The purpose of this project is to help realize a goal of the USDOE , Division of Geothermal Energy (DOE/DGE), to accelerate the actual commercial utilization of geothermal energy. This was done by: (1) identifying the potential for development of geothermal energy in the five-state regions of Arizona, Colorado, New Mexico, Nevada and Utah; and (2) identifying the actions needed to accomplish that development.

  5. Spectrum of histopathological findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    To determine the frequencies of histopathological findings in endometrial and endocervical biopsy samples with clinical history of Postmenopausal Bleeding (PMB). Study Design: Descriptive cross-sectional study. Place and Duration of Study: Section of Histopathology, Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from February 2012 to January 2013. Methodology: A total of 157 consecutive endometrial and endocervical biopsy specimens with history of postmenopausal bleeding were included. After microscopic examination, frequencies of histological findings in different age groups were generated. Chi-square and independent sample t-tests were applied to see whether the difference was significant which was set at p < 0.05. Results: One hundred and twenty-one (77.1%) specimens showed benign pathologies while 36 (22.9%) were malignant. Endometrial polyp was seen in 67 (42.7%) cases followed by endometrial carcinomas in 25 (15.9%), endometrial hyperplasia in 21 (13.4%), cervical carcinoma in 12 (7.6%) and cervical polyps in 9 (5.7%) cases. Ahighly significant increase in the percentage of malignant and pre-malignant lesions was seen with increasing age group (p < 0.001). Mean age of patients with type-2 endometrial carcinoma was higher than type-1 endometrial carcinoma but statistical significance was not observed (70.2 ± 6.5 vs. 61.8 ± 9.1 years respectively, p=0.069). Conclusion: Although benign pathologies were more common in postmenopausal bleeding but the collective proportion of endometrial and cervical malignancies and pre-malignant conditions was quite high. Therefore, PMB should be urgently evaluated for cause and early commencement of treatment. (author)

  6. An Unusual Case of Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Kristin N. Fiorino

    2011-01-01

    Full Text Available A 10-year-old boy presented with a 3-day history of worsening abdominal pain, fever, emesis and melena. Abdominal ultrasound revealed a right upper quadrant mass that was confirmed by computed tomography angiogram (CTA, which showed an 8 cm well-defined retroperitoneal vascular mass. 123Iodine metaiodobenzylguanidine (123MIBG scan indicated uptake only in the abdominal mass. Subsequent biopsy revealed a paraganglioma that was treated with chemotherapy. This case represents an unusual presentation of a paraganglioma associated with gastrointestinal (GI bleeding and highlights the utility of CTA and 123MIBG in evaluation and treatment.

  7. Reoperation for bleeding in cardiac surgery

    DEFF Research Database (Denmark)

    Kristensen, Katrine Lawaetz; Rauer, Line Juul; Mortensen, Poul Erik;

    2012-01-01

    bleeding, we aim to identify risk factors that predict reoperation. A total of 1452 consecutive patients undergoing cardiac surgery using extracorporeal circulation (ECC) between November 2005 and December 2008 at OUH were analysed. Statistical tests were used to identify risk factors for reoperation. We...... after cardiac surgery was low ejection fraction, high EuroSCORE, procedures other than isolated CABG, elongated time on ECC, low body mass index, diabetes mellitus and preoperatively elevated s-creatinine. Reoperated patients significantly had a greater increase in postoperative s-creatinine and higher...

  8. Devil's claw root: ulcers and gastrointestinal bleeding?

    Science.gov (United States)

    2013-12-01

    Harpagophytum procumbens, or devil's claw, is an African plant whose root is used to relieve minor joint symptoms. Several cases of gastrointestinal bleeding associated with the use of devil's claw root have been reported. A systematic review of the adverse effects of devil's claw root in about 20 randomised, double-blind, placebo-controlled clinical trials showed mainly gastrointestinal effects: gastralgia and dyspepsia. In practice, devil's claw root exposes patients to the risk of sometimes serious upper gastrointestinal disorders, yet has no established efficacy beyond a placebo effect. It is best avoided. PMID:24600731

  9. Proposed parameters of specific rain attenuation prediction for Free Space Optics link operating in tropical region

    Science.gov (United States)

    Suriza, A. Z.; Md Rafiqul, Islam; Wajdi, A. K.; Naji, A. W.

    2013-03-01

    As the demand for higher and unlimited bandwidth for communication channel is increased, Free Space Optics (FSO) is a good alternative solution. As it is protocol transparent, easy to install, cost effective and have capabilities like fiber optics, its demand rises very fast. Weather condition, however is the limiting factor for FSO link. In the temperate region the major blockage for FSO link feasibility is fog. In the tropical region high rainfall rate is expected to be the major drawback of FSO link availability. Rain attenuation is the most significant to influence FSO link availability in tropical region. As for now the available k and α values are developed using data from temperate regions. Therefore, the objective of this paper is to propose new parameters for specific rain attenuation prediction model that represents tropical weather condition. The proposed values are derived from data measured in Malaysia and using methods recommended by ITU-R.

  10. 75 FR 81157 - Version One Regional Reliability Standard for Transmission Operations

    Science.gov (United States)

    2010-12-27

    ... Henery (Technical Information), Office of Electric Reliability, Division of Policy Analysis and...- 8636. Danny Johnson (Technical Information), Office of Electric Reliability, Division of Reliability... by a physical difference in the Bulk-Power System. When the ERO reviews a regional...

  11. [Effects of heavy machinery operation on the structural characters of cultivated soils in black soil region of Northeast China].

    Science.gov (United States)

    Wang, En-Heng; Chai, Ya-Fan; Chen, Xiang-Wei

    2008-02-01

    With the cultivated soils in black soil region of Northeast China as test objects, this paper measured their structural characters such as soil strength, bulk density, and non-capillary porosity/capillary porosity (NCP/CP) ratio before and after heavy and medium-sized machinery operation, aimed to study the effects of machinery operation on the physical properties of test soils. The results showed that after machinery operation, there existed three distinct layers from top to bottom in the soil profiles, i.e., plowed layer, cumulative compacted layer, and non-affected layer, according to the changes of soil strength. Under medium-sized machinery operation, these three layers were shallower, and there was a new plow pan at the depth between 17.5 and 30 cm. Heavy machinery operation had significant positive effects on the improvement of topsoil structure (P machinery, the bulk density of topsoil decreased by 7.2% and 3.5%, respectively, and NCP/CP increased by 556.6% after subsoiling, which would benefit water infiltration, reinforce water storage, and weaken the threat of soil erosion. The main action of heavy machinery operation was soil loosening, while that of medium-sized machinery operation was soil compacting.

  12. Regional co-operation in the nuclear field: The Nordic experience

    International Nuclear Information System (INIS)

    Experience from 25 years of co-operation in the nuclear field between the Nordic countries is described. A pragmatic approach with a minimum of formalism is used. The co-operation takes place mainly through ''horizontal'' channels between corresponding bodies in the different countries - safety authorities, research institutions, electricity producers, etc. In addition, a ''vertical'' co-ordination between these different circles is accomplished through a Nordic Liaison Committee. The experience shows that valuable results can be obtained, mainly through rationalization and improved use of resources. Difficulties, which are inherent in international co-operation, can be reduced, provided that there is a strong political will, an efficient system to promote contacts, and a flexible financing scheme. Apart from the benefits obtained in each of the countries - whether or not it has its own nuclear power - particular advantages accrue when a ''Nordic group'' can present co-ordinated viewpoints on the international scene. (author)

  13. [EMERGENCY TREATMENT OF BLEEDING IN PATIENTS TAKING WARFARIN].

    Science.gov (United States)

    Prasolov, N V; Shulutko, E M; Bulanov, A Yu; Yatskov, K V; Shcherbakov, O V

    2015-01-01

    Anticoagulant therapy with vitamin K antagonists (AVK) is an effective treatment and prevention of thrombosis. One of the major disadvantages of the AVK is a risk for serious bleeding. Prothrombin complex concentrates (PCC), fresh frozen plasma (FFP) and vitamin K1 are available for control of these situations. The experience of special team ofthe Scientific Center for Hematology was the basis for presented retrospective study. Three regimens of warfarin-related bleeding were compared: PCC+ VK for several bleeding, FFP+ VK for different clinical situations and VKfor light bleeding. PCC showed himself as effective and safe hemostatic agent. Transfusions of FFP were sometimes not effective, sometimes led to TACO. Supplementation of vitamin K1 for patients of I and II groups provided more stable control of hemostasis. In III group VK vas effective to stop bleeding. Two impotent sings for conclusion: necessary of laboratory monitoring, TEG first of all; individual balance of hemostasis base of bleeding or thrombotic risks.

  14. Bioengineering factor Xa to treat bleeding.

    Science.gov (United States)

    Camire, Rodney M

    2016-05-01

    There is a clinical need to develop safe and rapid therapeutic strategies to control bleeding arising from a host of emergent situations. Over the past several years our laboratory has developed novel zymogen-like FXa variants and tested their safety and efficacy using hemophilia as a model system. The variants have a spectrum of properties resulting from an amino acid change at the N-terminus of the heavy chain that alters a critical conformational change. These properties, which include resistance to plasma protease inhibitors, low activity in the absence of FVa, and rescue of low activity upon incorporation in prothrombinase, yield remarkably effective pro-hemostatic agents. The FVa-dependent restoration of activity is a key aspect to their efficacy and also contributes to localizing the variants to the site of vascular injury. While pre-clinical data support their use in the setting of hemophilia, they have the potential to act as rapid pro-hemostatic agents for the treatment of a range of bleeding conditions. This review will discuss the biochemical properties of these FXa zymogen-like variants and their in vivo characterization. PMID:27207419

  15. Integration Strategies and Barriers to Co-Operation in Cross-Border Regions

    DEFF Research Database (Denmark)

    Hansen, Povl Adler; Serin, Göran Folke

    2007-01-01

    Abstract: The purpose of the article is to analyze strategies for cross-border integration in the Øresund Region. The point of departure is that the development of strategies for cross-border integration is dependent on the development on both the general level in the EU and deregulation of economy...... and business on the global level. In this respect, the article points out the importance of market forces and their influence on institutional change. Recent economic crises have put growth center stage at both the national and regional level, and have called for regional development programs on both...... the Swedish and Danish sides of the Sound. The strengths and weaknesses of the Øresund Region’s ‘traditional’ and new institutions as instruments for change are examined. The article identifies and discusses the structures, institutions, and players which are the driving forces in the field between markets...

  16. Operational and regulatory impacts of regional management on transportation of commercial low-level radioactive waste

    International Nuclear Information System (INIS)

    Results of the analysis indicate that a factor of two reduction in total shipping distance and cost is possible on a national scale if regional disposal sites are employed. Likewise, population risks and the demand for transportation services and equipment would be proportionally reduced because of shorter shipment distances and trip durations. The fate of regionalization of low level waste management and achievement of the cost and risk benefits that it implies is dependent on solving technical problems and resolving the institutional issues which result in multiple levels of regulations

  17. Bleeding and Filtration of Cement-Based Grout

    OpenAIRE

    Draganovic, Almir

    2009-01-01

    Grouting is a common method of sealing rock around tunnels to reduce or stop water inflow. Successful grouting significantly minimizes the maintenance cost and safety of the tunnel. Some questions about bleeding and penetrability of the grouts have to be examined more closely to carry out a successful grouting. Bleeding of cement-based grout is a complex problem. Measuring methods used today originate from the measuring of the bleeding of cement pastes used in ordinary building industry. Whet...

  18. Performance analysis of bleed condenser used in Indian PHWR

    International Nuclear Information System (INIS)

    Condensation of hot two phase bleed from the Primary Heat Transport (PHT) system is carried out by two different cooling modes in the bleed condenser of Indian PHWRs. These are the reflux and spray cooling modes. A computer code has been developed to predict the performance of bleed condensers used in Indian PHWRs for the above two cooling modes. Using the computer code the performance analysis was carried out for the reflux cooling and spray cooling modes separately. (author). 19 refs., 8 figs

  19. Gastrointestinal bleeding 30 years after a complicated cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Thorsten; Brechmann; Wolff; Schmiegel; Volkmar; Nicolas; Markus; Reiser

    2010-01-01

    Gastrointestinal bleeding from small-bowel varices is a rare and difficult to treat complication of portal hypertension. We describe the case of a 79-year-old female patient with recurrent severe hemorrhage from smallbowel varices 30 years after a complicated cholecystectomy. When double balloon enteroscopy was unsuccessful to reach the site of bleeding, a rendezvous approach was favored with intraoperative endoscopy. Active bleeding from varices within a biliodigestive anastomosis was found and controlled ...

  20. EVALUATING THE OVERALL TECHNICAL EFFICIENCY OF ISLAMIC BANKS OPERATING IN THE MENA REGION DURING THE FINANCIAL CRISIS.

    Directory of Open Access Journals (Sweden)

    Ali Said

    2013-04-01

    Full Text Available The present paper measured overall technical efficiency of Islamic banks operating in the MENA region during the financial crisis of 2007-2009 to address the question what are the levels of overall, pure technical and scale efficiency of Islamic banks operating in the MENA region and how they evolved during the financial crisis. This paper addresses this question technical, pure technical, and scale efficiency measures are analyzed by employing on-parametric technique, Data Envelopment Analysis (DEA. The study results suggested that Islamic banks in other MENA countries and North Africa on an average are relatively technically inefficient. This might be due to the underdeveloped banking system in those countries. In addition, the decomposition of technical efficiency into pure technical and scale efficiency shows that on average, the Islamic banks in North Africa counties and other MENA counties are having problems in the allocation of resources between their inputs and outputs mix compare to Islamic banks in GCC.

  1. The relevance of operational skills towards business sustainability: A focus on SMME manufacturers in the Vaal triangle region

    Directory of Open Access Journals (Sweden)

    R. Naidoo

    2010-12-01

    Full Text Available Purpose: Activities in the manufacturing sector are often considered the bedrock of an economy and a key driver of growth and development. Within the South African manufacturing sector, operations skills are reported to be deficient and are often cited as a main cause of failure in small, medium and micro enterprises (SMMEs. This study explores and tests this fragile relationship between operations skills and SMME sustainability. Empirical investigations are conducted in a high-density SMME manufacturing environment - the Vaal Triangle Region. Design/Methodology/Approach: Building on previously established literature on SMME sustainability and operations skills, various measures are developed and tested for reliability and validity. Factor analysis is used to identify relevant factors in terms of operations skills. Co-relational analysis is then employed to test the hypothesised relationship. The study is cross-sectional in design and relies on trained fieldworkers administering surveys for data collection. Findings: Five clear factors for operations skills are identified through factor analysis with an overall high reliability value. Based on descriptive and co-relational analysis results reveal that operations skills are positively associated with sustainability. Implications: SMME owners, educators and service providers may benefit from the study's findings in terms of the nature and associations that operational skills have on developing sustainable SMME's. Originality/Value: The study focused on a neglected area of SMMEs - the importance of operations towards business sustainability, and made an important contribution towards theory development through empirical explorations. In South Africa, this is the first time an instrument measuring operations skills has been validated and associated with SMMEs in a manufacturing context.

  2. Regional Co-operation for Literacy in Asia and the Pacific.

    Science.gov (United States)

    Sasaoka, Taichi

    1990-01-01

    Discusses the Asian Cultural Centre for UNESCO's copublication program producing follow-up reading materials for expanding literacy. Includes lists of materials produces, information of the development of materials, and personnel training. Describes how the regional literacy programs workshops, and activities ar managed. Suggests that regional…

  3. Recent Trends and Developments: Regional Co-operation in Population Education.

    Science.gov (United States)

    Population Education in Asia and the Pacific Newsletter and Forum, 1990

    1990-01-01

    Presented is an outline of objectives and outcomes specific to curriculum development, materials development, professional training, research and assessment, management and monitoring, and an agenda for future consultative seminars, all formulated at the UNESCO-sponsored regional consultative seminar on population education during May 1990, in…

  4. Operational and regulatory impacts of regional management on transportation of commercial low-level radioactive waste

    International Nuclear Information System (INIS)

    The 96th Congress of the United States, as part of the Low-level Radioactive Waste Policy Act of 1980 (Public Law 96-573), instructed the Secretary of the Department of Energy (DOE) to prepare a report on the current US low-level waste management situation and the conditions and requirements for management on a regional basis. The Transportation Technology Center has compared the transportation requirement and regional management scenarios for commercial low-level radioactive waste in support of the DOE response to this instruction. Using 1979 low-level waste volumes shipped to commercial burial grounds and six management regions postulated by DOE, transportation requirements were estimated and compared for the two management scenarios in terms of cumulative shipping distance and transportation cost. Effects of these results on the demand for transportation services and equipment and on population risks were considered. Finally, current regulatory issues and the potential effects of regional management on regulation of low-level waste transportation were reviewed

  5. Proceedings of Conference of Ministers of Energy on co-operation in the Baltic Sea Region

    International Nuclear Information System (INIS)

    The Conference of the Ministers of Energy on Cooperation in the Baltic Sea Region held in Helsinki on 24-25 October has been regarded as a success. The European Commission and eleven countries adopted a communique that outlined goals for the regional energy sector, defined tasks for the cooperation for the next few years and decided how to organise the cooperation. In December 1999, the Energy Council discussed the Northern Dimension (ND) policy and the energy sector cooperation in the Baltic Sea region. The work in the energy sector was stated to be important for the whole EU, and the Commission was charged with the task of following the developments and reporting to the Council on the progress. The Foreign Ministers' Conference on the Northern Dimension, held in Helsinki on 11-12 November 1999, identified - in addition to the energy sector - also many other prioritised ND policy action fields, such as the forest sector, transportation systems, environmental challenges, the cooperation for new solutions of many social, health-related and administrative problems and research work, just to mention some sectors. The European Commission is preparing an action plan for the ND policy on the basis of the results of the Foreign Ministers' Conference and the Commission Communications on the ND policy activities. Energy cooperation will certainly have a central role in this action programme provided that the international political atmosphere gives the framework and support for further integration and cooperation in the region

  6. ECONOMICS OF OPERATION AND STATE REGULATION DEVELOPMENT OF THE REGIONAL AGRICULTURE

    Directory of Open Access Journals (Sweden)

    Papahchyan I. A.

    2015-10-01

    Full Text Available The article considers current economic situation in the economy of the Krasnodar region, the importance of import substitution in the future functioning and regulation of regional development of agro-industrial complex. The positive impact on the agricultural economy, double sided grocery sanctions, the leadership of the rural economy of the region with annual growth of GDP of 9.2% (in Russia – 4,5% is pointed. The article shows that the growth of quantitative and qualitative indicators in the industry was provided with additional targeted investment to increase profitability of crop production to 44%. The advantages of big business that produces mostly grains are pointed out, because this factor will continue to determine the vector of development of agriculture. A big positive point of the livestock industry is the growth of profitability of milk production to 37%. At the same time, cattle breeding with the margin of 19.7% is still highly problematic on observance of technological discipline. Production of cattle meat remains unprofitable. A significant segment of production in farming is still taken by small farms. In 2014 the government regulated their development supporting them with money in the amount of more than 700 million RUB . The author believes to keep further growth of the livestock on it is necessary to stabilize the number of livestock, especially dairy cattle, to restore the production of pork, to continue the construction and reconstruction of farms and complexes, to provide animals with high quality food. The author also stresses the importance of development of business of rice growing, vegetable growing, fruit growing, the importance of updating and development of material and technical base. The work provides the data that at the expense of state regulation (support profitability of agriculture in the region has grown by an additional 7%, so it creates new opportunities for growth of the agricultural economy of our

  7. Asian regional co-operative project on food irradiation: Research and development

    International Nuclear Information System (INIS)

    The importance of food irradiation to reduce post-harvest food losses, improve the hygienic quality of foods and facilitate trade promotion has been recognized by the region of Asia and the Pacific. Several of the regional countries have initiated national programmes on food irradiation in the 50s and 60s. The first coordination programme sponsored by the Agency under RCA in 1974-1979 was the Coordinated Research Programme (CRP) on Radiation Preservation of Fish and Fishery Products. The Asian Regional Cooperative Project on Food Irradiation (RPFI) was implemented by the Agency in 1980 under the sponsorship of the Government of Japan. Bangladesh, People's Republic of China, India, Indonesia, Republic of Korea, Japan, Pakistan, the Philippines, Sri Lanka, Thailand and Vietnam participated in this Programme. Under the scope of this regional project R and D work was carried out on: (i) insect disinfestation and improving hygienic quality of dried and cured fishery products, (ii) insect disinfestation and shelf-life extension of mangoes; (iii) control of sprouting of onions, and (iv) improving hygienic quality of spices. In addition some work related to economic feasibility of food irradiation was also carried out. This publication contains the results of R and D conducted under the RPFI. Under the RPFI, it was demonstrated that the food irradiation technology could play an important role in reducing food losses and facilitating wider distribution of certain food products. The RPFI provided a strong impetus for Asian countries to coordinate their research programmes effectively towards the practical application of the technology to combat food losses and to make more food available to the population in the region. Refs, figs and tabs

  8. Risk factors for bleeding after endoscopic mucosal resection

    Institute of Scientific and Technical Information of China (English)

    Masatsugu Shiba; Toshio Watanabe; Kazunari Tominaga; Yoshihiro Fujiwara; Tomoshige Hayashi; Kei Tsumura; Tetsuo Arakawa; Kazuhide Higuchi; Kaori Kadouchi; Ai Montani; Kazuki Yamamori; Hirotoshi Okazaki; Makiko Taguchi; Tomoko Wada; Atsushi Itani

    2005-01-01

    AIM: To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).METHODS: A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates,were the measures of association.RESULTS: Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of ENR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after ENR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EM R for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.CONCLUSION: It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after ENR.

  9. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  10. Recent Update of Embolization of Upper Gastrointestinal Tract Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Nonvariceal upper gastrointestinal (UGI) bleeding is a frequent complication with significant morbidity and mortality. Although endoscopic hemostasis remains the initial treatment modality, severe bleeding despite endoscopic management occurs in 5-10% of patients, necessitating surgery or interventional embolotherapy. Endovascular embolotherapy is now considered the first-line therapy for massive UGI bleeding that is refractory to endoscopic management. Interventional radiologists need to be familiar with the choice of embolic materials, technical aspects of embolotherapy, and the factors affecting the favorable or unfavorable outcomes after embolotherapy for UGI bleeding.

  11. Transcatheter arterial embolization in gastric cancer patients with acute bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Joo; Shin, Ji Hoon; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Song, Ho-Young; Sung, Kyu-Bo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea)

    2009-04-15

    The safety and clinical effectiveness of transcatheter arterial embolization for bleeding associated with unresectable gastric cancer was evaluated. Twenty-three patients with bleeding from unresectable gastric cancer underwent transcatheter arterial embolization. Of the 23 patients, eight showed signs of active bleeding, such as contrast extravasation or pseudoaneurysm, seven showed only tumor staining, and the remaining eight patients showed negative angiographic findings. All embolization procedures were successful without procedure-related complications. In all eight active bleeding patients, immediate hemostasis was achieved. The overall clinical success rate was 52% (12/23). Recurrent bleeding within 1 month occurred in one (8%) in 12 patients with initial clinical success. One patient showed partial splenic infarction after embolization of the splenic artery for active bleeding from the short gastric artery. Overall 30-day mortality rate was 43% (10/23). The median overall survival period was 38 days. In patients with bleeding from unresectable gastric cancer, transcatheter arterial embolization was found to be safe and effective for achieving immediate hemostasis for active bleeding. Although the clinical success rate was not high, the recurrent bleeding rate was low at 1 month post procedure. (orig.)

  12. Angiography Diagnosis and Treatment of Traumatic Artery Bleeding

    Institute of Scientific and Technical Information of China (English)

    WANG Li; WANG Yan; LIU Jingzhang

    2002-01-01

    Objective After angiography and embolization of three cases suffering from traumatic artery bleeding we summarized the selective embolization of different artery bleeding cases and their treatment analysis. Methods The three cases were all female,among them,one suffering from hepatic artery bleeding by a traffic accident, the other two caused by iatrogenic damage. Of the two, one suffered from bleeding after the gall bladder removal, the other from bleeding after puncture biopsy through the kidney.Seldinger technique was used on the three cases, and puncture intubation was superselected and put through arterial femoralis. Catheters were put separately inside the target blood vessels to have radiography and contrast medium was found to have out flowed out to the bleeding artery. And then the mixed gelatin sponge particles were put into, Ultravist contrast medium to make suspension. Through fluoroscopy the suspension was injected into bleeding artery until no contrast medium out flowed. After that radiography was used to watch the result. Results After the embolization the three cases stopped bleeding at once with remarkable effects. Conclusion Therefore we conclude the embolization is the best method for treating artery bleeding.

  13. Study on the Key Success Factors of the Operation of a Regional Military Logistic Food Material Center

    Directory of Open Access Journals (Sweden)

    Fu-Jin Wang

    2010-01-01

    Full Text Available Problem statement: In order to establish an integrated supply system of the military food material, the study was to discuss the key success factors of operation of the military regional food material logistic center in Taiwan. Approach: The Delphi method, questionnaires and telephone interviews were used to collect and integrate the opinions of experts and scholars. Simultaneously, the Analytic Hierarchy Process (AHP was applied to confirm the evaluative factors of each level, i.e., one goal (to construct key success factors of the operation of a regional military logistic food material center for the first level, two analytical aspects (the external and internal environments for the second level, six evaluative facets (the safety design, strategic management, administrative effect, policy, service and internal and external integration for the third level and 19 evaluative criteria for the fourth level. Results: The 350 questionnaires from the second phase which were sent out to four kinds of respondents, 319 valid ones were returned. Conclusion: After AHP analysis, the results of this study could suggest an evaluation table for the key success factors of operation of the military regional food material logistic center in Taiwan.

  14. Experimental Study on the Expression of HIF-1α and Its Relationship to Apoptosis in Tissues around Cerebral Bleeding Loci

    Institute of Scientific and Technical Information of China (English)

    朱遂强; 唐洲平; 郭守刚; 彭岚; 方思羽; 张苏明

    2004-01-01

    The expression of hypoxia inducible factor-1 alpha (HIF-1α) and its relationship to apoptosis in tissues around cerebral bleeding loci was studied. The expression of HIF-1α and apoptosis in 37 samples of tissues around cerebral bleeding loci and 9 samples of normal cerebral tissues was assessed by immunohistochemical straining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling methods. In 37 tissue samples around cerebral bleeding loci, the positive rate of the HIF-1α expression was 40.6 %. Especially in the patients with amount of bleeding>60 ml, the positive rate (88.9 %) of the HIF-1α expression was significantly higher than those with the amount of bleeding ranging from 30-45 ml or 45-60 ml (P<0.05). The expression of HIF-1α was increased as the amount of bleeding and operative time increased (P<0.05). There existed a positive correlation between HIF-1α labeling index and apoptosis index (n= 12, r= 0.56, P<0.01). These results suggested that the expression of HIF-1α was closely related with the time of hemorrhage and the amount of bleeding, and could induce the apoptosis of neurons.

  15. The assessment of intracranial bleeding with virtual unenhanced imaging by means of dual-energy CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri; Novak, Milan; Mirka, Hynek; Baxa, Jan; Ferdova, Eva; Bednarova, Alena; Kreuzberg, Boris [Charles University Teaching Hospital Plzen, Radiodiagnostic Clinic (Czech Republic); Flohr, Thomas; Schmidt, Bernhard; Klotz, Ernst [Siemens Healthcare, Computed Tomography (Germany)

    2009-10-15

    The purpose of this study was to assess virtual unenhanced brain computed tomography (CT) images obtained by dual-energy CT angiography (CTA) for the detection of intracranial bleeding. In total, 25 patients were included in the study (average age 53.2 years, range 25-75 years, 14 male, 11 female), all with intracranial bleeding on unenhanced brain CT and who underwent additional CTA performed on a dual-source CT in a dual-energy acquisition mode. The two X-ray tubes were operated at 140 and 80 kV, respectively. Data were analyzed using dual-energy evaluation software. Virtual unenhanced images were calculated by removing the relative iodine content from each voxel. The virtual unenhanced images were evaluated by a radiologist blinded to the findings of the conventional images related to the presence of intracranial bleeding. The image quality and contrast-to-noise ratio (CNR) between bleeding and brain tissue were assessed. The virtual image quality was found to be sufficient in 96%. The agreement in detection of intracranial bleeding on virtual and conventional unenhanced images reached 96% in per-lesion analysis and 100% in per-patient analysis. The averaged CNR reached 2.63 in virtual unenhanced images and 3.27 in conventional. Virtual unenhanced images are sufficient for the detection of intracranial bleeding. (orig.)

  16. Effects of aggregating forests, establishing forest road networks, and mechanization on operational efficiency and costs in a mountainous re-gion in Japan

    Institute of Scientific and Technical Information of China (English)

    Kazuhiro Aruga; Gyo Hiyamizu; Chikara Nakahata; Masashi Saito

    2013-01-01

    We investigated forest road networks and forestry operations before and after mechanization on aggregated forestry operation sites. We developed equations to estimate densities of road networks with average slope angles, operational efficiency of bunching operations with road network density, and average forwarding distances with operation site areas. Subsequently, we analyzed the effects of aggregating forests, establishing forest road networks, and mechanization on operational efficiency and costs. Six ha proved to be an appropriate operation site area with minimum operation expenses. The operation site areas of the forest owners’ cooperative in this region aggregated approximately 6 ha and the cooperative conducted forestry operations on aggregated sites. Therefore, 6 ha would be an appropriate operation site area in this region. Regarding road network density, higher-density road networks increased operational expenses due to the higher direct operational expenses of strip road establishment. Therefore, road network density should be reduced to approximately 200 m⋅ha-1 within average pre-yarding dis-tances on which a grapple loader could conduct bunching without winching. With larger stem volumes a larger reduction in operational expenses occurred for the mechanized operation system compared to the conventional operation system. However, with smaller stem volumes, the operational expenses for the mechanized operation system were higher than for the conventional operation system. Therefore, the appropriate operation system and machine sizes should be determined based on stem volumes.

  17. Typhoid ulcer causing life-threatening bleeding from Dieulafoy's lesion of the ileum in a seven-year-old child: a case report

    Directory of Open Access Journals (Sweden)

    Rashid Abbas

    2010-06-01

    Full Text Available Abstract Introduction We describe a case of rare complication of typhoid fever in a seven-year-old child and review the literature with regard to other rare causes of bleeding per rectum. Dieulafoy's lesion is an uncommon but important cause of recurrent gastrointestinal bleeding. Dieulafoy's lesion located extragastrically is rare. We report a case of typhoid ulcer with Dieulafoy's lesion of the ileum causing severe life-threatening bleeding and discuss the management of this extremely uncommon entity. Case presentation As a complication of typhoid fever, a seven-year-old Kurdish girl from Northern Iraq developed massive fresh bleeding per rectum. During colonoscopy and laparotomy, she was discovered to have multiple bleeding ulcers within the Dieulafoy's lesion in the terminal ileum and ileocecal region. Conclusion Although there is no practical way of predicting the occurrence of such rare complications, we emphasize in this case report the wide array of pathologies that can result from typhoid fever.

  18. Multibeam Mapping and Remotely Operated Vehicle Exploration of the Puerto Rico and Virgin Islands Region

    Science.gov (United States)

    Coleman, D. F.; Ten Brink, U. S.; Armstrong, R.; Chaytor, J. D.; Demopoulos, A. W.

    2013-12-01

    During October 2013, an ocean exploration project took place off the coast of Puerto Rico and the Virgin Islands. This project, a collaborative effort between the Ocean Exploration Trust, the US Geological Survey, the University of Puerto Rico at Mayaguez, the University of Rhode Island, and NOAA, was aimed at exploring regions of the US exclusive economic zone (EEZ) south of the Puerto Rico Trench axis, and north of Mona Island, Puerto Rico, and the US and British Virgin Islands, and portions of the Anegada Passage. The research vessel E/V Nautilus and the Hercules/Argus ROV system were used to expand the multibeam sonar bathymetric data coverage of the region, collect high definition video footage of seafloor features, and to collect biological and geological samples along selected transects. Particular areas of interest for targeted ROV dives included: the region where a large M7.2 1918 earthquake produced a tsunami that struck northwestern corner of Puerto Rico; a transect up the vertical wall of the Mona Rift (4000 to 1500 m depth); transects along the Septentrional fault system; dives in areas of suspected fluid flow through faults, fissures, and offshore Karst systems associated with the tilted carbonate platform north of Puerto Rico; dives in the Anegada Passage at the entry points for surface Atlantic waters that circulate into the Caribbean; and in regions to investigate and date sedimentary features offset by fault motion and potential tsunamigenic landslides. Biological sampling of many deep-sea benthic organisms (including deep water corals) have never been attempted before in this area. These samples are being used to understand more about the diversity, population dynamics, genetics, and habitat connectivity of these communities, and to provide an age constraint for disturbed sedimentary features. Until this cruise, the location and distribution of deep coral habitats in the US Caribbean was largely unknown. The available information on benthic

  19. Asymptotics for Hessenberg matrices for the Bergman shift operator on Jordan regions

    CERN Document Server

    Saff, Edward B

    2012-01-01

    Let G be a bounded Jordan domain in the complex plane and consider the infinite upper Hessenberg matrix M associated with the Bergman orthogonal polynomials of G. This matrix represents the Bergman shift operator of G. The main purpose of the paper is to describe and analyze a close relation between M and the Toeplitz matrix with symbol the normalized conformal map of the exterior of the unit circle onto the complement of the closure of G. Our results are based on the strong asymptotics of the Bergman polynomials. As an application, we describe and analyze an algorithm for recovering the shape of G from its area moments.

  20. Tranexamic acid for upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Bennett, Cathy; Klingenberg, Sarah Louise; Langholz, Ebbe;

    2014-01-01

    Background Tranexamic acid reduces haemorrhage through its antifibrinolytic effects. In a previous version of the present review, we found that tranexamic acid may reduce mortality. This review includes updated searches and new trials.Objectives To assess the effects of tranexamic acid versus......-effect and random-effects model meta-analyses and presented results as risk ratios (RRs) with 95% confidence intervals (CIs) and used I² as a measure of between-trial heterogeneity. We analysed tranexamic acid versus placebo or no intervention and tranexamic acid versus antiulcer drugs separately. To analyse...... sources of heterogeneity and robustness of the overall results, we performed subgroup, sensitivity and sequential analyses.Main results We included eight randomised controlled trials on tranexamic acid for upper gastrointestinal bleeding. Additionally, we identified one large ongoing pragmatic randomised...

  1. Abnormal uterine bleeding: a clinicohistopathological analysis

    Directory of Open Access Journals (Sweden)

    Anupamasuresh Y

    2014-06-01

    Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

  2. Packing of renal fossa: useful technique for intractable bleeding after open pyelolithotomy surgery.

    Science.gov (United States)

    Malhotra, Mohinder Kumar; Malhotra, Suchitra

    2012-01-01

    There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours) to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU) is also described in trauma but not in controlling bleeding after open pyelolithotomy. This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications. PMID:24027393

  3. Packing of renal fossa: Useful technique for intractable bleeding after open pyelolithotomy surgery

    Directory of Open Access Journals (Sweden)

    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU is also described in trauma but not in controlling bleeding after open pyelolithotomy .This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications.

  4. Requirements assessment and operational demands for a resource mapping rover mission to the lunar polar regions

    Energy Technology Data Exchange (ETDEWEB)

    KLARER,PAUL R.; BINDER,ALAN B.; LENARD,ROGER X.

    2000-01-26

    A preliminary set of requirements for a robotic rover mission to the lunar polar region are described and assessed. Tasks to be performed by the rover include core drill sample acquisition, mineral and volatile soil content assay, and significant wide area traversals. Assessment of the postulated requirements is performed using first order estimates of energy, power, and communications throughput issues. Two potential rover system configurations are considered, a smaller rover envisioned as part of a group of multiple rovers, and a larger single rover envisioned along more traditional planetary surface rover concept lines.

  5. [Perioperative management and therapy of bleeding complications].

    Science.gov (United States)

    von Heymann, Christian; Kaufner, Lutz; Körber, Mareike

    2014-03-01

    The new oral anticoagulants directly inhibit either thrombin (Dabigatran, Pradaxa®,) or activated Factor X (rivaroxaban, Xarelto®, and apixaban, Eliquis®) and have been approved for thromboprophylaxis after hip and knee replacement surgery and stroke prevention in non-valvular atrial fibrillation. Moreover, rivaroxaban has been approved for the treatment of deep venous thrombosis, prevention of pulmonary embolism and anticoagulation after acute myocardial infarction. The direct FXa-inhibitor edoxaban (Lixiana®) expects approval for the prevention of stroke in atrial fibrillation in Germany in 2014. The half lives of all direct anticoagulants range between 8 and 17 hours. Dabigatran (Pradaxa®) and rivaroxaban (Xarelto®) are mainly excreted by the kidneys, apixaban (Eliquis®) by the liver (75%) and edoxaban (Lixiana®) by the kidneys (40%) and the faeces in 60%. Prior to surgery a shorter cessation is expected compared to the vitamin k antagonists phenprocoumon (Marcumar®, Falithrom®) and warfarin (Coumadin®). For acute bleedings caused by the direct thrombin inhibitor dabigatran (Pradaxa®) hemodialysis is recommended to eliminate the drug from the plasma. Due to the high protein binding the direkt FXa-inhibitors rivaroxaban (Xarelto®) and apixaban (Eliquis®) can not be hemodialysed. For edoxaban (Lixiana®) no data on elimination by renal replacement therapy are available. In case of life-threatening bleeding the replacement of a prothrombin complex preparation (PCC) containing the factors II, VII, IX and X and, second line, activated factor concentrates as recombinant factor VIIa or activated prothrombin complex preparations are recommended. PMID:24711240

  6. Platelet Function Tests in Bleeding Disorders.

    Science.gov (United States)

    Lassila, Riitta

    2016-04-01

    Functional disorders of platelets can involve any aspect of platelet physiology, with many different effects or outcomes. These include platelet numbers (thrombocytosis or thrombocytopenia); changes in platelet production or destruction, or capture to the liver (Ashwell receptor); altered adhesion to vascular injury sites and/or influence on hemostasis and wound healing; and altered activation or receptor functions, shape change, spreading and release reactions, procoagulant and antifibrinolytic activity. Procoagulant membrane alterations, and generation of thrombin and fibrin, also affect platelet aggregation. The above parameters can all be studied, but standardization and quality control of assay methods have been limited despite several efforts. Only after a comprehensive clinical bleeding assessment, including family history, information on drug use affecting platelets, and exclusion of coagulation factor, and tissue deficits, should platelet function testing be undertaken to confirm an abnormality. Current diagnostic tools include blood cell counts, platelet characteristics according to the cell counter parameters, peripheral blood smear, exclusion of pseudothrombocytopenia, whole blood aggregometry (WBA) or light transmission aggregometry (LTA) in platelet-rich plasma, luminescence, platelet function analysis (PFA-100) for platelet adhesion and deposition to collagen cartridges under blood flow, and finally transmission electron microscopy to exclude rare structural defects leading to functional deficits. The most validated test panels are included in WBA, LTA, and PFA. Because platelets are isolated from their natural environment, many simplifications occur, as circulating blood and interaction with vascular wall are omitted in these assays. The target to reach a highly specific platelet disorder diagnosis in routine clinical management can be exhaustive, unless needed for genetic counseling. The elective overall assessment of platelet function disorder

  7. Regional climate model simulations indicate limited climatic impacts by operational and planned European wind farms.

    Science.gov (United States)

    Vautard, Robert; Thais, Françoise; Tobin, Isabelle; Bréon, François-Marie; Devezeaux de Lavergne, Jean-Guy; Colette, Augustin; Yiou, Pascal; Ruti, Paolo Michele

    2014-01-01

    The rapid development of wind energy has raised concerns about environmental impacts. Temperature changes are found in the vicinity of wind farms and previous simulations have suggested that large-scale wind farms could alter regional climate. However, assessments of the effects of realistic wind power development scenarios at the scale of a continent are missing. Here we simulate the impacts of current and near-future wind energy production according to European Union energy and climate policies. We use a regional climate model describing the interactions between turbines and the atmosphere, and find limited impacts. A statistically significant signal is only found in winter, with changes within ±0.3 °C and within 0-5% for precipitation. It results from the combination of local wind farm effects and changes due to a weak, but robust, anticyclonic-induced circulation over Europe. However, the impacts remain much weaker than the natural climate interannual variability and changes expected from greenhouse gas emissions.

  8. Summary Report, Southwest Regional Geothermal Operations Research Program: First project year, June 1977-August 1978

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Richard T.; Davidson, Ray

    1978-12-01

    The overall objectives of the first year project were as follows: (1) to develop realistic but aggressive scenarios with certainty factors for the development of each identified geothermal resource area in Arizona, Colorado, Nevada, New Mexico, and Utah; (2) to delineate the public actions, together with their schedules, required for the scenarios to materialize; and (3) to develop a computer-based data storage and retrieval system (i.e. a Regional Program Progress Monitor) of the level of a preliminary working model, which is capable of displaying program approach but is not loaded with all available data. In addition, each sponsor had supplementary objectives aligned to its own programmatic goals. DOE sought to develop expertise and programs within the appropriate state agencies upon which future DOE development and commercialization activities could be structured. FCRC sought to promote the utilization of geothermal energy throughout the five-state region for purposes of expanded economic development, increased employment, and higher citizen incomes. The goals of the five states varied from state to state, but generally included the following: development of alternative energy sources to replace dwindling supplies of oil and natural gas; economic and industrial development in rural areas; encouragement of industry and utility development of geothermal energy for electrical power generation; demonstration of the practical applications of energy research and development; and close interaction with business and industry for the commercialization of both electric and direct thermal applications.

  9. The Role of Demand Resources In Regional Transmission Expansion Planning and Reliable Operations

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, Brendan J [ORNL

    2006-07-01

    Investigating the role of demand resources in regional transmission planning has provided mixed results. On one hand there are only a few projects where demand response has been used as an explicit alternative to transmission enhancement. On the other hand there is a fair amount of demand response in the form of energy efficiency, peak reduction, emergency load shedding, and (recently) demand providing ancillary services. All of this demand response reduces the need for transmission enhancements. Demand response capability is typically (but not always) factored into transmission planning as a reduction in the load which must be served. In that sense demand response is utilized as an alternative to transmission expansion. Much more demand response is used (involuntarily) as load shedding under extreme conditions to prevent cascading blackouts. The amount of additional transmission and generation that would be required to provide the current level of reliability if load shedding were not available is difficult to imagine and would be impractical to build. In a very real sense demand response solutions are equitably treated in every region - when proposed, demand response projects are evaluated against existing reliability and economic criteria. The regional councils, RTOs, and ISOs identify needs. Others propose transmission, generation, or responsive load based solutions. Few demand response projects get included in transmission enhancement plans because few are proposed. But this is only part of the story. Several factors are responsible for the current very low use of demand response as a transmission enhancement alternative. First, while the generation, transmission, and load business sectors each deal with essentially the same amount of electric power, generation and transmission companies are explicitly in the electric power business but electricity is not the primary business focus of most loads. This changes the institutional focus of each sector. Second

  10. Impact of inherited bleeding disorders on pregnancy and postpartum hemorrhage.

    Science.gov (United States)

    Shahbazi, Shirin; Moghaddam-Banaem, Lida; Ekhtesari, Fatemeh; Ala, Fereydoun A

    2012-10-01

    Inherited bleeding disorders are caused by various genetic defects in the proteins involved in haemostasis. Female patients or carriers are faced with the risk of haemorrhage throughout life. During pregnancy and postpartum, this complication affects the health of either the mother or the baby, or both. This retrospective cohort study was designed to assess the occurrence of obstetric bleeding in the three trimesters of pregnancy, along with primary and secondary postpartum haemorrhage among 100 women with inherited bleeding disorders. A questionnaire was designed in order to collect historical data. The patients were evaluated in three groups: haemophilia carriers, von Willebrand disease (VWD) and rare bleeding disorders. In comparison with normal women, significantly severe bleeding was observed among patients in all of the five stages. VWD patients showed a higher frequency of bleeding in first trimester but the rate of miscarriage was lower. Haemophilia carriers were threatened with bleeding complications during the prenatal period, but they also had the highest frequency of postpartum haemorrhage. Based on our results, vaginal bleeding is a serious threat in all three patient groups, especially during the first trimester of pregnancy and in the postpartum period. PMID:22821002

  11. The role of nuclear medicine in acute gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, P. (Saint James' s Hospital, Leeds (United Kingdom). Dept. of Radiology)

    1993-10-01

    In most patients with upper gastrointestinal (GI) bleeding, endoscopy will locate the site and cause of bleeding, and also provide an opportunity for local therapy. The cause of lower GI bleeding is often difficult to attribute, even when pathology is found by colonoscopy or barium enema. Nuclear medicine techniques can be used to identify the site of bleeding in those patients in whom the initial diagnostic procedures are negative or inconclusive. Methods using transient labelling of blood (e.g. [sup 99]Tc[sup m]-sulphur colloid) produce a high target-to-background ratio in positive cases, give quick results and localize bleeding sites accurately, but depend upon bleeding being active at the time of injection. Techniques using stable blood labelling (e.g. [sup 99]Tc[sup m]-labelled red blood cells) may be positive even with intermittent bleeding but may take several hours to produce a result and are less precise in localization. The most useful application is in patients with recurrent or prolonged bleeding, those with inconclusive endoscopy or barium studies, and those who are high-risk surgical candidates. (author).

  12. Role of endoscopy in the management of acute diverticular bleeding

    Institute of Scientific and Technical Information of China (English)

    Charalampos Pilichos; Emmanouil Bobotis

    2008-01-01

    Colonic diverticulosis is one of the most common causes of lower gastrointestinal bleeding. Endoscopy is not only a useful diagnostic tool for localizing the bleeding site, but also a therapeutic modality for its management. To date, haemostatic methods have included adrenaline injection, mechanical clipping, thermal and electrical coagulation or combinations of them. The results of all published data are herein reviewed.

  13. 14 CFR 33.66 - Bleed air system.

    Science.gov (United States)

    2010-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system. The engine must supply bleed air without adverse effect on the engine, excluding reduced thrust or...

  14. Gastrointestinal bleeding in patients with hereditary hemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Kjeldsen, J

    2000-01-01

    Gastrointestinal bleeding occurs in a number of patients with hereditary hemorrhagic telangiectasia (HHT) and may lead to a high transfusion need. The aim of this study was to estimate the occurrence and severity of gastrointestinal bleeding in a geographically well defined HHT population....

  15. Management of bleeding complications in patients with cancer on DOACs.

    Science.gov (United States)

    Schulman, Sam; Shrum, Jeffrey; Majeed, Ammar

    2016-04-01

    There has been a concern that major bleeding events (MBE) on direct-acting oral anticoagulants (DOACs) will be more difficult to manage than on vitamin K antagonists. Patients with cancer and DOAC-associated bleeding may be even more of a challenge to manage. We therefore reviewed the literature on bleeding in patients with cancer on DOACs. In addition, we performed an analysis of individual patient data from 5 phase III trials on treatment with dabigatran with focus on those with cancer. In 6 randomized trials the risk of MBE in patients with cancer was similar on treatment with DOACs compared to vitamin K antagonists. Bleeding was in the majority of patients managed with supportive therapy alone. In the individual patient data analysis there were no significant differences in use of hemostatic products, transfusion of red cells, effectiveness of management, bleeding-related mortality or 30-day all-cause mortality between patients with cancer treated with dabigatran or with warfarin. Local hemostatic therapy, including resection of the cancer site was more common in patients with gastrointestinal bleeding with cancer than among those without cancer. We conclude that management of bleeding in patients with cancer and on a DOAC does not pose a greater challenge than management of bleeding in patients without cancer. PMID:27067968

  16. Enhancing Tools and Geospatial Data to Support Operational Forest Management and Regional Forest Planning in the Face of Climate Change

    Science.gov (United States)

    Falkowski, M. J.; Fekety, P.; Hudak, A. T.; Kayastha, N.; Nagel, L. M.

    2014-12-01

    A detailed understanding of how forest composition, structure, and function will be impacted by projected climate change and related adaptive forest management activities are particularly lacking at local scales, where on-the-ground management activities are implemented. Climate sensitive forest dynamics models may prove to be effective tools for developing a comprehensive understanding. However, to be applicable to both regional forest planning and operational forest management, modeling approaches must be capable of simulating forest dynamics across large spatial extents (required for regional planning) while maintaining a high-level of spatial detail (required for operational management). LiDAR remote sensing has shown great utility for operational forest inventory and management, including forest dynamics modeling, albeit across relatively small spatial extents. We present a remote sensing driven approach to spatially initialize a climate-sensitive forest dynamics model (LANDIS-II) in the Pacific Northwest of the US via an integration of airborne LiDAR data with satellite remote sensing data. The system provides detailed forest inventory information - at the landscape level - that is subsequently employed to demonstrate how such models can be used to 1) investigate the potential impacts of climate change on future forest composition and structure, and 2) assess how various forest management practices may either enhance or degrade forest resilience to changing climate and disturbance regimes.

  17. Tennessee Valley region study: potential year 2000 radiological dose to population resulting from nuclear facility operations. [Includes glossary

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-06-01

    A companion report, DOE/ET-0064/1, presents a geographic, cultural, and demographic profile of the Tennessee Valley Region study area. This report describes the calculations of radionuclide release and transport and of the resultant dose to the regional population, assuming a projected installed capacity of 220,000 MW in the year 2000, of which 144,000 MW would be nuclear. All elements of the fuel cycle were assumed to be in operation. The radiological dose was calculated as a one-year dose based on ingestion of 35 different food types as well as for nine non-food pathways, and was reported as dose to the total body and for six specific organs for each of four age groups (infant, child, teen, and adult). Results indicate that the average individual would receive an incremental dose of 7 x 10/sup -4/ millirems in the year 2000 from the operation of nuclear facilities within and adjacent to the region, five orders of magnitude smaller than the dose from naturally occurring radiation in the area. The major contributor to dose was found to be tritium, and the most significant pathways were immersion in air, inhalation of air, transpiration of tritium (absorption through the skin), and exposure radionuclide-containing soil. 60 references.

  18. Performances and failure of field-aged PV modules operating in Saharan region of Algeria

    Science.gov (United States)

    Sadok, M.; Benyoucef, B.; Othmani, M.; Mehdaoui, A.

    2016-07-01

    This article deals with behaviour of PV modules, of different technologies and manufacturers, exposed for long periods in Saharan region of Algeria. These modules are exposed in Adrar in the south-western part of Algeria. The study uses experimental I-V curves of PV modules for determining their performances. The datasheet information of modules will be useful in determination of degradation rates of the modules. Three types of modules have been tested: Photowatt (PWX 500), UDTS-50 and Isofoton (I-75 and I-100 serials). Results showed that Isofoton I-100 modules present the highest degradation rate while the lowest degradation rate was reached with I-75 serial. However, these rates tallies with other studies. The visual inspection of the modules has revealed various kinds of failures and defects responsible of performances drop (EVA browning, delamination, burn marks,…).

  19. Empirical Verification of Fault Models for FPGAs Operating in the Subcritical Voltage Region

    DEFF Research Database (Denmark)

    Birklykke, Alex Aaen; Koch, Peter; Prasad, Ramjee;

    2013-01-01

    fault models might provide insight that would allow subcritical scaling by changing digital design practices or by simply accepting errors if possible. To facilitate further work in this direction, we present probabilistic error models that allow us to link error behavior with statistical properties...... of the binary signals, and based on a two-FPGA setup we experimentally verify the correctness of candidate models. For all experiments, the observed error rates exhibit a polynomial dependency on outcome probability of the binary inputs, which corresponds to the behavior predicted by the proposed timing error...... model. Furthermore, our results show that the fault mechanism is fully deterministic - mimicking temporary stuck-at errors. As a result, given knowledge about a given signal, errors are fully predictable in the subcritical voltage region....

  20. The Mechanisms of Abnormal Bleeding in Patients with Anovulatory Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    Lu LUO; Feng-chuan ZHU; Yao-ying ZENG

    2002-01-01

    Objective To investigate the mechanisms of abnormal bleeding in patients with anovulatory dysfunctional uterine bleeding (DUB) and to analyze the correlation between vascular endothelial growth factor (VEGF) and microvessel density in the endometrium Materials & Methods Immunohistochemistry was used to study the expression of VEGF protein in the proliferative and hyperplastic endometrium. CD34 ,a marker of microvessel, was selected to measure microvessel density (MVD) in the endometrium.Fifteen women who were found to have no condition with normal menstrual cycles were set as control group.Results VEGF immunoreactivity in glandular epithelia cells was significantly lower in the hyperplastic endometrium than that of controls(P < 0. 05). There was no significant difference in VEGF protein level between proliferative DUB endometrium and that of controls. A positive correlation was found between glandular VEGF and MVD in the endometrium(r=0. 666, P<0.05). Conclusion The anovulatory DUB is associated with down-regulation of VEGF in the endometrium, and decreased secretion of VEGF will result in the disruption of angiogenesis, as a clinical manifestation of irregular bleeding.

  1. The Text of the Agreement of 8 July Extending the Asian Regional Co-Operative Project on Food Irradiation. Extension Agreement

    International Nuclear Information System (INIS)

    The text of the Agreement to Extend the Agreement of 23 May 1980 Establishing the Asian Regional Co-operative Project on Food Irradiation within the framework of the Regional Co-operative Agreement for Research, Development and Training Related to Nuclear Science and Technology of 1972, as extended in 1977 and in 1982, is reproduced herein for the information of all Members

  2. Comparative effectiveness of flossing and brushing in reducing interproximal bleeding.

    Science.gov (United States)

    Graves, R C; Disney, J A; Stamm, J W

    1989-05-01

    This study assesses the comparative effectiveness of three types of dental floss and toothbrushing in reducing interproximal bleeding sites, measured by stimulation with wooden interdental cleaners using the interdental bleeding index assessment method. The 119 adult subjects with gingival inflammation were randomly assigned to one of four groups at the beginning of a supervised 2 week clinical trial. The toothbrushing only group achieved a 35% reduction in bleeding sites and the three flossing groups all demonstrated dramatic reductions of about 67%. The three varieties of dental flosses were about equally effective in reducing interproximal bleeding and doubly effective as toothbrushing alone. Compared to probing, the interdental bleeding index method is considered a simplified method of assessing interproximal gingival inflammation.

  3. Scintigraphic detection of gastrointestinal bleeding: a review of current methods

    International Nuclear Information System (INIS)

    Recent experience with radionuclide imaging has provided the clinician with several techniques to noninvasively detect and locate sources of gastrointestinal hemorrhage. These tests can be rapidly performed and often in an ICU setting. One method used Tc-99m sulfur colloid which, in an animal model, has been shown to detect acute bleeding at rates as low as 0.1 ml/min. However, because the tracer remains in the blood for a short period of time, it may be suboptimal for identifying patients with intermittent bleeding. Tc-99m red cells is a tracer that remains within the blood and permits detection of both acute and intermittent bleeding. With tagged red cells, sites of bleeding from both the upper and lower gastrointestinal tract can be found. Both of these techniques can provide important information in the patient with suspected active gastrointestinal bleeding and aid the clinician in more effective management including the use of invasive diagnostic and therapeutic techniques

  4. New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

    Institute of Scientific and Technical Information of China (English)

    Antonio; Damián; Sánchez-Capilla; Paloma; De; La; Torre-Rubio; Eduardo; Redondo-Cerezo

    2014-01-01

    Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-10-15

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

  6. DEA (Data Envelopment Analysis) assessment of operational and environmental efficiencies on Japanese regional industries

    International Nuclear Information System (INIS)

    A balance between industrial pollution and economic growth becomes a major policy issue to attain a sustainable society in the world. To discuss the problem from economics and business perspectives, this study proposes a new use of DEA (Data Envelopment Analysis) as a methodology for unified (operational and environmental) assessment. A unique feature of the proposed approach is that it separates outputs into desirable and undesirable categories. Such separation is important because energy industries usually produce both desirable and undesirable outputs. This study discusses how to unify the two types of outputs under natural and managerial disposability. The proposed DEA approach evaluates various organizations by the three efficiency measures such as OE (Operational Efficiency), UEN (Unified Efficiency under Natural disposability) and UENM (Unified Efficiency under Natural and Managerial disposability). An important feature of UENM is that it separates inputs into two categories and unifies them under the two disposability concepts in addition to the proposed output separation and unification. This study incorporates an amount of capital assets for technology innovation, as one of the two input group, into the measurement of UENM. Then, it compares UENM with the other two efficiency measures. This study is the first research effort in which DEA has an analytical capability to quantify the importance of investment on capital assets for technology innovation. To confirm the practicality of the proposed approach, this study applies the three efficiency measures to a data set regarding manufacturing and non-manufacturing industries of 47 prefectures in Japan. This study empirically confirms the validity of Porter hypothesis in Japanese manufacturing industries, so implying that environmental regulation has been effective for betterment on the performance of Japanese manufacturing industries. Another important finding is that the emission of greenhouse gases is a

  7. Bleeding disorders in the tribe: result of consanguineous in breeding

    Directory of Open Access Journals (Sweden)

    Borhany Munira

    2010-09-01

    Full Text Available Abstract Objective To determine the frequency and clinical features of bleeding disorders in the tribe as a result of consanguineous marriages. Design Cross Sectional Study Introduction Countries in which consanguinity is a normal practice, these rare autosomal recessive disorders run in close families and tribes. Here we describe a family, living in village Ali Murad Chandio, District Badin, labeled as haemophilia. Patients & Methods Our team visited the village & developed the pedigree of the whole extended family, up to seven generations. Performa was filled by incorporating patients, family history of bleeding, signs & symptoms, and bleeding from any site. From them 144 individuals were screened with CBC, bleeding time, platelet aggregation studies & RiCoF. While for PT, APTT, VWF assay and Factor VIII assay, samples were kept frozen at -70 degrees C until tested. Results The family tree of the seven generations comprises of 533 individuals, 63 subjects died over a period of 20 years and 470 were alive. Out of all those 144 subjects were selected on the basis of the bleeding history. Among them 98(68.1% were diagnosed to have a bleeding disorder; 44.9% patients were male and 55.1% patients were female. Median age of all the patients was 20.81, range (4 months- 80 yrs. The results of bleeding have shown that majority had gum bleeding, epistaxis and menorrhagia. Most common bleeding disorder was Von Willebrand disease and Platelet functional disorders. Conclusion Consanguineous marriages keep all the beneficial and adversely affecting recessive genes within the family; in homozygous states. These genes express themselves and result in life threatening diseases. Awareness, education & genetic counseling will be needed to prevent the spread of such common occurrence of these bleeding disorders in the community.

  8. Genotypes of Helicobacter pylori in patients with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Chin-Lin Perng; Hwai-Jeng Lin; Wen-Ching Lo; Guan-Ying Tseng; I-Chen Sun; Yueh-Hsing Ou

    2004-01-01

    AIM: Helicobacter pyloricauses chronic gastritis, peptic ulcer,gastric cancer and MALT-lymphoma. Different genotypes of Helicobacter pylori are confirmed from diverse geographic areas. Its association with bleeding peptic ulcer remains controversial. The aim of this study was to investigate the Helicobacter pylori vac4 alleles, cagA and iceA in patients with bleeding peptic ulcer.METHODS: We enrolled patients with bleeding, nonbleeding peptic ulcers and chronic gastritis. Biopsy specimens were obtained from the antrum of the stomach for rapid urease test, bacterial culture and PCR assay. DNA extraction and polymerase chain reaction were used to detect the presence or absence of cagA and to assess the polymorphism of vac4 and iceA.RESULTS: A total of 168 patients (60.4%) (25 patients with chronic gastritis, 26 patients with bleeding gastric ulcer,51 patients with non-bleeding gastric ulcer, 26 patients with bleeding duodenal ulcer, and 40 patients with non-bleeding duodenal ulcer) were found to have positive PCR results between January 2001 and December 2002. Concerning genotypes, we found cagA (139/278, 50%), vacA s1a (127/278, 45.7%), and iceA1 (125/278, 45%) predominated in all studied patients. In patients with bleeding peptic ulcers,vac4 s1a and m1T were fewer than those in patients with non-bleeding peptic ulcers (37/106 vs69/135, P=0.017, and 4/106 vs21/135, P=0.002).CONCLUSION: In patients with peptic ulcers, Hpylori vacA s1a and m1T prevent bleeding complication.

  9. Operation Strategy for a Power Grid Supplied by 100% Renewable Energy at a Cold Region in Japan

    Directory of Open Access Journals (Sweden)

    Jorge Morel

    2014-09-01

    Full Text Available This paper presents an operation strategy for a power system supplied from 100% renewable energy generation in Kitami City, a cold region in Japan. The main goal of this work is the complete elimination of the CO2 emissions of the city while keeping the power frequency within prescribed limits. Currently, the main energy related issue in Japan is the reduction of CO2 emissions without depending on nuclear generation. Also, there is a need for the adoption of distributed generation architecture in order to permit local autonomous operation of the system by the local generation of power. As a solution, this paper proposes a strategy to eliminate CO2 emissions that considers digital simulations using past hourly meteorological data and demand for one year. Results shows that Kitami City can be supplied entirely by renewable generation, reducing its CO2 emission to zero while keeping the quality of its power grid frequency within permitted limits.

  10. Methods, systems and apparatus for controlling third harmonic voltage when operating a multi-space machine in an overmodulation region

    Energy Technology Data Exchange (ETDEWEB)

    Perisic, Milun; Kinoshita, Michael H; Ranson, Ray M; Gallegos-Lopez, Gabriel

    2014-06-03

    Methods, system and apparatus are provided for controlling third harmonic voltages when operating a multi-phase machine in an overmodulation region. The multi-phase machine can be, for example, a five-phase machine in a vector controlled motor drive system that includes a five-phase PWM controlled inverter module that drives the five-phase machine. Techniques for overmodulating a reference voltage vector are provided. For example, when the reference voltage vector is determined to be within the overmodulation region, an angle of the reference voltage vector can be modified to generate a reference voltage overmodulation control angle, and a magnitude of the reference voltage vector can be modified, based on the reference voltage overmodulation control angle, to generate a modified magnitude of the reference voltage vector. By modifying the reference voltage vector, voltage command signals that control a five-phase inverter module can be optimized to increase output voltages generated by the five-phase inverter module.

  11. The prevalence of underlying bleeding disorders in patients with heavy menstrual bleeding with and without gynecologic abnormalities

    NARCIS (Netherlands)

    Knol, H. Marieke; Mulder, Andre; Bogchelman, Dick H.; Kluin-Nelemans, Hanneke C.; van der Zee, Ate G. J.; Meijer, Karina

    2013-01-01

    OBJECTIVE: The purpose of this study was to assess the prevalence of underlying bleeding disorders in women with heavy menstrual bleeding (HMB) with and without gynecologic abnormalities. STUDY DESIGN: We performed a single-center prospective cohort study of 112 consecutive patients who were referre

  12. Text of an African regional co-operative agreement for research, development and training related to nuclear science and technology

    International Nuclear Information System (INIS)

    As of 1 September 1994, notifications of acceptance of the African Regional Co-operative Agreement for Research, Development and Training Related to Nuclear Science and Technology (see INFCIRC/377), in accordance with Article XIII thereof, had been received by the Director General from the Governments of: Tunisia, Egypt, Algeria, Nigeria, Madagascar, Libya, Morocco, Kenya, Sudan, Ghana, Tanzania, Mauritius, Cameroon, South Africa, Zaire, Ethiopia, Zambia, Niger. The Agreement entered into force on 4 April 1990, the date of receipt of the third notification of acceptance

  13. Lateral supracerebellar infratentorial approach for microsurgical resection of large midline pineal region tumors: techniques to expand the operative corridor.

    Science.gov (United States)

    Kulwin, Charles; Matsushima, Ken; Malekpour, Mahdi; Cohen-Gadol, Aaron A

    2016-01-01

    Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a lateral supracerebellar infratentorial approach that was successfully used in the treatment of 10 large (> 3 cm) midline pineal region tumors. The patients were placed in a modified lateral decubitus position. A small lateral suboccipital craniotomy exposed the transverse sinus. Tentorial retraction sutures were used to gently rotate and elevate the transverse sinus to expand the lateral supracerebellar operative corridor. This approach placed only unilateral normal structures at risk and minimized vermian venous sacrifice. The surgeon achieved generous exposure of the caudal midline mesencephalon through a "cross-court" oblique trajectory, while avoiding excessive retraction on the culmen. All patients underwent the lateral approach with no approach-related complication. The final pathological diagnoses were consistent with meningioma in 3 cases, pilocytic astrocytoma in 3 cases, intermediate grade pineal region tumor in 2 cases, and pineoblastoma in 2 cases. The entire extent of these tumors was readily reachable through the lateral supracerebellar route. Gross-total resection was achieved in 8 (80%) of the 10 cases; in 2 cases (20%) near-total resection was performed due to adherence of these tumors to deep diencephalic veins. Large midline pineal region tumors can be removed through a unilateral paramedian suboccipital craniotomy. This approach is simple, may spare some of the midline vermian bridging veins, and may be potentially less invasive and more efficient.

  14. Combining operational models and data into a dynamic vessel risk assessment tool for coastal regions

    Science.gov (United States)

    Fernandes, R.; Braunschweig, F.; Lourenço, F.; Neves, R.

    2016-02-01

    The technological evolution in terms of computational capacity, data acquisition systems, numerical modelling and operational oceanography is supplying opportunities for designing and building holistic approaches and complex tools for newer and more efficient management (planning, prevention and response) of coastal water pollution risk events. A combined methodology to dynamically estimate time and space variable individual vessel accident risk levels and shoreline contamination risk from ships has been developed, integrating numerical metocean forecasts and oil spill simulations with vessel tracking automatic identification systems (AIS). The risk rating combines the likelihood of an oil spill occurring from a vessel navigating in a study area - the Portuguese continental shelf - with the assessed consequences to the shoreline. The spill likelihood is based on dynamic marine weather conditions and statistical information from previous accidents. The shoreline consequences reflect the virtual spilled oil amount reaching shoreline and its environmental and socio-economic vulnerabilities. The oil reaching shoreline is quantified with an oil spill fate and behaviour model running multiple virtual spills from vessels along time, or as an alternative, a correction factor based on vessel distance from coast. Shoreline risks can be computed in real time or from previously obtained data. Results show the ability of the proposed methodology to estimate the risk properly sensitive to dynamic metocean conditions and to oil transport behaviour. The integration of meteo-oceanic + oil spill models with coastal vulnerability and AIS data in the quantification of risk enhances the maritime situational awareness and the decision support model, providing a more realistic approach in the assessment of shoreline impacts. The risk assessment from historical data can help finding typical risk patterns ("hot spots") or developing sensitivity analysis to specific conditions, whereas real

  15. Combining operational models and data into a dynamic vessel risk assessment tool for coastal regions

    Directory of Open Access Journals (Sweden)

    R. Fernandes

    2015-07-01

    Full Text Available The technological evolution in terms of computational capacity, data acquisition systems, numerical modelling and operational oceanography is supplying opportunities for designing and building holistic approaches and complex tools for newer and more efficient management (planning, prevention and response of coastal water pollution risk events. A combined methodology to dynamically estimate time and space variable shoreline risk levels from ships has been developed, integrating numerical metocean forecasts and oil spill simulations with vessel tracking automatic identification systems (AIS. The risk rating combines the likelihood of an oil spill occurring from a vessel navigating in a study area – Portuguese Continental shelf – with the assessed consequences to the shoreline. The spill likelihood is based on dynamic marine weather conditions and statistical information from previous accidents. The shoreline consequences reflect the virtual spilled oil amount reaching shoreline and its environmental and socio-economic vulnerabilities. The oil reaching shoreline is quantified with an oil spill fate and behaviour model running multiple virtual spills from vessels along time. Shoreline risks can be computed in real-time or from previously obtained data. Results show the ability of the proposed methodology to estimate the risk properly sensitive to dynamic metocean conditions and to oil transport behaviour. The integration of meteo-oceanic + oil spill models with coastal vulnerability and AIS data in the quantification of risk enhances the maritime situational awareness and the decision support model, providing a more realistic approach in the assessment of shoreline impacts. The risk assessment from historical data can help finding typical risk patterns, "hot spots" or developing sensitivity analysis to specific conditions, whereas real time risk levels can be used in the prioritization of individual ships, geographical areas, strategic tug

  16. Current State and Expectation in Diagnosis and Treatment of Bleeding Disorders

    Institute of Scientific and Technical Information of China (English)

    WANG Zhao-yue王兆钺

    2002-01-01

    @@ 1 Classification and sreening tests of bleeding disorders Under the heading of bleeding disorders are grouped a number of diseases which have hemorrhagic problems. Bleeding disorders are very common, involving about one third of patients in the hematological consultation.

  17. Bleeding from gums: Can it be a dengue

    Directory of Open Access Journals (Sweden)

    Rajat Bansal

    2014-01-01

    Full Text Available Introduction: Bleeding from gums is a common feature in periodontitis patient. But abnormal bleeding from the gingiva or other areas of the oral mucosa that is difficult to control is an important clinical sign suggesting a hematological disorder. Case Report: A-40-year old male patient reported to our clinic with the chief complaint of acute gingival bleeding. There was continuous bleeding, fever since 3-4 days with weakness, retro orbital pain, and severe backache. Patient gave a history of bleeding from gums for last 24 hrs. His blood profile revealed; platelet count of 36,000, total wite blood cell (WBC count of 6000/cumm, differential leukocyte count (DLC (P45, L53, E2, and hemoglobin 12 g/dL. Patient sera was positive for dengue non-structural protein-1 antigen, anti-dengue immunoglobulin M (IgM, and anti-dengue immunoglobulin G (IgG antibodies. Discussion: Here is a case report capable of changing our vision that acute gingival bleeding can also occur in dengue fever. Dengue fever can also be considered as one of the differential diagnosis for the acute gingival bleeding.

  18. PRE-AETHIOLOGICAL TREATMENT IN UPPER GASTRO-INTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    G. Dimofte

    2005-01-01

    Full Text Available Upper gastro-intestinal bleeding remains a cornerstone in surgical practice and unfortunately its’ management is profoundly variable according to hospital protocols and local standards of care. Medical interventions are acting at different levels of medical care and a range of specialist are involved in the process, starting from family practitioners to surgeons, as well as highly trained specialist in interventional endoscopy or radiology. This review is trying to establish the landmarks in the early assessment and care of patients with upper gastro-intestinal bleeding, irrespective of the morphological cause of the bleeding. We propose a protocol for the management both of portal and non-portal upper-gastrointestinal bleedings, prior to endoscopic diagnosis. It is fundamental to establish a standard of care which is feasible in Romania and can work both in university and district hospitals. The protocol is marking the essential gestures with their relevance for the bleeding patient but also reminds the significance of clinical evaluation and safety in transportation of the patient to the nearest emergency room. A battery of simple test should be performed in every patient and data interpreted with care, as results vary according to the level of haemodynamic compensation. Standard empiric therapy for upper gastro-intestinal bleeding is not yet been established but a couple of alternatives emerge as possible solutions. We discuss the benefits of a standard therapy based on H2 blockers, proton pump inhibitors, octreoctide and somatostatin regarding both portal and non-portal bleedings.

  19. Quality laboratory issues in bleeding disorders.

    Science.gov (United States)

    Adcock, D M; Mammen, J; Nair, S C; de Lima Montalvão, S A

    2016-07-01

    Selected quality issues pertinent to the determination of accurate results in the haemostasis laboratory are discussed. Specifically, the implementation of a successful external quality-assessment scheme is described, including its impact on result accuracy as well as the programme's unique challenges and opportunities. Errors in the preanalytical phase of laboratory testing represent the greatest source for reporting incorrect test results. Some of the most common preanalytical errors are described including those that necessitate sample rejection. Analytical means to identify potential sources of error and analytical means to overcome particular interferences are described. Representing the most important clinical complication in the treatment of patients with haemophilia, quality issues related to determination of the presence of inhibitory antibodies against factor VIII (FVIII) are reviewed. Heat treatment of patient plasma prior to testing, particularly in patients receiving replacement FVIII concentrate or during induction of immune tolerance to achieve more accurate results is recommended, while screening activated partial thromboplastin time-based mixing tests to rule out inhibitor presence is discouraged. The initiatives presented in this review can be implemented in robust and resource restricted settings to improve the quality of laboratory testing in patients with bleeding disorders. PMID:27405682

  20. Selective serotonin reuptake inhibitors and the risk of bleeding

    Directory of Open Access Journals (Sweden)

    Padma L

    2013-06-01

    Full Text Available Background: Selective serotonin reuptake inhibitors (SSRIs are commonly prescribed agents for various conditions in general psychiatry. There is a strong consensus that blockade of serotonin reuptake affects primary hemostasis, namely platelet activity, thus resulting in a bleeding tendency. Considering that SSRIs are commonly prescribed, this study was conducted to assess if they were associated with an increased risk of bleeding. Methods: This was a prospective, open-label study of 30 patients attending the Psychiatry out-patient department, Dr. B. R. Ambedkar Medical College, Bangalore who satisfied DSM-IV criteria for a primary diagnosis of depression, treated with SSRIs. Bleeding time, clotting time, prothrombin time, partial thromboplastin time and platelet count were assessed at baseline and at the end of 6 weeks of treatment or occurrence of bleeding symptom. Results: The patients aged between 18-55 years of whom 21 were females, were treated with an SSRI (fluoxetine 12, escitalopram 12 and sertraline 6 patients. Six patients had overt symptoms of bleeding (upper gastrointestinal bleeding (hematemesis 4; epistaxis 2 and petechiae 2 of whom one patient gave a history of both hematemesis and petechiae and another of hematemesis and epistaxis. The average day after treatment beginning, on which patients reported with bleeding was 30.33 (26-40 days. There was a significant increase in the bleeding time (p=0.028 and clotting time (p=0.042, implying derangement in platelet aggregation. There was no significant change in the other parameters. Conclusion: Treatment with SSRIs increases the risk of bleeding. However, large, randomized controlled trials are required to re-affirm these findings. [Int J Basic Clin Pharmacol 2013; 2(3.000: 272-274

  1. National and Regional Scale Rice Crop Monitoring in Asia with the RIICE and PRISM Projects: From Research to Operation

    Science.gov (United States)

    Nelson, A.; Quicho, E. D.; Maunahan, A. A.; Setiyono, T. D.; Raviz, J. V.; Rala, A. B.; Laborte, A. G.; Holecz, F.; Collivignarelli, F.; Gatti, L.; Barbieri, M.; Mabalay, M. R. O.; De Dios, J. L.; Quilang, E. J. P.

    2015-12-01

    In recent years, remote sensing based mapping and monitoring of the rice crop have been demonstrated in many pilot studies and research sites - mainly in Asia - using both optical and SAR sensors and ground based observations. These efforts have been partly driven by the high demand for more timely, more detailed and more accurate information on the rice crop for applications in both public and private sector, such as food security policy, crop and land management, infrastructure investment and crop insurance. The basic premise being that better access to better information leads to eventual benefits for both producers and consumers through better investment and management at all levels. To realise these benefits means scaling up this work to national and regional levels. This presentation summarises the progress of two related projects in Asia: RIICE (Remote Sensing-based Information and Insurance in emerging Economies) and PRISM (Philippine Rice Information SysteM) that are making the transition from research to operation with the support of national governments and international donors. The presentation focuses on the technology, the partnerships, the achievements and the challenges in embedding both the capacity and the technology for remote sensing based monitoring of rice in countries in South and South East Asia. We highlight several aspects which are essential for a successful transition to a sustainable operational status and lessons learned in each country where the two projects have been operating.

  2. Improving vehicle adaptability to the operating conditions of «smart» cities in the northern regions

    Directory of Open Access Journals (Sweden)

    Anisimov Ilya

    2016-01-01

    Full Text Available The paper reviews a relevant problem of providing a higher quality of people’s living in the northern regions by the application of the modern technologies within transport in order to improve its environmental performance and efficiency. The aim of the research is to substantiate methods of increasing the adaptability of vehicles to variable low-temperature operating conditions based on a neural control system of preheating and maintaining the optimum temperature of technological fluids by SHF radiation and improving diesel fuel properties by introducing a multifunctional additive. It has been found that SHF radiation influences the physical and chemical parameters of diesel fuel, as well as the engine output parameters. SHF radiation results in a reduction of fuel consumption to 7%, smoke from the exhaust to 15%, and nitrogen oxide emission to 30%. A conclusion is made that using SHF radiation for technological fuel preheating is essential. An approach has been developed that improves low-temperature properties of diesel fuels and increases engine operation efficiency under severe climatic conditions by introducing a multifunctional additive. The additive will enable a significant decrease in fuel consumption under low-temperature operating conditions and a complex improvement of fuel properties.

  3. Clival chordoma manifesting as nasal bleeding. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kitai, Ryuhei; Yoshida, Kazuhiko; Kubota, Toshihiko; Sato, Kazufumi; Handa, Yuji; Kasahara, Kazuma [University of Fukui, Department of Neurosurgery, Fukui (Japan); Nakajima, Hirofumi [Tsuruga Municipal Hospital, Department of Neurosurgery, Fukui (Japan)

    2005-05-01

    Chordoma is a rare cartilaginous tumor, for which bleeding presentation is unusual. We report a case of rare hemorrhaged clival chordoma, which was diagnosed correctly by magnetic resonance imaging. A 32-year-old man presented with nasal bleeding. The tumor was totally removed via a trans-sphenoidal approach, from which the surgical specimen confirmed chordoma. Epistaxis seemed to be caused by the spreading of the intratumoral hemorrhage into the sphenoid sinus. This case demonstrates the importance of an exact differential diagnostic evaluation, including chordoma, by use of modern imaging techniques for nasal bleeding. (orig.)

  4. ULTRASONOGRAPHIC EVALUATION OF PREGNANCY WITH BLEEDING PER VAGINA

    Directory of Open Access Journals (Sweden)

    Amit C

    2014-12-01

    Full Text Available This study of 150 patients presenting with bleeding per vagina in first, second & third trimester was conducted to evaluate the cause of bleeding, access the severity of condition, to predict the later coarse of pregnancy & to evaluate the role of ultrasonography in management. This study was conducted in department of Radiology at Basaweshwar Teaching & General hospital, Government general hospital & Sangameshwer teaching & General hospital. This study concludes that, Ultrasonography should be the first line of investigation in all the cases of bleeding per vagina in pregnancy

  5. Interventional angiography in the diagnosis of acute lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Interventional angiography with the use of indwelling arterial catheters, anticoagulants, vasodilators and fibrinolytic agents, complements conventional angiography in the diagnosis of acute lower gastrointestinal bleeding. These interventional techniques prolong, augment or reactive bleeding and, by enabling better timing of examinations, they increase the diagnostic efficacy of angiography. In the reported series of 63 patients with acute lower gastrointestinal hemorrhage, interventions increased the diagnostic yield of angiography for demonstration of extravasation from 32% to 65% and decreased the percentage of negative angiograms from 27% to 16%. Indications, techniques and risks of interventional angiography in the diagnosis of acute lower gastrointestinal bleeding are discussed. (orig.)

  6. Scintigraphic demonstration of gastrointestinal bleeding due to mesenteric varices

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, M.E.; Coleman, R.E. (Duke Univ. Medical Center, Durham, NC (USA))

    1990-07-01

    Mesenteric varices can appear as massive, acute lower gastrointestinal bleeding. The small bowel or colon may be involved, varices usually developing at sites of previous surgery or inflammation in patients with portal hypertension. Two patients with alcoholic cirrhosis and protal hypertension presented with rectal bleeding. Tc-99m RBC studies demonstrated varices and extravasation into the adjacent bowel. The varices were documented by mesenteric angiography. Characteristic features of Tc-99m labeled RBC studies can identify mesenteric varices as the cause of intestinal bleeding and localize the abnormal vessels.

  7. Risk of bleeding related to antithrombotic treatment in cardiovascular disease

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette;

    2012-01-01

    Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without...

  8. Embolization of Bleeding Stomal Varices by Direct Percutaneous Approach

    International Nuclear Information System (INIS)

    Stomal varices can occur in patients with stoma in the presence of portal hypertension. Suture ligation, sclerotherapy, angiographic embolization, stoma revision, beta blockade, portosystemic shunt, and liver transplantation have been described as therapeutic options for bleeding stomal varices. We report the case of a 21-year-old patient with primary sclerosing cholangitis and colectomy with ileostomy for ulcerative colitis, where stomal variceal bleeding was successfully treated by direct percutaneous embolization. We consider percutaneous embolization to be an effective way of treating acute stomal bleeding in decompensated patients while awaiting decisions regarding shunt procedures or liver transplantation.

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

    Science.gov (United States)

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

    2007-03-01

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

  10. Prediction of bleeding and prophylactic platelet transfusions in cancer patients with thrombocytopenia

    DEFF Research Database (Denmark)

    Vinholt, Pernille J; Alnor, Anne; Nybo, Mads;

    2016-01-01

    platelet transfusion within 30 days were registered. Of 197 patients enrolled, 56 (28%) experienced bleeding. In multivariate analyses, predictors of bleeding were infection (adjusted odds ratio (OR) = 2.65 and 95% confidence interval (95% CI) 1.04-6.74); treatment with platelet inhibitors, heparin...... platelet transfusion but not bleeding. Bleeding risk factors were previous haematuria or gastrointestinal bleeding, infection, antiplatelet or anticoagulant treatment, high urea nitrogen, low haemoglobin or high creatinine.......Studies on markers for bleeding risk among thrombocytopenic cancer patients are lacking. This prospective observational cohort study investigated whether platelet parameters and a standardised bleeding questionnaire predicted bleeding or prophylactic platelet transfusions in patients with cancer...

  11. The Mechanism of Stall Margin Improvement in a Centrifugal Compressor with the Air Bleeding Circumferential Grooves Casing Treatment

    Science.gov (United States)

    Gao, P.; Chu, W. L.; Wu, Y. H.

    The air bleeding circumferential grooves casing treatment has the potential to extent the operating range of centrifugal compressor with no loss in efficiency. A time accurate 3-dimentional numerical simulation was performed in a low speed centrifugal compressor with the air bleeding circumferential grooves casing treatment. The numerical results agreed well with experimental test data for the global performance. Detailed analyses of the flow visualization at the tip of blades have exposed the different tip flow topologies between the cases with casing treatment and with untreated smooth wall, and the reasons how the second flow vortex is retrained. The mechanism of stall margin improvement is gained finally.

  12. Bleeding management in remote environment: the use of fresh whole blood transfusion and lyophilised plasma.

    Science.gov (United States)

    Sicard, Bruno; Marouzé, Frédéric; Roche, Céline; Carron, Mathieu; Ausset, Sylvain; Sailliol, Anne

    2016-01-01

    To mitigate medical risks in remote environments, the authors have implemented an innovative integrated medical support solution for bleeding management on board ships since 2013. Fresh whole blood transfusion (FWBT) and lyophilised plasma were put in place to address life threatening haemorrhages in maritime operations in the Arctic and Antarctica. The authors are illustrating the bleeding risks with an actual case occurring in Antarctica prior to the implementation of these procedures. They are presenting the different steps involved in the complex process of FWBT, from blood donors' qualifications to actual transfusions. The pros and cons of blood transfusion in extreme remote environment are discussed, including the training of health care professionals, equipment requirements, legal and ethical issues, decision making in complex blood group matching, medical benefits and risks. PMID:27364172

  13. Septic Bleeding of the Common Carotid Artery Following Total Thyroidectomy: An Atypical Complication

    Directory of Open Access Journals (Sweden)

    T. Jamaan

    2010-01-01

    Full Text Available Septic rupture of the common carotid artery following total thyroidectomy may rapidly lead to exsanguination. We present a case report of a 16-year-old girl, diagnosed with a questionable thyroglossal duct cyst. Following the initial operative intervention with local excision of the cyst including resection of the medial part of the hyoid bone, pathology revealed papillary carcinoma. Thus secondary total thyroidectomy with locoregional lymphadenectomy was performed. One week later, a wound infection developed, necessitating lavage and drainage. On the 8th postoperative day, a dramatic bleeding of the right common carotid artery occurred. To our knowledge, this is the first reported case in the literature with a septic bleeding of the common carotid artery following total thyroidectomy after one week.

  14. Interventional embolization with coils for the treatment of surgical stoma bleeding caused by portal hypertension: a therapeutic analysis

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and safety of interventional embolization with coils in treating surgical stoma bleeding caused by portal hypertension. Methods: From February 2008 to May 2010, the authors treated eight patients with surgical stoma bleeding associated with portal hypertension. The patients included 5 females and 3 males, with a mean age of 57 years. The diagnosis was confirmed preoperatively by enhanced CT scanning and vascular reconstruction, and was further verified by angiography after operation. All patients were treated with coil embolization. The percutaneous transhepatic catheterization was performed, after that the catheter was manipulated to pass portal vein into the tortuous dilated mesenteric vein. The bleeding veins were occluded with gelatin sponge, and the spleen was embolized at the same time. The patients were followed up for two months to two years. Based on CT angiographic manifestations, color-Doppler ultrasound findings and clinical conditions the therapeutic results were evaluated. Results: Technical success with single procedure was achieved in all eight patients, the hemostasis rate was 100%. No serious complications occurred. During the follow-up period no recurrent bleeding of the surgical stoma was seen. Conclusion: For the treatment of surgical stoma bleeding caused by portal hypertension interventional embolization with coils is a safe and effective technique. It is worth popularizing this method in clinical practice. (authors)

  15. Capacity Building for Rare Bleeding Disorders in the Remote Commonwealth of the Northern Mariana Islands.

    Science.gov (United States)

    Lin, Tiffany F; Carhill, Pam; Huang, James N; Baker, Judith R

    2016-04-01

    The US Pacific Commonwealth of the Northern Mariana Islands is home to an underserved hemophilia population. We developed a strategy in 2014 to build sustainable island-wide medical, patient and family, and community support for this rare disease. Collaboration with regional bleeding disorder leadership galvanized a weeklong conference series. More than 200 participants attended discipline-specific seminars; pre-post test evaluations documented educational benefits. This time-concentrated island-wide education intervention promoted the rapid identification of new cases and stimulated sustainable bleeding disorder care development. The education series proved feasible, efficient, and effective in increasing knowledge and reducing patient and professional isolation, serving as a model for improving capacity for orphan diseases (those that affect fewer than 200 000 people in any particular country) in underresourced areas. PMID:26890163

  16. The р53 expression in cells of marginal zone of duodenal ulcers during acute bleeding

    Directory of Open Access Journals (Sweden)

    Sulayeva O.N.

    2009-01-01

    Full Text Available The aim of the work was to estimate the intensity and tissue distribution of proapoptogen p53 expression in duodenal mucosa in patients with acute bleeding caused by peptic ulcers. In 31 patients (1st group the healing of ulcer was detected after effective endoscopic hemostasis and in 15 patients rebleeding took place (2nd group. Performed immunocytochemical investigation allow to determine that acute ulcer bleeding was associated with activation of marginal zone cells apoptosis which was maximal in covering epithelium, vascular endothelium and regions infiltrated by lymphocytes. In patients with rebleeding the higher values of р53 expression were detected in crypts epithelium and in endothelium of dilatating vessels accompanied with intensive edema and lymphocytes infiltration of lamina propria and muscularis mucosae with perifocal activation of cells death. Additionally to apoptosis in 2nd group duodenum the necrosis of cells and epithelium desquamation were found, reflecting the tissue disintegration of duodenal mucosa.

  17. Controlling Bleeding from Proximal and Coronary Ostial Anastomoses by Using Blood Cardioplegia Delivering Antegradely while Performing Bentall Procedure

    Directory of Open Access Journals (Sweden)

    Erol Şener

    2011-04-01

    Full Text Available Bentall procedure is one of the valved conduit techniques which is used in the treatment of aortic valve diseases accompanied by ascending aortic aneurysm and dissection and it is used commonly around the world. In Bentall procedure, which is a complicated and long surgery, the rate of mortality and morbidity are not only related to the operation itself but also to the complications like major neurological events, myocardial damage and bleeding which take place during the intraoperative and postoperative period. Although the quantity and frequency of bleeding is declined with teflon strips and biological tissue glues, modifications of Bentall procedure are still an important problem. This study was conducted retrospectively with 48 patients in terms of early results of complication of bleeding caused specifically by proximal suture line and coronary ostium anastomosis lines controlled by the method of blood cardioplegia while performing Bentall procedure and supracoronary aort replacement in our clinic.

  18. Anode reactive bleed and injector shift control strategy

    Science.gov (United States)

    Cai, Jun [Rochester, NY; Chowdhury, Akbar [Pittsford, NY; Lerner, Seth E [Honeoye Falls, NY; Marley, William S [Rush, NY; Savage, David R [Rochester, NY; Leary, James K [Rochester, NY

    2012-01-03

    A system and method for correcting a large fuel cell voltage spread for a split sub-stack fuel cell system. The system includes a hydrogen source that provides hydrogen to each split sub-stack and bleed valves for bleeding the anode side of the sub-stacks. The system also includes a voltage measuring device for measuring the voltage of each cell in the split sub-stacks. The system provides two levels for correcting a large stack voltage spread problem. The first level includes sending fresh hydrogen to the weak sub-stack well before a normal reactive bleed would occur, and the second level includes sending fresh hydrogen to the weak sub-stack and opening the bleed valve of the other sub-stack when the cell voltage spread is close to stack failure.

  19. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    Directory of Open Access Journals (Sweden)

    Zeytunlu Murat

    2009-01-01

    Full Text Available Abstract Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding.

  20. Post-biliary sphincterotomy bleeding despite covered metallic stent deployment

    Science.gov (United States)

    Donatelli, Gianfranco; Cereatti, Fabrizio; Dumont, Jean-Loup; Dhumane, Parag; Tuszynski, Thierry; Vergeau, Bertrand Marie; Meduri, Bruno

    2016-01-01

    Objectives: Several endoscopic techniques have been proposed for the management of post-sphincterotomy bleeding. Lately, self-expandable metal stents deployment has gained popularity especially as a rescue therapy when other endoscopic techniques fail. Methods-results: We report the case report of a massive post-sphincterotomy bleeding in a patient with a self-expandable metal stent in the biliary tree. Despite the presence of a correctly positioned self-expandable metal stent, a new endoscopic session was required to control the bleeding. Conclusions: Self-expandable metal stent may be useful to manage post-endoscopic sphincterotomy bleeding. However, up to now there is no specifically designed self-expandable metal stent for such complication. Large new designed self-expandable metal stent may be a useful tool for biliary endoscopist. PMID:27489716

  1. Fibrinogen concentrates for bleeding trauma patients: what is the evidence?

    DEFF Research Database (Denmark)

    Meyer, Martin; Ostrowski, S R; Windeløv, N A;

    2011-01-01

    A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions....

  2. Modern issues on the treatment of peptic ulcer bleedings

    Directory of Open Access Journals (Sweden)

    Potakhin S.N.

    2014-03-01

    Full Text Available Despite the success of therapeutic treatment of peptic ulcer and the introduction of endoscopic technologies, the problem of peptic ulcer hemorrhage remains valid. A large number of publications in foreign literature are dedicated to epidemiology and prevention of bleeding, evaluation of modern tactics and search for new methods of treatment. The works relating to organization of aid to patients with peptic ulcer bleeding are of particular interest. According to the recent data not all clinics even in economically developed countries manage to follow the recommendations of an international consensus-2010 for non-variceal bleeding treatment of upper gastrointestinal tract. Among the causes of non-compliance of international recommendations there are subjective and objective factors, the understanding of which can significantly affect the optimization of aid to patients with peptic ulcer bleeding.

  3. Risk of bleeding related to antithrombotic treatment in cardiovascular disease

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Olesen, Jonas B; Charlot, Mette;

    2012-01-01

    Antithrombotic therapy is a cornerstone of treatment in patients with cardiovascular disease with bleeding being the most feared complication. This review describes the risk of bleeding related to different combinations of antithrombotic drugs used for cardiovascular disease: acute coronary...... syndrome (ACS), atrial fibrillation (AF), cerebrovascular (CVD) and peripheral arterial disease (PAD). Different risk assessment schemes and bleeding definitions are compared. The HAS-BLED risk score is recommended in patients with AF and in ACS patients with AF. In patients with ACS with or without...... a stent dual antiplatelet therapy with a P2Y12 receptor antagonist and acetylsalicylic acid (ASA) is recommended for 12 months, preferable with prasugrel or ticagrelor unless there is an additional indication of warfarin or increased risk of bleeding. In patients with AF, warfarin is recommended...

  4. Pregnancy Complications: Bleeding and Spotting from the Vagina

    Science.gov (United States)

    ... problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb ... is a sign of a serious problem, like: Miscarriage . Almost all women who miscarry have bleeding or ...

  5. Recent trends of study on esophageal variceal bleeding

    Institute of Scientific and Technical Information of China (English)

    CHENG Liu-fang; LI Chang-zheng

    2010-01-01

    @@ Esophageal variceal bleeding (EVB), a severe complication and main mortality cause of portal hypertension, had reached a relatively mature stage in its research. The mortality rate of EVB within 5 days showed decreased tendency in recent years, which may be due to wide adoption of endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS).1 Endoscopic treatment had been widely used because of its simple procedure, high hemostasis rate and low recurrent bleeding rate, and had become a main measure in cease of first episode and prevention of recurrent bleeding. The technique of endoscopic procedures had less progress in the last 5 years. Recent studies on EVB mainly focused on further improvement of clinical outcome, including primary prevention by EVL, selection and combination of different hemostatic measures, minimizing complications, better long-term management and forecast of bleeding risk.

  6. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops.

    Science.gov (United States)

    Sawant, Abhijeet D; Shah, Rasik; Shah, Nitin; Gupta, Tarun

    2016-01-01

    Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia. PMID:27170918

  7. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops

    Directory of Open Access Journals (Sweden)

    Abhijeet D Sawant

    2016-04-01

    Full Text Available Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  8. Magnetic structure in the entrance region of spheromaks sustained by a magnetized coaxial plasma gun under long pulse operation

    International Nuclear Information System (INIS)

    The magnetic structure in coaxial-gun-sustained spheromaks has been investigated. The plasma gun has been operated with a small axial/radial bias magnetic flux as compared to the azimuthal magnetic flux produced by the discharge current. Stronger magnetic field is observed in the entrance region (ER) than in the flux conserver (FC). In both ER and FC, the magnetic structure is nearly axisymmetric. The axial magnetic field in ER is amplified up to about sixteen times as large as the bias magnetic field. This amplification is limited by the drastic change in the magnetic structure, which occurs when the discharge current becomes very large. The magnetic structure before the drastic change is interpreted with the Bessel function model. The μ estimation shows that the magnetic structure is mainly determined by the boundary geometry, not by the external magnetic flux and current. (author)

  9. Developing skills and competence of employees of the Kujawsko-Pomorskie regional operational programme managing body – research findings

    Directory of Open Access Journals (Sweden)

    Małgorzata Michalcewicz-Kaniowska

    2011-01-01

    Full Text Available In the contemporary world it is the employees or the human capital of any company who are responsible for effective management and caring for the future of their business. Organisations change all the time which means that continual staff training should be provided. The purpose of the research was to evaluate the training policy of the managing body of the Kujawsko-Pomorskie Regional Operational Programme (IZ RPO WK-P and its employees’ development potential. The research participants preferred mentoring (47%, coaching (27% and briefing (26% techniques. They also benefited from a range of educational techniques such as training courses, post-graduate studies etc. and a wide choice of subjects. Thus, it is necessary to conduct periodic research on training requirements, focusing on subjects and training techniques.

  10. Ohio's statewide land use inventory: An operational approach for applying LANDSAT data to state, regional and local planning programs

    Science.gov (United States)

    Baldridge, P. E.; Geosling, P. H.; Leone, F.; Minshall, C.; Rodgers, R. H.; Wilhelm, C. L.

    1975-01-01

    The programmatic, technical, user application, and cost factors associated with the development of an operational, statewide land use inventory from LANDSAT data are described. The LANDSAT multispectral data are subjected to geometrical and categorical processing to produce map files for each of the 200 fifteen (15) minute quads covering Ohio. Computer compatible tapes are rescanned to produce inventory tapes which identify eight (8) Level I land use categories and a variety of Level II categories. The inventory tapes are processed through a series of ten (10) software programs developed by the State of Ohio. The net result is a computerized inventory which can be displayed in map or tabular form for various geographic units, at a variety of scales and for selected categories of usage. The computerized inventory data files are applied to technical programs developed by the various state agencies to be used in state, regional, and local planning programs.

  11. Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    Ram; Elazary; Mahmoud; Abu-Gazala; Avraham; Schlager; Noam; Shussman; Avraham; I; Rivkind; Allan; I; Bloom

    2010-01-01

    We present the case of an 18-year-old female transferred to our center from an outside hospital due to persistent gastrointestinal bleeding. Two weeks prior to her transfer she underwent duodenal omentopexy for a perforated duodenal peptic ulcer. The patient underwent a computed tomography angiogram which identified the source of bleeding as a giant gastroduodenal artery (GDA) pseudoaneurysm. The patient was taken to interventional radiology where successful microcoil embolization was performed. We present ...

  12. Transarterial embolization for management of severe postcoital bleeding

    Directory of Open Access Journals (Sweden)

    Armen Eskandari

    2016-08-01

    Full Text Available Objectives: Postcoital bleeding is an uncommon cause of gynecologic hemorrhage; however, it can be severe in a majority of cases necessitating surgical management. Methods: We report a case of severe postcoital bleeding in a young woman requiring blood transfusion. Results: Hemostasis was achieved using subselective embolization of cervical artery by metallic coils. Conclusion: Our case demonstrates a minimally invasive treatment for control of non-obstetric hemorrhage.

  13. Double-balloon enteroscopy in detecting small intestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    ZHI Fa-chao; PAN De-shou; ZHOU Dian-yuan; XIAO Bing; JIANG Bo; WAN Tian-mo; GUO Yu; ZHOU Dan; WANG Li-hui; CHEN Jin-feng; XIE Lu

    2005-01-01

    @@ Digestive tract hemorrhage is a common disease of the digestive system, but about 0.4%-5% intestinal bleeding can not be detected with gastroscope or colonscope.1 Since the intestine is long, tortuous, far away from both ends of the digestive tract and unfixed in position, clinical diagnosis of the bleeding is relatively difficult. Yamamoto and Sugano2 reported the clinical application of double-balloon enteroscope at American DDW in 2003.

  14. The Significance of Small Cerebral Bleeds in Neurodegenerative Dementia Syndromes

    OpenAIRE

    De Reuck, Jacques L.

    2012-01-01

    Small cerebral bleeds are frequently observed in brains of patients with Alzheimer disease (AD) and cerebral amyloid angiopathy (CAA). However, they are also observed in patients with other neurodegenerative dementias and in persons without cognitive impairment. The aim of this survey is to compare the bleeding load in brains with different dementia syndromes and in age-matched controls. Hundred sixty-five brains were examined. The prevalence and the severity of the different cerebrovascular ...

  15. Fibrinogen concentrates for bleeding trauma patients: what is the evidence?

    DEFF Research Database (Denmark)

    Meyer, Martin; Ostrowski, S R; Windeløv, N A;

    2011-01-01

    A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions.......A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions....

  16. Fallot′s tetralogy presenting with variceal bleed.

    Directory of Open Access Journals (Sweden)

    Kejariwal D

    2001-07-01

    Full Text Available The erythrocytosis of Fallot′s tetralogy may lead to spontaneous thrombosis at any site, but splenic vein thrombosis and variceal bleed is rarely a presentation of Fallot′s tetralogy. A case of a 48 years old female with undiagnosed Fallot′s tetralogy, presenting with variceal bleed due to splenic vein thrombosis, is reported. It is also interesting to note that the patient survived till this age without any medical or surgical treatment.

  17. Practical Approach to Endoscopic Management for Bleeding Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Suk [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Bleeding from gastric varices is generally more severe than bleeding from esophageal varices, although it occurs less frequently. Recently, new endoscopic treatment options and interventional radiological procedures have broadened the therapeutic armamentarium for gastric varices. This review provides an overview of the classification and pathophysiology of gastric varices, an introduction to current endoscopic and interventional radiological management options for gastric varices, and details of a practical approach to endoscopic variceal obturation using N-butyl-2-cyanoacrylate.

  18. Lessons Learned from Animal Models of Inherited Bleeding Disorders

    OpenAIRE

    Nichols, Timothy C.

    2014-01-01

    Advances in treatment of hemophilia and von Willebrand disease (VWD) depend heavily on the availability of well-characterized animal models. These animals faithfully recapitulate the severe bleeding phenotype that occurs in humans with these inherited bleeding disorders. Research in these animal models represents important early and intermediate steps of translational research aimed at addressing current limitations in treatment such as the development of inhibitory antibodies to coagulation ...

  19. Prolonged bleeding on the neck in leech therapy: Case report

    OpenAIRE

    Atakan Savrun; Selim Bozkurt; Mehmet Okumus; Emre Gokcen; Murat Turkaslan

    2015-01-01

    Superficial skin bleeding can usually be stopped by applying short-time compression, unless the patient suffers from coagulation disorders or uses anticoagulant. Because of the anticoagulant component of leech saliva, a leech bite may cause long-time bleeding, which cannot be stopped via compression. In this study, the case of a patient who applied leech therapy on her neck for the treatment of migraine has been presented. [Arch Clin Exp Surg 2015; 4(4.000): 234-237

  20. An unusual cause of upper gastrointestinal system bleeding: Duodenal varices

    OpenAIRE

    Yılmaz, Ömer; Ataseven, Hilmi

    2012-01-01

    Abstract Duodenal varices are an uncommon site of hemorrhage in patients with portal hypertension, but their rupture is a serious and often fatal event. We report the case of a 27- year- old man with liver cirrhosis who presented with upper gastrointestinal bleeding. Upper gastrointestinal endoscopy revealed nodular varices in the second portion of the duodenum which were considered to be the source of bleeding. We decided to inject N-butyl-2-cyanoacrylate (Histoacryl), an adhesive agent, and...

  1. Endoscopic Removal of an Unusual Foreign Body Causing Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    A. Karaman

    2010-09-01

    Full Text Available Foreign body ingestion is a condition more common in the pediatric population than in adults. In adults, although foreign body ingestion can be well tolerated, approximately 10–20% of patients require endoscopic intervention. Delayed diagnosis and unremoved foreign bodies can cause serious and fatal complications including perforation, fistula and gastrointestinal bleeding. Here we report a patient with bleeding duodenal ulcer thought to be initiated by a large foreign body.

  2. The Text of the Regional Co-operative Agreement for Research, Development and Training related to Nuclear Science and Technology, 1987

    International Nuclear Information System (INIS)

    The text of the Regional Co-operative Agreement for Research, Development and Training Related to Nuclear Science and Technology, 1987 (the 1987 RCA), is reproduced herein for the information of all Members

  3. CASE STUDIES OF CROSS-BORDER CO-OPERATION IN EUROPEAN TOURISM – PERSPECTIVES AND CHALLENGES FOR THE CROSS-BORDER REGION BUCOVINA/OBLAST TSCHERNIWZI

    OpenAIRE

    HEIKE BÄHRE

    2016-01-01

    The article focuses on success factors and management models in destination management for cross-border co-operation in tourism. The method is based on literature research, case-studies in European cross-border-regions and descriptive.

  4. Diagnosis and therapy of non-variceal upper gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Erwin; Biecker

    2015-01-01

    Non-variceal upper gastrointestinal bleeding(UGIB) is defined as bleeding proximal to the ligament of Treitz in the absence of oesophageal, gastric or duodenal varices. The clinical presentation varies according to the intensity of bleeding from occult bleeding to melena or haematemesis and haemorrhagic shock. Causes of UGIB are peptic ulcers, Mallory-Weiss lesions,erosive gastritis, reflux oesophagitis, Dieulafoy lesions or angiodysplasia. After admission to the hospital a structured approach to the patient with acute UGIB that includes haemodynamic resuscitation and stabilization as well as pre-endoscopic risk stratification has to be done. Endoscopy offers not only the localisation of the bleeding site but also a variety of therapeutic measures like injection therapy, thermocoagulation or endoclips. Endoscopic therapy is facilitated by acid suppression with proton pump inhibitor(PPI) therapy. These drugs are highly effective but the best route of application(oral vs intravenous) and the adequate dosage are still subjects of discussion. Patients with ulcer disease are tested for Helicobacter pylori and eradication therapy should be given if it is present. Non-steroidal antiinflammatory drugs have to be discontinued if possible. If discontinuation is not possible, cyclooxygenase-2 inhibitors in combination with PPI have the lowest bleeding risk but the incidence of cardiovascular events is increased.

  5. Liquefied Bleed for Stability and Efficiency of High Speed Inlets

    Science.gov (United States)

    Saunders, J. David; Davis, David; Barsi, Stephen J.; Deans, Matthew C.; Weir, Lois J.; Sanders, Bobby W.

    2014-01-01

    A mission analysis code was developed to perform a trade study on the effectiveness of liquefying bleed for the inlet of the first stage of a TSTO vehicle. By liquefying bleed, the vehicle weight (TOGW) could be reduced by 7 to 23%. Numerous simplifying assumptions were made and lessons were learned. Increased accuracy in future analyses can be achieved by: Including a higher fidelity model to capture the effect of rescaling (variable vehicle TOGW). Refining specific thrust and impulse models ( T m a and Isp) to preserve fuel-to-air ratio. Implementing LH2 for T m a and Isp. Correlating baseline design to other mission analyses and correcting vehicle design elements. Implementing angle-of-attack effects on inlet characteristics. Refining aerodynamic performance (to improve L/D ratio at higher Mach numbers). Examining the benefit with partial cooling or densification of the bleed air stream. Incorporating higher fidelity weight estimates for the liquefied bleed system (heat exchange and liquid storage versus bleed duct weights) could be added when more fully developed. Adding trim drag or 6-degree-of-freedom trajectory analysis for higher fidelity. Investigating vehicle optimization for each of the bleed configurations.

  6. Ultrasound contrast agents for bleeding detection and acoustic hemostasis

    Science.gov (United States)

    Zderic, Vesna; Luo, Wenbo; Brayman, Andrew; Crum, Lawrence; Vaezy, Shahram

    2005-04-01

    Objective: To investigate the application of ultrasound contrast agents (UCA) in improving both therapeutic and diagnostic aspects of ultrasound-guided High Intensity Focused Ultrasound (HIFU) therapy. Methods: Incisions (3 cm long, 0.5 cm deep) were made in rabbit livers (in anterior surface for HIFU treatment, or posterior surface for bleeding detection). UCA Optison (~0.1 ml/kg) was injected into mesenteric vein or ear vein. A HIFU applicator (5.5 MHz, 6400 W/cm2) was scanned manually over the incision until hemostasis was achieved. Occult bleeding was monitored with Doppler ultrasound. Results: The presence of Optison produced 37% reduction in hemostasis times normalized to initial bleeding rates. Gross and histological observations showed similar appearance of HIFU lesions produced in the presence of Optison and control HIFU lesions. The temperature reached 100°C in both HIFU only and HIFU+UCA treatments. Tension strength of hemostatic liver incisions was 0.9+/-0.5 N. Almost no bleeding could be detected before Optison injection. First appearance of contrast enhancement localized at the bleeding site was 15 s after Optison injection, and lasted for ~50 s. Conclusion: The presence of UCA during HIFU treatment of liver incisions resulted in shortening of HIFU application times and better visualization of bleeding sites.

  7. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  8. Studies on supratentorial subdural bleeding using a porcine model.

    Science.gov (United States)

    Zwetnow, N N; Orlin, J R; Wu, W H; Tajsic, N

    1993-01-01

    A porcine model for an acute lethal arterial subdural bleeding in man is presented. Blood from the abdominal aorta was led via an electronic drop recorder into a collapsed intracranial subdural rubber balloon. Systemic arterial pressure (SAP), two intracranial pressures and 6 other vital parameters were monitored continuously in spontaneously breathing (n = 4) and mechanically ventilated (n = 4) pigs. In both animal groups bleeding caused an immediate rise in intracranial pressures (ICP) with transtentorial pressure gradients developing. As a result the cerebral perfusion pressures (CPP) decreased progressively, leading to an isoelectric EEG. In spontaneously breathing animals, the pressure changes resulted in apnoea within 2-4 minutes, irregularities in heart rhythm and in a marked rise in SAP (the Cushing reaction). A final collapse of all pressures occurred after 222 +/- 68 sec at a mean bleeding volume of 10.3 +/- 1.9 ml. In contrast, in mechanically ventilated animals, the course of bleeding was less dramatic. No change in cardiac rhythm or rise in SAP appeared despite a larger mean bleeding volume (12.0 +/- 1.6 ml). Instead, SAP slowly fell, reaching a level of approximately 40 mm Hg within 1 hour, while CPP concomitantly decreased from 120 mm Hg to 15 mm Hg. The findings in this and in a parallel study are explained in terms of the intracranial volume tolerance concept (Zwetnow et al. 1986). The beneficial effect of assisted ventilation on the course of subdural bleeding is multifactorial, involving both metabolic and mechanical mechanisms. PMID:8475809

  9. Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods

    Science.gov (United States)

    Kataoka, Yosuke; Tsuji, Yosuke; Sakaguchi, Yoshiki; Minatsuki, Chihiro; Asada-Hirayama, Itsuko; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Fujishiro, Mitsuhiro; Koike, Kazuhiko

    2016-01-01

    Endoscopic submucosal dissection (ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection (EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD.

  10. Multidetector computed tomography in acute lower gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    John Palma

    2010-11-01

    Full Text Available John Palma, Marius Mihaila, Frank PilleulDépartement de Radiologie Digestive et des Urgences, Hôpital Edouard Herriot, Hospices Civils de Lyon, CHU, Lyon, FranceBackground: The aim of this study is to evaluate multidetector computed tomography (MDCT in acute massive lower gastrointestinal bleeding, with endoscopy and surgery as reference examinations.Methods: A single-center retrospective study involving 34 patients with acute massive lower gastrointestinal bleeding was carried out. All patients were evaluated by MDCT scan then endoscopic or surgical examinations. Sensitivity, specificity, and positive and negative predictive values of MDCT scan were calculated using the extravasation of the contrast agent as the main criterion.Results: Extravasation of the contrast agent was found in 30 of 34 patients (88%. The bleeding site seen on CT was always the same as on endoscopic or surgical examinations (100%. Sensitivity of MDCT scan was 94%, specificity 100%, positive predictive value 100%, and negative predictive value 50% (P < 0.001. Twelve diverticulum bleedings were seen on MDCT scan compared with 13 (92% on endoscopic or surgical examinations. Angiodysplasia was overestimated by MDCT scan.Conclusion: MDCT scan appears to be an excellent tool to find and localize the bleeding site in cases of acute massive lower gastrointestinal disease.Keywords: MDCT, acute lower gastrointestinal bleeding, extravasation, contrast agent

  11. Land application of waste waters in the Alligator Rivers region, Northern Territory - environmental constraints on design and operation

    International Nuclear Information System (INIS)

    The existing uranium mines in the Alligator River Region presently operate under a no release water management regime for water stored within the designated restricted release zones (RRZ). This water is of variable quality ranging from rainwater influenced by runoff from the mill sites and ore stockpiles to mill process water stored within the trailings repositories. There is a pressing need to reduce the volume of stored RRZ water at Nabarlek as a prerequisite to decommissioning. There is also a requirement at Ranger to rapidly reduce the volume of stored water in the mine pit at the end of the season to allow the mining of ore. Land application of RRZ water by spray irrigation has been investigated at both sites because it offers the benefits of applying chemical constituents in the wastewater within a clearly defined irrigation area. the environmental planning for the design of a land application system involves calculations of the chemical load in the wastewater and evaluation of the assimilative capacity of the soil-plant system. The monsoon climate, lateritic soil and fluctuating water table creates a unique set of environmental constraints and conditions in which to design and operate a successful land application system for the treatment of stored water at minesites within ecologically sensitive areas

  12. Results of the regional intercomparison exercise for the determination of operational quantity Hp(d) in Latin America

    International Nuclear Information System (INIS)

    Full text: Several intercomparison exercises were organized by the International Atomic Energy Agency (IAEA) on the determination of operational quantities at the regional or interregional basis. These exercises revealed significant differences in the approach, methods and assumptions, and consequently in the measurement results obtained by participating laboratories. In the Latin America region, an intercomparison for determination of operational quantity Hp(10), organized within the frame of a technical cooperation regional project, was completed mid-2004, as a follow-up to previous exercises carried out during the 1990s. Eighteen laboratories from 19 member states participated in the first phase; the second phase grouped 15 laboratories from 16 member states. Dosimeter irradiations (5 different radiation qualities for photon simulating workplace fields) were done by 4 Secondary Standards Dosimetry Laboratories (SSDL). The preparations for the exercise involved an audit by the IAEA SSDL, where reference irradiations were provided to all participants for verification of their system. During the first phase (2002/03), only 9 out of 18 laboratories met the performance requirements for such monitoring services. Necessary corrective actions and procedure verification were implemented, and staff involved in these evaluations were subsequently trained. During the second phase (2004), 11 out of 15 laboratories fulfilled the performance criteria. The 4 laboratories still having difficulties in assessing occupational exposure participated in a results meeting, during which problem areas were identified. An ongoing technical cooperation mission is expected to assist these laboratories accordingly. There has been a definite improvement in the second phase and most laboratories demonstrated a good performance in the quantity tested. The technical results clearly show that the laboratories' capability in assessing occupational exposure from external sources of radiation is

  13. 75 FR 25310 - Port Harbor Railroad, Inc.-Lease and Operation Exemption-Line of Tri-City Regional Port District

    Science.gov (United States)

    2010-05-07

    ... Surface Transportation Board Port Harbor Railroad, Inc.--Lease and Operation Exemption--Line of Tri-City Regional Port District Port Harbor Railroad, Inc. (Port Harbor), a noncarrier, has filed a verified notice of exemption under 49 CFR 1150.31 to lease from Tri- City Regional Port District (Tri-City), and...

  14. Ultra-Low-Voltage CMOS-Based Current Bleeding Mixer with High LO-RF Isolation

    Directory of Open Access Journals (Sweden)

    Gim Heng Tan

    2014-01-01

    Full Text Available This journal presents an ultra-low-voltage current bleeding mixer with high LO-RF port-to-port isolation, implemented on 0.13 μm standard CMOS technology for ZigBee application. The architecture compliments a modified current bleeding topology, consisting of NMOS-based current bleeding transistor, PMOS-based switching stage, and integrated inductors achieving low-voltage operation and high LO-RF isolation. The mixer exhibits a conversion gain of 7.5 dB at the radio frequency (RF of 2.4 GHz, an input third-order intercept point (IIP3 of 1 dBm, and a LO-RF isolation measured to 60 dB. The DC power consumption is 572 µW at supply voltage of 0.45 V, while consuming a chip area of 0.97 × 0.88 mm2.

  15. Ultra-low-voltage CMOS-based current bleeding mixer with high LO-RF isolation.

    Science.gov (United States)

    Tan, Gim Heng; Sidek, Roslina Mohd; Ramiah, Harikrishnan; Chong, Wei Keat; Lioe, De Xing

    2014-01-01

    This journal presents an ultra-low-voltage current bleeding mixer with high LO-RF port-to-port isolation, implemented on 0.13 μm standard CMOS technology for ZigBee application. The architecture compliments a modified current bleeding topology, consisting of NMOS-based current bleeding transistor, PMOS-based switching stage, and integrated inductors achieving low-voltage operation and high LO-RF isolation. The mixer exhibits a conversion gain of 7.5 dB at the radio frequency (RF) of 2.4 GHz, an input third-order intercept point (IIP3) of 1 dBm, and a LO-RF isolation measured to 60 dB. The DC power consumption is 572 µW at supply voltage of 0.45 V, while consuming a chip area of 0.97 × 0.88 mm(2). PMID:25197694

  16. Massive upper GI bleeding: A rare complication of Zenker′s diverticulum

    Directory of Open Access Journals (Sweden)

    Haas I

    2008-01-01

    Full Text Available Bleeding from a Zenker′s diverticulum is rare. A 71-year-old man was urgently admitted with massive hematemesis. It was known that he had a Zenker′s diverticulum, but on emergency endoscopy, the source of bleeding was not detected due to large blood clots in the esophagus, hypo-pharynx and also into the tracheal-bronchial tree. Computerized tomography angiography demonstrated a blush of intravenous contrast arising from the diverticulum. The patient was operated upon urgently; the diverticle had a deep ulceration which was the source of the bleeding. The cause of the ulceration is unknown but it is possible that it was caused by the direct effect of an aspirin pill within the diverticle. A similar case with the same conclusion has been published in the past and since the use of aspirin has become common, especially in the elder population, we present this case report to highlight this possible life-threatening complication of Zenker′s diverticulum in patients receiving aspirin.

  17. Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming; Christensen, E;

    1994-01-01

    As identification of patients at risk of bleeding or death is essential for prophylaxis, we determined the prognostic influence of various patient characteristics on the risk of bleeding and death. Fifty-five patients with cirrhosis and oesophageal varices without previous bleeding were included...... a significant relation with an increased risk of bleeding or death: high plasma volume (p varices (p

  18. OPERATIONAL REMOTE SENSING SERVICES IN NORTH EASTERN REGION OF INDIA FOR NATURAL RESOURCES MANAGEMENT, EARLY WARNING FOR DISASTER RISK REDUCTION AND DISSEMINATION OF INFORMATION AND SERVICES

    OpenAIRE

    Raju, P.L.N.; Sarma, K. K.; Barman, D.; B. K. Handique; D Chutia; S. S. Kundu; Das, R. Kr.; Chakraborty, K.; Das, R; Goswami, J.; Das, P; Devi, H. S.; Nongkynrih, J. M.; Bhusan, K.; Singh, M. S.

    2016-01-01

    North Eastern Region (NER) of India comprising of eight states considered to be most unique and one of the most challenging regions to govern due to its unique physiographic condition, rich biodiversity, disaster prone and diverse socio-economic characteristics. Operational Remote Sensing services increased manifolds in the region with the establishment of North Eastern Space Applications Centre (NESAC) in the year 2000. Since inception, NESAC has been providing remote sensing services in gen...

  19. Analysis of the treatment outcomes of esophageal variceal bleeding patients from multiple centers in China

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    This study aimed to investigate the treatment outcomes of esophageal variceal bleeding(EVB)in China.A total of 1087 cases were collected from 19 hospitals in 16 large and medium sized cities across China between January 1st,2005 and January 1st,2006.There were 313 cases(29.0%)of mild(<400 mL),494 cases(45.8%)of moderate(400-1500 mL)and 272 cases(25.2%)of severe (>1500 mL)bleeding.Successful hemostasis was achieved in 89.8% of cases.Seven hundred and eighty-five cases were treated by medication with a hemostasis rate of 91.8%.Seventy-one cases were treated using a SengstakenBlakemore tube with a hemostasis rate of 54.9%.Thirtyseven cases were treated with emergency endoscopic variceal ligation with a hemostasis rate of 83.8%.Seventyseven cases were treated with endoscopic sclerotherapy with a hemostasis rate of 94.8%.Forty-three cases were treated with emergency surgical operation with a hemostasis rate of 95.3%.Sixty-six cases were treated with combined therapy with a hemostasis rate of 97.0%.There was a significant difference(P<0.01)in the successful hemostasis rate between different treatments.The overall mortality was 10.1%,among which 6.6% was directly caused by bleeding.The multivariate logistic regression analysis shows that the severity of bleeding,treatment methods,liver dysfunction and activation of hepatitis were predictive factors for successful hemostasis.Most cases of EVB were mild and moderate in severity.The first-line treatment for EVB is medication.Emergency endoscopic intervention has not been widely available yet.The overall management outcome of EVB has been improved.

  20. Severe renal bleeding caused by a ruptured renal sheath: case report of a rare complication of percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Gunes Ali

    2002-09-01

    Full Text Available Abstract Background Percutaneous nephrolithotomy is a minimally invasive intervention for renal stone disease. Complications, which are rare and usually presented as case reports, are diversified as the utilization of the procedure is expanded. The procedure causes less blood loss and less morbidity when compared to open surgical procedures. Yet, there are some reports involving severe bleeding and relevant morbidity during surgery. These are usually related with the surgical technique or experience of the surgeon. Renal sheaths are designed to cause minimal trauma inside the kidney and, to our knowledge, there are no reports presenting the rupture of a sheath causing severe bleeding during the procedure. Case report We present an adult patient who had severe bleeding during percutaneous nephrolithotomy due to parenchymal injury caused by a ruptured renal sheath. During retrieval, due probably to rough handling of the equipment, a piece of stone with serrated edges ruptured the tip of the sheath, and this tip caused damage inside the kidney. The operation was terminated and measures were taken to control bleeding. The patient was transfused with a total of 1600 ml of blood, and the stones were cleared in a second look operation. Conclusion Although considered to be a minimally invasive procedure, some unexpected complications may arise during percutaneous nephrolithotomy. After being fragmanted, stone pieces may damage surgical equipment, causing acute and severe harm to the kidney. Surgeons must manipulate the equipment with fine and careful movements in order to prevent this situation.

  1. Single vs double antiplatelet therapy in acute coronary syndrome: Predictors of bleeding after coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    Vincenzo; Tarzia; Giacomo; Bortolussi; Edward; Buratto; Carla; Paolini; Carlo; Dal; Lin; Giulio; Rizzoli; Tomaso; Bottio; Gino; Gerosa

    2015-01-01

    AIM:To investigate the contribution of anti-platelet therapy and derangements of pre-operative classical coagulation and thromboelastometry parameters to major bleeding post-coronary artery bypass grafting(CABG).METHODS:Two groups of CABG patients were studied:Group A,treated with aspirin alone(n=50),and Group B treated with aspirin and clopidogrel(n=50).Both had similar preoperative,clinical,biologic characteristics and operative management.Classic coagulation parameters and rotational thromboelastometry(ROTEM)profiles were determined preoperatively for both groups and the same heparin treatment was administered.ROTEM profiles(INTEM and EXTEM assays)were analyzed,both for traditional parameters,and thrombin generation potential,expressed by area-under-curve(AUC).RESULTS:There was no significant difference betweenrates of major bleeding between patients treated with aspirin alone,compared with those treated with aspirin and clopidogrel(12%vs 16%,P=0.77).In the 14 cases of major bleeding,pre-operative classic coagulation and traditional ROTEM parameters were comparable.Conversely we observed that the AUC in the EXTEM test was significantly lower in bleeders(5030±1115 Ohm*min)than non-bleeders(6568±548Ohm*min)(P<0.0001).CONCLUSION:We observed that patients with a low AUC value were at a significantly higher risk of bleeding compared to patients with higher AUC,regardless of antiplatelet treatment.This suggests that thrombin generation potential,irrespective of the degree of platelet inhibition,correlates with surgical bleeding.

  2. Upper gastrointestinal bleeding in Kuala Lumpur Hospital, Malaysia.

    Science.gov (United States)

    Lakhwani, M N; Ismail, A R; Barras, C D; Tan, W J

    2000-12-01

    Despite advancements in endoscopy and pharmacology in the treatment of peptic ulcer disease the overall mortality has remained constant at 10% for the past four decades. The aim of this study was to determine the age, gender, racial distribution, incidence and causes of endoscopically diagnosed cases of upper gastrointestinal (UGI) bleeding to summarise treatments undertaken and to report their outcome. A prospective study of UGI bleeding in 128 patients was performed in two surgical wards of Kuala Lumpur Hospital, involving both elective and emergency admissions. The study group comprised of 113 (88.2%) males and 15 (11.7%) females. The mean age was 51.9 years (range 14 to 85 years) and 37.5% (48 of 128 patients) were older than 60 years. The Indian race was over-represented in all disease categories. Smoking (50.1%), alcohol consumption (37.5%), non-steroidal anti-inflammatory drugs (NSAIDs) (17.2%), traditional remedies (5.5%), anti-coagulants (2.3%) and steroids (0.8%) were among the risk factors reported. Common presenting symptoms and signs included malaena (68.8%), haematemesis (59.4%) and fresh per rectal bleeding (33.6%). The commonest causes of UGI bleeding were duodenal ulcer (32%), gastric ulcer (29.7%), erosions (duodenal and gastric) (21.9%), oesophageal varices (10.9%) and malignancy (3.9%). UGI bleeding was treated non-surgically in 90.6% of cases. Blood transfusions were required in 62.6% (67/107) of peptic ulcer disease patients. Surgical intervention for bleeding peptic ulcer occurred in around 10% of cases and involved under-running of the bleeding vessel in most high risk duodenal and gastric ulcer patients. The overall mortality from bleeding peptic ulcer disease was 4.7%. Six patients died from torrential UGI haemorrhage soon after presentation, without the establishment of a cause. Active resuscitative protocols, early endoscopy, more aggressive interventional therapy, early surgery by more senior surgeons, increasing intensive care unit

  3. Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Jan Yi-Yin

    2006-01-01

    Full Text Available Abstract Background A bleeding pseudoaneurysm in patients with chronic pancreatitis is a rare and potentially lethal complication. Optimal treatment of bleeding peripancreatic pseudoaneurysm remains controversial. This study reports on experience at Chang Gung Memorial Hospital (CGMH in managing of bleeding pseudoaneurysms associated with chronic pancreatitis. Methods The medical records of 9 patients (8 males and 1 female; age range, 28 – 71 years; median, 36 years with bleeding pseudoaneurysms associated with chronic pancreatitis treated at CGMH between Aug. 1992 and Sep. 2004 were retrospectively reviewed. Alcohol abuse (n = 7;78% was the predominant predisposing factor. Diagnoses of bleeding pseudoaneurysms were based on angiographic (7/7, computed tomographic (4/7, ultrasound (2/5, and surgical (2/2 findings. Whether surgery or angiographic embolization was performed was primarily based on patient clinical condition. Median follow-up was 38 months (range, 4 – 87 months. Results Abdominal computed tomography revealed bleeding pseudoaneurysms in 4 of 7 patients (57%. Angiography determined correct diagnosis in 7 patients (7/7, 100%. The splenic artery was involved in 5 cases, the pancreaticoduodenal artery in 2, the gastroduodenal artery in 1, and the middle colic artery in 1. Initial treatment was emergency (n = 4 or elective (n = 3 surgery in 7 patients and arterial embolization in 2. Rebleeding was detected after initial treatment in 3 patients. Overall, 5 arterial embolizations and 9 surgical interventions were performed; the respective rates of success of these treatments were 20% (1/5 and 89% (8/9. Five patients developed pseudocysts before treatment (n = 3 or following intervention (n = 2. Pseudocyst formation was identified in 2 of the 3 rebleeding patients. Five patients underwent surgical treatment for associated pseudocysts and bleeding did not recur. One patient died from angiography-related complications. Overall mortality

  4. Computed tomography angiography in patients with active gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Fatima Regina Silva; D' Ippolito, Giuseppe, E-mail: fatima.rsreis@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Cardia, P.P. [Hospital Vera Cruz, Campinas, SP (Brazil)

    2015-11-15

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. (author)

  5. Management of dabigatran-induced bleeding with continuous venovenous hemodialysis.

    Science.gov (United States)

    Paul, Suman; Hamouda, Danae; Prashar, Rohini; Mbaso, Chiamaka; Khan, Abdur; Ali, Abdulmonam; Shah, Sarthi; Assaly, Ragheb

    2015-06-01

    Dabigatran, a direct thrombin inhibitor, is increasingly used for stroke prevention in patients with non-valvular atrial fibrillation. Dabigatran has a stable pharmacokinetic profile with minimum drug interactions, and requires no routine laboratory evaluation to measure level of anticoagulation. This provides a huge advantage over warfarin, and has the potential to improve patient compliance. The disadvantages of dabigatran are the lack of a reversal agent to counter dabigatran-related bleeding and the absence of a widely available laboratory test that can quantify the extent of coagulopathy in dabigatran overdose. Hemodialysis can rapidly lower dabigatran levels and assist in controlling bleeding secondary to dabigatran overdose. However, in cases in which hemodynamic instability precludes the use of hemodialysis, alternative methods have to be utilized to control dabigatran-associated bleeding. Here we document a case of massive gastrointestinal bleeding secondary to dabigatran use that was successfully managed by continuous venovenous hemodialysis (CVVHD), along with supportive care with blood product transfusions. CVVHD reduces thrombin time and activated partial thrombin time, and causes a parallel decrease in amount of active bleeding. Finally, we show that compared to the rapid lowering of elevated thrombin time observed in hemodialysis, CVVHD requires several days to reduce thrombin time to normal range. PMID:25633777

  6. Computed tomography angiography in patients with active gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Fatima Regina Silva Reis

    2015-12-01

    Full Text Available Abstract Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

  7. Factors affecting hospital mortality in acute upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Alam Mohammed

    2000-01-01

    Full Text Available This retrospective analysis studied the records of 564 consecutive patients admitted to Gastrointestinal Bleeding Unit of Riyadh Medical Complex with acute upper gastrointestinal bleeding over a 2-year period (May 1996-April 1998. The purpose of the study was to analyze the mortality with an aim to identify the risk factors affecting mortality in these patients. Majority of patients were men (82% and Saudis (54%. Their mean age was 52.46 + 17.8 years. Esophageal varices (45% were the main causes of bleeding followed by duodenal ulcers (24%. Overall mortality in this series was 15.8% (89 patients. Comorbid diseases were responsible for death in 68 (76% patients, whereas, bleeding was considered to be directly responsible for death in 21 (24% patients. On analysis of data from this study, old age (>60 years, systolic pressure < 90 mm Hg on admission, comorbid disease, variceal bleeding and Child′s grade C in patients with chronic liver disease were associated with adverse outcome.

  8. Technical Note: An operational landslide early warning system at regional scale based on space-time variable rainfall thresholds

    Science.gov (United States)

    Segoni, S.; Battistini, A.; Rossi, G.; Rosi, A.; Lagomarsino, D.; Catani, F.; Moretti, S.; Casagli, N.

    2014-10-01

    We set up an early warning system for rainfall-induced landslides in Tuscany (23 000 km2). The system is based on a set of state-of-the-art intensity-duration rainfall thresholds (Segoni et al., 2014b), makes use of LAMI rainfall forecasts and real-time rainfall data provided by an automated network of more than 300 rain-gauges. The system was implemented in a WebGIS to ease the operational use in civil protection procedures: it is simple and intuitive to consult and it provides different outputs. Switching among different views, the system is able to focus both on monitoring of real time data and on forecasting at different lead times up to 48 h. Moreover, the system can switch between a very straightforward view where a synoptic scenario of the hazard can be shown all over the region and a more in-depth view were the rainfall path of rain-gauges can be displayed and constantly compared with rainfall thresholds. To better account for the high spatial variability of the physical features, which affects the relationship between rainfall and landslides, the region is subdivided into 25 alert zones, each provided with a specific threshold. The warning system reflects this subdivision: using a network of 332 rain gauges, it allows monitoring each alert zone separately and warnings can be issued independently from an alert zone to another. An important feature of the warning system is the use of thresholds that may vary in time adapting at the conditions of the rainfall path recorded by the rain-gauges. Depending on when the starting time of the rainfall event is set, the comparison with the threshold may produce different outcomes. Therefore, a recursive algorithm was developed to check and compare with the thresholds all possible starting times, highlighting the worst scenario and showing in the WebGIS interface at what time and how much the rainfall path has exceeded or will exceed the most critical threshold. Besides forecasting and monitoring the hazard scenario

  9. Electrodermal screening of biologically active points for upper gastrointestinal bleeding.

    Science.gov (United States)

    Tseng, Ying-Jung; Hu, Wen-Long; Hung, I-Ling; Hsieh, Chia-Jung; Hung, Yu-Chiang

    2014-01-01

    The purpose of this case-control study was to investigate the relationship between the electrical resistance of the skin at biologically active points (BAPs) on the main meridians and upper gastrointestinal bleeding (UGIB). Electrical resistance to direct current at 20 BAPs on the fingers and toes of 100 patients with (38 men, 12 women; mean age [range], 58.20 ± 19.62 [18-83] years) and without (27 men, 23 women; 49.54 ± 12.12 [22-74] years) UGIB was measured through electrodermal screening (EDS), based on the theory of electroacupuncture according to Voll (EAV). Data were compared through analysis of variance (ANOVA), receiver operating characteristic (ROC) curve analysis, and logistic regression. The initial readings were lower in the UGIB group, indicating blood and energy deficiency due to UGIB. Significant differences in indicator drop values were observed at nine BAPs (p < 0.05) on the bilateral small intestine, bilateral stomach, bilateral circulation, bilateral fibroid degeneration, and right lymph meridians. The area under the ROC curve values of the BAPs on the bilateral small intestine and stomach meridians were larger than 0.5, suggesting the diagnostic accuracy of EDS for UGIB on the basis of the indicator drop of these BAPs. Logistic regression revealed that when the indicator drop of the BAP on the left stomach meridian increased by one score, the risk of UGIB increased by about 1.545-3.523 times. In conclusion, the change in the electrical resistance of the skin measured by EDS at the BAPs on the bilateral small intestine and stomach meridians provides specific information on UGIB.

  10. DEXAMETHASON ADMINISTRATION IN INTRAVENOUS REGIONAL ANESTHESIA: ITS AFFECT ON POST OPERATIVE PAIN A RANDOMIZED DOUBLE BLINDED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    H SARYAZDI

    2002-03-01

    Full Text Available Introduction. Intravenous regional anesthesia (IVRA is one of the successful method of anesthesia in relief of pain of surgery. It has a multiple advantages including feasibility, rapidity of recovery, rapid onest, muscular relaxation and controllable onset of anesthesia. But this technique dose not relief postoperative pain. In the previous studies it had been tried to add some drugs to local anesthetic in IVRA for relief postoperative pain. Methods. One hundred and ten adult patients in class I and II ASA scheduled for elective operation of unilatral upper extrimeties under IVRA, randomly allocated into interventional and control groups. NRA was done with Lidocaine 0.5 percent with or without dexamethason. Postoperative pain was assessed by visual analogue scale. Results. Addition of dexamethason to local anesthetic in IVRA resulted in better tolleration of turniquate pain and reduced VAS score. Frequency of severe postoperative pain was reduced in case group. Discussion. It seems that dexamethason usage in local anesthetic in IVRA prevents sever postoperative pain in patients. The results of this study is simillar to the study wich added ketorolac to IVRA solution.

  11. Recommendations for siting, development, and operation of a regional low-level radioactive waste disposal facility in Ohio

    Energy Technology Data Exchange (ETDEWEB)

    Harf, J.

    1994-12-31

    In 1984, pursuant to passage of the federal Low-Level Radioactive Waste Policy Act of 1980, the Ohio General Assembly voted overwhelmingly to join the Midwest Interstate Low-Level Radioactive Waste Commission. The original members of the Midwest Compact were Indiana, Iowa, Michigan, Minnesota, Missouri, Ohio, and Wisconsin; however, Michigan was expelled in July 1991, for failure to fulfill its obligations as host state for the first regional facility. At that time, Ohio assumed responsibility as host state and proceeded to negotiate amendments to the Compact. In September 1992, the legislative leadership requested that Governor George V. Voinovich appoint a Blue Ribbon Committee to offer recommendations on siting criteria and that the Low-Level Radioactive Waste Advisory Committee report on other aspects of facility development, operation, and long-term care. After a year of meetings, public hearings, and deliberation, the two reports were released. The reports contain detailed recommendations on a wide variety of issues, including socio-economic, hydrogeologic, and health effects criteria; the establishment of an administrative structure and process; implementation of public education and information programs; community compensation and benefits plans; and achievement of agreement state status with the NRC for purposes of licensing and regulating the Ohio facility. The recommendations will be incorporated into enabling legislation for introduction later this year.

  12. Increased accuracy in heparin and protamine administration decreases bleeding

    DEFF Research Database (Denmark)

    Runge, Marx; Møller, Christian H; Steinbrüchel, Daniel A

    2009-01-01

    Three to 5 percent of the patients undergoing cardiac surgery are reoperated because of bleeding. When a surgical cause can be excluded, heparin/protamine mismatch may be considered. Insufficient reversal of heparin and overdosing of protamine may cause postoperative bleeding. The purpose...... of the study was to evaluate whether a heparin-protamine titration system, Hemochron RxDx, could reduce postoperative bleeding and blood transfusion. Fifty-three patients were included prospectively over a 6-month period. The test group (RxDx group; 28 patients) received heparin and protamine doses calculated...... using the Hemochron RxDx system, which performs a baseline activated clotting time (ACT) value together with a heparin response test. An accurate heparin dose was calculated based on the Bull dose/response curve. Protamine doses were calculated by the same method. In the control group (25 patients...

  13. Evaluation and outcomes of patients with obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Cositha; Santhakumar; Ken; Liu

    2014-01-01

    Obscure gastrointestinal bleeding(OGIB) is defined as recurrent or persistent bleeding or presence of iron deficiency anaemia after evaluation with a negative bidirectional endoscopy. OGIB accounts for 5% of gastrointestinal bleeding and presents a diagnostic challenge. Current modalities available for the investigation of OGIB include capsule endoscopy, balloon assisted enteroscopy, spiral enteroscopy and computed tomography enterography. These modalities overcome the limitations of previous techniques. Following a negative bidirectional endoscopy, capsule endoscopy and double balloon enteroscopy remain the cornerstone of investigation in OGIB given their high diagnostic yield. Longterm outcome data in patients with OGIB is limited, but is most promising for capsule endoscopy. This article reviews the current literature and provides an overview of the clinical evaluation of patients with OGIB, available diagnostic and therapeutic modalities and longterm clinical outcomes.

  14. Reduced bleed air extraction for DC-10 cabin air conditioning

    Science.gov (United States)

    Newman, W. H.; Viele, M. R.; Hrach, F. J.

    1980-01-01

    It is noted that a significant fuel savings can be achieved by reducing bleed air used for cabin air conditioning. Air in the cabin can be recirculated to maintain comfortable ventilation rates but the quality of the air tends to decrease due to entrainment of smoke and odors. Attention is given to a development system designed and fabricated under the NASA Engine Component Improvement Program to define the recirculation limit for the DC-10. It is shown that with the system, a wide range of bleed air reductions and recirculation rates is possible. A goal of 0.8% fuel savings has been achieved which results from a 50% reduction in bleed extraction from the engine.

  15. PALM-COEIN Nomenclature for Abnormal Uterine Bleeding.

    Science.gov (United States)

    Deneris, Angela

    2016-05-01

    Approximately 30% of women will experience abnormal uterine bleeding (AUB) during their life time. Previous terms defining AUB have been confusing and imprecisely applied. As a consequence, both clinical management and research on this common problem have been negatively impacted. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Group (FMDG) published PALM-COEIN, a new classification system for abnormal bleeding in the reproductive years. Terms such as menorrhagia, menometrorrhagia, metrorrhagia, dysfunctional uterine bleeding, polymenorrhea, oligomenorrhea, and uterine hemorrhage are no longer recommended. The PALM-COEIN system was developed to standardize nomenclature to describe the etiology and severity of AUB. A brief description of the PALM-COEIN nomenclature is presented as well as treatment options for each etiology. Clinicians will frequently encounter women with AUB and should report findings utilizing the PALM-COEIN system. PMID:26969858

  16. Predictors of recurrent venous thromboembolism and bleeding on anticoagulation.

    Science.gov (United States)

    Menapace, Laurel A; McCrae, Keith R; Khorana, Alok A

    2016-04-01

    The impact of venous thromboembolism (VTE) in the cancer population remains substantial despite significant advances in detecting and treating thrombotic events. While there is extensive literature regarding predictors of first VTE event in cancer patients as well as a validated predictive score, less data exist regarding recurrent VTE in cancer cohorts and associated predictive variables. A similar paucity of data in regard to bleeding events in cancer patients receiving anticoagulation has been observed. This review article will highlight clinical risk factors as well as predictive biomarkers associated with recurrent VTE and bleeding in cancer patients receiving therapeutic anticoagulation. Predictive risk assessment models for cancer-associated recurrent VTE and bleeding are also discussed. PMID:27067987

  17. Dosimetric Analysis of Radiation-induced Gastric Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Mary, E-mail: maryfeng@umich.edu [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Normolle, Daniel [Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Pan, Charlie C. [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Dawson, Laura A. [Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario (Canada); Amarnath, Sudha [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Ensminger, William D. [Department of Internal Medicine, Division of Hematology Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Lawrence, Theodore S.; Ten Haken, Randall K. [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States)

    2012-09-01

    Purpose: Radiation-induced gastric bleeding has been poorly understood. In this study, we described dosimetric predictors for gastric bleeding after fractionated radiation therapy. Methods and Materials: The records of 139 sequential patients treated with 3-dimensional conformal radiation therapy (3D-CRT) for intrahepatic malignancies were reviewed. Median follow-up was 7.4 months. The parameters of a Lyman normal tissue complication probability (NTCP) model for the occurrence of {>=}grade 3 gastric bleed, adjusted for cirrhosis, were fitted to the data. The principle of maximum likelihood was used to estimate parameters for NTCP models. Results: Sixteen of 116 evaluable patients (14%) developed gastric bleeds at a median time of 4.0 months (mean, 6.5 months; range, 2.1-28.3 months) following completion of RT. The median and mean maximum doses to the stomach were 61 and 63 Gy (range, 46-86 Gy), respectively, after biocorrection of each part of the 3D dose distributions to equivalent 2-Gy daily fractions. The Lyman NTCP model with parameters adjusted for cirrhosis predicted gastric bleed. Best-fit Lyman NTCP model parameters were n=0.10 and m=0.21 and with TD{sub 50} (normal) = 56 Gy and TD{sub 50} (cirrhosis) = 22 Gy. The low n value is consistent with the importance of maximum dose; a lower TD{sub 50} value for the cirrhosis patients points out their greater sensitivity. Conclusions: This study demonstrates that the Lyman NTCP model has utility for predicting gastric bleeding and that the presence of cirrhosis greatly increases this risk. These findings should facilitate the design of future clinical trials involving high-dose upper abdominal radiation.

  18. Bleeding rates necessary for detecting acute gastrointestinal bleeding with technetium-99m-labeled red blood cells in an experimental model

    International Nuclear Information System (INIS)

    Proponents of [/sup 99m/Tc]sulfur colloid for GI bleeding studies argue that, although labeled red blood cells are useful for intermittent bleeding, they are not capable of detecting low bleeding rates. Studies of dogs with experimental GI bleeding have indicated bleeding rates of 0.05 ml/min can be detected with [/sup 99m/Tc]sulfur colloid. Since similar data in the dog model were unavailable for /sup 99m/Tc-labeled red blood cells, we undertook this study. To simulate lower GI bleeding, catheters were inserted into the bowel lumen. Each dog's blood was labeled with /sup 99m/Tc using an in vitro technique. Venous blood was then withdrawn and re-infused into the lumen of the bowel using a Harvard pump. Fourteen dogs were studied, ten receiving a bleeding rate from 4.6-0.02 ml/min in the descending colon and four with proximal jejunal bleeds of 0.20-0.02 ml/min. Bleeding rates of 4.6-0.2 ml/min were detected within 10 min in the colon and bleeding rates as low as 0.04 ml/min were seen by 55 min. Slower bleeding rates were not detected. Similar findings were noted for proximal jejunal bleeds. Based on the time of appearance, a minimum volume of approximately 2-3 ml labeled blood was necessary to detect bleeding. We conclude that /sup 99m/Tc-labeled RBCs are sensitive for low bleeding rates in the dog model. The rates are comparable to those described for [/sup 99m/Tc]sulfur colloid in this experimental setting. The time of appearance of activity is related to the bleeding rate

  19. Infliximab stopped severe gastrointestinal bleeding in Crohn's disease

    OpenAIRE

    Aniwan, Satimai; Eakpongpaisit, Surasak; Imraporn, Boonlert; Amornsawadwatana, Surachai; Rerknimitr, Rungsun

    2012-01-01

    To report the result of rapid ulcer healing by infliximab in Crohn’s patients with severe enterocolic bleeding. During 2005 and 2010, inflammatory bowel disease database of King Chulalongkorn Memorial and Samitivej hospitals were reviewed. There were seven Crohn’s disease (CD) patients (4 women and 3 men; mean age 52 ± 10.4 years; range: 11-86 years). Two of the seven patients developed severe gastrointestinal bleeding (GIB) as a flare up of CD whereas the other five patients presented with G...

  20. [Emergency embolization in gynaecological bleeding. Two case reports].

    Science.gov (United States)

    Hatremi, Rajhi; Sameh, Amous; Azza, Salem; Najla, Mnif; Rym, Ben Hmid; Sami, Mahjoub; Faouzia, Zouari; Radhi, Hamza

    2005-08-01

    Two patients with gynaecological hemorrhage underwent successfully trans-arterial embolization. The first womanhad an uncontrollable perineal hemorrhage following a delivery with forceps. Angiography showed extravasation of contrast from right and left vaginal artery. Hyperselective embolisation stopped the vaginal bleeding. The second woman had massive hemorrhage following radiotherapy for cervical cancer. Angiography demonstrated extravasation of contrast from both uterine arteries. The bleeding was controlled after hyperselective embolisation. Emergency arterial embolisation is a safe and effective means of control of irrepressible genital hemorrhage. PMID:16238279

  1. Application of double-balloon enteroscopy in jejunal diverticular bleeding

    Institute of Scientific and Technical Information of China (English)

    Tsung-Hsing; Chen; Cheng-Tang; Chiu; Chen-Ming; Hsu

    2010-01-01

    AIM:To evaluate the efficacy of endoscopic diagnosis and therapy for jejunal diverticular bleeding.METHODS:From January 2004 to September 2009,154 patients underwent double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding.Ten consecutive patients with jejunal diverticula (5 males and 5 females) at the age of 68.7 ± 2.1 years (range 1995 years) at Chang Gung Memorial Hospital,Academic Tertiary Referral Center,were enrolled in this study.RESULTS:Of the 10 patients,5 had melena,2 had hematochezi...

  2. Massive extra-enteric gastrointestinal bleeding: angiographic diagnosis.

    Science.gov (United States)

    Koehler, P R; Nelson, J A; Berenson, M M

    1976-04-01

    Two patients with massive gastrointestinal bleeding are reported. One bled from an aneurysm of a branch of the left hepatic artery, the blood reaching the bowel through communication with the biliary tree. The second had an aneurysm of a branch of the splenic artery which communicated with the pancreatic duct. This type of bleeding is intermittent and, consequently, actual extravasation of contrast media is not always seen. Therefore, if one sees an aneurysm of a visceral artery, even if it does not directly supply the enteric tract, one should consider the possibility that it is the origin of the hemorrhage. Pathogenesis, diagnostic modalities, and therapeutic implications are discussed. PMID:1083037

  3. Retained fetal bones: an unusual cause of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Sonia Chawla

    2016-06-01

    Full Text Available Abnormal uterine bleeding (AUB is a common gynaecological problem with most common causes being fibroid, polyp, endometritis, neoplasia and coagulation disorder. Presence of retained intrauterine fetal bones as a cause of AUB, is a rare but well recognized entity. Patient may present with subfertility, secondary infertility, chronic pelvic pain, vaginal discharge, pelvic inflammatory disease, abnormal uterine bleeding. Incidence reported in literature is 0.15% among patients undergoing diagnostic hysteroscopy. Calcification appears as hyperechoeic area on ultrasound. Hysteroscopy guided removal of bony fragments is the gold standard and leads to complete resolution of symptoms. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 2032-2033

  4. Prolonged bleeding on the neck in leech therapy: Case report

    Directory of Open Access Journals (Sweden)

    Atakan Savrun

    2015-12-01

    Full Text Available Superficial skin bleeding can usually be stopped by applying short-time compression, unless the patient suffers from coagulation disorders or uses anticoagulant. Because of the anticoagulant component of leech saliva, a leech bite may cause long-time bleeding, which cannot be stopped via compression. In this study, the case of a patient who applied leech therapy on her neck for the treatment of migraine has been presented. [Arch Clin Exp Surg 2015; 4(4.000: 234-237

  5. Management of bleeding from pseudoaneurysms following pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Hyung; Geun; Lee; Jin; Seok; Heo; Seong; Ho; Choi; Dong; Wook; Choi

    2010-01-01

    AIM:To review the clinical course and the management of pseudoaneurysms post-pancreaticoduodenectomy.METHODS: Medical records of 907 patients who underwent pancreaticoduodenectomies from January 1995 to May 2007 were evaluated retrospectively. The clinical course, management strategy, and outcome of ruptured pseudoaneurysms cases were analyzed.RESULTS: Twenty-seven (3.0%) of 907 cases had post-operative hemorrhage from ruptured pseudoan-eurysms. Pancreatic fistula was evident in 12 (44%) cases. Sentinel ble...

  6. Prothrombin complex concentrate for reversal of vitamin K antagonist treatment in bleeding and non-bleeding patients

    DEFF Research Database (Denmark)

    Johansen, Mathias; Wikkelsø, Anne; Lunde, Jens;

    2015-01-01

    BACKGROUND: Treatment with vitamin K antagonists is associated with increased morbidity and mortality. Reversal therapy with prothrombin complex concentrate (PCC) is used increasingly and is recommended in the treatment of patients with bleeding complications undertaking surgical interventions......, as well as patients at high risk of bleeding. Evidence is lacking regarding indication, dosing, efficacy and safety. OBJECTIVES: We assessed the benefits and harms of PCC compared with fresh frozen plasma in the acute medical and surgical setting involving vitamin K antagonist-treated bleeding and non...... finding a beneficial effect of PCC in reducing the volume of fresh frozen plasma (FFP) transfused to reverse the effect of vitamin K antagonist treatment. The number of new occurrences of transfusion of red blood cells (RBCs) did not seem to be associated with the use of PCC (RR 1.08, 95% CI 0.82 to 1...

  7. Quantifying Uncertainties of Seasonal and Regional Evapotranspiration Estimates from Operational Simplified Surface Energy Balance Model in the Contiguous USA

    Science.gov (United States)

    Chen, M.; Senay, G. B.; Verdin, J. P.; Bohms, S.

    2015-12-01

    An operational simplified surface energy balance (SSEBop) model can provide site to regional and daily to seasonal evapotranspiration (ET) estimation. Like other ET models, SSEBop model also faces a challenging issue—uncertainty from inevitable input errors, poorly defined parameters, and inadequate model structures. Recent uncertainty assessment at multiple Ameriflux tower sites showed the uncertainties of seasonal ET estimates by the SSEBop model were within a reasonable range (less than 20%). In this study, we further quantified the uncertainties of seasonal SSEBop ET estimates at 1-km pixel resolution for the contiguous U.S.A. (CONUS) from 2001 to 2014. The uncertainty analysis focused on quantifying uncertainties from errors of key parameters (i.e., difference between cold and hot temperature boundaries (dT)) and primary driving forces, including the 8-day composite 1-km Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) data, Global Land Data Assimilation System daily air temperature data, and USGS/EROS daily short grass reference ET data. The sensitivity analysis indicated that relative errors of ET estimates from errors of input data and parameters were less than 20% in most areas of CONUS, except for western mountain areas with complex topography, southwestern bare desert areas with high albedo and dry climate conditions, and southeastern areas with high emissivity and humid climate conditions. The relative errors of ET estimates were around 30% in those specific areas where the large ET errors stemmed from errors of input data and parameters, such as LST data with errors over 1.5K, and dT with errors over 2.5K. The uncertainty assessment showed that SSEBop model is a reliable method for wide-area ET calculation. Reduction of errors from input variables (e.g., LST from MODIS) and key parameters (e.g., dT) in topographically complex areas and high albedo and emissivity surfaces can significantly improve the ET calculation

  8. Investigating Effect of Drug Use on Short-term Complications and Bleeding in Patients Undergoing Off-pump CABG (OPCAB

    Directory of Open Access Journals (Sweden)

    M Hadadzadeh

    2013-08-01

    Full Text Available Introduction: Opioid abuse is a major social and health problem in many parts of the world especially in Iran. There are not much information about effect of drugs (addiction on short-term complications and bleeding after CABG. This study aimed to assess the relationship between addiction with short-term complications and bleeding after CABG. Methods: This is a descriptive study in which 100 male patients who underwent off-pump CABG in Afshar hospital in yazd were followed during 3 months to investigate their short-term complications. preoperative and post-operative Hb, Plt, Pt, Ptt, bleeding and packed cells after operation were recorded. Then, collected data was analyzed by chi-square, fisher and exact test . Results: In this study, 30 patients were addicts and 70 male patients were non-addicts. All patients were males and similar in preoperative characteristics such as HTN, DM, HLP, CAD, LIMA usage and NYHA FC. Addicted patients were younger than non-addicts and most of them were cigarette smokers. Regarding medical and dietary recommendation after operation, addicted patients observed these recommendation significantly less than non-addicted patients. After operation, pulmonary, neurologic and infective complications were significantly more common in addicted patients. Conclusion: According the study results and other similar studies, drug use in patients with cardiovascular disease is noticeable. Moreover, regarding the postoperative outcomes in addicted patients, more studies needs to be conducted in this field.

  9. Iatrogenic Complications in Five Patients with Upper Gastrointestinal Bleeding due to Ambient Air: Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Christine N. Manser

    2012-04-01

    Full Text Available Despite the increasing use of carbon dioxide for endoscopies during the last years, ambient air is still used. The amount of air depends on several factors such as examination time, presumable diameter of the endoscope channel and of course active use of air by the operator. Although endoscopic complications due to ambient air in the gastrointestinal (GI tract are a rare observation and mostly described in the colon, we report five cases in the upper GI tract due to insufflating large amounts of air through the endoscopes. All 5 patients needed an emergency upper endoscopy for acute presumed upper GI bleeding. In two cases both esophageal variceal bleeding and ulcer bleeding were detected; the fifth case presented with a bleeding due to gastric cancer. Due to insufflation of inadequate amounts of air through the endoscope channel, all patients deteriorated in circulation and ventilation. Two rumenocenteses and consecutively three laparotomies had to be performed in three patients. In the other two, gastroscopies had to be stopped for an emergency computed tomography. All critical incidents were believed to be a consequence of a long-lasting examination with use of too much air. Therefore in emergency situations, endoscopies should be performed with either submersion, low air flow pumps or even better by the use of carbon dioxide.

  10. Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically.

    Science.gov (United States)

    Wang, Jianzong; Hu, Duanming; Tang, Wen; Hu, Chuanyin; Lu, Qin; Li, Juan; Zhu, Jianhong; Xu, Liming; Sui, Zhenyu; Qian, Mingjie; Wang, Shaofeng; Yin, Guojian

    2016-06-01

    The goal of this study is to evaluate how to predict high-risk nonvariceal upper gastrointestinal bleeding (NVUGIB) pre-endoscopically. A total of 569 NVUGIB patients between Match 2011 and January 2015 were retrospectively studied. The clinical characteristics and laboratory data were statistically analyzed. The severity of NVUGIB was based on high-risk NVUGIB (Forrest I-IIb), and low-risk NVUGIB (Forrest IIc and III). By logistic regression and receiver-operating characteristic curve, simple risk score systems were derived which predicted patients' risks of potentially needing endoscopic intervention to control bleeding. Risk score systems combined of patients' serum hemoglobin (Hb) ≤75 g/L, red hematemesis, red stool, shock, and blood urine nitrogen ≥8.5 mmol/L within 24 hours after admission were derived. As for each one of these clinical signs, the relatively high specificity was 97.9% for shock, 96.4% for red stool, 85.5% for red hematemesis, 76.7% for Hb ≤75 g/L, and the sensitivity was 50.8% for red hematemesis, 47.5% for Hb ≤75 g/L, 14.2% for red stool, and 10.9% for shock. When these 5 clinical signs were presented as a risk score system, the highest area of receiver-operating characteristic curve was 0.746, with sensitivity 0.675 and specificity 0.733, which discriminated well with high-risk NVUGIB. These simple risk factors identified patients with high-risk NVUGIB of needing treatment to manage their bleeding pre-endoscopically. Further validation in the clinic was required. PMID:27367977

  11. Direct Versus Video Laryngoscopy for Intubating Adult Patients with Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Jestin N. Carlson

    2015-12-01

    Full Text Available Introduction: Video laryngoscopy (VL has been advocated for several aspects of emergency airway management; however, there are still concerns over its use in select patient populations such as those with large volume hematemesis secondary to gastrointestinal (GI bleeds. Given the relatively infrequent nature of this disease process, we sought to compare intubation outcomes between VL and traditional direct laryngoscopy (DL in patients intubated with GI bleeding, using the third iteration of the National Emergency Airway Registry (NEARIII. Methods: We performed a retrospective analysis of a prospectively collected national database (NEARIII of intubations performed in United States emergency departments (EDs from July 1, 2002, through December 31, 2012. All cases where the indication for intubation was “GI bleed” were analyzed. We included patient, provider and intubation characteristics. We compared data between intubation attempts initiated as DL and VL using parametric and non-parametric tests when appropriate. Results: We identified 325 intubations, 295 DL and 30 VL. DL and VL cases were similar in terms of age, sex, weight, difficult airway predictors, operator specialty (emergency medicine, anesthesia or other and level of operator training (post-graduate year 1, 2, etc. Proportion of successful first attempts (DL 261/295 (88.5% vs. VL 28/30 (93.3% p=0.58 and Cormack-Lehane grade views (p=0.89 were similar between devices. The need for device change was similar between DL [2/295 (0.7% and VL 1/30 (3.3%; p=0.15]. Conclusion: In this national registry of intubations performed in the ED for patients with GI bleeds, both DL and VL had similar rates of success, glottic views and need to change devices.

  12. The Text of the Agreement of 20 August 1984 extending the Asian Regional Co-Operative Project on Food Irradiation. Second Extension Agreement

    International Nuclear Information System (INIS)

    The text of the Second Agreement to Extend the Agreement of 23 May 1980 Establishing the Asian Regional Co-operative Project on Food Irradiation within the framework of the Regional Cooperative Agreement for Research, Development and Training Related to Nuclear Science and Technology of 1972, as extended in 1977 and in 1982, is reproduced herein for the information of all Members. The First Extension Agreement of 8 July 1983 was due to expire on 27 August 1984

  13. Coagulation Parameter Thresholds Associated with Non-Bleeding in the Eighth Hour of Adult Cardiac Surgical Post-Cardiotomy Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Riley, Jeffrey B; Schears, Gregory J; Nuttall, Gregory A; Oliver, William C; Ereth, Mark H; Dearani, Joseph A

    2016-06-01

    Excessive bleeding and allogeneic transfusion during adult post-cardiotomy venoarterial extracorporeal membrane oxygenation (ECMO) are potentially harmful and expensive. Balancing the inhibition of clotting and distinguishing surgical from non-surgical bleeding in post-operative period is difficult. The sensitivity of coagulation tests including Thromboelastography(®) (TEG) to predict chest tube drainage in the early hours of ECMO was examined with the use of receiver-operating characteristics (ROC). The results are useful to incorporate in clinical evidence-based algorithms to guide management decisions. In the eighth hour of ECMO, 26 of the 53 adult patients (49%) studied were identified as non-bleeders (less than 2.0 mL/kg/h). All had experienced various types of cardiac surgical procedures. Fifty-two percent were female and the group was 54 ± 19 (mean ± 1 SD) years old. The coagulation parameter threshold with the maximum sensitivity and specificity to predict non-bleeding at 8 hours on ECMO was the kaolin plus heparinase TEG maximum amplitude (KH-TEG MA) at a significant ROC threshold (t) > 50 mm. The activated partial thromboplastin time (aPTT) t 51°, and the kaolin activated clotting time (ACT) t < 148 seconds were sensitive predictors of non-bleeders. The whole-blood KH-TEG MA was superior to the plasma-based aPTT or International Normalization Ratio (INR) to predict bleeding in the eighth hour of ECMO. Using coagulation laboratory thresholds that predict non-bleeding can begin a process of identifying patients earlier that are likely to bleed. Awareness of these parameter thresholds may improve care through patient protection from unnecessary transfusion and prolonging the life of the ECMO circuit. An algorithm incorporating the ROC thresholds was created to help recognize surgical bleeding to minimize unnecessary transfusions. PMID:27578897

  14. Embolotherapy using N-butyl cyanoacrylate for abdominal wall bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Koh, Young Hwan; Han, Dae Hee; Kim, Ji Hoon; Cha, Joo Hee; Lee, Eun Hye; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2008-05-15

    We describe our experience with the use of N-butyl cyanoacrylate (NBCA) embolization of abdominal wall bleeding and we evaluate the clinical effectiveness of the procedure. Embolization was performed in nine patients with abdominal wall bleeding. The sites of embolization were the left first lumbar (n = 1), left second lumbar (n = 1), right inferior epigastric (n 2), left inferior epigastric (n = 3), right circumflex iliac (n = 1), and left circumflex iliac artery (n = 1). A coil was used with NBCA in one patient due to difficulty in selecting only a bleeding focus and anticipated reflux. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:4. Blood pressure and heart rate were measured before and after the embolization procedure, and the serial hemoglobin and hematocrit levels and transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Hemostasis was obtained in six out of the nine patients and technical success was achieved in all patients. There were no procedure-related complications. Four out of the nine patients died due to rebleeding of a subarachnoid hemorrhage (n = 1), multiorgan failure (n = 1), and hepatic failure (n =2) that occurred two to nine days after the embolization procedure. One patient had rebleeding. The five surviving patients had no rebleeding, and the patients continue to visit the clinical on an outpatient basis. NBCA embolization is a clinically safe procedure and is effective for abdominal wall bleeding.

  15. Management of Adult Jehovah's Witness Patients with Acute Bleeding

    NARCIS (Netherlands)

    K. Berend; M. Levi

    2009-01-01

    Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working i

  16. The effect of different interdental cleaning devices on gingival bleeding

    NARCIS (Netherlands)

    N.A.M. Rosema; N.L. Hennequin-Hoenderdos; C.E. Berchier; D.E. Slot; D.M. Lyle; G.A. van der Weijden

    2011-01-01

    Objective: To compare the effectiveness of an oral irrigator (OI) with a prototype jet tip or a standard jet tip to floss as adjunct to daily toothbrushing on gingival bleeding. Methods: In this single masked, 3-group parallel, 4-week home use experiment, 108 subjects were randomly assigned to one o

  17. A sensitive venous bleeding model in haemophilia A mice

    DEFF Research Database (Denmark)

    Pastoft, Anne Engedahl; Lykkesfeldt, Jens; Ezban, M.;

    2012-01-01

    evaluation of pro-coagulant compounds for treatment of haemophilia. Interestingly, the vena saphena model proved to be sensitive towards FVIII in plasma levels that approach the levels preventing bleeding in haemophilia patients, and may, thus, in particular be valuable for testing of new long...

  18. Happy ending of life-threatening upper GI bleeding

    Science.gov (United States)

    Islam, Quazi Tarikul; Siddiqui, Mahmudur Rahman; Rahman, Md Anisur; Ahmed, Syed Salahuddin

    2011-01-01

    Strongyloides stercoralis is an intestinal nematode in humans, and estimated about tens of millions of people are infected worldwide. This parasite is endemic in tropical or temperate and subtropical climates like Bangladesh. The authors report a 33-year-old man who presented with recurrent life-threatening upper gastrointestinal bleeding from gastric infection by S stercoralis. PMID:22673715

  19. Strongyloides hyper-infection causing life-threatening gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Lajos Csermely; Hassan Jaafar; Jorgen Kristensen; Antonio Castella; Waldemar Gorka; Ahmed Ali Chebli; Fawaz Trab; Hussain Alizadeh; Béla Hunyady

    2006-01-01

    A 55-year old male patient was diagnosed with strongyloides hyper-infection with stool analysis and intestinal biopsy shortly after his chemotherapy for myeloma.He was commenced on albendazole anthelmintic therapy. After initiation of the treatment he suffered lifethreatening gastrointestinal (GI) bleeding. Repeated endoscopies showed diffuse multi-focal intestinal bleeding. The patient required huge amounts of red blood cells and plasma transfusions and correction of haemostasis with recombinant activated factor Ⅶ.Abdominal aorto-angiography showed numerous microinferior mesenteric arteries' territories. While the biopsy taken prior to the treatment with albendazole did not show evidence of vasculitis, the biopsy taken after initiation of therapy revealed leukoclastic aggregations around the vessels. These findings suggest that, in addition to direct destruction of the mucosa, vasculitis could be an important additive factor causing the massive GI bleeding during the anthelmintic treatment.This might result from substances released by the worms that have been killed with anthelmintic therapy.Current guidelines advise steroids to be tapered and stopped in case of systematic parasitic infections as they might reduce immunity and precipitate parasitic hyper-infection. In our opinion, steroid therapy might be of value in the management of strongyloides hyperinfection related vasculitis, in addition to the anthelmintic treatment. Indeed, steroid therapy of vasculitis with other means of supportive care resulted in cessation of the bleeding and recovery of the patient.

  20. [Intravesical active prostate bleeding diagnosed in B-mode ultrasound].

    Science.gov (United States)

    Kirchgesner, T; Danse, E; Tombal, B

    2013-09-01

    Hematuria is one of the most frequent minor complications after prostatic biopsy. We would like to report the case of a 68-year-old patient with massive hematuria after prostatic biopsy and intravesical active prostate bleeding diagnosed in B-mode ultrasonography. PMID:24034804

  1. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Saroj A. Bolde

    2014-08-01

    Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

  2. Update on the endoscopic management of peptic ulcer bleeding

    NARCIS (Netherlands)

    I.L. Holster (Ingrid); E.J. Kuipers (Ernst)

    2011-01-01

    textabstractUpper gastrointestinal bleeding is the most common gastrointestinal emergency, with peptic ulcer as the most common cause. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of

  3. A STUDY ON ENDOSCOPIC EVALUATION OF UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Pranaya Kumar

    2016-03-01

    Full Text Available CONTEXT Upper gastrointestinal bleeding (UGIB is one of the commonest gastrointestinal emergencies encountered by clinicians. Peptic ulcers are the most common cause of UGIB. Endoscopy has become the preferred method for diagnosis in patients with acute UGIB. This study is done in a diagnostic upper gastrointestinal endoscopy (UGIE setup of a tertiary care hospital to ascertain the causes of UGIB prevalent in this part of our country which might differ from other studies. AIM To ascertain prevalent causes of UGIB in patients of this part of India admitted to a Govt. Tertiary Hospital with a provisional diagnosis of UGIB. METHOD One hundred consecutive patients with UGIB were subjected to UGIE to find out the aetiology. The clinical profile and endoscopic findings were analysed and compared with the data on UGIB from other studies. RESULTS The mean age of patients was 47.03 years with male: female ratio of 2.33:1. 58% of patients were first time bleeders. Majority of patients presented with melaena. Visualisation of active bleeding achieved to 85.7% when endoscopy was done within first 24 hrs. The commonest cause of UGIB was duodenal ulcer (DU which accounted for 41% cases. Gastric ulcer was responsible in 13% of cases. Portal hypertension was responsible for bleed in only 13%. Neoplasms accounted for 25% of cases. Other less common causes were erosive gastritis (3%, gastric polyp (3%, Mallory-Weiss tear (1%, and Dieulafoy’s lesion (1%. Among bleeding peptic ulcers, 27.8% of cases were classified as Forrest IIa and 20.4% in Forrest IIb & IIc each. Acid peptic disease was past history elicited in majority (33% followed by NSAID (26% and alcohol (26%. CONCLUSION The present study has diagnosed various causes of upper gastrointestinal bleeding in this part of country. The incidence of gastric carcinoma as a cause of upper gastrointestinal bleeding is significantly high compared to those in other studies. UGI endoscopy should be done in every case

  4. Screening Bleeding Disorders in Adolescents and Young Women with Menorrhagia

    Directory of Open Access Journals (Sweden)

    Suar Çakı Kılıç

    2013-06-01

    Full Text Available OBJECTIVE: Chronic menorrhagia causes anemia and impairment of life quality. In this study the aim was the screening of bleeding disorders in adolescents and young women with menorrhagia. METHODS: The study was performed prospectively by pediatric hematologists. A form including demographic characteristics of the patients, bleedings other than menorrhagia, familial bleeding history, characteristics of the menorrhagia, and impairment of life quality due to menorrhagia was filled out by the researcher during a face-to-face interview with the patient. A pictorial blood assessment chart was also used for evaluation of blood loss. All patients underwent pelvic ultrasound sonography testing and women also received pelvic examination by gynecologists. Whole blood count, peripheral blood smear, blood group, serum transaminases, urea, creatinine, ferritin, PFA-100, PT, aPTT, INR, TT, fibrinogen, VWF: Ag, VWF: RCo, FVIII, and platelet aggregation assays were performed. Platelet aggregations were studied by lumiaggregometer. RESULTS: Out of 75 patients enrolled, 60 patients completed the study. The mean age was 20.68±10.34 (range: 10-48 years and 65% (n=39 of the patients were younger than 18 years. In 18 (46% of the adolescents, menorrhagia subsided spontaneously. In 20% (n=12 of the patients, a bleeding disorder was detected (1 case of type 3 von Willebrand disease, 2 patients with low VWF: Ag, 1 case of probable von Willebrand disease, 3 cases of Bernard-Soulier syndrome, 2 cases of Glanzmann thrombasthenia, 2 cases of immune thrombocytopenic purpura, 1 case of congenital factor VII deficiency. CONCLUSION: In patients with menorrhagia, at least complete blood count, peripheral smear, aPTT, PT, VWF: Ag, VWF: RCo, FVIII, and fibrinogen assays must be performed. When there is history of nose and gum bleeding, platelet function assay by lumiaggregometer must also be performed. In nearly 50% of adolescents, menorrhagia is dysfunctional and transient

  5. Value of transient elastography for the prediction of variceal bleeding

    Institute of Scientific and Technical Information of China (English)

    Ioan Sporea; Iulia Ra(t)iu; Roxana (S)irli; Alina Popescu; Simona Bota

    2011-01-01

    AIM: To determine if liver stiffness (LS) measurements by means of transient elastography (TE) correlate with the presence of significant esophageal varices (EV) and if they can predict the occurrence of variceal bleeding. METHODS: We studied 1000 cases of liver cirrhosis divided into 2 groups: patients without EV or with grade 1 varices (647 cases) and patients with significant varices (grade 2 and 3 EV) (353 cases). We divided the group of 540 cases with EV into another 2 subgroups: without variceal hemorrhage (375 patients) and patients with a history of variceal bleeding (165 cases). We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve. RESULTS: The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV (26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa,P < 0.0001). Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV,with 83% sensitivity (95% CI: 79.73%-85.93%) and 62% specificity (95% CI: 57.15%-66.81%),with 76.2% positive predictive value (PPV) (95% CI: 72.72%-79.43%) and 71.3% negative predictive value (NPV) (95% CI: 66.37%-76.05%) (AUROC 0.7807,P < 0.0001). The mean LS values in the group with a history of variceal bleeding (165 patients) was statistically significantly higher than in the group with no bleeding history (375 patients): 51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa,P < 0.0001). For a cut-off value of 50.7 kPa,LS had 53.33% sensitivity (95% CI: 45.42%-61.13%) and 82.67% specificity (95% CI: 78.45%-86.36%),with 82.71% PPV (95% CI: 78.5%-86.4%) and 53.66% NPV (95% CI: 45.72%-61.47%) (AUROC 0.7300,P < 0.0001) for the prediction of esophageal bleeding. CONCLUSION: LS measurement by means of TE is a reliable noninvasive method for the detection of EV and for the prediction of variceal bleeding.

  6. “I Just Look at Books”: Reading the Monetary Metareality of Bleeding Edge

    OpenAIRE

    Sascha Pöhlmann

    2016-01-01

    The essay analyzes 'Bleeding Edg'e for its pervasive representation of money, arguing that it operates as a metareality in the novel both on the levels of plot and style. Money is presented as a symbolic structure behind reality that is accessible to the initiated, the interpretation of which offers genuine insight about the world and its interrelations, in parallel to religious or scientific discourses. This does not simply mean that everything—politics, society, culture, technology, etc.—is...

  7. Efficacy of TachoSil® patches in controlling Dacron suture-hole bleeding after abdominal aortic aneurysm open repair

    OpenAIRE

    Mirabella Domenico; Pecoraro Felice; Bajardi Guido

    2009-01-01

    Abstract Purpose The aim of this study is evaluate the efficacy of TachoSil® patches in controlling suture-hole bleeding after elective infrarenal abdominal aortic aneurysm (AAA) replacement with Dacron graft. Materials and methods Patients undergoing elective replacement of infrarenal AAA with Dacron grafts were prospectively randomized to TachoSil® patches (Group I) or standard compression with surgical swabs (Group II). We evaluated time to haemostasis, blood loss during the operation, blo...

  8. N-butyl cyanoacrylate embolotherapy for acute gastroduodenal ulcer bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Kim, Ji Hoon; Koh, Young Hwan; Han, Dae Hee; Cha, Joo Hee; Seong, Chang Kyu; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2007-01-15

    Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.

  9. N-butyl cyanoacrylate embolotherapy for acute gastroduodenal ulcer bleeding

    International Nuclear Information System (INIS)

    Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding

  10. Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting.

    Science.gov (United States)

    Ghadimi, Kamrouz; Levy, Jerrold H; Welsby, Ian J

    2016-05-01

    Prothrombin complex concentrates (PCCs) contain vitamin K-dependent clotting factors (II, VII, IX, and X) and are marketed as 3 or 4 factor-PCC formulations depending on the concentrations of factor VII. PCCs rapidly restore deficient coagulation factor concentrations to achieve hemostasis, but like with all procoagulants, the effect is balanced against thromboembolic risk. The latter is dependent on both the dose of PCCs and the individual patient prothrombotic predisposition. PCCs are approved by the US Food and Drug Administration for the reversal of vitamin K antagonists in the setting of coagulopathy or bleeding and, therefore, can be administered when urgent surgery is required in patients taking warfarin. However, there is growing experience with the off-label use of PCCs to treat patients with surgical coagulopathic bleeding. Despite their increasing use, there are limited prospective data related to the safety, efficacy, and dosing of PCCs for this indication. PCC administration in the perioperative setting may be tailored to the individual patient based on the laboratory and clinical variables, including point-of-care coagulation testing, to balance hemostatic benefits while minimizing the prothrombotic risk. Importantly, in patients with perioperative bleeding, other considerations should include treating additional sources of coagulopathy such as hypofibrinogenemia, thrombocytopenia, and platelet disorders or surgical sources of bleeding. Thromboembolic risk from excessive PCC dosing may be present well into the postoperative period after hemostasis is achieved owing to the relatively long half-life of prothrombin (factor II, 60-72 hours). The integration of PCCs into comprehensive perioperative coagulation treatment algorithms for refractory bleeding is increasingly reported, but further studies are needed to better evaluate the safe and effective administration of these factor concentrates. PMID:26983050

  11. Endoscopic band ligation for bleeding lesions in the small bowel

    Institute of Scientific and Technical Information of China (English)

    Takashi; Ikeya; Naoki; Ishii; Yuto; Shimamura; Kaoru; Nakano; Mai; Ego; Kenji; Nakamura; Koichi; Takagi; Katsuyuki; Fukuda; Yoshiyuki; Fujita

    2014-01-01

    AIM: To investigate the safety and efficacy of endo-scopic band ligation(EBL) for bleeding lesions in the small bowel.METHODS: This is a retrospective study evaluating EBL in six consecutive patients(three males, three fe-males, 46-86 years of age) treated between May 2009 and February 2014: duodenal vascular ectasia; 1, je-junal bleeding diverticulum; 1, ileal Dieulafoy’s lesion; 1 and ileal bleeding diverticula; 3. The success of the initial hemostasis was evaluated, and patients were observed for early rebleeding(within 30 d after EBL), and complications such as perforation and abscess for-mation. Follow-up endoscopies were performed in four patients.RESULTS: Initial hemostasis was successfully achieved with EBL in all six patients. Eversion was not sufficient in four diverticular lesions. Early rebleeding occurred three days after EBL in one ileal diverticulum, and arepeat endoscopy revealed dislodgement of the O-band and ulcer formation at the banded site. This rebleeding was managed conservatively. Late rebleeding occurred in this case(13 and 21 mo after initial EBL), and re-EBL was performed. Follow-up endoscopies revealed scar formation and the disappearance of vascular lesions at the banded site in the case with a duodenal bleeding lesion, and unresolved ileal diverticula in three cases. Surgery or transarterial embolization was not required without any complications during the median follow-up period of 45(range, 2-83) mo.CONCLUSION: EBL is a safe and effective endoscopic treatment for hemostasis of bleeding lesions in the small bowel.

  12. The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis

    OpenAIRE

    Elghuel, Abdulbaset

    2011-01-01

    Background: Acute upper gastrointestinal bleeding (UGIB) is a common reason for hospital admissions worldwide. Aetiological causes of UGIB vary according to geographic region and socioeconomic status. However, despite the implementation of early endoscopy as the standard method for the diagnosis and treatment of UGIB, data on the characteristics of patients with UGIB in Libya are still minimal. In this study, we describe patient demographics, aetiological causes for UGIB, and possible risk fa...

  13. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review

    OpenAIRE

    Tang, Shan-Hong; Zeng, Wei-Zheng; He, Qian-Wen; Qin, Jian-Ping; WU, XIAO-LING; Tao WANG; Wang, Zhao; He, Xuan; Zhou, Xiao-Lei; Fan, Quan-Shui; Jiang, Ming-De

    2015-01-01

    Gastric varices (GV) are one of the most common complications for patients with portal hypertension. Currently, histoacryl injection is recommended as the initial treatment for bleeding of GV, and this injection has been confirmed to be highly effective for most patients in many studies. However, this treatment might be ineffective for some types of GV, such as splenic vein thrombosis-related localized portal hypertension (also called left-sided, sinistral, or regional portal hypertension). H...

  14. The Text of the Agreement of 20 August 1984 Extending the Asian Regional Co-Operative Project on Food Irradiation. Additional acceptance of the Second Extension Agreement

    International Nuclear Information System (INIS)

    A notification of acceptance of the Second Agreement to Extend the Agreement Establishing the Asian Regional Co-operative Project on Food Irradiation by the Governments of Sri Lanka was received by the Agency on 28 October 1985. Pursuant to Article II, paragraph 2, the Second Extension Agreement consequently entered into force on that date with respect to the Government of Sri Lanka

  15. The Text of the Agreement of 20 August 1984 Extending the Asian Regional Co-Operative Project on Food Irradiation. Additional acceptance of the Second Extension Agreement

    International Nuclear Information System (INIS)

    A notification of acceptance of the Second Agreement to Extend the Agreement Establishing the Asian Regional Co-operative Project on Food Irradiation by the Governments of the Philippines was received by the Agency on 25 September 1985. Pursuant to Article II, paragraph 2, the Second Extension Agreement consequently entered into force on that date with respect to the Government of the Philippines

  16. ARCAL. Regional co-operative arrangements for the promotion of nuclear science and technology in Latin America, Phase I (1985-1990)

    International Nuclear Information System (INIS)

    The Regional Co-operative Arrangement for the Promotion of Nuclear Science and Technology in Latin America, ARCAL, has completed its first five-year phase (1985-1989). This booklet summarizes the first phase of the ARCAL programme and contains descriptions of projects in the fields of agriculture, medicine, industry and energy

  17. Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

    Institute of Scientific and Technical Information of China (English)

    Konstantinos C Thomopoulos; Konstantinos P Mimidis; George J Theocharis; Anthie G Gatopoulou; Georgios N Kartalis; Vassiliki N Nikolopoulou

    2005-01-01

    AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy.The purpose of this study was to describe the causes and clinical outcome of these patients.METHODS: From January 1999 to October 2003, 111patients with acute upper gastrointestinal bleeding (AUGIB)were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001with AUGIB who were not taking warfarin.RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (P<0.05). No identifiable source of bleeding could be found in 33 patients (29.7%) compared to 31/604(5.1%) patients not receiving anticoagulants (P= 0.0001).The majority of patients with concurrent use of non-steroidal anti-inflammatory drugs (NSATDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%)patients not taking a great dose of NSATDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported.Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy.CONCLUSION: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants.Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

  18. Analysis on the Regional Brand Operation Mode for Carya Cathayensis——A Case Study of Lin’an in Zhejiang

    Institute of Scientific and Technical Information of China (English)

    Xiaoling; TU; Yueli; ZHANG

    2013-01-01

    Lin’an City has a long history of growing,processing and selling Carya Cathayensis,a traditional special local product for which the city is well known.In recent years,Lin’an Carya Cathayensis gives full play to the industry cluster advantages and gains the reputation of"regional name brand of Zhejiang".However,it faces the predicament of regional brand operation,so industry transformation and upgrading as well as intensive farming for this brand are inevitable and necessary.This paper analyzes the current regional brand operation mode of Carya Cathayensis in Lin’an to find out that the growth of this brand is constrained by messy business entities,weak brand protection effect,significant lemon market effect,insufficient industry association efforts and wanting brand culture construction,thus it puts forward the conception of a business alliance based regional brand operation mode for the Carya Cathayensis in Lin’an.The results of this study shall provide theoretical guidance and empirical basis for the marketing practice of the regional brand of Carya Cathayensis in Lin’an.

  19. Protect Your Baby from Bleeds: Talk to Your Healthcare Provider about Vitamin K

    Science.gov (United States)

    ... Bleeds – Talk to Your Healthcare Provider about Vitamin K Without enough vitamin K, your baby has a chance of bleeding into ... death. Infants who do not receive the vitamin K shot at birth can develop VKDB up to ...

  20. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients

    DEFF Research Database (Denmark)

    Schulman, S; Angerås, U; Bergqvist, D;

    2010-01-01

    The definition of major bleeding varies between studies on surgical patients, particularly regarding the criteria for surgical wound-related bleeding. This diversity contributes to the difficulties in comparing data between trials. The Scientific and Standardization Committee (SSC), through its...

  1. Therapeutic barium enema for bleeding colonic diverticula:Four case series and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Jun-ichi Iwamoto; Yuji Mizokami; Koichi Shimokobe; Takeshi Matsuoka; Yasushi Matsuzaki

    2008-01-01

    The prevalence of diverticular diseases of the colon, including severe and persistent bleeding in Eastern countries, has increased in the last decades. The bleeding from colonic diverticula is the most common cause of acute lower gastrointestinal bleeding. Herein, we report four cases of severe and persistent bleeding of colonic diverticular disease that could be treated with a high concentration barium enema. These four cases showed a similar pattern of bleeding whose source could not be identified. Colonoscopy revealed fresh blood in the entire colon and many diverticula were noted throughout the colon. No active bleeding source was identified, but large adherent clots in some diverticula were noted. After endoscopic and angiographic therapies failed, therapeutic barium enema stopped the severe bleeding. These patients remained free of re-bleeding in the follow-up period (range 17-35 mo) after the therapy. We report the four case series of therapeutic barium enema and reviewed the literature pertinent to this procedure.

  2. Risk Factors and Outcome for Massive Intra-Abdominal Bleeding Among Patients With Infected Necrotizing Pancreatitis

    OpenAIRE

    Shen, Xiao; Sun, Jing; Zhang, Jingzhu; Ke, Lu; Tong, Zhihui; Li, Gang; Jiang, Wei; Li, Weiqin; Li, Jieshou

    2015-01-01

    Abstract The incidence of acute bleeding is reported to be 13.5% in patients with acute necrotizing pancreatitis. However, of all the bleeding events, intra-abdominal bleeding was less studied in the literature and its risk factors have not been well defined yet. The purpose of the present study was to investigate the risk factors for massive intra-abdominal bleeding among the patients with infected necrotizing pancreatitis and assessed the outcome of these patients. Both univariate and multi...

  3. Selective Serotonin Reuptake Inhibitor and Bleeding in a Cynomolgus Macaque (Macaca fascicularis)

    OpenAIRE

    Silverstein, Marnie G.; El-Amin, Colette Kirk; Shively, Carol A.

    2014-01-01

    Selective serotonin reuptake inhibitors (SSRI) are associated with an increased bleeding risk in humans. This report describes a bleeding event in a cynomolgus macaque (Macaca fascicularis) treated with the SSRI sertraline HCl (Zoloft). During the treatment course, the subject presented with a maculopapular rash, cutaneous bleeding, epistaxis, bleeding from the eye, melena, and a severe thrombocytopenia. To our knowledge, this report is the first description of an SSRI-related adverse event i...

  4. OUTCOME OF PREGNANCIES HAVING BLEEDING PERVAGINA IN THE FIRST TRIMESTER

    Directory of Open Access Journals (Sweden)

    Sukhamoy Barik

    2016-07-01

    Full Text Available BACKGROUND Vaginal bleeding in early weeks being one of the frequent occurrence, about 20-25% of all pregnancies and have a lot of attention during the last few decades as a predictor of subsequent foetal outcome. In those pregnancies which continue, there is increased incidence of later problems including preterm labour/delivery, Low Birth Weight (LBW, gestational hypertension/Pregnancy Induced Hypertension (PIH, Intrauterine Foetal Death (IUFD, etc. AIMS To evaluate the pregnancy outcome (Both maternal and foetal among groups of patients having bleeding per vagina in the first trimester. SETTING Tertiary level hospital. STUDY DESIGN A hospital-based observational comparative study. METHOD AND MATERIAL In this study, total 200 patients (100 in study group and 100 in control group were taken from September 2009 to August 2010. Out of this 200, 6 patients in study group and 5 patients in control group lost during followup. So, finally 94 patients in study group and 95 patients in control group were critically compared. RESULT In this study mothers who had history of bleeding in 1st trimester, 28.72% had miscarriage, whereas in control group it was 11.57%. 65.95% of women who bleed in 1st trimester continued their pregnancy beyond 28 weeks, which is statistically significant when compared with control group. Incidence of APH (13.82% was also found statistically significant. 15.95% babies were found suffering from IUGR when compared with control group, which was 7.36%. Incidence of vaginal delivery in study group was significantly less when compared with control group. We also found that women who bleed in 1st trimester 3.19% turn out to be ectopic pregnancy, 2.12% were molar pregnancy. No significance was noted in the study group in respect to placenta previa, PROM, PIH, CS delivery. The neonatal morbidity and mortality were also found not significant when compared to control group. CONCLUSION Pregnancies continuing following vaginal bleeding in

  5. Recent pharmacological management of oral bleeding in hemophilic patient

    Directory of Open Access Journals (Sweden)

    Monica Widyawati Setiawan

    2011-09-01

    Full Text Available Background: Hemophilia is a hereditary bleeding disorder that can increase the risk of disease in oral cavity. Sometimes hemophilia is not always established already in a patient. The lack of awareness of hemophilia presence can cause serious problem. Purpose: The purpose of this review is to explain about dental bleeding manifestation and management in hemophilic patient. Reviews: Hemophilia can be manifested as dental bleeding that cannot stop spontaneously. It should be treated with factor VIIII either by giving whole blood, fresh plasma, fresh frozen plasma, cryoprecipitate, and factor VIII concentrate. Factor VIII dose for hemophilia treatment can be calculated based on factor VIII present in hemophilia patient’s body. Factor VIII can also be given as prophylaxis to prevent bleeding. Complications that can be caused by factor VIII replacement therapy are the presence of factor VIII inhibitor and transfusion related diseases. Treatment of dental bleeding due to hemophilia consists of factor replacement therapy and supportive therapy. Conclusion: Treatment of dental bleeding due to hemophilia consists of factor replacement therapy and supportive therapy. There are complications that can happen due to factor VIII replacement therapy that should be considered and anticipated.Latar belakang: Hemofilia adalah kelainan pembekuan darah yang diturunkan. Hemophilia dapat meningkatkan resiko penyakit rongga mulut. Hemofilia tidak selalu sudah terdiagnosa saat penderita melakukan kunjungan ke dokter gigi. Kurangnya kewaspadaan akan adanya hemofilia dapat menyebabkan masalah serius. Tujuan: Tujuan dari kajian pustaka ini adalah memaparkan tentang manifestasi dan penanganan perdarahan gigi pada penderita hemofilia. Tinjauan pustaka: hemofilia dapat bermanifestasi sebagai perdarahan gigi yang tidak dapat berhenti secara spontan. Pada keadaan perdarahan tersebut, pemberian faktor VIII yang diberikan sebagai whole blood, fresh plasma, fresh frozen plasma

  6. Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Chae, Eun Young; Myung, Seung Jae; Ko, Gi Young; Gwon, Dong Il; Sung, Kyu Bo [Asan Medical Center, Seoul (Korea, Republic of)

    2009-08-15

    To evaluate the incidence, predictive factors, and clinical outcomes of angiographically negative acute arterial upper and lower gastrointestinal (GI) bleeding. From 2001 to 2008, 143 consecutive patients who underwent an angiography for acute arterial upper or lower GI bleeding were examined. The angiographies revealed a negative bleeding focus in 75 of 143 (52%) patients. The incidence of an angiographically negative outcome was significantly higher in patients with a stable hemodynamic status (p < 0.001), or in patients with lower GI bleeding (p = 0.032). A follow-up of the 75 patients (range: 0-72 months, mean: 8 {+-} 14 months) revealed that 60 of the 75 (80%) patients with a negative bleeding focus underwent conservative management only, and acute bleeding was controlled without rebleeding. Three of the 75 (4%) patients underwent exploratory surgery due to prolonged bleeding; however, no bleeding focus was detected. Rebleeding occurred in 12 of 75 (16%) patients. Of these, six patients experienced massive rebleeding and died of disseminated intravascular coagulation within four to nine hours after the rebleeding episode. Four of the 16 patients underwent a repeat angiography and the two remaining patients underwent a surgical intervention to control the bleeding. Angiographically negative results are relatively common in patients with acute GI bleeding, especially in patients with a stable hemodynamic status or lower GI bleeding. Most patients with a negative bleeding focus have experienced spontaneous resolution of their condition.

  7. Increased Bleeding Risk With Concurrent Use of Selective Serotonin Reuptake inhibitors and Coumarins

    NARCIS (Netherlands)

    Schalekamp, Tom; Klungel, Olaf H; Souverein, Patrick C; de Boer, Anthonius

    2008-01-01

    BACKGROUND: Treatment with vitamin K antagonists (coumarins) is associated with an increased risk of bleeding. Because use of selective serotonin reuptake inhibitors (SSRIs) is also associated with an increased risk of bleeding, we assessed the odds ratio (OR) of abnormal bleeding associated with SS

  8. Natural history of bleeding and characteristics of early bleeders among warfarin initiators – a cohort study in Finland

    Directory of Open Access Journals (Sweden)

    Rikala M

    2016-02-01

    Full Text Available Maria Rikala,1 Helena Kastarinen,1,2 Pekka Tiittanen,1 Risto Huupponen,1,3 Maarit Jaana Korhonen1,4,5 1Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Turku, 2Social Insurance Institution, Regional Office for Eastern and Northern Finland, Kuopio, 3Unit of Clinical Pharmacology, Turku University Hospital, 4Department of Public Health, University of Turku, Turku, Finland; 5Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, NC, USA Aims: The demand for oral anticoagulant therapy will continue to increase in the future along with the aging of the population. This study aimed to determine the rate of bleeding requiring hospitalization and to characterize early bleeders among persons initiating warfarin therapy. Characterization of those most susceptible to early bleeding is important in order to increase the safety of warfarin initiation. Patients and methods: Using data from nationwide health registers, we identified persons initiating warfarin therapy between January 1, 2009 and June 30, 2012, n=101,588, and followed them until hospitalization for bleeding, death, or administrative end of the study (December 31, 2012. We defined early bleeders as persons with a bleeding requiring hospitalization within 30 days since warfarin initiation. Results: The rate of hospitalization for bleeding during a median follow-up of 1.9 years was 2.6% per person-year (95% confidence interval [CI] 2.5%–2.7%, with a peak within the first 30 days of warfarin initiation (6.5% per person-year, 95% CI 6.0%–7.1%. In a multivariable Cox proportional hazards regression analysis, early bleeders were characterized by prior bleeding (<180 days before initiation, hazard ratio [HR] =13.7, 95% CI 10.9–17.1; during 180 days–7 years before initiation, HR =1.48, 95% CI 1.15–1.90, male sex (HR =1.32, 95% CI 1.10–1.57, older age (HR =1.13, 95% CI 1.04–1

  9. Local causes, regional co-operation and global financing for environemntal problems: the case of Southeast Asian Haze pollution

    OpenAIRE

    Luca Tacconi; Frank Jotzo; R. Quentin Grafton

    2006-01-01

    Lack of action on cross-border environmental problems in developing countries is often ascribed to gaps in local capacity and resources, failure of regional cooperation, and lack of financial support from rich countries. Using the case of the Southeast Asian Haze pollution from forest and peat fires in Indonesia, we explore the challenges posed by environmental problems whose causes are closely linked to local development and livelihood strategies, and whose impacts are local, regional (haze)...

  10. [Protection of working mothers: operational guide document. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) ].

    Science.gov (United States)

    Alessandroni, Morena; Balzani, Barbara; Cancellieri, Francesca; Colao, Annamaria; Comai, M; Elezi, Lindita; Mengucci, Rosella; Montesi, Simona; Olivi, Cinzia; Perticaroli, Patrizia; Pettinari, A; Ruschioni, Angela

    2013-01-01

    Protection of working mothers: operational guide document. The aim of this operational guide document is to protect the health of working mothers and their babies during pregnancy, puerperium and breastfeeding. The project was developed by a technical working group which included professionals in the pertinent fields from the Workplace Prevention and Safety Services of the local Vasta-2 Area of the Marche Regional Health Service:physicians, health assistants, and nurses. It is considered to be a useful tool for risk assessment at the workplace aimed at professionals who are involved, with various duties and responsibilities, in the health care of the working mother. This paper consists of two functionally related sections, "Table of risks" and "Technical specifications". In the "Table of Risks" section, the occupational hazards for women during pregnancy or postpartum were analyzed with the highest possible degree of care. To this end the technical group provided, for each occupational hazard, its own operational suggestions, in relation to legislation, current scientific knowledge and Guidelines of other Italian Regions. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) participated in the final draft of the entire document. The second section, "Technical Specifications", illustrates the main tasks and any risks involved in the 34 manufacturing sectors most prevalent in this area. This operational guide document is intended to be the beginning of a common strategy in public health to achieve a wider field of action in promotion and information aimed at protecting the reproductive health of working mothers. PMID:24228309

  11. Hemospray application in nonvariceal upper gastrointestinal bleeding: results of the Survey to Evaluate the Application of Hemospray in the Luminal Tract

    NARCIS (Netherlands)

    Smith, L.A.; Stanley, A.J.; Bergman, J.J.; Kiesslich, R.; Hoffman, A.; Tjwa, E.T.; Kuipers, E.J.; Holstein, C.S. von; Oberg, S.; Brullet, E.; Schmidt, P.N.; Iqbal, T.; Mangiavillano, B.; Masci, E.; Prat, F.; Morris, A.J.

    2014-01-01

    BACKGROUND: Hemospray TM (TC-325) is a novel hemostatic agent licensed for use in nonvariceal upper gastrointestinal bleeding (NVUGIB) in Europe. GOALS: We present the operating characteristics and performance of TC-325 in the largest registry to date of patients presenting with NVUGIB in everyday c

  12. Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm.

    Science.gov (United States)

    Vultaggio, Fabrice; Morère, Pierre-Henri; Constantin, Christophe; Christodoulou, Michel; Roulin, Didier

    2016-06-27

    Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else. Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery. The patient was successfully treated by selective embolization of microcoils. We discuss the etiologies of hemobilia and its treatment with selective embolization, which remains favored over surgical treatment. Although aneurysm of the hepatic artery is rare, especially without trauma, a high index of suspicion is needed in order to ensure appropriate treatment. PMID:27358680

  13. Computerized tomography in the diagnosis of spontaneous bleedings from a kidney ultimately attributable to a renal cyst. Spontane Nierenblutung auf dem Boden einer Nierenzyste: Computertomographische Diagnose

    Energy Technology Data Exchange (ETDEWEB)

    Steidle, B. (Radiologische Klinik des St.-Elisabethen-Krankenhauses, Ravensburg (Germany))

    1994-06-01

    This case report gives a description of retroperitoneal bulk bleeding from a kidney caused by a ruptured renal cyst. Computerized tomography showed a very heavy effusion of blood from all peripheries of the left kidney into the left retroperitoneal region. The elimination of contrast medium through the tubular system of the affected kidney was still normal. (orig./MG)

  14. First Trimester Bleeding and Pregnancy Outcomes: Case-Control Study

    OpenAIRE

    Betül Yakıştıran; Tuncay Yüce; Feride Söylemez

    2016-01-01

    Objectives: The purpose of this study was to determine the perinatal outcome and pregnancy complication (preterm delivery, preterm prelabour rupture of membrane [PPROM], preeclampsia, placental abruption and intrauterine growth restriction [IUGR]) of threatened miscarriage. Materials and Methods: A total of 963 patients attended the study. Of these, 493 women had threatened miscarriage. The control group included 470 pregnants without first trimester vaginal bleeding. We compared the two g...

  15. Trends on gastrointestinal bleeding and mortality: Where are we standing?

    Institute of Scientific and Technical Information of China (English)

    Ahmed Mahmoud EI-Tawil

    2012-01-01

    Bleeding from the gastrointestinal tract and its management are associated with significant morbidity and mortality.The predisposing factors that led to the occurrence of these hemorrhagic instances are largely linked to the life style of the affected persons.Designing a new strategy aimed at educating the publics and improving their awareness of the problem could effectively help in eradicating this problem with no associated risks and in bringing the mortality rates down to almost zero.

  16. Acute gingival bleeding as a complication of dengue hemorrhagic fever

    OpenAIRE

    Saif Khan; Gupta, N. D.; Sandhya Maheshwari

    2013-01-01

    Dengue fever is mosquito borne disease caused by dengue virus (DENV) of Flaviviridae family. The clinical manifestations range from fever to severe hemorrhage, shock and death. Here, we report a case of 20-year-old male patient undergoing orthodontic treatment presenting with acute gingival bleeding with a history of fever, weakness, backache, retro orbital pain and ecchymosis over his right arm. The hematological investigations revealed anemia, thrombocytopenia and positive dengue non-struct...

  17. Prevention of vitamin K deficiency bleeding in newborn infants

    DEFF Research Database (Denmark)

    Mihatsch, Walter; Braegger, Christian; Bronsky, Jiri;

    2016-01-01

    Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence, d...... whose mothers have taken medications that interfere with vitamin K metabolism. Parents who receive prenatal education about the importance of vitamin K prophylaxis may be more likely to comply with local procedures....

  18. An Unusual Cause of Gastrointestinal Bleeding: Duodenal Lipoma

    Directory of Open Access Journals (Sweden)

    R. Kadaba

    2011-04-01

    Full Text Available Common causes of chronic upper gastrointestinal bleeding include oesophageal varices, gastroduodenal ulcers and malignancy, and patients mostly present with iron deficiency type anaemia. We present the case of a 60-year-old lady who presented with iron deficiency anaemia and on investigation was found to have a large duodenal polyp requiring surgical excision. On histological examination, the polyp was revealed to be a lipoma. We review the recent literature and formulate a management plan for this rare entity.

  19. CLINICAL APPLICATION OF LIDUI (ST 45) BLEEDING METHOD

    Institute of Scientific and Technical Information of China (English)

    李春研; 王军

    2004-01-01

    Lidui (厉兑 ST 45) is the Jing (井 Well) point of the Stomach Meridian of Foot-Yangming. It's effective to reduce the heat from the stomach or the Stomach Meridian. The Stomach Meridian is abundant with qi and blood, and is in charge of hemopathy. So, in clinic, we often apply Lidui (ST 45) point bleeding method to the treatment of many kinds of diseases and get good therapeutic effects. Following are 3 typical cases.

  20. Double blind, placebo-controlled trial of Tranexamic acid on recent internal hemorrhoid bleeding

    Directory of Open Access Journals (Sweden)

    Abdul A. Rani

    2002-12-01

    Full Text Available Double blind randomized placebo controlled trial was conducted to evaluate the efficacy of Tranexamic acid in 54 patients with recent hemorrhoid bleeding. Age, gender, body weight, height, grade of hemorrhoid, time of onset of recent bleeding were comparable between two groups. Analysis of haemostatic effect or stop bleeding as an immediate outcome of this study revealed that in the grade 2 patients, 23/23 (100% of tranexamic group and 18/23(78.26% of placebo group the bleeding stop. After 3 days of observation, there was statistically significant different for the rate of stop bleeding as well as at the end of observation. Bleeding stop earlier in the Tranexamic group with median 4 days (3-5 days, compare to placebo, median 11(9.55-12.45. Analysis of recurrent bleeding as an outcome of this study revealed that in the placebo group 9/18(50% of grade 2 patients and all grade 3 (100%patients suffered from recurrent bleeding. Since the days 4, both group have significant different time for recurrent bleeding and at the end of observation, cumulative probability of free of bleeding between two groups significantly different. Median still stop bleeding in the placebo group was 36 days, and the tranexamic group never reaches the median until the end of observation. Conclusion: tranexamic acid was an effective drug to stop recent hemorrhoid bleeding and prevent further recurrent bleeding, significantly better than placebo. (Med J Indones 2002;11: 215-21Keywords: Tranexamic acid, hemorrhoid bleeding, haemostatic effect, recurrent bleeding.

  1. Chattering of bleed condenser relief valves in Darlington NGS

    International Nuclear Information System (INIS)

    The Bleed Condenser (BC) is part of the Pressure and Inventory Control System. The Primary Heat Transport System (PHTS) will transfer water to the Bleed Condenser via the PHT liquid relief valves (LRV) every time overpressure occurs in the main circuit. The BC is designed to withstand full PHT pressure and is protected against overpressurization by two spring loaded Relief Valves (RV). Chattering of these relief valves was observed during commissioning tests in Darlington, when opening of the LRVs pressurized the bleed condenser above the RVs set point. The chattering caused a drift in the valve setpoint and ruptured a pipe connected to the relief line. Similar undesirable events were observed in Bruce NGS. This paper presents the thermalhydraulic analysis of the system, during the above mentioned event and proposes several possible solutions to the problem. The computer simulation was performed using the SOPHT code, developed by Ontario Hydro. Considering the various limitations imposed by design on the relief valves and on the system, the recommended solution is to prolong the valve closing time by 400-800 milliseconds. (author) 9 refs., 11 figs

  2. Infliximab stopped severe gastrointestinal bleeding in Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Satimai Aniwan; Surasak Eakpongpaisit; Boonlert Imraporn; Surachai Amornsawadwatana; Rungsun Rerknimitr

    2012-01-01

    To report the result of rapid ulcer healing by infliximab in Crohn's patients with severe enterocolic bleeding.During 2005 and 2010,inflammatory bowel disease database of King Chulalongkorn Memorial and Samitivej hospitals were reviewed.There were seven Crohn's disease (CD) patients (4 women and 3 men; mean age 52 ± 10.4 years; range:11-86 years).Two of the seven patients developed severe gastrointestinal bleeding (GIB) as a flare up of CD whereas the other five patients presented with GIB as their first symptom for CD.Their mean hemoglobin level dropped from 12 ± 1.3 g/dL to 8.7 ± 1.3 g/dL in a 3-d period.Median packed red blood cells units needed for resuscitation was 4 units.Because of uncontrolled bleeding,surgical resection was considered.However,due to the poor surgical candidacy of these patients (n =3) and/or possible development of short bowel syndrome (n =6),surgery was not pursued.Likewise angiographic embolization was not considered in any due to the risk of large infarction.All severe GIBs successfully stopped by one or two doses of intravenous infliximab.Our data suggests that infliximab is an alternative therapy for CD with severe GIB when surgery has limitation or patient is a high risk.

  3. Sex hormones alter the effect of aspirin on bleeding

    Directory of Open Access Journals (Sweden)

    Muhammad Tariq Aftab

    2013-10-01

    Full Text Available Background: Interaction of aspirin and sex hormones was investigated through bleeding time. Methods: Bleeding time in 32 males and 105 unmarried females with previous 6 normal menstrual cycles and all aged between 18 to 21 years was found by Duke’s method before and after 2 hours of aspirin administration. Phase of menstrual cycle of each female was determined by present menstrual history. Results: Bleeding time in 32 male was 69.33± 4.94 seconds and in 105 female was 73.03±1.89 seconds which were not statistically different (P>0.05.This time was increased to 107.66±4.76 seconds in males and 113.65±3.73 seconds in females after aspirin administration which were statistically different (P0.05 difference after aspirin administration with a greater effect in Follicular phase probably due to estradiol. Conclusion: Males respond to aspirin more as compared to females which is likely the effect of the drug and testosterone interaction. Similarly females in the follicular phase respond to aspirin more as compared to females in the luteal phase which may be a result of interaction of estrogen and aspirin. [Int J Basic Clin Pharmacol 2013; 2(5.000: 537-540

  4. Meatspace is Cyberspace: The Pynchonian Posthuman in Bleeding Edge

    Directory of Open Access Journals (Sweden)

    Jason Siegel

    2016-06-01

    Full Text Available This article examines Thomas Pynchon’s indirect critique of utopian posthumanism in 'Bleeding Edge' by analyzing the deleterious effects that an emerging Internet culture has on the novel’s characters. By seeping into every aspect of their lives, embedding itself in their minds, and becoming a prosthetic consciousness, the Internet has transformed the characters into posthumans and altered their subject positions within a technological global capitalist culture. Contrasting the novel’s take on the posthuman with the posthuman theories of Donna Harraway, N. Katherine Hayles, Robert Pepperell, Rosi Braidotti, David Roden and Seb Franklin, I argue that, while the dominant utopian strain in posthuman theory imagines the advent of posthumanism as an opportunity for liberation from the sexism, racism, and colonial oppression that are enabled by the positing of the classical humanist subject, Pynchon demonstrates that because the Internet technology that brought about the posthuman condition is controlled by governments and corporations, it has become just one more lost chance at freedom that was converted into an instrument of increased control and surveillance. Reading 'Bleeding Edge' against William Gibson’s prototypical posthuman novel Neuromancer, I also contend that while Gibson, despite challenging the ontological primacy of meatspace over cyberspace, keeps the two realms separate, Pynchon, who borrows Gibson’s terms, shows that cyberspace has already merged with meatspace. As a result, Maxine Tarnow, the protagonist of 'Bleeding Edge', has nowhere to run in her attempt to find a provisional refuge for herself and her family.

  5. Heavy menstrual bleeding in adolescents: hormonal or hematologic?

    Science.gov (United States)

    Appelbaum, H; Acharya, S S

    2011-12-01

    Adolescence in girls is marked by a host of physical and psychological changes including those associated with menstruation. Heavy menstrual bleeding is one of the most commonly encountered medical problems during transition from childhood to adulthood. Although common, it is likely underreported given that the definition is dependent upon personal experience and influenced by their perception of "normal". Anovulatory cycles related to an immaturity of the hypothalamic pituitary ovarian axis seems to be common, however bleeding disorders such as coagulation factor deficiencies including von Willebrand disease, and quantitative and qualitative abnormalities of platelets must be ruled out. Other medical conditions such as endocrinopathies including diabetes mellitus, Cushing syndrome, polycystic ovarian syndrome, hypothyroidism, chronic hepatic and renal disease, anatomical uterine anomalies, pregnancy, obesity, medications causing hyperprolactinemia must also be considered. Management is based on the presence of hemodynamic instability and acuity of presentation. Treatment options include the use of combined oral contraceptive pills and antifibrinolytic agents; levonorgesterel impregnated intrauterine devices and or treatment of the specific underling bleeding disorder or endocrinopathy. Ongoing management needs to be accomplished through a multi disciplinary team approach in a comprehensive care setting with an adolescent gynecologist, hematologist, pediatrician, and nutritionist involved in the program for a better outcome of this problem. PMID:22036758

  6. Stroke and bleeding risk assessment: where are we now?

    Directory of Open Access Journals (Sweden)

    Mikhail S Dzeshka; Gregory Y.H. Lip

    2014-04-01

    Full Text Available Atrial fibrillation (AF is one of major problems of the contemporary cardiology. Ischaemic stroke is a common complication of the AF, and effective prophylaxis requires treatment with oral anticoagulants. The purpose of this current review article is to provide an overview of the various stroke and bleeding risk assessment scores that help decision making with respect to thromboprophylaxis. Particular focus is made on the currently guideline-recommended stroke and bleeding risk scores, such as CHA2DS2-VASc (congestive heart failure or left ventricular dysfunction, hypertension, age ≥75, diabetes, stroke, vascular disease, age 65–74 and sex category [female] and HAS-BLED (uncontrolled hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly [e.g. age >65, frail condition], drugs [e.g. aspirin, nonsteroidal anti-inflammatory drugs]/excessive alcohol is made. Future directions for improvement of predictive ability of risk assessment with clinical factors and biomarkers are also discussed.

  7. Superfund record of decision (EPA Region 7): Former Nebraska Ordnance Plant Site, Operable Unit 1, Mead, NE, August 29, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    This decision document presents the selected remedial action for the former Nebraska Ordnance Plant (NOP) site, in Mead, Nebraska. The former NOP site was used as an ordnance loading, assembly, and packing facility. Operations at the NOP resulted in contamination of soil with explosive compounds. Operable Unit 1 (OU1) encompasses the upper 4 feet of soil contaminated with explosive compounds. The remedial action for OU1 addresses one of the principal threats at the site, explosives-contaminated soil, by thermally treating the contaminated soil on-site.

  8. “I Just Look at Books”: Reading the Monetary Metareality of Bleeding Edge

    Directory of Open Access Journals (Sweden)

    Sascha Pöhlmann

    2016-02-01

    Full Text Available The essay analyzes 'Bleeding Edg'e for its pervasive representation of money, arguing that it operates as a metareality in the novel both on the levels of plot and style. Money is presented as a symbolic structure behind reality that is accessible to the initiated, the interpretation of which offers genuine insight about the world and its interrelations, in parallel to religious or scientific discourses. This does not simply mean that everything—politics, society, culture, technology, etc.—is ultimately determined by economic factors, but rather that money underlies the reality of these phenomena like a kind of source code, and that it is readable as such, for better or worse. In the novel, real and virtual money is heavily associated with moral values and their loss, although it is not at all only associated negatively with greed and the abuse of power. Money also harbors subversive potential in 'Bleeding Edge', as it can uncover corruption and fraud as much as other conspiratorial phenomena (especially in connection to 9/11. In particular, cash money can become an alternative medium of communication that combines the private and the public. Money does exhibit a tendency towards moral corruption in the novel, but at the same time it eludes any complete control and remains an economic as well as symbolic tool that can undermine the very capitalist system it seems to perpetuate.

  9. The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

    Science.gov (United States)

    Sandberg, E C; Pelligra, R

    1983-07-01

    Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

  10. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review.

    Science.gov (United States)

    Tang, Shan-Hong; Zeng, Wei-Zheng; He, Qian-Wen; Qin, Jian-Ping; Wu, Xiao-Ling; Wang, Tao; Wang, Zhao; He, Xuan; Zhou, Xiao-Lei; Fan, Quan-Shui; Jiang, Ming-De

    2015-10-16

    Gastric varices (GV) are one of the most common complications for patients with portal hypertension. Currently, histoacryl injection is recommended as the initial treatment for bleeding of GV, and this injection has been confirmed to be highly effective for most patients in many studies. However, this treatment might be ineffective for some types of GV, such as splenic vein thrombosis-related localized portal hypertension (also called left-sided, sinistral, or regional portal hypertension). Herein, we report a case of repeated pancreatitis-induced complete splenic vein thrombosis that led to intractable gastric variceal bleeding, which was treated by splenectomy. We present detailed radiological and pathological data and blood rheology analysis (the splenic artery - after a short gastric vein or stomach vein - gastric coronary vein - portal vein). The pathophysiology can be explained by the abnormal direction of blood flow in this patient. To our knowledge, this is the first reported case for which detailed pathology and blood rheology data are available.

  11. Experience with abdominal gamma imaging in patients with bleeding of the lower digestive tube

    International Nuclear Information System (INIS)

    This study concerns our experiences with abdominal gamma imaging using Tc-99m colloid and with abdominal angiography using Tc-99m-pyrophosphate labelled erythrocytes ''in vivo'' based on the modified technique described by Callahan. The dynamic or perfusion phase was first performed, then the static phase during which for the first two hours scans were taken every 15 minutes and thereafter every 4-6 hours. The routine image corresponds to the first, although it was necessary at times to take oblique projections. The study was felt to be accomplished after 48 hours upon observing no extravasation of radioactive material in the abdominal region, or upon detecting a bleeding site. The investigation was performed on 11 patients, 8 having positive scans of abdominal extravasation, later confirmed in 6 by endoscopy and by surgery. In 2, the presence of salmonelosis was shown by laboratory analysis. Endoscopy and angiography XR are both invasor methods. Various authors for the past 20 years have tried to perform examinations with different radionuclides in order to detect bleeding sites of the lower digestive tract. Our study demonstrates the possibility of detecting this type of pathology by means of studies with colloids and labelled erithrocytes. (author)

  12. Evidence supporting the use of recombinant activated factor VII in congenital bleeding disorders

    Directory of Open Access Journals (Sweden)

    Pär I Johansson

    2010-06-01

    Full Text Available Pär I Johansson, Sisse R OstrowskiCapital Region Blood Bank, Section for Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Recombinant activated factor VII (rFVIIa, NovoSeven® was introduced in 1996 for the treatment of hemophilic patients with antibodies against coagulation factor VIII or IX.Objective: To review the evidence supporting the use of rFVIIa for the treatment of patients with congenital bleeding disorders.Patients and methods: English-language databases were searched in September 2009 for reports of randomized controlled trials (RCTs evaluating the ability of rFVIIa to restore hemostasis in patients with congenital bleeding disorders.Results: Eight RCTs involving 256 hemophilic patients with antibodies against coagulation factors, also known as inhibitors, were identified. The evidence supporting the use of rFVIIa in these patients was weak with regard to dose, clinical setting, mode of administration, efficacy, and adverse events, given the limited sample size of each RCT and the heterogeneity of the studies.Conclusion: The authors suggest that rFVIIa therapy in hemophilic patients with inhibitors should be based on the individual’s ability to generate thrombin and form a clot, and not on the patient’s weight alone. Therefore, assays for thrombin generation, such as whole-blood thromboelastography, have the potential to significantly improve the treatment of these patients.Keywords: hemophilia, inhibitors, coagulation factor VIII, coagulation factor IX, rFVIIa, NovoSeven, FEIBA, hemostasis, RCT

  13. The effective control of a bleeding injury using a medical adhesive containing batroxobin

    International Nuclear Information System (INIS)

    Many types of hemostatic agents have been studied for the effective control of bleeding. In this study, a powdery medical adhesive composed of aldehyded dextran and ε-poly (L-lysine) was used with the recombinant batroxobin. Batroxobin is a venomous component from the snake Bothrops atrox moojeni and catalyzes fibrinogen conversion to form soluble fibrin clots. This research aims to examine the performance of the batroxobin-containing adhesive for hemostasis, and evaluate its potential as a novel hemostatic adhesive. The fibrinogen conversion ability of batroxobin was evaluated by a fibrinogen clotting assay and a whole blood clotting assay. Both experiments demonstrated the effectiveness of the batroxobin-containing adhesive for blood clot formation. Animal experiments were also conducted. After a pricking wound was made in an ICR (imprinting control region) mouse liver, the adhesive and various concentrations of batroxobin were applied. The total amount of blood loss was reduced with increasing concentrations of batroxobin. For excessive bleeding conditions, the femoral artery wound model of SD (Sprague-Dawley) rats was adopted. With higher concentrations of batroxobin, hemostasis was more rapidly achieved. Histological analysis of the liver model also supports the hemostatic effects through fibrin clot formation. In conclusion, batroxobin and medical adhesive effectively facilitate blood coagulation, and could be developed for clinical use. (paper)

  14. The effective control of a bleeding injury using a medical adhesive containing batroxobin.

    Science.gov (United States)

    You, Kyung Eun; Koo, Min-Ah; Lee, Dae-Hyung; Kwon, Byeong-Ju; Lee, Mi Hee; Hyon, Suong-Hyu; Seomun, Young; Kim, Jong-Tak; Park, Jong-Chul

    2014-04-01

    Many types of hemostatic agents have been studied for the effective control of bleeding. In this study, a powdery medical adhesive composed of aldehyded dextran and ε-poly (L-lysine) was used with the recombinant batroxobin. Batroxobin is a venomous component from the snake Bothrops atrox moojeni and catalyzes fibrinogen conversion to form soluble fibrin clots. This research aims to examine the performance of the batroxobin-containing adhesive for hemostasis, and evaluate its potential as a novel hemostatic adhesive. The fibrinogen conversion ability of batroxobin was evaluated by a fibrinogen clotting assay and a whole blood clotting assay. Both experiments demonstrated the effectiveness of the batroxobin-containing adhesive for blood clot formation. Animal experiments were also conducted. After a pricking wound was made in an ICR (imprinting control region) mouse liver, the adhesive and various concentrations of batroxobin were applied. The total amount of blood loss was reduced with increasing concentrations of batroxobin. For excessive bleeding conditions, the femoral artery wound model of SD (Sprague-Dawley) rats was adopted. With higher concentrations of batroxobin, hemostasis was more rapidly achieved. Histological analysis of the liver model also supports the hemostatic effects through fibrin clot formation. In conclusion, batroxobin and medical adhesive effectively facilitate blood coagulation, and could be developed for clinical use. PMID:24487019

  15. Safety analysis for operating the Annular Core Research Reactor with Cintichem-type targets installed in the central region of the core

    Energy Technology Data Exchange (ETDEWEB)

    PARMA JR.,EDWARD J.

    2000-01-01

    Production of the molybdenum-99 isotope at the Annular Core Research Reactor requires highly enriched, uranium oxide loaded targets to be irradiated for several days in the high neutron-flux region of the core. This report presents the safety analysis for the irradiation of up to seven Cintichem-type targets in the central region of the core and compares the results to the Annular Core Research Reactor Safety Analysis Report. A 19 target grid configuration is presented that allows one to seven targets to be irradiated, with the remainder of the grid locations filled with aluminum ''void'' targets. Analyses of reactor, neutronic, thermal hydraulics, and heat transfer calculations are presented. Steady-state operation and accident scenarios are analyzed with the conclusion that the reactor can be operated safely with seven targets in the grid, and no additional risk to the public.

  16. Safety analysis for operating the Annular Core Research Reactor with Cintichem-type targets installed in the central region of the core

    International Nuclear Information System (INIS)

    Production of the molybdenum-99 isotope at the Annular Core Research Reactor requires highly enriched, uranium oxide loaded targets to be irradiated for several days in the high neutron-flux region of the core. This report presents the safety analysis for the irradiation of up to seven Cintichem-type targets in the central region of the core and compares the results to the Annular Core Research Reactor Safety Analysis Report. A 19 target grid configuration is presented that allows one to seven targets to be irradiated, with the remainder of the grid locations filled with aluminum ''void'' targets. Analyses of reactor, neutronic, thermal hydraulics, and heat transfer calculations are presented. Steady-state operation and accident scenarios are analyzed with the conclusion that the reactor can be operated safely with seven targets in the grid, and no additional risk to the public

  17. An assessment of the failure rate for the beltline region of PWR pressure vessels during normal operation and certain transient conditions. Technical report

    International Nuclear Information System (INIS)

    A study was conducted to assess the failure rate for the beltline region of a generic pressurized-water reactor (PWR) pressure vessel. This assessment included the evaluation of several normal operating and transient reactor conditions. Failure rates were calculated from a computer code that used fracture mechanics methods to model the failure process; random number generation techniques were used to simulate random variables and model their interaction in the failure-process. This investigation had three major objectives: (1) to better define the effect of neutron irradiation, material variation, and flaw distribution on the failure rate for the beltline region of PWR pressure vessels, (2) to estimate the relative margins against failure for normal operation and certain transient conditions associated with nuclear pressure vessels, and (3) to evaluate the current limitations for using fracture mechanics models to predict failure rates for nuclear pressure vessels

  18. Marketing research-level marketing and logistics operation of the machine-building enterprises of Khmelnitsky region

    OpenAIRE

    Z.M. Andrushkevich

    2011-01-01

    The article defines the role of marketing research in the analysis of marketing and logistics industries. The necessity of conducting regular market research. Presents the results of market research to determine the level of marketing and logistics activities of industrial enterprises of Khmelnitsky region, identified weaknesses practical use of marketing and logistics functions in the enterprise.

  19. The Law of International Responsibility and Multilayered Institutional Veils: The Case of Authorized Regional Peace-Enforcement Operations

    NARCIS (Netherlands)

    J. d' Aspremont

    2013-01-01

    This short article sheds some light on the difficulties inherent in the application of international responsibility mechanisms to situations of authorized regional uses of force. It shows the extent to which the double institutional veil that characterizes these situations comes to frustrate the app

  20. The law of international responsibility and multilayered institutional veils: the case of authorized regional peace-enforcement operations

    NARCIS (Netherlands)

    J. d' Aspremont

    2014-01-01

    This short article sheds some light on the difficulties inherent in the application of international responsibility mechanisms to situations of authorized regional uses of force. It shows the extent to which the double institutional veil that characterizes these situations comes to frustrate the app

  1. The Agreement to Extend the Agreement 23 May 1980 Establishing the Asian Regional Co-Operative Project on Food Irradiation. Additional acceptances of the Agreement

    International Nuclear Information System (INIS)

    The Governments of the Philippines and India notified the Agency of their acceptance of the Agreement to Extend the Agreement Establishing the Asian Regional Co-operative Project on Food Irradiation of 8 July 1983, in accordance with Article II, paragraph 1 thereof, on 23 September 1983 and 27 September 1983 respectively. Pursuant to Article II, paragraph 2, the Extension Agreement consequently entered into force with respect to these Governments on the respective dates

  2. Regional operations research program for commercialization of geothermal energy in the Rocky Mountain basin and range. Final technical report, January 1980-March 1981

    Energy Technology Data Exchange (ETDEWEB)

    1981-07-01

    This report describes the work accomplished from January 1980 to March 1981 in the Regional Operations Research efforts for the Rocky Mountain Basin and Range Geothermal Commercialization Program. The work included continued data acquisition and extension of the data base, enhancement and refinement of the economic models for electric and direct use applications, site-specific and aggregated analyses in support of the state teams, special analyses in support of several federal agencies, and marketing assistance to the state commercialization teams.

  3. The effect of interface phonons on operating electron states in three-barrier resonant tunneling structure as an active region of quantum cascade detector

    OpenAIRE

    M.V. Tkach; Ju.O. Seti; Grynyshyn, Y. B.; O.M. Voitsekhivska

    2014-01-01

    The Hamiltonian of electrons interacting with interface phonons in three-barrier resonant tunneling structure is established using the first principles within the models of effective mass and polarization continuum. Using the Green's functions method, the temperature shifts and decay rates of operating electron states are calculated depending on geometric design of three-barrier nano-structure GaAs/AlxGa1-xAs which is an active region of quantum cascade detector. It is established that indepe...

  4. Spectral Properties of the Periodic Magnetic Schrödinger Operator in the High-Energy Region. Two-Dimensional Case

    Science.gov (United States)

    Karpeshina, Yulia

    2004-11-01

    The goal is to investigate spectral properties of the operator H=(-i∇ +a(x))2+a0(x) in the two-dimensional situation, a(x), a0(x)) being periodic. We construct asymptotic formulae for Bloch eigenvalues and eigenfunctions in the high-energy region, describe properties of isoenergetic curves in the space of quasimomenta and give a new proof of the Bethe-Sommerfeld conjecture.

  5. Successful treatment of Depot Medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in Adolescents

    Directory of Open Access Journals (Sweden)

    Kristin M. Rager

    2006-01-01

    Full Text Available High discontinuation rates for depot medroxyprogesterone acetate (DMPA in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.

  6. THE INFLUENCE OF GEOLOGY ON BATTLEFIELD TERRAIN AND IT’S AFFECTS ON MILITARY OPERATIONS IN MOUNTAINS AND KARST REGIONS: EXAMPLES FROM WW1 AND AFGHANISTAN

    Directory of Open Access Journals (Sweden)

    Marko Zečević

    2007-12-01

    Full Text Available During the World War I conflict between the Austrian and Italian army, Austrian engineer units constructed hallways in the karst region of Soča river. Those hallways, karst phenomena (caverns, caves and other fortifications, gave the Austrian army a tactical advantage. The construction principle of caverns is the consequence of the geological structure of the terrain. We are watching another military conflict in Afghanistan. In country where many armies in history have been defeated, where the terrain morphology condition a guerilla tactic, where the function effect of modern military technology is limited by battlefield configuration and with low military value of individual target, we are creating a "picture" of the possible view of the future battlefield. Al-Qai'da operatives in east Afghanistan take advantage of the opportunity of geological structure of the terrain and construct tunnel network across natural caves. Although the tunnel network in Afghanistan is constructed mostly in sandstones and metamorphic rocks, we may partly compare it with Austrian hallways. In that sense this work shows the influence of geological structure of the terrain on the effect of military operations in mountains and karst regions, and the analogy between military operations on the Soča river and military operations in Afghanistan.

  7. New product introduction and supplier integration in sales and operations planning:evidence from the Asia Pacific region

    OpenAIRE

    Goh, Shao Hung; Eldridge, Stephen

    2015-01-01

    Purpose: This paper investigates the implementation and performance benefits of Sales and Operations Planning (S&OP) within organizations in Asia Pacific. Design/methodology/approach: A case study method was used, with two companies selected. The first company had recently commenced S&OP and applied it to facilitate New Product Introduction, while the second had integrated its supplier into an existing S&OP program. Supply chain performance data was collected and analyzed in the context of an...

  8. Developing Port Klang as National Load Centre and Regional Hub Through Synchronized Supply Chain and Efficient Port Operation

    OpenAIRE

    Fong, Loo Ming

    2007-01-01

    The ocean covers more than two third of the earth’s surface and this provides immense maritime opportunities in marine transportation and trade. Ships that ply the maritime domain are primary mode of transportation and carry about 80% of the world trade volume (Organisation of Economic Cooperation and Development, OECD July 2003). Port Operations and ancillary services such as freight forwarding, shipping play an enormous role in generating economic growth. Seaborne trades through port termin...

  9. Environmental Radiation Surveillance Results from over the Last Decade of Operational Experience at the Regional Radiation Monitoring Stations(RRMS)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hae Young [Daegu Regional Radiation Monitoring Station, Daegu (Korea, Republic of); Yoo, Dong Han [Ulsan Regional Radiation Monitoring Station, Ulsan (Korea, Republic of); Lee, Sang Hoon [Kyungpook National University, Daegu (Korea, Republic of)

    2015-10-15

    The objectives of the current program are to monitor environmental radiation/radioactivity level in Korea and to provide the base-line data on environmental radiation/radioactivity which will be useful in the case of radiological emergency situations. This program plays an important role in the view of protecting the public health against the potential hazards of radiation and maintaining a clean environment. This paper describes an introduction to the Regional Radiation Monitoring Stations (RRMS), and also presents some results of recent years (2001-2014). The environmental radiation surveillance results of years 2001-2014 have been described. It indicates normal levels of radiation in the past years. These kinds of studies are very important in providing references in understanding the environmental radioactivity level in a particular region.

  10. An HTS flux pump operated by directly driving a superconductor into flux flow region in the E– J curve

    Science.gov (United States)

    Geng, Jianzhao; Coombs, T. A.

    2016-09-01

    High-T c superconducting (HTS) flux pumps are capable of compensating the persistent current decay in HTS magnets without electrical contact. In this paper, following work on a low-T c superconducting self-switching flux pump, we propose a new HTS flux pump by directly driving a high-T c superconductor into the flux flow region in the E– J curve. The flux pump consists of a transformer which has a superconducting secondary winding shorted by an YBCO-coated conductor bridge. A high alternating current with a much higher positive peak value than the negative peak value is induced in the secondary winding. The current always drives the bridge superconductor into the flux flow region only at around its positive peak value, thus resulting in flux pumping. The proposed flux pump is much simpler than existing HTS flux pumps.

  11. Operational Remote Sensing Services in North Eastern Region of India for Natural Resources Management, Early Warning for Disaster Risk Reduction and Dissemination of Information and Services

    Science.gov (United States)

    Raju, P. L. N.; Sarma, K. K.; Barman, D.; Handique, B. K.; Chutia, D.; Kundu, S. S.; Das, R. Kr.; Chakraborty, K.; Das, R.; Goswami, J.; Das, P.; Devi, H. S.; Nongkynrih, J. M.; Bhusan, K.; Singh, M. S.; Singh, P. S.; Saikhom, V.; Goswami, C.; Pebam, R.; Borgohain, A.; Gogoi, R. B.; Singh, N. R.; Bharali, A.; Sarma, D.; Lyngdoh, R. B.; Mandal, P. P.; Chabukdhara, M.

    2016-06-01

    North Eastern Region (NER) of India comprising of eight states considered to be most unique and one of the most challenging regions to govern due to its unique physiographic condition, rich biodiversity, disaster prone and diverse socio-economic characteristics. Operational Remote Sensing services increased manifolds in the region with the establishment of North Eastern Space Applications Centre (NESAC) in the year 2000. Since inception, NESAC has been providing remote sensing services in generating inventory, planning and developmental activities, and management of natural resources, disasters and dissemination of information and services through geo-web services for NER. The operational remote sensing services provided by NESAC can be broadly divided into three categories viz. natural resource planning and developmental services, disaster risk reduction and early warning services and information dissemination through geo-portal services. As a apart of natural resources planning and developmental services NESAC supports the state forest departments in preparing the forest working plans by providing geospatial inputs covering entire NER, identifying the suitable culturable wastelands for cultivation of silkworm food plants, mapping of natural resources such as land use/land cover, wastelands, land degradation etc. on temporal basis. In the area of disaster risk reduction, NESAC has initiated operational services for early warning and post disaster assessment inputs for flood early warning system (FLEWS) using satellite remote sensing, numerical weather prediction, hydrological modeling etc.; forest fire alert system with actionable attribute information; Japanese Encephalitis Early Warning System (JEWS) based on mosquito vector abundance, pig population and historical disease intensity and agriculture drought monitoring for the region. The large volumes of geo-spatial databases generated as part of operational services are made available to the administrators and

  12. OPERATIONAL REMOTE SENSING SERVICES IN NORTH EASTERN REGION OF INDIA FOR NATURAL RESOURCES MANAGEMENT, EARLY WARNING FOR DISASTER RISK REDUCTION AND DISSEMINATION OF INFORMATION AND SERVICES

    Directory of Open Access Journals (Sweden)

    P. L. N. Raju

    2016-06-01

    Full Text Available North Eastern Region (NER of India comprising of eight states considered to be most unique and one of the most challenging regions to govern due to its unique physiographic condition, rich biodiversity, disaster prone and diverse socio-economic characteristics. Operational Remote Sensing services increased manifolds in the region with the establishment of North Eastern Space Applications Centre (NESAC in the year 2000. Since inception, NESAC has been providing remote sensing services in generating inventory, planning and developmental activities, and management of natural resources, disasters and dissemination of information and services through geo-web services for NER. The operational remote sensing services provided by NESAC can be broadly divided into three categories viz. natural resource planning and developmental services, disaster risk reduction and early warning services and information dissemination through geo-portal services. As a apart of natural resources planning and developmental services NESAC supports the state forest departments in preparing the forest working plans by providing geospatial inputs covering entire NER, identifying the suitable culturable wastelands for cultivation of silkworm food plants, mapping of natural resources such as land use/land cover, wastelands, land degradation etc. on temporal basis. In the area of disaster risk reduction, NESAC has initiated operational services for early warning and post disaster assessment inputs for flood early warning system (FLEWS using satellite remote sensing, numerical weather prediction, hydrological modeling etc.; forest fire alert system with actionable attribute information; Japanese Encephalitis Early Warning System (JEWS based on mosquito vector abundance, pig population and historical disease intensity and agriculture drought monitoring for the region. The large volumes of geo-spatial databases generated as part of operational services are made available to the

  13. The lucid interval associated with epidural bleeding: evolving understanding.

    Science.gov (United States)

    Ganz, Jeremy C

    2013-04-01

    The aim of this paper was to elucidate the evolution of our understanding of the term "lucid interval." A number of texts were reviewed to assess their suitability for analysis. The primary requirement was that the text contain detailed descriptions of a series of patients. Details of the clinical course, the findings and timing of surgery, and, when relevant, the time of death and postmortem findings were required. Books written by Henri-François Le Dran, Percival Pott, and James Hill fulfilled these criteria. Surgical findings included the presence and type of fractures, changes in the bone, separation of periosteum, malodorous or purulent material, tense brain, and hematoma. Postmortem findings supplemented and/or complemented the surgical findings. The courses of the patients were then tabulated, and the correlation between different clinical and operative findings was thereby determined. Our understanding of a lucid interval began in the early 18th century with the work of Henri-François Le Dran and Percival Pott in London. They did not, however, demonstrate an interval without symptoms between trauma and deterioration in patients with epidural hematomas (EDHs). The interval they described was longer than usually expected with EDHs and occurred exclusively in patients who had a posttraumatic infection. In 1751, James Hill, from Dumfries, Scotland, described the first hematoma-related lucid interval in a patient with a subdural hematoma. The first case of a lucid interval associated with an EDH was described by John Abernethy. In the 19th century, Jonathan Hutchinson and Walter Jacobson described the interval as it is known today, in cases of EDH. The most recent work on the topic came from studies in Cincinnati and Oslo, where it was demonstrated that bleeding can separate dura mater and that hemorrhage into the epidural space can be shunted out via the veins. This shunting could delay the accumulation of a hematoma and thus the rise in intracranial pressure

  14. Environmental Assessment for the construction and operation of the Three Rivers Solid Waste Authority regional waste management center at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    This Environmental Assessment (EA) has been prepared by the US Department of Energy (DOE) to assess the potential environmental impacts associated with the construction and operation of a landfill and technology center for regionally-generated municipal solid waste at the Savannah River Site (SRS) near Aiken, South Carolina. The facility would serve the municipal solid waste disposal needs for SRS and at least nine of the surrounding counties who currently comprise the Three Rivers Solid Waste Authority (TRSWA). Additional counties could become included in the proposed action at some future date. Current Federal and state requirements do not afford individual counties and municipalities within the region encompassing SRS the ability to efficiently or economically operate modern waste management facilities. In addition, consolidation of regional municipal solid waste at one location would have the benefit of reducing the duplicity of environmental consequences associated with the construction and operation of county-level facilities. The option to seek a combined disposal and technology development facility based on a regionally-cooperative effort was selected as a viable alternative to the existing individual SRS or county disposal activities. This document was prepared in compliance with the National Environmental Policy Act (NEPA) of 1969, as amended, the requirements of the Council on Environmental Quality Regulations for Implementing NEPA (40 CFR Part 1021). NEPA requires the assessment of environmental consequences of Federal actions that may affect the quality of the human environment. Based on the potential for impacts described for impacts described herein, DOE will either publish a Finding of No Significant Impact or prepare an environmental impact statement (EIS).

  15. Environmental Assessment for the construction and operation of the Three Rivers Solid Waste Authority regional waste management center at the Savannah River Site

    International Nuclear Information System (INIS)

    This Environmental Assessment (EA) has been prepared by the US Department of Energy (DOE) to assess the potential environmental impacts associated with the construction and operation of a landfill and technology center for regionally-generated municipal solid waste at the Savannah River Site (SRS) near Aiken, South Carolina. The facility would serve the municipal solid waste disposal needs for SRS and at least nine of the surrounding counties who currently comprise the Three Rivers Solid Waste Authority (TRSWA). Additional counties could become included in the proposed action at some future date. Current Federal and state requirements do not afford individual counties and municipalities within the region encompassing SRS the ability to efficiently or economically operate modern waste management facilities. In addition, consolidation of regional municipal solid waste at one location would have the benefit of reducing the duplicity of environmental consequences associated with the construction and operation of county-level facilities. The option to seek a combined disposal and technology development facility based on a regionally-cooperative effort was selected as a viable alternative to the existing individual SRS or county disposal activities. This document was prepared in compliance with the National Environmental Policy Act (NEPA) of 1969, as amended, the requirements of the Council on Environmental Quality Regulations for Implementing NEPA (40 CFR Part 1021). NEPA requires the assessment of environmental consequences of Federal actions that may affect the quality of the human environment. Based on the potential for impacts described for impacts described herein, DOE will either publish a Finding of No Significant Impact or prepare an environmental impact statement (EIS)

  16. The effect of Adernalinated lidpcaine on Blood Pressure, Heart rate and Bleeding during DCR surgery in General Anesthesia

    Directory of Open Access Journals (Sweden)

    M. Shakhrezaee

    2005-01-01

    Full Text Available Background and purpose : NLD obstraction causes chronic or acute Dacryiocytits resistant epiphora. Current treatment is DCR for persistent conection between lscrimal sac and nasal cavity. Vasocontrictor drugs are used facilitasing the operation.Materials and methods : Being approved in the ethics committee of the Mazandaran University of Medical Sciences the study performed on 57 patients ASAL, II whom were divided in to two groups; Adrenaline group, no=23 and non adrenaline group no= 34. 10-15-ml adrenalin 1/200000 was injected at surgical area, before surgery in AG. BP, PR and bleeding were recorded during before and 1, 3, 5, 10,… min during the surgery. The results were analysed using t-test, and paired t-test at a significance level of< 0.05.Results : Maximum BP was measured at 3 minuts after adrenaline injection. The average of bleeding in adrenaline group was 38.3 ml and in nonadernaline group was 49.16 ml(P=0.007. The time of surgery in adrenalin group is shorter than non adrenaline group(P=0.003.Conclusion : Althragh adrenaline decreased the bleeding during surgery and facilitated the procedure, it is potentially dangerous for patients with cardiovascular disease during DCR syrgery.

  17. TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    K. G. M. Premleel

    2016-06-01

    Full Text Available OBJECTIVES To evaluate whether saline contrast sonohysterography (SCSH improved the diagnostic accuracy of transvaginal sonography (TVS for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS The uterine cavity was evaluated with TVS and SCSH in 60 premenopausal patients with abnormal uterine bleeding. All 58 patients underwent operative hysteroscopy or hysterectomy within 4 months which provided a detailed description of the uterine cavity and was used as the true value for exclusion of polyps and submucous myomas. RESULT Out of 60 patients, 45 had uterine abnormalities on TVS and SCSH and rest of the patients who appeared normal but had other abnormalities such as ovarian haemorrhagic cyst. Out of the 45 patients, 9 patients had submucous myomas and 9 were diagnosed as endometrial polyp. The findings were confirmed using hysterectomy/hysteroscopy/endometrial sampling. CONCLUSION The use of TVS without saline contrast left nine submucosal fibroids and five in nine of the polyps undiagnosed in referred patients with complaints of abnormal bleeding. It also helps in reducing the rate of more invasive procedures such as hysteroscopy. However, studies carried out for longer duration and large study population are required to validate our findings

  18. CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY

    DEFF Research Database (Denmark)

    Elenius Madsen, Daniel

    2012-01-01

    Title: CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY Objectives: Orthognathic surgery involves surgical manipulation of jaw and face skeletal structure. A subgroup of patients undergoing orthognathic surgery suffers from excessive...... into account the complex interplay between coagulation factors, blood platelets and components of the fibrinolytic system. Patients undergoing orthognathic surgery were included in this prospective study, and their preoperative thrombelastographic data were collected and compared to their intraoperative blood...... predictive values. An α angleex above 67o did with 95% certainty predict a blood loss below 400 mL, and a receiver-operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.8. Conclusion: By means of the α angleex it is possible to separate orthognathic surgery patients according...

  19. Management of abnormal uterine bleeding by northern, rural and isolated primary care physicians: PART I – How are we doing?

    Directory of Open Access Journals (Sweden)

    Stewart Donna E

    2002-11-01

    Full Text Available Abstract Background Canadian hysterectomy rates have declined in recent years. However, hysterectomy rates for discretionary indications, principally abnormal uterine bleeding (AUB, remain high in some regions. In northern Ontario, hysterectomy rates for women aged 34–45 are almost triple the rates in southern, urban areas. Primary care physicians (family doctors usually manage AUB initially in these northern areas where a severe shortage of gynecologists exists. Methods We surveyed 194 family physicians in northern Ontario with a case scenario of a pre-menopausal woman with heavy vaginal bleeding to characterize management and to gain physicians' perspectives on the factors that affect it. Results To investigate her heavy vaginal bleeding, only 17% of physicians recommended a pelvic examination for the woman in our case scenario. Most physicians advocated a course of medical therapy before referral to a gynecologist, for whom the average waiting time was seven weeks. However, most physicians recommended referral after only one failed trial of medical treatment. Physicians felt that major deterrents to medical treatments were patient desires for immediate relief and/or permanent solutions, poor patient compliance and the high cost of medication. Only 25% of respondents indicated that they would perform an endometrial biopsy prior to referral. Conclusions Family physicians would benefit from further education on appropriate investigations for AUB, primarily training in pelvic examination and endometrial biopsy techniques, as well as appropriate treatment algorithms. Further research into patient perspectives on treatment options is needed.

  20. Relationship of pelvic bone fracture pattern and bleeding foci on angiography

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate the relationship between the patterns of pelvic bone fracture and location of hemorrhage on angiography. We retrospectively reviewed 56 patients with pelvic bone fracture and active bleeding. Fractures were classified according to Tile classification. Locations of bleedings were divided into four groups; main trunk/anterior/posterior divisions of internal iliac artery, and other locations. The relationship between the fracture pattern and bleedings were analyzed statistically. Forty one bleedings were in 22 patients with type A fracture. Twenty (49%) were at the anterior division, 12 (29%) were at the posterior division, and 9 (22%) were found in other location. Thirty three bleedings were in 23 patients with type B fracture. Fifteen (45%) were at the posterior division, 10 (30%) were at the anterior division, 3 (9%) were at the main trunk of the internal iliac artery, and 5 (16%) were at other location. Eighteen bleedings were in 11 patients with type C fracture. Thirteen (72%) were at the posterior division, 4 (22%) were at the anterior division, and 1 (6%) was at main trunk of internal iliac artery. Anterior divisional bleedings were more common in type A, posterior divisional bleedings were more common in type B and C fractures (p = 0.014). The distribution of bleeding is significantly related to the fracture patterns. Fracture pattern may help in predicting the location of bleeding foci on embolization

  1. Registry of hemophilia and other bleeding disorders in Syria.

    Science.gov (United States)

    Ali, T; Schved, J F

    2012-11-01

    Creating a national registry for bleeding disorders is a major step in establishing a National Hemophilia Care Program in all countries. Creating such a registry which would contain accurate and regularly updated data, including laboratory analysis confirmed by a reference laboratory established at the Syrian Hemophilia Society. Blood samples were drawn and analysed in the Society reference laboratory for the following screening tests: prothrombin time (PT), APTT and coagulation factor assays. Inhibitor detection and VWF RiCof were performed depending on the result of the screening tests. HBs Ag, anti-HCV, anti-HIV 1+2 and syphilis tests were also performed to detect transfusion transmitted agents (TTA). Diagnosis of the bleeding disorder type was confirmed for 760 of these cases. Among the 760 confirmed patients, 82.5% had haemophilia. Among these, 89.6%were haemophilia A; 10.4% were haemophilia B; 8.3% had VWD; 9.2% had other rare bleeding disorders as follows: 1.2% FVII deficiency, 0.7% FV deficiency, 1.8% F1 deficiency, 0.4% FX deficiency, 1.4% platelets dysfunctions (mainly Glanzmann Thrombasthenia) and 3.7% had combined FVIII and FV deficiency. Eighty (21.3%) cases of 375 screened for transfusion transmitted agents were positive for at least one infection: 0.5% were HBsAg positive, 19.7% were anti-HCV positive, 0.8% had combined HBsAg and anti-HCV positivity and 0.3% was anti-Syphilis positive. All patients were negative for HIV1 and HIV2. The preliminary data presented here follow known data on haemophilia A, haemophilia B and VWD disease. This registry will certainly help in improving haemophilia care in Syria.

  2. Sangrado de origen ginecológico Gynaecological bleeding

    Directory of Open Access Journals (Sweden)

    I. Jiménez Ubieto

    2009-01-01

    Full Text Available El sangrado genital es la alteración ginecológica más frecuente en las mujeres en edad reproductiva siendo, en los países occidentales, una de las causas más frecuentes de anemia y que puede ser motivo de absentismo laboral. Ante una paciente con sangrado en el Servicio de Urgencias lo primero habrá que valorar la repercusión hemodinámica, adoptando las medidas necesarias. Se realizará una anamnesis y exploración detalladas para establecer el origen. Cuando aparece sangrado en el área genital generalmente se piensa en un origen uterino, pero no siempre es así y habrá que descartar origen en el tracto genital inferior, en el tracto genital superior u otro origen extraginecológico en el área digestiva y/o urológica. Con el diagnóstico se valorará el tratamiento oportuno y la necesidad o no de ingreso hospitalario.Genital bleeding is the most frequent gynaecological alteration in women of reproductive age. In industrial countries it is one of the most frequent causes of anaemia and can be a cause of labour absenteeism. Facing a patient with bleeding in the Accident and Emergency Service, the first thing is to evaluate the haemodynamic repercussion and take the necessary measures. A detailed case history and exploration are carried out to establish its origin. A uterine origin is usually considered when bleeding appears in the genital area, but this is not always the case, and it is necessary to rule out an origin in the lower genital tract, upper genital tract or an extragynaecological origin in the digestive and/or urological area. With the diagnosis an appropriate treatment will be considered, as well the possible need for hospital admission.

  3. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  4. Women’s perceptions about reducing the frequency of monthly bleeding: results from a multinational survey

    Directory of Open Access Journals (Sweden)

    Szarewski A

    2013-05-01

    Full Text Available Anne Szarewski,1 Cecilia Moeller2 1Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom; 2Bayer HealthCare Pharmaceuticals, Global Market Research General Medicine, Berlin, Germany Background: Monthly bleeding can have a negative impact on daily life and, given the choice, many women would reduce the frequency of bleeding. While some women choose to occasionally postpone or reduce bleeding frequency with an oral contraceptive (OC, most women have no or limited experience of regularly reducing the frequency of scheduled bleeding with OCs, ie, the extended OC regimen. Study design: An online survey of 4039 women aged 15–49 years who were currently using, had used, or would consider using any form of hormonal contraception was conducted in Brazil, Canada, Czech Republic, France, Germany, Italy, UK, and USA to assess awareness of and the reasons for and against reducing bleeding frequency. Results: Overall, 51.1% and 30.7% of women surveyed were aware that they could occasionally or regularly reduce bleeding frequency with an OC. Moreover, 27.6% and 9.9% of previous/current OC users had occasionally or regularly reduced bleeding frequency with an OC. The main reasons for reducing bleeding frequency were convenience, physician recommendations, special events, and relief of problems associated with bleeding. Many women mistakenly believed that reducing bleeding frequency would have a negative health impact. Conclusion: Additional efforts are needed to educate women about the possibility and potential health benefits of reducing bleeding frequency and to dispel misconceptions about the use of extended OC regimens. Keywords: extended regimen, menstruation, oral contraceptive, withdrawal bleeding, scheduled bleeding

  5. A massive bleeding from a gastrointestinal stromal tumor of a Meckel’s diverticulum

    Directory of Open Access Journals (Sweden)

    Chabowski Mariusz

    2016-01-01

    Full Text Available Introduction. Meckel’s diverticulum is the most common congenital anomaly of the gastro intestinal tract, present in about 2% of population. Case Outline. The article presents the case of a 44-year-old otherwise healthy man with anemia, who was diagnosed lower gastrointestinal bleeding. An abdominal CT scan revealed a clearly demarcated solid tumor in hypogastric region, measuring 65 Ч 45 mm. A laparotomy through lower midline incision was performed. A surgical resection of a lesion of a Meckel’s diverticulum was carried out and a final diagnosis of gastrointestinal stromal tumor was made. The patient made an uneventful recovery. Conclusion. The preoperative diagnosis of a complicated Meckel’s diverticulum may be challenging. CT is usually an adequate method to diagnose tumors arising from Meckel’s diverticulum.

  6. Microcirculatory remodeling in marginal zone of duodenal ulcer after bleeding

    Directory of Open Access Journals (Sweden)

    Sulayeva О.N.

    2009-01-01

    Full Text Available To estimate objectively vessels network remodeling in duodenal mucosa after ulcer bleeding the morphometric analysis of marginal ulcer zone biopsies was performed in 32 patients. It was shown that reparation is accompanied with chronic inflammation and acute alteration of microcirculation. Injection hemostasis led to enhancement of microcirculation, development of edema and ischemic alteration of mucosal tissues. Acute neutrophilic infiltration during 1 day was changed on 3 day with granular tissue development and angiogenesis stimulation. Intensification and prolongation of angiogenesis paral-leled with lymphocytes infiltration after 7 days resulted to villi dysmorphogenesis and changes in cellular content of intestinal epithelium.

  7. Three infants with rotavirus gastroenteritis complicated by severe gastrointestinal bleeding.

    Science.gov (United States)

    Kawamura, Yoshiki; Miura, Hiroki; Mori, Yuji; Sugata, Ken; Nakajima, Yoichi; Yamamoto, Yasuto; Morooka, Masashi; Tsuge, Ikuya; Yoshikawa, Akiko; Taniguchi, Koki; Yoshikawa, Tetsushi

    2016-01-01

    Rotavirus gastroenteritis causes substantial morbidity and mortality worldwide in children. We report three infants with rotavirus gastroenteritis complicated by various severity of gastrointestinal bleeding. Two patients (cases 1 and 2) recovered completely without any specific treatments. One patient (case 3) died despite extensive treatments including a red blood cell transfusion and endoscopic hemostatic therapy. Rotavirus genotypes G1P[8] and G9P[8] were detected in cases 2 and 3, respectively. Rotavirus antigenemia levels were not high at the onset of melena, suggesting that systemic rotaviral infection does not play an important role in causing melena. PMID:26100228

  8. How we treat bleeding associated with direct oral anticoagulants

    Science.gov (United States)

    Marano, Giuseppe; Vaglio, Stefania; Pupella, Simonetta; Liumbruno, Giancarlo M.; Franchini, Massimo

    2016-01-01

    Direct oral anticoagulants are at least as effective as vitamin K antagonists for the prevention and treatment of thromboembolism. Unfortunately, differently from vitamin K antagonists, they have the great drawback of lacking specific antidotes in the case of bleeding or emergency situations such as trauma, stroke requiring thrombolysis, and urgent surgery. The progressive development of antidotes for these new drugs, which, it is hoped, will become available in the near future, will allow better and safer management of the rapid reversal of their anticoagulant effect. PMID:27136433

  9. Improving Quality of Care in Peptic Ulcer Bleeding

    DEFF Research Database (Denmark)

    Rosenstock, Steffen J; Møller, Morten H; Larsson, Heidi Jeanet;

    2013-01-01

    OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered...... demographic, clinical, and prognostic data. QOC was evaluated using eight process and outcome indicators, including time to initial endoscopy, hemostasis obtainment, proportion undergoing surgery, rebleeding risks, and 30-day mortality.RESULTS:A total of 13,498 PUB patients (median age 74 years) were included...

  10. How we treat bleeding associated with direct oral anticoagulants.

    Science.gov (United States)

    Marano, Giuseppe; Vaglio, Stefania; Pupella, Simonetta; Liumbruno, Giancarlo M; Franchini, Massimo

    2016-09-01

    Direct oral anticoagulants are at least as effective as vitamin K antagonists for the prevention and treatment of thromboembolism. Unfortunately, differently from vitamin K antagonists, they have the great drawback of lacking specific antidotes in the case of bleeding or emergency situations such as trauma, stroke requiring thrombolysis, and urgent surgery. The progressive development of antidotes for these new drugs, which, it is hoped, will become available in the near future, will allow better and safer management of the rapid reversal of their anticoagulant effect. PMID:27136433

  11. Superfund Record of Decision (EPA Region 8): Rocky Flats Plant (USDOE), Operable Unit 3, Golden, CO, June 3, 1997

    International Nuclear Information System (INIS)

    This decision document presents the selected remedial action/corrective action for the Rocky Flats Environmental Technology Site (RFETS) Operable Unit (OU) 3: Offsite Areas, located near Broomfield and Westminster, Colorado. OU 3 is comprised of four Individual Hazardous Substance Sites (IHSS's): Contamination of the Land Surface (IHSS 199), Great Western Reservoir (IHSS 200), Standley Lake (IHSS 201) and Mower Reservoir (IHSS 202). Based upon the Baseline Risk Assessment and the Environmental Risk Assessment contained in the RCRA Facility Investigation/Remedial Investigation (RFI/RI) Report of June 1996, DOE, the lead agency under CERCLA for OU 3, concludes that no action is appropriate for OU 3. The RFI/RI Report concludes that all IHSS's within OU 3 are already in a state protective of human health and the environment

  12. An operational two-layer remote sensing model to estimate surface flux in regional scale: Physical background

    Institute of Scientific and Technical Information of China (English)

    ZHANG; Renhua; SUN; Xiaomin; WANG; Weimin; XU; Jinping; ZH

    2005-01-01

    Based on the improved interaction mechanism of two-layer model, this paper proposed Pixel Component Arranging and Comparing Algorithm (PCACA) and theoretically positioning algorithm, estimated the true temperature of mixed pixel in four extreme points in combination with the measurements of dry and wet points in calibration fields and improved the reliability of positioning dry and wet line. A new two-layer energy-separation algorithm was proposed,which was simple and direct without resistance network parameters for each pixel. We also proposed a new thought about the effect of advection. The albedo of mixed pixel was also separated with PCACA. In combination with two-layer energy-separation algorithm, the net radiation of mixed pixel was separated to overcome the uncertainty of conventional energy-separation algorithm using Beer's Law. Through the validation of retrieval result, this method is proved to be feasible and operational. At the same time, the uncertainty of this algorithm was objectively analyzed.

  13. Ytterbium-sensitized thulium-doped fiber laser with a single-mode output operating at 1900-nm region

    Institute of Scientific and Technical Information of China (English)

    S. W. Harun; S. K. Bhadra; A. Halder; M. C. Paul; S. M. M. Ali; N. Saidin; S. S. A. Damanhuri; H. Ahmad; S. Das; M. Pal

    2012-01-01

    A single-mode laser is demonstrated using a newly developed double-clad thulium-ytterbium-doped fiber (TYDF) in a linear cavity formed by two fiber Bragg gratings (FBGs).The YTF used is drawn from a D-shape preform fabricated using the modified chemical vapor deposition and solution doping technique.The laser is operated at 1 901.6 nm via the transition of thulium ions from 3F4 to 3H6 with the assistance of ytterbium to thulium ion energy transfer.The efficiencies of the laser are 0.71% and 0.75% at 927-and 905-nm multimode pumping,respectively.The thresholds of the launched pump power for 927- and 905-nm pumping are 1314 and 1458 mW,respectively.A 7-mW output is obtained at a 905-nm pump power of 2 400 mW.

  14. Excess long-term mortality following non-variceal upper gastrointestinal bleeding: a population-based cohort study

    OpenAIRE

    Colin John Crooks; Timothy Richard Card; Joe West

    2013-01-01

    Editors' Summary Background Acute gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of admission to hospital. Upper gastrointestinal bleeding (bleeding derived from a source above the ligament of Treitz, which connects the fourth portion of the duodenum to the diaphragm) is roughly four times as common as bleeding from the lower gastrointestinal tract and is a major cause of morbidity and mortality. Upper gastrointestinal bleeding is a...

  15. Placement of Covered Self-Expandable Metal Biliary Stent for the Treatment of Severe Postsphincterotomy Bleeding: Outcomes of Two Cases

    OpenAIRE

    Davide Cintorino; Luca Barresi; Ilaria Tarantino; Marta Di Pisa; Mario Traina

    2010-01-01

    We report two cases of severe postsphincterotomy bleeding in an adult and a pediatric patient treated, as first options, with available techniques to induce hemostasis without success. Because of persisting bleeding, an expandable, partially covered, metallic stent was placed into the choledocho to mechanically compress the bleeding site. The bleeding was stopped. In the following days, both patients remained hemodynamically stable with no further episodes of bleeding. We believe that the app...

  16. 14 CFR 33.89 - Operation test.

    Science.gov (United States)

    2010-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Turbine Aircraft Engines § 33.89 Operation test. (a) The operation... following engine load conditions: (i) No bleed air and power extraction for aircraft use. (ii)...

  17. Physical and chemical properties of the surface in the regions of operation of the Lunokhod-1 and Yutu rovers on the Moon

    Science.gov (United States)

    Shevchenko, Vladislav; Lu, Yangxiaoyi; Skobelev, Tatiana

    2016-07-01

    From the remotely determined spectropolarimetric and gamma-spectrometric characteristics of the regolith surface layer, the exposure age (the maturity), the mean effective size of particles of the fine fraction, the absolute age of the formations, and the iron content in the soil were estimated for the both regions. The Luna-17 and Chang'E 3 space probes, that transported the remotely controlled Lunokhod-1 rover (1970) and the Yutu vehicle of the analogous type (2013), respectively, onto the lunar surface, landed 400 km apart in the northern part of Mare Imbrium. As is known, the exposure age (or the maturity) of the lunar soil is a complex characteristic of the evolutionary history and the current state of the blanket material of the Moon. The values of the spectropolarimetric ratio Isp=Pmax(0.352µm)/Pmax(0.600µm) selected for the objects located in the close vicinity of the analyzed sites in Mare Imbrium are considered as the measured characteristics. For the Lunokhod-1 operation region the value of the spectropolarimetric index of the soil maturity is Isp = 1.5675 (the averaged value for the whole operation region). For the region, where the Yutu rover gathered the data, the value of this index is Isp = 1.4596. According to the data available, the exposure age (or the soil maturity) of the Lunokhod-1 operation region is close to that of the Apollo 16 and Apollo 17 landing sites. It should be taken into consideration that the maturity of the lunar soils is almost independent of the landscape type - highland or mare - because it is determined by the influence of the "space weathering" processes for relatively short periods (several tens of millions of years). The exposure age of the soil surface layer of the studied regions was derived from the relationship that is approximated by the power law T = 358 885e-5.9226 Isp, where the reliability of the approximation of the measured data determined by the standard method is R2 = 0.8927. From these data, the exposure

  18. Operational approaches to managing forests of the future in Mediterranean regions within a context of changing climates

    International Nuclear Information System (INIS)

    Many US forest managers have used historical ecology information to assist in the development of desired conditions. While there are many important lessons to learn from the past, we believe that we cannot rely on past forest conditions to provide us with blueprints for future management. To respond to this uncertainty, managers will be challenged to integrate adaptation strategies into plans in response to changing climates. Adaptive strategies include resistance options, resilience options, response options, and realignment options. Our objectives are to present ideas that could be useful in developing plans under changing climates that could be applicable to forests with Mediterranean climates. We believe that managing for species persistence at the broad ecoregion scale is the most appropriate goal when considering the effects of changing climates. Such a goal relaxes expectations that current species ranges will remain constant, or that population abundances, distribution, species compositions and dominances should remain stable. Allowing fundamental ecosystem processes to operate within forested landscapes will be critical. Management and political institutions will have to acknowledge and embrace uncertainty in the future since we are moving into a time period with few analogs and inevitably, there will be surprises.

  19. Role of proton pump inhibitors in the management of peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Hwai-Jeng; Lin

    2010-01-01

    Peptic ulcer bleeding is a serious medical problem with significant morbidity and mortality.Endoscopic therapy significantly reduces further bleeding,surgery and mortality in patients with bleeding peptic ulcers and is now recommended as the first hemostatic modality for these patients.The efficacy of large-dose proton pump inhibitor(PPI) therapy in reducing re-bleeding after endoscopic therapy has been supported by evidence derived from randomized controlled trials.It may be premature to recommend small-dose intravenous injection PPI after endoscopic hemostasis in patients with bleeding ulcers.An updated systematic review shows that PPI therapy before endoscopy significantly reduces the proportion with major stigmata and requirement for endoscopic therapy at index endoscopy.Some studies show that there is no significant difference between oral and intravenous PPIs in raising intragastric pH.However,clinical data is lacking in patients with peptic ulcer bleeding to date.

  20. Severe gastric variceal bleeding successfully treated by emergency splenic artery embolization.

    Science.gov (United States)

    Sankararaman, Senthilkumar; Velayuthan, Sujithra; Vea, Romulo; Herbst, John

    2013-06-01

    Bleeding from gastric varices due to splenic vein obstruction is extremely rare in children, but it can be catastrophic. Reported herein is the case of a teenager with splenic vein thrombosis and chronic decompensated liver disease from autoimmune hepatitis who presented with massive gastric variceal bleeding. Standard medical management did not control the bleeding. Due to decompensated liver disease and continuous active bleeding, emergency partial splenic artery embolization was preferred over splenectomy or a shunt procedure. Bleeding was successfully controlled by partial splenic artery embolization by decreasing the inflow of blood into the portal system. It is concluded that emergency partial splenic artery embolization is a safer alternative life-saving procedure to manage severe gastric variceal bleeding due to splenic vein obstruction in a patient with high surgical risk. To our knowledge, only one other patient with similar management has been reported in the pediatric age group.