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Sample records for branch duct intraductal

  1. Pancreatic-duct-lavage cytology in candidates for surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas: should the International Consensus Guidelines be revised?

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    Sai, Jin Kan; Suyama, Masafumi; Kubokawa, Yoshihiro; Watanabe, Sumio; Maehara, Tadayuki

    2009-03-01

    The International Consensus Guidelines are helpful for the management of branch-duct intraductal papillary mucinous neoplasms (IPMNs), because they allow us to exclude malignancy. However, it is not possible to predict malignancy with certainty, and further preoperative differentiation between benign and malignant IPMNs is required to avoid the false-positive results. To examine the usefulness of pancreatic-duct-lavage cytology by using an originally designed double-lumen catheter for discriminating benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines. Pancreatic-duct-lavage cytology was investigated in 24 patients with branch-duct IPMNs who underwent surgical resection based on the International Consensus Guidelines, namely, they either had intramural nodules or the ectatic branch duct was >30 mm in diameter. Single-center retrospective study. Academic medical center. The sensitivity and specificity of pancreatic-duct-lavage cytology for discriminating benign from malignant IPMNs. More than 30 mL of pancreatic-duct-lavage fluid was obtained from each patient, and there were no patients with noninformative results. The sensitivity, specificity, positive predictive value, and negative predictive value of the cytologic diagnosis were 78%, 93%, 88%, and 88%, respectively. Single-center and small number of patients. Pancreatic-duct-lavage cytology can improve differentiation between benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines.

  2. Higher Growth Rate of Branch Duct Intraductal Papillary Mucinous Neoplasms Associates With Worrisome Features.

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    Kolb, Jennifer M; Argiriadi, Pamela; Lee, Karen; Liu, Xiaoyu; Bagiella, Emilia; Lucas, Aimee L; Kim, Michelle Kang; Kumta, Nikhil A; Nagula, Satish; Sarpel, Umut; DiMaio, Christopher J

    2018-03-11

    For patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs, cysts), it is a challenge to identify those at high risk for malignant lesions. We sought to identify factors associated with development of pancreatic cancer, focusing on neoplasm growth rate. We performed a retrospective study of 189 patients with BD-IPMNs who underwent at least 2 contrast-enhanced cross-sectional imaging studies, 1 year or more apart, at a tertiary referral center from January 2003 through 2013. Patients with cysts that had Fukuoka worrisome or high-risk features were excluded. Two radiologists reviewed all images. Cyst size was recorded at the initial and final imaging studies and growth rate was calculated. We collected patient demographic data, cyst characteristics, and clinical outcomes; univariate logistic regression models were used to determine the odds of developing worrisome features. The primary outcomes were to determine growth rate of low-risk BD-IPMNs and to assess whether cyst growth rate correlates high-risk features of IPMNs. Based on image analyses, cysts were initially a median 11 mm (range, 3-31 mm) and their final size was 12.5 mm (range, 3-42 mm). After a median follow-up time of 56 months (range, 12-163 months), the median cyst growth rate was 0.29 mm/year. Twelve patients developed worrisome features, no patients developed high-risk features, 4 patients had surgical resection, and no cancers developed. The rate of BD-IPMN growth was greater in patients who developed worrisome features than those who did not (2.84 mm/year vs 0.23 mm/year; P < .001). The odds of developing worrisome features increased for each unit (mm) increase in cyst size (odds ratio, 1.149; 95% CI, 1.035-1.276, P = .009). In a retrospective analysis of images from patients with BD-IPMN, we found low-risk BD-IPMNs to grow at an extremely low rate (less than 0.3 mm/year). BD-IPMNs in only about 6% of patients developed worrisome features, and none developed high-risk features

  3. CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs)

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    Delavaud, Christophe; Assignies, Gaspard d' ; Vilgrain, Valerie; Vullierme, Marie-Pierre [Hopital Beaujon, Service de Radiologie, Clichy (France); Cros, Jerome [Hopital Beaujon, Service d' Anatomopathologie, Clichy (France); Ruszniewski, Philippe; Hammel, Pascal; Levy, Philippe [Hopital Beaujon, Service de Pancreato-Gastro-Enterologie, Clichy (France); Couvelard, Anne [Hopital Bichat, Service d' Anatomopathologie, Paris (France); Sauvanet, Alain; Dokmak, Safi [Hopital Beaujon, Service de Chirurgie Hepato-Pancreato-Biliaire, Clichy (France)

    2014-09-15

    To describe CT and MR imaging findings of acinar cell cystadenoma (ACC) of the pancreas and to compare them with those of branch duct intraductal papillary mucinous neoplasia (BD-IPMN) to identify distinctive elements. Five patients with ACC and the 20 consecutive patients with histologically proven BD-IPMN were retrospectively included. Clinical and biological information was collected and histological data reviewed. CT and MR findings were analysed blinded to pathological diagnosis in order to identify imaging diagnostic criteria of ACC. Patients with ACC were symptomatic in all but one case and were younger than those with BD-IPMN (p = 0.006). Four radiological criteria allowed for differentiating ACC from IPMN: five or more cysts, clustered peripheral small cysts, presence of cyst calcifications and absence of communication with the main pancreatic duct (p < 0.05). Presence of at least two or three of these imaging criteria had a strong diagnostic value for ACC with a sensitivity of 100 % and 80 % and a specificity of 85 % and 100 %, respectively. Preoperative differential diagnosis between ACC and BD-IPMN can be achieved using a combination of four CT and/or MR imaging criteria. Recognition of ACC patients could change patient management and lead to more conservative treatment. (orig.)

  4. A case of branch duct type intraductal papillary neoplasm of the bile duct treated by open surgery after 11 years of follow-up.

    Science.gov (United States)

    Fujita, Mitsuru; Wakui, Noritaka; Yamauchi, Yoshiya; Takeda, Yuki; Sato, Takemasa; Ueki, Nobuo; Otsuka, Takafumi; Oba, Nobuyuki; Nishinakagawa, Shuta; Minagawa, Masami; Takeda, Yasushi; Shiono, Saori; Kojima, Tatsuya

    2013-11-01

    The intraductal papillary neoplasm of the bile duct (IPNB) is a novel disease concept that was recently classified as a biliary cystic tumor by the revised World Health Organization classification. This is the case report of a 70-year-old female patient who experienced repeated episodes of obstructive jaundice and cholangitis since 2000, attributed to a mucus-producing hepatic tumor. Surgery was advised due to the repeated episodes; however, the patient refused. In May, 2011, the patient developed jaundice and fever and was treated with antibiotics. Since there was no improvement, the patient was admitted to the Tokyo Rosai Hospital. Abdominal computed tomography (CT) revealed a 50-mm cystic mass with an internal septum in the left hepatic lobe. Although the tumor size had remained almost unchanged compared to the initial CT scan performed in 2000, intra- and extra-hepatic bile duct dilation was more prominent on the second CT scan. Following admission, endoscopic retrograde cholangiopancreatography was performed and revealed an expanded papilla of Vater due to a mucous plug. A balloon catheter was inserted into the bile duct to remove the mucous plug, resulting in the drainage of copious amounts of mucus and infected bile. The patient finally consented to surgery and left hepatic lobectomy was performed. Consequently, the diagnosis of low-grade IPNB was made. Branch duct type IPNB, which is characterized by imaging appearance of a cystic mass and slow progression, is attracting increasing attention. In the present case, a cystic mass was identified in the left hepatic lobe, with no significant change in size after 11 years of follow-up, leading to the diagnosis of branch duct type IPNB. Considering the fact that IPNB is usually treated surgically at the time of diagnosis, the present case, due to the long-term follow-up, provides valuable insight into the natural history of the tumor.

  5. A case of branch duct type intraductal papillary neoplasm of the bile duct treated by open surgery after 11 years of follow-up

    OpenAIRE

    FUJITA, MITSURU; WAKUI, NORITAKA; YAMAUCHI, YOSHIYA; TAKEDA, YUKI; SATO, TAKEMASA; UEKI, NOBUO; OTSUKA, TAKAFUMI; OBA, NOBUYUKI; NISHINAKAGAWA, SHUTA; MINAGAWA, MASAMI; TAKEDA, YASUSHI; SHIONO, SAORI; KOJIMA, TATSUYA

    2013-01-01

    The intraductal papillary neoplasm of the bile duct (IPNB) is a novel disease concept that was recently classified as a biliary cystic tumor by the revised World Health Organization classification. This is the case report of a 70-year-old female patient who experienced repeated episodes of obstructive jaundice and cholangitis since 2000, attributed to a mucus-producing hepatic tumor. Surgery was advised due to the repeated episodes; however, the patient refused. In May, 2011, the patient deve...

  6. Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up

    International Nuclear Information System (INIS)

    Uehara, Hiroyuki; Ishikawa, Osamu; Katayama, Kazuhiro

    2011-01-01

    A mural nodule is a strong predictive factor for malignancy in branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas, but the nodule size has hardly been considered. The aim of this study was to investigate whether a mural nodule of 10 mm was appropriate as an indicator of surgery for IPMN during follow-up. The follow-up outcomes of 100 patients who had branch duct IPMN without mural nodules or who had branch duct IPMN with mural nodules of less than 9 mm in a tertiary care setting were investigated retrospectively. The patients underwent abdominal ultrasound (US) every 3 months and additional imaging examinations or cytologic examination of pancreatic juice when necessary. Surgery was recommended to them when a mural nodule developed or when a nodule enlarged and reached 10 mm. During an average follow-up period of 97 months, branch duct IPMNs developed mural nodules that reached 10 mm in 5 patients (0.62% per year). In one patient the IPMN was revealed to be non-invasive carcinoma by resection, 1 IPMN was shown to be malignant by further follow-up, and 3 were not resected because of refusal or the patient's age. In 7 patients, mural nodules stayed within 9 mm. The remaining 88 patients lacked mural nodules in their branch duct IPMNs throughout the follow-up. The occurrence of invasive carcinoma around the IPMN was not indicated by imaging examinations in any patient. Univariate analysis showed that the size of the cyst at baseline significantly predicted the development of a mural nodule that reached 10 mm during follow-up (P=0.05). A mural nodule of 10 mm is appropriate as an indicator of surgery in the follow-up of branch duct IPMN. (author)

  7. Intraductal papillary neoplasm of the bile duct: a case report.

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    Peeters, Karen; Delvaux, Peter; Huysentruyt, Frederik

    2017-08-01

    Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors, characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. The Western experience, however, remains limited. In this article, we report a 56-year-old man, referred to our hospital because of deranged liver function tests. Further imaging modalities showed a cystic lesion of 9 cm diameter, arising from the left hepatic duct. Inlying was a heterogeneous, lobulated mass. The patient underwent a left hemihepatectomy and adjuvant chemotherapy. Despite recent advanced technologies, diagnosis of IPNB is still challenging, especially in western countries due to its rarity. Early identification and resection of lesions, even in asymptomatic or minimally symptomatic patients, are however important prognostic factors.

  8. Imaging features of intraductal papillary neoplasm of the bile duct

    International Nuclear Information System (INIS)

    Liu Yubao; Li Meng; Zhong Xiaomei; Liu Zaiyi; Liang Changhong

    2014-01-01

    Objective: To investigate the CT and MRI features of intraductal papillary neoplasm of the bile duct (IPNB). Methods: Thirty eight patients with IPNB finally diagnosed by puncture biopsy or surgery were enrolled in this study. All the CT or MRI data were investigated retrospectively. Twenty one patients underwent CT examinations, 17 patients underwent MRI examinations. The features of IPNB including the distribution features of the nodules or masses, CT and MRI features of cholangiectasis, mucus were analyzed. The accuracy differences of CT and MRI for the preoperatively diagnosing mucus and tumor growing along mucous were compared by nonparametric test. Results: The lesions (including 5 patients with solitary lesions and 19 patients with multiple lesions) were located in intrahepatic bile duct in 24 patients, 3 patients occurred simultaneously in intrahepatic and portal bile duct, 2 lesions occurred in portal bile duct, 8 lesions occurred in common bile duct, the lesions of 1 patient occurred simultaneously in common bile duct, cystic duct and gallbladder. Seventeen and 11 patients appeared nodules locating in dilated bile duct on CT and MRI, respectively. Four and 5 patients appeared cystic lesions with multiple nodules of the liver on CT and MRI, respectively. Higher contrast enhancement on CT and MRI in arterial phase than that in portal vein and equilibrium phase were observed in 18 and 12 patients, respectively. Excluding the patients undergoing puncture, CT was better than MRI in evaluating whether the mucus was present, with the accuracies of 30.0% (6/20) and 6.3% (1/16) for CT and MRI, respectively (Z=2.58, P<0.05). CT was worse than MRI in preoperatively evaluating the features of tumor growing along mucous, with the accuracies of 77.8% (14/18) and 92.6% (13/14) for CT and MRI, respectively (Z=4.23, P<0.01). Conclusion: IPNB had the features of growing along mucous of the bile duct, nodule or mass in dilated bile duct and other features, CT and MRI are

  9. Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms

    OpenAIRE

    Ying, Shi-Hong; Teng, Xiao-Dong; Wang, Zhao-Ming; Wang, Qi-Dong; Zhao, Yi-Lei; Chen, Feng; Xiao, Wen-Bo

    2015-01-01

    AIM: To investigate gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) of intraductal papillary mucinous neoplasms of the bile duct (IPMN-B).

  10. Simultaneous liver mucinous cystic and intraductal papillary mucinous neoplasms of the bile duct: a case report.

    Science.gov (United States)

    Budzynska, Agnieszka; Hartleb, Marek; Nowakowska-Dulawa, Ewa; Krol, Robert; Remiszewski, Piotr; Mazurkiewicz, Michal

    2014-04-14

    Cystic hepatic neoplasms are rare tumors, and are classified into two separate entities: mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms of the bile duct (IPMN-B). We report the case of a 56-year-old woman who presented with abdominal pain and jaundice due to the presence of a large hepatic multilocular cystic tumor associated with an intraductal tumor. Partial hepatectomy with resection of extrahepatic bile ducts demonstrated an intrahepatic MCN and an intraductal IPMN-B. This is the first report of the simultaneous occurrence of these two histologically distinct entities in the liver.

  11. [Value of MR imaging in the diagnosis of intraductal papillary neoplasm of the bile duct].

    Science.gov (United States)

    Song, Fengxiang; Zhou, Jun; Shi, Yuxin; Zeng, Mengsu; Zhou, Kangrong; Ding, Yuqin; Cao, Yingli; Zhou, Jianjun

    2015-01-01

    To analyze the value of MR imaging in diagnosis of intraductal papillary neoplasm of the bile duct (IPN-B). Fourteen patients with intraductal papillary neoplasms of the bile duct confirmed by surgical pathology were included in this study. The patients underwent MR routine plain scanning and enhancement scanning (including T1WI, T2WI with fat suppression, FALSH T1WI, and three-phase enhancement scanning), diffusion weighted imaging(DWI) and magnetic resonance cholangiopancreatography (MRCP) before operation. The imaging data were reviewed and analyzed retrospectively in comparison with the surgical and pathological results. In these patients, 7 cases had tumors located in the left lobe, 2 cases had tumors in both the left and right lobes, 2 cases in the hepatic hilum, 2 cases in the common bile duct, and 1 case in both the right lobe and the common bile duct. Solitary or multiple intraductal masses could be found in 12 cases, with 11 cases appeared as papillary masses and one case as flat mass. In the other two cases the tumor was not visible (one case had too many stones, and in another case the tumor was too small). The tumors in the 12 cases showed hypointensity on T1WI and hyperintensity on T2WI. On the dynamic contrast-enhanced MRI, 11 cases showed mild and one showed moderate enhancement in arterial phase, and all the cases showed mildly and gradually delayed enhancement. On DWI, the lesion areas showed high signal intensity in all the cases, and the ADC value of the tumor area (1.697×10(-3)mm(2)/s) was significantly lower than that of the normal bile (3.973×10(-3)mm(2)/s) (t = -10.94, P invisible tumors ). In the 3 cases with aneurysmal bile dilatation, the multiple directions of MRCP images helped to find the communication between the aneurysmal dilatation and the bile duct. All the cases showed significant proximal bile duct dilatation (the extent of dilatation >100%), and 9 cases also showed distal bile duct dilatation. Bile duct stones were noted in 6

  12. Low-grade salivary duct carcinoma or low-grade intraductal carcinoma? Review of the literature.

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    Kuo, Ying-Ju; Weinreb, Ilan; Perez-Ordonez, Bayardo

    2013-07-01

    Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with "Roman Bridges", "pseudocribriform" proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in non-invasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/high-grade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are non-invasive neoplasms; the terms "cribriform cystadenocarcinoma" and LG-SDC should be replaced by "low-grade intraductal carcinoma" (LG-IDC) of salivary gland or "low-grade intraductal carcinoma with areas of invasive carcinoma" in those cases with evidence of invasive carcinoma.

  13. Unexpected metastasis of intraductal papillary mucinous neoplasm of the bile duct into thoracic cavity with direct extension: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Tae; Heo, Jeong Nam; Park, Choong Ki [Hanyang Univ. Guri Hospital, Guri (Korea, Republic of); Choi, Yo Won; Jeon, Seok Chol [Hanyang Univ. Seoul Hospital, Seoul (Korea, Republic of)

    2012-08-15

    Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension.

  14. Unexpected metastasis of intraductal papillary mucinous neoplasm of the bile duct into thoracic cavity with direct extension: Case report

    International Nuclear Information System (INIS)

    Kim, Eung Tae; Heo, Jeong Nam; Park, Choong Ki; Choi, Yo Won; Jeon, Seok Chol

    2012-01-01

    Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension

  15. Dynamic contrast-enhanced CT appearances of the intraductal papillary neoplasms of the bile duct

    International Nuclear Information System (INIS)

    Song Fengxiang; Zhou Jianjun; Zeng Mengsu; Zhou Kangrong; Ding Yuqin; He Deming; Shi Yuxin; Zhou Jun

    2013-01-01

    Objective: To analyze the dynamic contrast-enhanced CT appearances of intraductal papillary neoplasms of the bile duct and improve its diagnostic accuracy. Methods: Sixteen patients with intraductal papillary neoplasms of the bile duct confirmed histopathologically after surgical operation underwent dynamic contrast-enhanced multi-detector row CT scans. All imaging data were reviewed and analyzed retrospectively in correlation with surgical and pathological findings. CT values of 38 well-visualized lesions in 12 of the 16 patients at the pre-contrast phase, arterial phase and venous phase were measured. Four of the 12 patients with 17 lesions had benign tumors, and 8 of the 12 patients with 21 lesions had malignant tumors. Comparisons of CT values at the three phases between the two groups were carried out using independent sample t test. The bile CT values were measured in these 12 cases, 40 normal volunteers, and 40 subjects with bile duct stones, and the Wilcoxon signed-rank test was applied to compare the bile CT values between tumor group and the normal group and between tumor group and the bile duct stone group. The diameters of the bile ducts proximal to and distal to tumors were also measured, and Fisher exact method was carried to analyze the data. Results: Lesions located at the left lobe in 8 out of the 16 patients, the right lobe in 1 case, both the left and right lobes in 1 case, the hepatic hilum in 1 case, the common bile duct in 3 cases, and both the right lobe and the common bile duct in 2 cases. Eleven lesions appeared as papillary masses, 3 as flat masses, 1 as mixed papillary and flat masses. In one case, tumor mass could not be definitely visualized, and only dilated bile ducts and stones were demonstrated. The mean CT values of the benign tumors were (25.8 ± 8.0), (37.7 ± 10.3) and (51.7 ± 17.1) HU respectively at pre-contrast phase, arterial phase, and venous phase, and the malignant tumors were (38.4 ± 10.2), (56.6 ± 18.0) and (68.4

  16. Localization of intraductal mass through the ostium of the duct using wire guided ductography technique

    International Nuclear Information System (INIS)

    Aslam, M.

    2014-01-01

    To localize intraductal mass (Papilloma) before surgery Materials Guide wire 10-15 cm length of 2/3-0 Prolene/Surgipro Plastic 26G to 20G I/V cannulas Kopans breast lesion localization hook wire Disposable syringe heaving 2ml non-ionic contrast High intensity light and magnified glass. Methods: Prepare patient in sitting or lying position adjust high intensity light clean the nipple with antiseptic lotion. Elicit the discharge with gentle periareolar pressure or ask the patient to bring the discharge. If the opening with discharge is not clearly visualize use magnified glass or loop. Slowly inserted the wire into the duct orifice, it should pass freely into the duct. Introduce the 26G I/V plastic cannula coaxially over the guide wire and remove the guide wire. Gently inject 0.2-0.4 ml contrast, remove and the syringe and apply stopper. The cannula stopper assembly is secured to the breast with tape. Magnified craniocaudal view of the breast is taken, the 26G cannula removed and bigger length 22/20G cannula gradually passed over the guide wire according to distance of lesion from the ostium. Intraductal mass location is verified the hook wire is replaced with guide wire, the position of hook confirmed by mammographic film. The wire is cut 2cms from the nipple and pt. send to operation theater Results:Hook localization has been successfully carried out in six patients. Conclusion:This is a new method of localization of intraductal mass it enables the surgeon to do microductectomy with minimal cosmetic effects to the breast. (author)

  17. Diagnostic performance of CT and MRI in distinguishing intraductal papillary neoplasm of the bile duct from cholangiocarcinoma with intraductal papillary growth

    International Nuclear Information System (INIS)

    Liu, Yubao; Zhong, Xiaomei; Yan, Lifen; Zheng, Junhui; Liu, Zaiyi; Liang, Changhong

    2015-01-01

    We aimed to evaluate the diagnostic performance of CT and MRI for distinguishing intraductal papillary neoplasm of the bile duct (IPNB) from cholangiocarcinoma (CC) with intraductal papillary growth (IPG). Forty-two patients with either IPNB or CC with IPG proven by histopathology were independently reviewed in retrospect. Strict criteria for diagnosis of IPNB included presence of the designated imaging features as follows: local dilatation of the bile duct, nodule within the dilated bile duct, growing along the interior wall of bile duct. Any lesion that was not consistent with the criteria was classified as CC with IPG. Sensitivity, specificity, positive and negative predictive values for characterization of IPNB were calculated, and k test was used to assess the level of agreement. Two imaging reviewers correctly identified 21 of 26 (80.8 %) and 22 of 26 (84.6 %) IPNB cases, respectively. Alternatively, they correctly identified 14 of 16 (87.5 %) and 15 of 16 (93.8 %) CC with IPG, respectively. Agreement between the two reviewers was perfect (k = 0.81) for the diagnosis of IPNB and differentiation from CC with IPG. By using our designated diagnostic criteria of CT and MRI, IPNB can be accurately identified and possible to be distinguished from CC with IPG. (orig.)

  18. Diagnostic performance of CT and MRI in distinguishing intraductal papillary neoplasm of the bile duct from cholangiocarcinoma with intraductal papillary growth

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yubao; Zhong, Xiaomei; Yan, Lifen; Zheng, Junhui; Liu, Zaiyi; Liang, Changhong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China)

    2015-07-15

    We aimed to evaluate the diagnostic performance of CT and MRI for distinguishing intraductal papillary neoplasm of the bile duct (IPNB) from cholangiocarcinoma (CC) with intraductal papillary growth (IPG). Forty-two patients with either IPNB or CC with IPG proven by histopathology were independently reviewed in retrospect. Strict criteria for diagnosis of IPNB included presence of the designated imaging features as follows: local dilatation of the bile duct, nodule within the dilated bile duct, growing along the interior wall of bile duct. Any lesion that was not consistent with the criteria was classified as CC with IPG. Sensitivity, specificity, positive and negative predictive values for characterization of IPNB were calculated, and k test was used to assess the level of agreement. Two imaging reviewers correctly identified 21 of 26 (80.8 %) and 22 of 26 (84.6 %) IPNB cases, respectively. Alternatively, they correctly identified 14 of 16 (87.5 %) and 15 of 16 (93.8 %) CC with IPG, respectively. Agreement between the two reviewers was perfect (k = 0.81) for the diagnosis of IPNB and differentiation from CC with IPG. By using our designated diagnostic criteria of CT and MRI, IPNB can be accurately identified and possible to be distinguished from CC with IPG. (orig.)

  19. Assessment of a Revised Management Strategy for Patients With Intraductal Papillary Mucinous Neoplasms Involving the Main Pancreatic Duct.

    Science.gov (United States)

    Sugimoto, Motokazu; Elliott, Irmina A; Nguyen, Andrew H; Kim, Stephen; Muthusamy, V Raman; Watson, Rabindra; Hines, O Joe; Dawson, David W; Reber, Howard A; Donahue, Timothy R

    2017-01-18

    According to the 2012 International Consensus Guidelines, the diagnostic criterion of intraductal papillary mucinous neoplasms (IPMNs) involving the main duct (MD IPMNs) or the main and branch ducts (mixed IPMNs) of the pancreatic system is a main pancreatic duct (MPD) diameter of 5.0 mm or greater on computed tomography (CT) or magnetic resonance imaging (MRI). However, surgical resection is recommended for patients with an MPD diameter of 10.0 mm or greater, which is characterized as a high-risk stigma. An MPD diameter of 5.0 to 9.0 mm is not an indication for immediate resection. To determine an appropriate cutoff (ie, one with high sensitivity and negative predictive value) of the MPD diameter on CT or MRI as a prognostic factor for malignant disease and to propose a new management algorithm for patients with MD or mixed IPMNs. This retrospective cohort study included 103 patients who underwent surgical resection for a preoperative diagnosis of MD or mixed IPMN and in whom IPMN was confirmed by surgical pathologic findings at a single institution from July 1, 1996, to December 31, 2015. Malignant disease was defined as high-grade dysplasia or invasive adenocarcinoma on results of surgical pathologic evaluation. An appropriate MPD diameter on preoperative CT or MRI to predict malignant disease was determined using a receiver operating characteristic curve analysis. The prognostic value of the new management algorithm that incorporated the new MPD diameter cutoff was evaluated. Among the 103 patients undergoing resection for an MD or mixed IPMN (59 men [57.3%]; 44 women [42.7%]; median [range] age, 71 [48-86] years), 64 (62.1%) had malignant disease. Diagnostic accuracy for malignant neoplasms was highest at an MPD diameter cutoff of 7.2 mm (area under the receiver operating characteristic curve, 0.70; 95% CI, 0.59-0.81). An MPD diameter of 7.2 mm or greater was also an independent prognostic factor for malignant neoplasms (odds ratio, 12.76; 95% CI, 2

  20. Diagnostic Utility of Endoscopic Retrograde Cholangiography/Intraductal Ultrasound (ERC/IDUS) in Distinguishing Malignant from Benign Bile Duct Obstruction.

    Science.gov (United States)

    Chen, Lu; Lu, Yi; Wu, Jia-Chuan; Bie, Like; Xia, Lu; Gong, Biao

    2016-02-01

    Accurately differentiating malignant diseases from benign ones in patients having bile duct obstruction is of significant importance and remains a major clinical problem. This study investigated the diagnostic yield of endoscopic retrograde cholangiography/intraductal ultrasound (ERC/IDUS) in distinguishing malignant from benign bile duct obstruction and assessed some image findings from ERC/IDUS which might be useful in differentiation. From January 2008 to January 2015, patients who underwent ERC/IDUS for bile duct obstruction were enrolled. Patient's ERC/IDUS diagnosis was compared with the final diagnosis determined by pathologic findings and/or clinical outcome of follow-up. One hundred and ninety-three patients with bile duct obstruction were included. IDUS correctly identified 94 of 97 malignant diseases and 76 of 96 benign diseases with sensitivity, specificity, and accuracy rate of 96.91, 79.17, and 88.08 %, respectively. Additionally, the accuracy rate of IDUS for diagnosis of proximal bile duct obstruction was higher than that of distal bile duct obstruction (98.08 vs. 82.73 %, p = 0.006). Besides, there was a significant difference in the length at the obstruction site between benign and malignant diseases (13.76 ± 7.37 vs. 19.97 ± 11.37 mm, p 7 mm without extrinsic compression had a positive predictive value (PPV) of 100 % for including malignancy, while length ≧20 mm demonstrated a PPV of 93.44 %. ERC/IDUS is effective in distinguishing malignant from benign bile duct obstruction, thus helping in further clinical management.

  1. CT findings of intraductal papillary neoplasm of the bile duct: Assessment with multiphase contrast-enhanced examination using multi-detector CT

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    Ogawa, H., E-mail: ogawa.hiroshi@h.mbox.nagoya-u.ac.jp [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, S. [Department of Radiology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya (Japan); Nagasaka, T. [Department of Medical Technology, Nagoya University School of Health Sciences, Nagoya (Japan); Suzuki, K. [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Ota, T. [Department of Radiology, Aichi Medical University Hospital, Nagakute Aichi (Japan); Naganawa, S. [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2012-03-15

    Aim: To evaluate multi-detector computed tomography (MDCT) findings of intraductal papillary neoplasm of the bile duct (IPNB), a neoplasm that is considered to be the biliary counterpart of pancreatic intraductal papillary mucinous neoplasm. Materials and methods: Two radiologists retrospectively evaluated multiphase contrast-enhanced CT images with 0.5 or 1 mm collimation in 37 consecutive patients with resected IPNB diagnosed by a single pathologist. The CT findings were correlated with the pathological findings concerning invasion of the surrounding organs and vessels. Results: All patients showed bile duct dilatation. An intraductal mass was detected in 36 patients and the following findings were observed: extensive infiltration along the bile duct more than 20 mm (n = 32), compared with normal hepatic parenchyma, isodense or hyperdense during the late arterial phase (n = 31), not hyperdense during the portal-venous and delayed phases (n = 36), and intense enhancement rim at the base of the mass during the portal-venous or delayed phase (n = 27). Parenchymal invasion of the surrounding organs was seen in eight of 16 tumours showing irregular or bulging margins. Vascular invasion was false positive in four of eight tumours. Conclusions: IPNB exhibits relatively characteristic findings with multiphase contrast-enhanced examination using MDCT. A tendency to overestimate invasion of the surrounding organs and vessels was seen.

  2. Main-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection.

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    Salvia, Roberto; Fernández-del Castillo, Carlos; Bassi, Claudio; Thayer, Sarah P; Falconi, Massimo; Mantovani, William; Pederzoli, Paolo; Warshaw, Andrew L

    2004-05-01

    To describe clinical characteristics and outcomes of a large cohort of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas affecting the main pancreatic duct. IPMNs are being diagnosed with increasing frequency. Preoperative determination of malignancy remains problematic, and reported results of long-term survival following resection are conflicting. The combined databases from the Massachusetts General Hospital and the Pancreatic Unit of the University of Verona were analyzed. To avoid confusing overlap with mucinous cystic neoplasms, only patients with tumors of the main pancreatic duct (with or without side branch involvement) were included. A total of 140 tumors consecutively resected between 1990 and 2002 were classified as either benign (adenoma and borderline tumors) or malignant (carcinoma in situ or invasive cancer) to compare their characteristics and survival. Men and women were equally affected (mean age 65 years). Seven patients (12%) had adenomas, 40 (28%) borderline tumors, 25 (18%) carcinoma in situ, and 58 (42%) invasive carcinoma. The median age of patients with benign IPMN was 6.4 years younger than those with malignant tumors (P = 0.04). The principal symptoms were abdominal pain (65%), weight loss (44%), acute pancreatitis (23%), jaundice (17%), and onset or worsening of diabetes (12%); 27% of patients were asymptomatic. Jaundice and diabetes were significantly associated with malignant tumors. Five- and 10-year cancer-specific survival for patients with noninvasive tumors was 100%, and comparable survival of the 58 patients with invasive carcinoma was 60% and 50%. Cancer is found in 60% of patients with main-duct IPMNs. Patients with malignant tumors are 6 years older than their benign counterparts and have a higher likelihood of presenting with jaundice or new onset diabetes. No patients with benign tumors or carcinoma in situ died of their disease following resection, and those with invasive cancer had a markedly better

  3. Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?

    International Nuclear Information System (INIS)

    Purysko, Andrei S.; Gandhi, Namita S.; Veniero, Joseph C.; Walsh, R.M.; Obuchowski, Nancy A.

    2014-01-01

    To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN). This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results. There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P = 0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P = 0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P > 0.05). Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN. (orig.)

  4. Mucinous Cystic Neoplasm of the Liver or Intraductal Papillary Mucinous Neoplasm of the Bile Duct? A Case Report and a Review of Literature.

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    Kunovsky, Lumir; Kala, Zdenek; Svaton, Roman; Moravcik, Petr; Mazanec, Jan; Husty, Jakub; Prochazka, Vladimir

    2018-01-01

    Mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are diagnoses that were classified by the World Health Organization in 2010 as mucin-producing bile duct tumors of the hepatobiliary system. The preoperative differential diagnosis between these two entities is difficult; the presence of a communication with the bile duct is usually considered as a typical sign of IPMN-B. However, the presence of an ovarian-like stroma (OLS) has been established to define the diagnosis of MCN-L. We present the case of a 33-year-old woman with a rapid progression of a cystic tumor of the liver. In 2 years, the lesion increased from 27 to 64 mm and a dilation of the left hepatic duct appeared. Percutaneous transhepatic drainage with a biopsy was performed. No malignant cells were found on biopsy. Because of the rapid progression of the cystic tumor and unclear malignant potential, left hemihepatectomy was performed. Even though tumor masses were present in the biliary duct, on the basis of the presence of OLS, histology finally confirmed MCN-L with intermediate-grade intraepithelial dysplasia to high-grade intraepithelial dysplasia. The patient is currently under oncologic follow-up with no signs of recurrence of the disease. We present a rare case where MCN-L caused a dilation of the left hepatic duct, a sign that is usually a characteristic of IPMN-B.

  5. BREAST INTRADUCTAL PAPILLOMA

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    Shantanu Kumar Sahu; Prashant Kumar Singh; Birinder Pal Singh; Smriti Bhushan; Kush Aeron; Mohanish Sinha; Praveendra Kumar Sachan

    2012-01-01

    Introduction Intraductal papilloma of the breast is characterized by a proliferation of epithelial and myoepithelial cells overlying fibrovascular stalks creating an arborescent structure within the lumen of duct. Case report We present a 36 years female patient with history of bleeding from the nipple of right breast since last 3months. Examination of right nipple revealed bleeding and mammography show a right ductal papilloma. We performed microdochectomy of the involved duct with excision ...

  6. Cystic lesion of pancreas - Intraductal papillary mucinous neoplasm

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    Rajiv Baijal

    2013-01-01

    Full Text Available Intraductal papillary mucinous neoplasm (IPMN of the pancreas is an intraductal mucin-producing epithelial neoplasm that arises from the main and/or branched pancreatic duct. It usually presents as cystic lesion of pancreas. There are well known differential diagnosis of cystic pancreatic lesion. Pancreatic cystic neoplasms are detected at an increasing frequency due to an increased use of abdominal imaging. The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN of the pancreas has evolved over the past decade. IPMN represents a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. IPMN has a prognosis, which is different from adenocarcinoma of the pancreas. We report a case of a 58-year-old male with intraductal papillary neoplasm involving main duct and side branches presenting to us with clinical symptoms of chronic pancreatitis with obstructive jaundice and cholangitis treated surgically.

  7. Risk Factors for Progression or Malignancy in Main-Duct and Mixed-Type Intraductal Papillary Mucinous Neoplasm of the Pancreas.

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    Jang, Dong Kee; Ryu, Ji Kon; Chung, Kwang Hyun; Lee, Ban Seok; Park, Joo Kyung; Lee, Sang Hyub; Kim, Yong-Tae

    2016-08-01

    The 2012 international guidelines state that surgery should be considered for all surgically fit patients with pancreatic main-duct (MD)/mixed intraductal papillary mucinous neoplasms (IPMNs). This study evaluated the follow-up results of MD/mixed IPMNs and risk factors for progression or malignancy. Patients with MD/mixed IPMNs were retrospectively enrolled and divided into surgical and nonsurgical groups. These 2 groups were compared and further categorized as progression/malignancy or not. In the nonsurgical group, disease progression was defined as radiologic tumor growth or adjacent organ invasion. Data from 101 patients (73 males; mean [SD] age, 66.3 [9.1] years), including 27 and 74 in the nonsurgical and surgical groups, respectively, were analyzed. Mural nodules were more frequently detected in the surgical group (7.4% vs 31.1%, P = 0.018), whereas more multifocal cysts were observed in the nonsurgical group (40.7% vs 20.3%, P = 0.037). Forty-one patients (40.6%) showed progression or malignancy. Multivariate analysis showed that main pancreatic duct of 10 mm or greater (odds ratio, 4.368; P = 0.024) and pre-existing diabetes (odds ratio, 3.077; P = 0.046) were independent risk factors for progression or malignancy. A watchful waiting strategy could be feasible for some patients with MD/mixed IPMNs, particularly those with a main pancreatic duct of less than 10 mm and without diabetes.

  8. Intraductal mucin-hypersecreting neoplasm of the pancreas : US, CT and ERP findings

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    Lee, Ki Yeol

    1997-01-01

    To evaluate US, CT and endoscopic retrograde pancreatography (ERP) findings of intraductal mucin-hypersecreting neoplasm(IMHN). We categorized an IMHN as belonging to a group of disease that can be clinically detected by the pooling of mucus produced by tumors inside the main duct or branch ducts of the pancreas, thus causing dilatation of these ducts. We retrospectively reviewed the US, CT and ERP findings of five patients(hyperplasia, 4;adenocarcinoma, 1). On US and/or CT, diffuse dilatation of the main pancreatic duct was demonstrated in five patients. In two cystic lesions corresponding to cystic dilatation of branch ducts were noted at the pancreatic head(n=1) and neck(n=1). In one patient, multiple cystic lesions were seen on CT along the entire pancreas, but these were not detected on US. In all patients, dilatation of the main duct and /or its branch ducts was seen on ERP. Filling defects resulting from mucin in the main duct or branch ducts were noted in all cases. Lymphadenopathy was not seen on US or CT, but carcinoma peritonei was found in the adenocarcinoma patient at the time of operation. IMHN usually shows smooth, diffuse dilatation of the main duct, and on US or CT, dilated branch ducts are occasionally noted. ERP findings are the most characteristic and conclusive;dilatation of the main duct and/or branch ducts is noted, with a filling defect corresponding to mucin. If overlooked during diagnosis, an IMHN might be interpreted simply as chronic pancreatitis, and so the recognition of this neoplasm is important

  9. Imaging diagnosis of intraductal papillary mucinous tumor of the pancreas

    International Nuclear Information System (INIS)

    Zhang Huimao; Lai Ying; Yang Shuqin; Yang Haishan; Murakami, K.

    2005-01-01

    Objective: To explore the diagnostic value of intraductal papillary mucinous tumor (IPMT) of the pancreas, and to assess its clinical and characteristic radiological features. Methods: Thirty-six cases with IPMT who underwent CT and MRI with plain and contrast enhancement before operation were reviewed. The clinical presentation and characteristic imaging findings of main duct type (8 cases) and branch duct type (28 cases) were retrospectively reviewed. Results: Typical imaging findings of main duct type were segmental or diffuse dilation of MPD (diameter was over 9 mm) with enhanced mural nodules after contrast medium administration. MR cholangiopancreatography (MRCP) showed dilation of MPD with flat/nodule filling defects in 4 cases and MPD dilatation in the head side in 2 cases. Branch duct type was more frequently located in the head or uncinate. Typical imaging findings of branch duct type were unilocular or multilocular cystic tumors with septa, mural nodules, and MPD dilatation. MRCP showed septa in 24 cases, filling defects in 15 cases, and MPD dilatation in 8 cases. Communication between the cystic lesion and the MPD was demonstrated in 19 cases by MRCP. Conclusion: It is extremely important to accurately make the diagnosis of IPMT for planning the surgical strategy. MRCP is a noninvasive and useful method in detecting and making definite diagnosis of IPMT. (authors)

  10. Ultrasonographic Diagnosis of Intraductal Papilloma

    International Nuclear Information System (INIS)

    Seong, Ki Ho; Cho, Dae Hyoun; Hwang, Mi Soo

    1996-01-01

    To demonstrate the ultrasonographic findings in the diagnosis of intraductal papilloma by comparing it with mammography and ductography. The findings of mammography (n = 22), ultrasonography (n= 15), and ductography (n = 5) were analyzed in 25 women with intraductal papilloma. The mammographic findings were asymmetric focal increase in density (n = 4 : 18%), mass without calcification (n = 6 : 27%), mass with calcification (n = 2 : 9%), and calcification only (n = 1 : 5%). Nine studies (41%) showed no abnormal findings. The ultrasonographic findings were ductal dilatation with a mass (n = 7 : 47%), mass only (n = 5 : 33%),and intra cystic mass (n = 3 : 20%). There is no case of normal findings on ultrasonography. Three ductograms (60%)showed a filling defect within duct : the other two studies were normal. Ultrasonography offers very useful findings in early detecting the intraductal papilloma in conjunction with mammography and ductography

  11. Modified Functional Superficial Parotidectomy With Ligation of the Major Branch of the Parotid Duct Extending to the Superficial Lobe.

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    Chang, Jung Woo; Leem, Soo Seong; Choi, Hwan Jun; Lee, Jang Hyun

    2017-05-01

    A functional superficial parotidectomy can maintain salivary function by preserving the Stensen duct. However, this technique still brings the possibility of salivary leakage, because major branches of the parotid duct from the resected site do not get ligated. To reduce this complication, this study introduces a modified technique with major branch ligation. From December 2008 to February 2015, 14 patients who underwent superficial parotidectomy were divided into 2 groups. Group A was treated with the modified functional superficial parotidectomy involving the major branch between the superficial lobe and parotid duct. Group B was treated with the conventional superficial parotidectomy without involving the major branch of the parotid duct. The clinical complications, period of Hemovac usage, and surgical duration were noted in each group. Two of 8 patients in group A had a major branch from Stensen duct that was ligated, and there was no evidence of salivary leakage or sialocele in any of the patients of group A, whereas group B contained 2 cases of salivary leakage, one of which became sialocele. Group A had a significantly longer Hemovac maintenance period than group B (P < 0.05), and the duration of surgery was also significantly different between the 2 groups (P < 0.05). Because a solitary major branch of the main parotid duct occasionally extends toward the superficial lobe, our modified technique-functional superficial parotidectomy with ligation of the major branch toward the superficial lobe-is a useful option for treatment of a benign parotid mass in such cases.

  12. Ultrasound appearance of chronic mammary duct ectasia

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    Duchesne, N. [Ottawa Hospital, Dept. of Radiology, Ottawa, Ontario (Canada)]. E-mail: nathalie_duchesne_22@yahoo.ca; Skolnik, S. [Univ. of Toronto, Dept. of Family Medicine, Toronto, Ontario (Canada); Bilmer, S. [Ottawa Hospital, Dept. of Radiology, Ottawa, Ontario (Canada)

    2005-12-15

    Mammary duct ectasia (MDE), also called periductal mastitis, mammary dysplasia, or plasma cell mastitis, is a benign condition of the mammary gland first described by Haagensen in 1951. The etiology of MDE is unknown and its pathogenesis still controversial; the periductal inflammation could be either the cause or the result of dilated damaged ducts. The process is usually bilateral and asymptomatic, with only a small percentage of patients presenting with symptoms that may include long course of tumour formation, usually subareolar breast lumps, nipple discharge, nipple retraction, mastalgia, and mammary abscess or fistulas. Mammographic presentation of MDE is well known; its features include periductal calcification, benign intraductal calcification, and retroareolar duct dilatation. The periductal calcification results from dystrophic calcification and forms calcified rings or very dense, oval, elongated calcifications, each with a central lucency representing the dilated duct. Intraductal calcifications of duct ectasia represent inspissated intraductal material and are typically of uniform high density, often needle-like, and occasionally branching. Occasionally, there are no mammographic findings, and the diagnosis must rely on sonographic features. Appearance of MDE on ultrasonography (US) depends on the stage of the disease and the contents of the dilated ducts. The acute presentation has been demonstrated in the literature more often than has its chronic counterpart. In the former, duct content can vary from anechoic to isoechoic with surrounding fatty tissue. In chronic MDE, episodes of inflammation are longer. This tends to result in secretions that have a more solid, cheesy texture, partly due to cholesterol crystals, foam cells, and inflammatory cells. For both types of MDE, the appearance can mimic high-grade ductal carcinoma in situ (DCIS) on US. In this essay, 2 chronic MDE cases are presented and their US appearance discussed. Our goal is to explore

  13. Ultrasound appearance of chronic mammary duct ectasia

    International Nuclear Information System (INIS)

    Duchesne, N.; Skolnik, S.; Bilmer, S.

    2005-01-01

    Mammary duct ectasia (MDE), also called periductal mastitis, mammary dysplasia, or plasma cell mastitis, is a benign condition of the mammary gland first described by Haagensen in 1951. The etiology of MDE is unknown and its pathogenesis still controversial; the periductal inflammation could be either the cause or the result of dilated damaged ducts. The process is usually bilateral and asymptomatic, with only a small percentage of patients presenting with symptoms that may include long course of tumour formation, usually subareolar breast lumps, nipple discharge, nipple retraction, mastalgia, and mammary abscess or fistulas. Mammographic presentation of MDE is well known; its features include periductal calcification, benign intraductal calcification, and retroareolar duct dilatation. The periductal calcification results from dystrophic calcification and forms calcified rings or very dense, oval, elongated calcifications, each with a central lucency representing the dilated duct. Intraductal calcifications of duct ectasia represent inspissated intraductal material and are typically of uniform high density, often needle-like, and occasionally branching. Occasionally, there are no mammographic findings, and the diagnosis must rely on sonographic features. Appearance of MDE on ultrasonography (US) depends on the stage of the disease and the contents of the dilated ducts. The acute presentation has been demonstrated in the literature more often than has its chronic counterpart. In the former, duct content can vary from anechoic to isoechoic with surrounding fatty tissue. In chronic MDE, episodes of inflammation are longer. This tends to result in secretions that have a more solid, cheesy texture, partly due to cholesterol crystals, foam cells, and inflammatory cells. For both types of MDE, the appearance can mimic high-grade ductal carcinoma in situ (DCIS) on US. In this essay, 2 chronic MDE cases are presented and their US appearance discussed. Our goal is to explore

  14. Intraductal papillary mucinous neoplasm of the pancreas. Personal series and synthetic review

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    F. Gallucci

    2012-12-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs are rare pancreatic tumors, accounting for less than 1-2% of all neoplasms of the pancreas. The main characteristic of IPMNs is their favorable prognosis, as these pre-malignant or malignant lesions are usually slow-growing tumors and radical surgery is frequently possible. According to the localization of the lesions, three different tumor types have been identified: the main-duct IPMN, the branch-duct IPMN and the mixed-type IPMN (involving both the main pancreatic duct and the side branches. IMPNs do not present pathognomonic signs or symptoms. The obstruction of the main pancreatic duct system may cause abdominal pain and acute pancreatitis (single or recurrent episodes. The tumor may be incidentally discovered in asymptomatic patients, particularly in those with branch-duct IPMNs. In clinical practice, any non-inflammatory cystic lesion of the pancreas should be considered as possible IPMN. Computed tomography, magnetic resonance imaging with cholangiopancreatography and endoscopic ultrasonography can localize an IPMN and assess its morphology and size. The choice between non-operative and surgical management depends on the risk of malignancy and on the definitive distinction between benign and malignant IPMNs. Main-duct IPMNs have a high risk of malignant degeneration, especially in older patients. The clinical and radiological features, as well as treatment and outcome, of eight patients with IPMN (five with main-duct, two with branch-duct and one with mixed-type observed by the authors over the last ten years are presented.

  15. The Utilization of Imaging Features in the Management of Intraductal Papillary Mucinous Neoplasms

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    Stefano Palmucci

    2014-01-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs represent a group of cystic pancreatic neoplasms with large range of clinical behaviours, ranging from low-grade dysplasia or borderline lesions to invasive carcinomas. They can be grouped into lesions originating from the main pancreatic duct, main duct IPMNs (MD-IPMNs, and lesions which arise from secondary branches of parenchyma, denominated branch-duct IPMNs (BD-IPMNs. Management of these cystic lesions is essentially based on clinical and radiological features. The latter have been very well described in the last fifteen years, with many studies published in literature showing the main radiological features of IPMNs. Currently, the goal of imaging modalities is to identify “high-risk stigmata” or “worrisome feature” in the evaluation of pancreatic cysts. Marked dilatation of the main duct (>1 cm, large size (3–5 cm, and intramural nodules have been associated with increased risk of degeneration. BD-IPMNs could be observed as microcystic or macrocystic in appearance, with or without communication with main duct. Their imaging features are frequently overlapped with cystic neoplasms. The risk of progression for secondary IPMNs is lower, and subsequently an imaging based follow-up is very often proposed for these lesions.

  16. Current recommendations for surveillance and surgery of intraductal papillary mucinous neoplasms may overlook some patients with cancer.

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    Nguyen, Andrew H; Toste, Paul A; Farrell, James J; Clerkin, Barbara M; Williams, Jennifer; Muthusamy, V Raman; Watson, Rabindra R; Tomlinson, James S; Hines, O Joe; Reber, Howard A; Donahue, Timothy R

    2015-02-01

    The 2012 Sendai Criteria recommend that patients with 3 cm or larger branch duct intraductal papillary mucinous neoplasms (BD-IPMN) without any additional "worrisome features" or "high-risk stigmata" may undergo close observation. Furthermore, endoscopic ultrasound (EUS) is not recommended for BD-IPMN 3 cm were removed based on size alone. Our results suggest that "larger" size on noninvasive imaging can indicate high-grade/invasive cysts, and EUS-FNA may help identify "smaller" cysts with high-grade/invasive pathology.

  17. Intraductal fibroadenoma under the nipple in an 11-year-old female.

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    Hayano, Fumiko; Yamada, Sohsuke; Nakano, Shigeo; Watanabe, Teruo; Sasaguri, Yasuyuki; Koga, Sunao

    2014-02-10

    Recently, Chung et al. have reported the detailed clinicopathological features of an extremely rare case sharing similar histopathological characteristics with fibroadenomas, phyllodes tumours, intraductal papillomas or ductal adenomas, given the name of intraductal fibroadenomatosis, as an unusual variant of intracanalicular fibroadenoma. Herein we demonstrated a very unusual case of intraductal fibroadenoma of the breast with admixture of components of intracanalicular type fibroadenoma or benign phyllodes tumour and a smaller amount of intraductal papilloma, occupying the one duct and some adjacent ductules, presenting as a well-demarcated nodule.

  18. Intraductal papillary mucinous neoplasms of the pancreas: Correlation of helical CT features with pathologic findings

    International Nuclear Information System (INIS)

    Liu Yu; Lin Xiaozhu; Upadhyaya, Manavendra; Song Qi; Chen Kemin

    2010-01-01

    Objective: To evaluate the CT features of intraductal papillary mucinous neoplasms of the pancreas (IPMNs), and to compare with pathological findings in order to identify CT features that can be helpful in differentiating benign IPMNs from malignant IPMNs. Materials and methods: The CT findings in 25 patients were reviewed for tumor location, tumor type, dilatation of the main pancreatic duct (MPD), MPD involvement, mural node or solid attenuating component, tumor size in branch duct or mixed duct type, dilatation of common bile duct (CBD) and invasion of surrounding structures. The data was subjected to Chi-Square Tests or Fisher's Exact Test using SPSS13.0 software with p value < 0.05 indicating significant statistical difference. Results: Presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, dilatation of CBD was more common in malignant IPMNs (p < 0.05). None of tumor location, tumor type, dilatation of MPD, MPD involvement, tumor size, and invasion of surrounding structures was statistically significant in differentiating benign from malignant IPMNs. Conclusions: CT features suggestive of malignant or invasive IPMNs include presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, and dilatation of CBD.

  19. Diagnostic value of computed tomography for invasion toward the caudate bile duct branch in carcinoma of the hepatic hilum

    International Nuclear Information System (INIS)

    Nagino, Masato; Nimura, Yuji; Hayakawa, Naokazu; Kamiya, Junichi; Kondoh, Satoshi; Shionoya, Shigehiko

    1988-01-01

    The visualization of the caudate bile duct branch (B 1 ) in computed tomography (CT-scan) with a high dose of contrast medium was evaluated in 71 patients with carcinoma of the liver, biliary tract and pancreas, preoperatively. The patients were classified into four groups: Group A, 22 patients (twelve hepatomas, six gall bladder cancers and four cancers of the pancreas body or tail) without abnormal findings in the biliary tract ; Group B, two patients (cancer of the pancreas head and the common bile duct) with obstructive jaundice whose CT-scans were taken before percutaneous transhepatic cholangiodrainage (PTCD) ; Group C, 22 patients (16 cancers of the pancreas head and six common bile duct cancers) whose CT-scans were taken after release of jaundice by PTCD ; Group D, 25 patients with carcinoma of the hepatic hilum whose CT-scans were taken after release of jaundice by PTCD. The results were as follows. 1) In Group A, B 1 was invisible in all the patients. 2) In Group B, B 1 was clearly visible in all the patients. But in Group C, B 1 was visible only in one patient. 3) In Group D, B 1 was visible in 19 out of 25 patients and in 18 patients out of these 19 patients, cancer invasion toward B 1 was histopathologically confirmed. In contrast, invasion was revealed only in one out of six patients whose B 1 s were invisible. From these results, it is concluded that in carcinoma of the hepatic hilum the visualization of B 1 in CT-scan after release of jaundice by PTCD strongly suggests the cancer invasion on B 1 , and requests the caudate lobe resection. (author)

  20. The use of film imaging techniques in the diagnosis of mammary intraductal papilloma (report of 23 cases)

    International Nuclear Information System (INIS)

    Wei Shaohua; Liu Genshou

    2001-01-01

    Objective: To summarize the value of the film imaging techniques in the diagnosis of mammary intraductal papilloma. Methods: Retrospectively analysis 23 in patients with mammary intraductal papilloma which was confirmed by diagnosis with multiple function ultrasound instrument, mammography and breast duct imaging techniques. Results: The diagnosis sensitivities of multiple function ultrasound instrument and breast duct imaging techniques were 66.7% and 70.6% respectively (P > 0.05). Both of them had a definite value in diagnosis of mammary intraductal papilloma. Conclusion: Film imaging techniques are valuable to locate lesions, but is not useful for making pathological diagnosis

  1. Multiple intraductal papillomas of breast clinically masquerading as malignancy

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    Singh Pallavi

    2010-01-01

    Full Text Available Background: Intraductal papilloma is characterized by proliferation of epithelial and myoepithelial cells overlying fibro-vascular stalks creating an arborescent structure within the lumen of duct. Some times multiple papillomas with florid proliferation of epithelium may be confused with malignancy. A case of multiple intraductal papillomas of breast with ulceration of overlying skin and large lump leading to clinical diagnosis of malignancy is documented here. Case Report: A 45-year-old female presented with ulcerated mass of six months duration in the left breast. On examination, a firm, immobile lump of 8× 10 cm in size involving nipple with excoriation of surrounding skin and serosanguinous discharge from nipple was present. There was no axillary lymphadenopathy. No family history of carcinoma breast was present. Fine needle aspiration smears showed benign cellular changes with apocrine metaplasia. Biopsy from an area adjacent to nipple showed intraductal papilloma. Simple mastectomy showed lobulated dirty white mass with well circumscribed nodules below the nipple and areola. On histology with immunohistochemistry a diagnosis of multiple intraductal papillomas was made. Patient is on regular follow-up and doing well. Conclusion: The case highlights the problem in differentiating marked papillomatosis from a malignant lesion of breast and importance of biopsy with immunohistochemistry in such cases for proper management.

  2. The mammographic spectrum of intraductal carcinoma

    International Nuclear Information System (INIS)

    Ikeda, D.M.; Andersson, I.

    1988-01-01

    To analyze the atypical radiographic spectrum of ductal carcinoma in situ (DCIS), the authors retrospectively reviewed the mammograms of 190 women who had biopsy-proved DCIS at Malmo General Hospital between January 1976 and March 1988. Of these, 117 (61.6%) showed clustered microcalcifications as the major abnormality, a finding often associated with DCIS. The remaining 73 women (38.4%) had either negative mammograms (30 women) or radiographic findings not usually associated with DCIS (43 women), including circumscribed masses (15 women) and focal conglomerates of prominent ducts and nodules (12 cases). Since treatment of DCIS may cure the disease, the radiologist should learn to recognize the more unusual mammographic manifestations of intraductal carcinoma

  3. Incidental intraductal papillomas (breast diagnosed on needle core biopsy do not need to be excised.

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    Jaffer, Shabnam; Bleiweiss, Ira J; Nagi, Chandandeep

    2013-01-01

    biopsy. However, on excision, residual pleomorphic calcifications on mammogram correlated with both fibrocystic changes and intraductal papilloma. No cases were upstaged on excision to atypical duct hyperplasia or intraductal or invasive carcinoma. With the exception of one case, all incidental intraductal papillomas diagnosed on core needle biopsy were either completely excised or remained incidental. The exception occurred due to sampling error and accounted for the change from an incidental intraductal papillomas on core needle biopsy to one that was associated with calcifications on excision. Given the complete lack of upstaging, it is difficult to recommend excision of incidental intraductal papillomas diagnosed on core needle biopsy provided the index lesion has been adequately sampled and radiologic follow-up is maintained. © 2013 Wiley Periodicals, Inc.

  4. Oncocytic Type Intraductal Papillary Mucinous Neoplasm of the Pancreas with Unusually Low Mucin Production Mimicking Intraductal Tubulopapillary Neoplasm: A Report of a Case Diagnosed by a Preoperative Endoscopic Biopsy

    Science.gov (United States)

    Yoshida, Yukinari; Endo, Takao; Tanaka, Eiichi; Kikuchi, Takefumi; Akino, Kimishige; Mita, Hiroaki; Adachi, Yasuyo; Nakamura, Masahiro; Adachi, Yasushi; Ishii, Yoshifumi; Matsumoto, Joe; Hirano, Satoshi; Nitta, Takeo; Mitsuhashi, Tomoko; Kato, Yasuo

    2017-01-01

    We herein report the case of a 78-year-old woman with an intraductal tumor with scant mucin production in a moderately dilated main pancreatic duct that resembled an intraductal tubulopapillary neoplasm (ITPN) on imaging. An endoscopic transpapillary forceps biopsy enabled an accurate preoperative diagnosis of the tumor as an oncocytic type intraductal papillary mucinous neoplasm (IPMN) of the pancreas microscopically showing papillary growth consisting of oncocytic cells with a typical mucin expression profile, although with few intraepithelial lumina containing mucin. This is the first case of an oncocytic type IPMN mimicking an ITPN that was able to be diagnosed preoperatively. PMID:29021473

  5. Intraductal membranous fat necrosis in a fibroadenoma of breast: a case report.

    Science.gov (United States)

    Coyne, John D

    2014-09-01

    Membranous fat necrosis is an unusual type of fat necrosis occurring in the breast and normally involves the parenchyma. This report describes an apparently unique intraductal focus in a fibroadenoma following prior needling. Displacement of fatty tissue in the form of membranous fat necrosis within ducts could be added to the list of histological features following core biopsy. © The Author(s) 2013.

  6. Differential diagnosis of benign and malignant intraductal papillary mucinous tumors of the pancreas: MR cholangiopancreatography and MR angiography

    International Nuclear Information System (INIS)

    Choi, Byung Se; Kim, Tae Kyoung; Kim, Ah Young; Kim, Kyoung Won; Park, Sung Won; Kim, Pyo Nyun; Ha, Kyun Kwon; Lee, Moon Gyu; Kim, Song Cheol

    2003-01-01

    To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy. During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA. Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p<0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p<0.05), and the presence of mural nodules was more frequent (p<0.001). Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas

  7. Hepatocellular carcinoma with bile duct involvement : computed Tomographic (CT) findings

    International Nuclear Information System (INIS)

    Lee, Joon Woo; Han, Joon Koo; Kim, Tae Kyoung; And others

    2000-01-01

    To describe the radiologic features of computed tomography (CT) in hepatocellular carcinoma (HCC) with bile duct involvement. We retrospectively analyzed the two phase spiral CT findings of 31 patients in whom HCC with bile duct invasion (n=3D28) or compression (n=3D3), was diagnosed. Eight of these underwent follow up CT after transarterial chemoembolization. We analyzed the size, type, location, enhancement pattern, and lipiodol retention of parenchymal and intraductal masses, as well as their lymphadenopathy. In all patients with bile duct invasion, single or multiple masses were demonstrated in the bile ducts. Intraductal masses showed the same enhancement characteristics as the parenchymal mass (kappa 0.550, p less than 0.001), and were contiguous to this mass. In 14 of 28 patients, intraductal masses filled the peripheral intrahepatic bile ducts and extended to the common bile ducts. In the other 14, the parenchymal mass extended to the area of the porta hepatis and then directly invaded the large ducts. In nine of the 28 patients, there was a hypoattenuated cleft between the intraductal mass and ductal wall. In six, a parenchymal mass was not apparent (n=3D2), or was smaller than 2cm (n=3D4). In five of eight patients (62.5%), follow-up CT after transarterial chemoembolization showed compact or partial lipiodol retention within the intraductal mass. In patients with bile duct compression, perihilar lymph nodes were noted along with the dilated intrahepatic duct but no intra ductal mass was demonstrated in the duct. Hepatocellular carcinomas cause bile duct dilatation either by direct invasion or by extrinsic compression of the bile duct with surrounding enlarged nodes. For the diagnosis of this condition, CT is helpful. (author)

  8. Features of the Diagnosis of Intraductal Breast Diseases in Adolescent Girls Through the Example of Clinical Cases. The Algorithm of Examination And Treatment of Pathologies in Adolescence

    Directory of Open Access Journals (Sweden)

    M. L. Travina

    2016-01-01

    Full Text Available Intraductal breast diseases are characterized by a high risk of transformation in breast cancer. Difficulties of diagnosing intraductal lesions are associated with the only symptom — the appearance of pathologic discharge from the breast nipple. In adolescent girls, taking into account the immaturity of the nipple and it flatness, there are difficulties with removing it correctly. On physical examination, as well as with the high density of the surrounding tissue and areola, the control over the presence of pathologic discharge from the mammary ducts is difficult. The intraductal pathology requires ultrasound examination, mammography, and only after a full examination — ductographic research. The article presents its own clinical observations of the intraductal pathology in adolescent girls aged 14 and 15 years. The algorithms of examination and patient surveillance with intraductal pathology are described.

  9. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Thula Cannon; Steffen, Ingo G.; Stelter, Lars H.; Hamm, Bernd; Denecke, Timm; Grieser, Christian [Charite - Universitaetsmedizin Berlin, Klinik fuer Radiologie, Campus Virchow-Klinikum, Berlin (Germany); Maurer, Martin H. [Universitaetsklinik Bern, Universitaetsinstitut fuer Radiologe, Inselspital, Bern (Switzerland); Bahra, Marcus; Faber, Wladimir; Klein, Fritz [Charite - Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie Campus Virchow-Klinikum, Berlin (Germany); Blaeker, Hendrik [Charite - Universitaetsmedizin Berlin, Institut fuer Pathologie, Campus Charite Mitte, Berlin (Germany)

    2015-05-01

    Evaluation of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiation of pancreatic intraductal papillary mucinous neoplasm (IPMN) subtypes based on objective imaging criteria. Fifty-eight patients with 60 histologically confirmed IPMNs were included in this retrospective study. Eighty-three imaging studies (CT,n = 42; MRI,n = 41) were analysed by three independent blinded observers (O1-O3), using established imaging criteria to assess likelihood of malignancy (-5, very likely benign; 5, very likely malignant) and histological subtype (i.e., low-grade (LGD), moderate-grade (MGD), high-grade dysplasia (HGD), early invasive carcinoma (IPMC), solid carcinoma (CA) arising from IPMN). Forty-one benign (LGD IPMN,n = 20; MGD IPMN,n = 21) and 19 malignant (HGD IPMN,n = 3; IPMC,n = 6; solid CA,n = 10) IPMNs located in the main duct (n = 6), branch duct (n = 37), or both (n = 17) were evaluated. Overall accuracy of differentiation between benign and malignant IPMNs was 86/92 % (CT/MRI). Exclusion of overtly malignant cases (solid CA) resulted in overall accuracy of 83/90 % (CT/MRI). The presence of mural nodules and ductal lesion size ≥30 mm were significant indicators of malignancy (p = 0.02 and p < 0.001, respectively). Invasive IPMN can be identified with high confidence and sensitivity using CT and MRI. The diagnostic problem that remains is the accurate radiological differentiation of premalignant and non-invasive subtypes. (orig.)

  10. Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience.

    Science.gov (United States)

    Yu, Songfeng; Takasu, Naoki; Watanabe, Toshihiro; Fukumoto, Tsuyoshi; Okazaki, Shinji; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

    2017-08-01

    The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF. The positive predictive values of HRS and WF were 66.7% and 35.7% for branch duct IPMN and 80% and 38.1% for main duct IPMN, respectively. Univariate analysis indicated that all the factors in HRS and WF had statistical significance. Whereas multivariate analysis revealed only enhanced solid component (odds ratio [OR], 50.01; P = 0.008), presence of mural nodule (OR, 73.83; P < 0.001) and lymphadenopathy (OR, 20.85; P = 0.03) were independent predictors. Scoring HRS and WF by different numbers of positive factors resulted in improved predictive value. The area under the curve of HRS score was significantly lower than that of WF or HRS + WF score (0.680 vs 0.900 or 0.902, respectively; P < 0.001). As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

  11. Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology

    OpenAIRE

    Verbeke, Caroline S

    2010-01-01

    Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal...

  12. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

    International Nuclear Information System (INIS)

    Kurz, Kathinka D; Roy, Sumit; Saleh, Andreas; Diallo-Danebrock, Raihana; Skaane, Per

    2011-01-01

    Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis

  13. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, Kathinka D; Roy, Sumit (Dept. of Radiology, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: kurk@sus.no; Saleh, Andreas (Inst. of Diagnostic Radiology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Diallo-Danebrock, Raihana (Inst. of Pathology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Skaane, Per (Dept. of Radiology, Ullevaal Univ. Hospital, Univ. of Oslo, Oslo (Norway))

    2011-04-15

    Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis

  14. Intraductal papillary mucinous neoplasms (IPMN of the pancreas: clinico-pathologic results Neoplasia papilar mucinosa intraductal del páncreas: resultados clínico-patológicos

    Directory of Open Access Journals (Sweden)

    J. A. Cienfuegos

    2010-05-01

    Full Text Available Background: intraductal papillary mucinous neoplasm (IPMN shows a series of lesions which evolve from benign lesions -adenoma- to invasive carcinoma. Aim: to analyze the clinical and pathological results of 15 patients diagnosed of IPMN, and surgically treated according to the guidelines of International Consensus Conference. Material and methods: a retrospective analysis of 15 patients surgically treated between March 1993 and September 2009, according to the International Consensus recommendation. Demographic, diagnostic tools, surgical report, pathologic database and actuarial survival were analyzed with a follow-up from one and a half month through nine years. Results: 6 patients underwent pancreaticoduodenectomies, 4 total pancreatectomies, 2 body or central pancreatectomies, 2 partial pancreatectomies (enucleation and 1 distal pancreatectomy. A morbidity of 46 and 0% hospital mortality were assessed, with a median length hospital stay of 10 days. In five cases, the IPMN was combined type (both main and branch pancreatic ducts involved in four main duct-type and branch duct-type in the another six as well. Several atypia (IPMN carcinoma in situ was observed in 2 patients and invasive carcinoma with negative lymph nodes was identified in 3 patients. A patient without invasive carcinoma died at 66 months of follow-up for pancreas adenocarcinoma. The actuarial survival up to recurrence or death was 105,133 months with a range of follow-up from 1 month and a half until 9 years. Conclusions: IPMN main duct or mixed type warrants complete resection due to its incidence of invasive carcinoma or precursor lesions of malignancy as well. Due to its multifocal pattern, patients should be followed in long-term surveillance. The management of asymptomatic IPMN type branch less than 3 cm is controversial.Introducción: la neoplasia papilar mucinosa intraductal (NPMI del páncreas comprende una serie de lesiones que evolucionan desde lesiones benignas

  15. Intraductal location of the sclerosing adenosis of the breast.

    Science.gov (United States)

    Unal, Bulent; Gur, A Serhat; Bhargava, Rohit; Edington, Howard; Ahrendt, Gretchen; Soran, Atilla

    2009-01-01

    Sclerosing adenosis is a benign breast disease with non-specific images on ultrasound or mammogram. It can mimic infiltrating carcinoma when the above mentioned imaging techniques are used. Herein we present a patient with breast cancer who received neoadjuvant chemotherapy and subsequently underwent mastectomy. Ductoscopy was performed to the mastectomised breast specimen as per the ductoscopy research protocol. Ductoscopy revealed several nodular lesions in the duct with no additional demonstrable intraductal pathology. The lesions were reported as sclerosing adenosis by pathologist. As to our knowledge, this is the first case in literature that demonstrates the use of ductoscopy in diagnosing the sclerosing adenosis in the breast tissue. Ductoscopy and development of ductoscopy guided biopsy techniques may be used as an early diagnostic method for the ductal breast lesions (Fig. 2, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

  16. Predictors of malignancy in intraductal papillary mucinous neoplasm of the pancreas: analysis of 310 pancreatic resection patients at multiple high-volume centers.

    Science.gov (United States)

    Shimizu, Yasuhiro; Yamaue, Hiroki; Maguchi, Hiroyuki; Yamao, Kenji; Hirono, Seiko; Osanai, Manabu; Hijioka, Susumu; Hosoda, Waki; Nakamura, Yasushi; Shinohara, Toshiya; Yanagisawa, Akio

    2013-07-01

    The present study was a retrospective investigation of predictors of malignancy in intraductal papillary mucinous neoplasm (IPMN) of the pancreas. The subjects were 310 patients who underwent pancreatic resection at 3 high-volume centers. Preoperative laboratory and imaging findings were analyzed in logistic regression analyses. Endoscopic ultrasonography measurements were essential for the size of mural nodules, and a central review was conducted for pathological diagnosis. Pathological diagnosis was benign IPMN in 150 cases and malignant in 160 (noninvasive carcinoma, n = 100; invasive, n = 60). In multivariate analysis, size of mural nodules, diameter of main pancreatic duct, and cyst size of branch pancreatic duct were independent predictors of malignancy, and areas under the receiver operating characteristic curve for these 3 factors were 0.798, 0.643, and 0.601, respectively. With 7 mm taken as the cutoff value for the size of mural nodules, the diagnosis of malignant IPMN had sensitivity of 74.3% and specificity of 72.7%. Carcinoma without nodules was present in 15 patients (15/160 [9.4%]). The size of mural nodules measured with endoscopic ultrasonography showed high predictive ability. However, about 10% of carcinoma patients did not have nodules, and the handling of the diagnosis in such cases is a problem for the future.

  17. Technical Feasibility and Oncological Legitimacy of Enucleation of Intraductal Papillary Mucinous Neoplasm Located at the Pancreatic Head or Uncinate Process.

    Science.gov (United States)

    Soejima, Yuji; Toshima, Takeo; Motomura, Takashi; Yokota, Tomoyuki; Joko, Kouji; Oshiro, Yumi; Takahashi, Ikuo; Nishizaki, Takashi; Maehara, Yoshihiko

    2017-01-01

    Surgical indications and strategies for branch duct (BD)-intraductal papillary mucinous neoplasm (IPMN) at the pancreatic head (PH) are controversial issues. We investigated the technical feasibility and oncological legitimacy of enucleation for IPMN of the PH. The clinicopathological parameters of 11 patients with IPMN who underwent conventional pancreaticoduodenectomy (PD, n=7) or enucleation (n=4) during the same period were evaluated. The mean operative time (442 vs. 280 min, p<0.05) and blood loss (864 vs. 93 ml, p<0.05) were significantly better in the enucleation group. The final pathological diagnosis (low-/intermediate-/high-grade dysplasia) in the PD and enucleation groups was 4/2/1 and 3/1/0, respectively. The incidence of grade B pancreatic fistula and Clavien III complications was 14% vs. 0% and 43% vs. 25%, respectively. No recurrent pancreatitis or exocrine or endocrine dysfunction was noted in the enucleation group; however, de novo or exacerbated diabetes mellitus developed in three patients in the PD group. All patients were alive and no disease recurrence was noted at a mean follow-up of 1,059 days. Enucleation of BD-IPMN at the PH is a technically feasible and oncologically acceptable procedure which should be justified in patients with IPMNs with a low risk of malignancy. Copyright© 2017 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. CT differentiation of mucin-producing cystic neoplasms of the liver from solitary bile duct cysts.

    Science.gov (United States)

    Kim, Hyoung Jung; Yu, Eun Sil; Byun, Jae Ho; Hong, Seung-Mo; Kim, Kyoung Won; Lee, Jong Seok; Kim, So Yeon

    2014-01-01

    The purpose of this study was to identify the CT features required for differentiating mucin-producing cystic neoplasms of the liver (mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct) from solitary bile duct cysts. CT images of pathologically confirmed mucinous cystic neoplasms (n = 15), cyst-forming intraductal papillary neoplasms of the bile duct (n = 16), and solitary bile duct cysts (n = 31) were reviewed. Analysis of the CT findings included shape, presence of septa, location of septa (peripheral vs central), thickness of septa (thin vs thick), mosaic pattern, mural nodules, intracystic debris, calcification, upstream bile duct dilatation, downstream bile duct dilatation, and communication between a cystic lesion and the bile duct. The maximum size of a cystic lesion and the maximum size of the largest mural nodule were measured. The presence of septa, central septa, mural nodules, upstream bile duct dilatation, and downstream bile duct dilatation were found to be significant CT findings for differentiating mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct from solitary bile duct cysts (p bile duct were 87% (27 of 31) and 87% (27 of 31), respectively. When two of these five criteria were used in combination, the sensitivity and specificity for diagnosing mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct were 87% (27 of 31) and 87% (27 of 31), respectively [corrected]. With the use of specific CT criteria, mucin-producing cystic neoplasms of the liver can be differentiated from solitary bile duct cysts with a high degree of accuracy.

  19. Intraductal biliopancreatic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review.

    Science.gov (United States)

    Tringali, Andrea; Lemmers, Arnaud; Meves, Volker; Terheggen, Grischa; Pohl, Jürgen; Manfredi, Guido; Häfner, Michael; Costamagna, Guido; Devière, Jacques; Neuhaus, Horst; Caillol, Fabrice; Giovannini, Marc; Hassan, Cesare; Dumonceau, Jean-Marc

    2015-08-01

    This technology review expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) on the available techniques for intraductal biliopancreatic imaging. The three cholangioscopy techniques are described: the "dual-operator" and " single-operator" mother-baby approaches using dedicated instruments, and the "direct" technique using currently available ultrathin gastroscopes. The mother-baby method is standardized and reproducible, while direct cholangioscopy is technically demanding and its safety requires further evaluation. As well as direct visualization of the bile ducts, cholangioscopy has the further advantage of allowing targeted biopsy. Image quality is still suboptimal for single-operator cholangioscopy, while the other techniques have achieved adequately detailed imaging. The costs of mother-baby cholangioscopy are high and its application in clinical practice should be restricted to selected cases (i.e. indeterminate biliary strictures/intraluminal lesions, difficult biliary stones) and to the setting of tertiary care centers. Peroral pancreatoscopy may find an indication in situations where other imaging modalities (mainly EUS) are inconclusive (i.e. delineation of main duct intraductal papillary mucinous neoplasia extension, sampling of indeterminate main pancreatic duct strictures). Intraductal ultrasonography (IDUS) has a poorer performance than EUS in the staging of pancreatic malignancies and can increase the risk of pancreatitis. A promising indication for IDUS could be the evaluation of indeterminate biliary strictures and ampullary tumors. Probe-based confocal laser endomicroscopy (pCLE) of the bile ducts is a difficult and expensive technique. Appropriate training needs to be established, since interpretation of images is challenging. pCLE can be an important diagnostic tool in the setting of indeterminate biliary strictures. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Diagnosis of a Nonpalpable Intraductal Papilloma without Radiological Abnormality by Nipple Discharge Smear Examination: A Case Report

    Directory of Open Access Journals (Sweden)

    Anshul Singh

    2014-01-01

    Full Text Available Nipple discharge is the third most common breast complaint after breast pain and breast mass, most commonly associated with endocrine alterations and/or medications, pregnancy, lactation, post lactation, fibrocystic disease, intraductal papilloma, duct ectasia, nipple adenoma, infection, chronic mastitis, subareolar abscess, and least frequently, breast carcinoma. Cytological examination of nipple discharge (ND is a noninvasive method of diagnosing the underlying breast pathology. We report a 46 year old female, who presented with pain and blood-mixed ND from the right breast with an impalpable mass. Cytological examination of the discharge was done and diagnosis of papillary neoplasm with degeneration, metaplasia, and atypia was given, which was further confirmed on histology and positive IHC for HMWCK and p63. Final diagnosis was intraductal papilloma of the lactiferous duct with squamous metaplasia and infarction. Differentiating benign papilloma from a carcinoma is challenging to the cytopathologist and requires clinicopathological correlation and a good knowledge of cytology.

  1. Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology.

    Science.gov (United States)

    Verbeke, Caroline S

    2010-10-27

    Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal studies suggest that IPMNs develop in the context of a field-defect and reveal their possible relationship with other neoplastic precursor lesions of pancreatic cancer.

  2. Percutaneous intraductal radiofrequency ablation in the management of unresectable Bismuth types III and IV hilar cholangiocarcinoma.

    Science.gov (United States)

    Wang, Yu; Cui, Wei; Fan, Wenzhe; Zhang, Yingqiang; Yao, Wang; Huang, Kunbo; Li, Jiaping

    2016-08-16

    To assess the feasibility and safety of percutaneous intraductal radiofrequency ablation (RFA) for unresectable Bismuth types III and IV hilar cholangiocarcinoma. Percutaneous intraductal RFA combined with metal stent placement was successful in all patients without any technical problems; the technical success rate was 100%. Chemotherapy was administered to two patients. After treatment, serum direct bilirubin levels were notably decreased. Six patients died during the follow-up period. Median stent patency from the time of the first RFA and survival from the time of diagnosis were 100 days (95% confidence interval (CI), 85-115 days) and 5.3 months (95% CI, 2.5-8.1 months), respectively. No acute pancreatitis, bile duct bleeding and perforation, bile leakage, or other severe complications occurred. Four cases of procedure-related cholangitis, three cases of postoperative abdominal pain, and five cases of asymptomatic transient increase in serum amylase were observed. One patient who presented with stent blockage 252 days' post-procedure underwent repeat ablation. Between September 2013 and May 2015, nine patients with unresectable Bismuth types III and IV hilar cholangiocarcinoma who were treated with percutaneous intraductal RFA combined with metal stent placement after the percutaneous transhepatic cholangial drainage were included in the retrospective analysis. Procedure-related complications, stent patency, and survival after treatment were investigated. Percutaneous intraductal RFA combined with metal stent placement is a technically safe and feasible therapeutic option for the palliative treatment of unresectable Bismuth types III and IV hilar cholangiocarcinoma. Its long-term efficacy and safety is promising, but needs further study via randomized and prospective trials that include a greater number of patients.

  3. Utility of whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs).

    Science.gov (United States)

    Hoffman, David H; Ream, Justin M; Hajdu, Christina H; Rosenkrantz, Andrew B

    2017-04-01

    To evaluate whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs), including in comparison with conventional MRI features. Eighteen branch-duct IPMNs underwent MRI with DWI prior to resection (n = 16) or FNA (n = 2). A blinded radiologist placed 3D volumes-of-interest on the entire IPMN on the ADC map, from which whole-lesion histogram metrics were generated. The reader also assessed IPMN size, mural nodularity, and adjacent main-duct dilation. Benign (low-to-intermediate grade dysplasia; n = 10) and malignant (high-grade dysplasia or invasive adenocarcinoma; n = 8) IPMNs were compared. Whole-lesion ADC histogram metrics demonstrating significant differences between benign and malignant IPMNs were: entropy (5.1 ± 0.2 vs. 5.4 ± 0.2; p = 0.01, AUC = 86%); mean of the bottom 10th percentile (2.2 ± 0.4 vs. 1.6 ± 0.7; p = 0.03; AUC = 81%); and mean of the 10-25th percentile (2.8 ± 0.4 vs. 2.3 ± 0.6; p = 0.04; AUC = 79%). The overall mean ADC, skewness, and kurtosis were not significantly different between groups (p ≥ 0.06; AUC = 50-78%). For entropy (highest performing histogram metric), an optimal threshold of >5.3 achieved a sensitivity of 100%, a specificity of 70%, and an accuracy of 83% for predicting malignancy. No significant difference (p = 0.18-0.64) was observed between benign and malignant IPMNs for cyst size ≥3 cm, adjacent main-duct dilatation, or mural nodule. At multivariable analysis of entropy in combination with all other ADC histogram and conventional MRI features, entropy was the only significant independent predictor of malignancy (p = 0.004). Although requiring larger studies, ADC entropy obtained from 3D whole-lesion histogram analysis may serve as a biomarker for identifying the malignant potential of IPMNs, independent of conventional MRI features.

  4. Does a family history of pancreatic ductal adenocarcinoma and cyst size influence the follow-up strategy for intraductal papillary mucinous neoplasms of the pancreas?

    Science.gov (United States)

    Mandai, Koichiro; Uno, Koji; Yasuda, Kenjiro

    2014-08-01

    This study aimed to evaluate the relationship between pancreatic ductal adenocarcinoma (PDAC) family history and PDAC development in patients followed up for intraductal papillary mucinous neoplasms (IPMNs) and to assess the cyst size relevance in determining follow-up strategies. We analyzed 300 patients with branch duct and mixed-type IPMN who were followed up at our facility. Among the patients aged 70 years or older, the frequency of PDAC did not differ significantly between those with 1 first-degree relative with PDAC and those without a family history. Although patients with IPMNs of greater than or equal to 30 mm were followed up for a significantly shorter duration than those patients with IPMNs of less than 30 mm, the frequency of IPMN progression and malignant IPMN was significantly greater in the former. The frequency of IPMN progression and pancreatic cancer did not differ significantly according to IPMN size (family history. Special attention should be paid to IPMN progression and malignant transformation in patients with IPMNs of greater than or equal to 30 mm, but cyst size need not be considered when determining follow-up strategies for patients with IPMNs of less than 30 mm without mural nodules.

  5. Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Natalie E. Cookson

    2015-01-01

    Full Text Available Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”. Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT imaging revealed hyperdense material in the common bile duct (CBD compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient’s jaundice and sepsis. Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.

  6. 3 T MR 3D fast imaging employing steady state acquisition demonstrating branches of intraparotid facial nerve, parotid duct, and relation with parotid tumors

    International Nuclear Information System (INIS)

    Li Yan; Li Chuanting; Zhang Dongsheng; Ai Bin; Zhang Weidong; Wu Lebin

    2010-01-01

    Objective: To investigate the usefulness of 3 T MRI 3D-FIESTA in the evaluation of the intraparotid components of the facial nerve and parotid duct, and compare them with surgical findings. Methods: Twenty-two cases with parotid benign tumors were scanned with conventional and 3D-FIESTA sequences on 3 T MRI scanner. Postprocessed multiplanar images were obtained with the workstation. Parotid ducts and facial nerves and tumors were identified on these images. The relationship of the tumors to the facial nerves and Parotid ducts was confirmed at surgery. Results: Various types of parotid benign tumors had their characteristics on 3 T MR imaging. Parotid benign tumors mainly showed hypo-intensity on T 1 WI in 21 cases, and hyper-intensity on T 2 WI in 22 cases. But on 3D-FIESTA images, they appeared hypointensity (10 cases) or high intensity (12 cases) due to different types. Facial nerves in parotid appeared as linear structures with hypo-inteusity. The indication of the main trunks were 16 and 18 cases for T 1 WI and T 2 WI images, while on 3D-FIESTA images, the main trunks and cervicofacial and temporofacial divisions of the facial nerves were found in 22, 21,22 cases. Parotid ducts appeared as structures with hypo-intensity on T 1 WI and hyper-intensity on multiplanar images (14, 20, 22 cases). Compared with surgical results, the main trunks of the facial nerve were correctly showed by 3D-FIESTA images in 20 cases. However, in 2 cases they were not located in the operation because of shifting. Conclusion: 3 T MR 3D-FIESTA imaging could depict the extracranial facial nerve and the parotid duct in the parotid gland, which is useful for preoperative evaluation of parotid gland tumors. (authors)

  7. 3D-FIESTA MRI at 3 T demonstrating branches of the intraparotid facial nerve, parotid ducts and relation with benign parotid tumours

    International Nuclear Information System (INIS)

    Li Chuanting; Li Yan; Zhang Dongsheng; Yang Zhenzhen; Wu Lebin

    2012-01-01

    Aim: To investigate the usefulness of three-dimensional (3D) fast imaging employing steady state precession (FIESTA) magnetic resonance imaging (MRI) at 3 T in evaluating the intraparotid components of the facial nerve and parotid ducts, and to compare the MRI images with surgical findings. Materials and methods: Thirty-one cases of benign parotid tumours were studied with conventional and 3D FIESTA MRI sequences at 3T using a head coil. The most clinically useful 3D FIESTA images were acquired at parameters of 4.9 ms repetition time (TR); 1.5 effective echo time (TEeff); a flip of 55°, a field of view of 18 to 20 cm, a matrix of 512 × 320, an axial plane, no gaps, and a section thickness of 1 mm. Post-processed multiplanar images were obtained with an Advantage Windows (AW sdc 4.3) workstation. Parotid ducts, facial nerves, and tumours were identified on these images. The relationship of the tumours to the facial nerves and parotid ducts was confirmed at surgery. Results: The facial nerves appeared as linear structures of low intensity. The main trunk of the facial nerve was identified bilaterally in 93.5% of the 3D-FIESTA sequence images. Parotid ducts appeared as structures of high intensity on multiplanar 3D-FIESTA images (100%). The relationships of the tumours with the cervicofacial and temporofacial divisions of the facial nerve were correctly diagnosed in 26 of 31 cases (83.9%) using 3D-FIESTA sequence images. Conclusion: 3D-FIESTA MRI at 3 T depicted the main trunk, cervicofacial and temporofacial divisions of the facial nerve, and the main parotid duct. It is useful for preoperative evaluation of parotid gland tumours.

  8. Intraductal delivery of adenoviruses targets pancreatic tumors in transgenic Ela-myc mice and orthotopic xenografts.

    Science.gov (United States)

    José, Anabel; Sobrevals, Luciano; Miguel Camacho-Sánchez, Juan; Huch, Meritxell; Andreu, Núria; Ayuso, Eduard; Navarro, Pilar; Alemany, Ramon; Fillat, Cristina

    2013-01-01

    Gene-based anticancer therapies delivered by adenoviruses are limited by the poor viral distribution into the tumor. In the current work we have explored the feasibility of targeting pancreatic tumors through a loco-regional route. We have taken advantage of the ductal network in the pancreas to retrogradelly inject adenoviruses through the common bile duct in two different mouse models of pancreatic carcinogenesis: The transgenic Ela-myc mice that develop mixed neoplasms displaying both acinar-like and duct-like neoplastic cells affecting the whole pancreas; and mice bearing PANC-1 and BxPC-3 orthotopic xenografts that constitute a model of localized human neoplastic tumors. We studied tumor targeting and the anticancer effects of newly thymidine kinase-engineered adenoviruses both in vitro and in vivo, and conducted comparative studies between intraductal or intravenous administration. Our data indicate that the intraductal delivery of adenovirus efficiently targets pancreatic tumors in the two mouse models. The in vivo application of AduPARTKT plus ganciclovir (GCV) treatment induced tumor regression in Ela-myc mice. Moreover, the intraductal injection of ICOVIR15-TKT oncolytic adenoviruses significantly improved mean survival of mice bearing PANC-1 and BxPC-3 pancreatic xenografts from 30 to 52 days and from 20 to 68 days respectively (p less than 0.0001) when combined with GCV. Of notice, both AduPARTKT and ICOVIR15-TKT antitumoral responses were stronger by ductal viral application than intravenously, in line with the 38-fold increase in pancreas transduction observed upon ductal administration. In summary our data show that cytotoxic adenoviruses retrogradelly injected to the pancreas can be a feasible approach to treat localized pancreatic tumors.

  9. A Review of Double Common Bile Duct and Its Sequelae.

    Science.gov (United States)

    Kolli, Sindhura; Etienne, Denzil; Reddy, Madhavi; Shahzad, Ghulamullah

    2018-02-01

    A double or accessory common bile duct (ACBD) is a rare congenital anomaly. We report the case of a 60-year-old American Asian male, who was found to have a double or duplicated common bile duct after being admitted for evaluation of a pancreatic mass. A duplicated bile duct has the same mucosa histologically as a single bile duct. However, the opening of a duplicated bile duct lacks a sphincter allowing retrograde flow of gut contents which results in a higher probability of intraductal calculus formation. On rare occasions, it can predispose to liver abscesses, pancreatitis, pancreatic cancer, gallbladder cancer, gastric cancer, and ampullary cancer depending on the location of the opening of the ACBD. We present an integrative review of the limited cases of ACBD with correlation to the current case and discussion regarding the aspects of diagnosis and management.

  10. Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Mizandari, Malkhaz [Tbilisi State Medical University, Department of Radiology (Georgia); Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk; Xi Feng [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Ao Guokun [The 309 Hospital of Chinese PLA, Department of Radiology (China); Kyriakides, Charis [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Dickinson, Robert [Imperial College London, Department of Bioengineering (United Kingdom); Nicholls, Joanna; Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom)

    2013-06-15

    Purpose. Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods. Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results. Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. Conclusions. In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.

  11. A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge.

    Science.gov (United States)

    Lian, Zhen-Qiang; Wang, Qi; Zhang, An-Qin; Zhang, Jiang-Yu; Han, Xiao-Rong; Yu, Hai-Yun; Xie, Si-Mei

    2015-04-01

    Mammary ductoscopy (MD) is commonly used to detect intraductal lesions associated with nipple discharge. This study investigated the relationships between ductoscopic image-based indicators and breast cancer risk, and developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge. A total of 879 consecutive inpatients (916 breasts) with nipple discharge who underwent selective duct excision for intraductal neoplasms detected by MD from June 2008 to April 2014 were analyzed retrospectively. A nomogram was developed using a multivariate logistic regression model based on data from a training set (687 cases) and validated in an independent validation set (229 cases). A Youden-derived cut-off value was assigned to the nomogram for the diagnosis of breast cancer. Color of discharge, location, appearance, and surface of neoplasm, and morphology of ductal wall were independent predictors for breast cancer in multivariate logistic regression analysis. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.36. Area under the curve values of 0.812 (95 % confidence interval (CI) 0.763-0.860) and 0.738 (95 % CI 0.635-0.841) was obtained in the training and validation sets, respectively. The accuracies of the nomogram for breast cancer diagnosis were 71.2 % in the training set and 75.5 % in the validation set. We developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge based on MD image findings. This model may aid individual risk assessment and guide treatment in clinical practice.

  12. Intraductal papilloma in an axillary lymph node of a patient with human immunodeficiency virus: a case report and review of the literature.

    Science.gov (United States)

    Cottom, Hannah; Rengabashyam, Bhavani; Turton, Philip E; Shaaban, Abeer M

    2014-05-23

    Inclusions of ectopic breast tissue in axillary lymph nodes are reported very infrequently and typically are only identified microscopically as an incidental finding. Furthermore the development of a benign proliferative lesion in the form of an intraductal papilloma from intranodal ectopic breast tissue is an extremely rare phenomenon with only three previous cases reported. This report describes an unusual and rare case of an intraductal papilloma arising in an axillary lymph node of a patient known to have the human immunodeficiency virus. A 40-year-old Black African woman underwent excision of an enlarged palpable axillary lymph node. In the preceding 7 years she had received at least six separate surgical excisions to her ipsilateral breast for papillomatosis. The last surgical intervention was performed 1 year prior to presentation with an enlarged axillary lymph node. Histological examination of her axillary lymph node revealed a papillomatous proliferative epithelial lesion within an apparent encompassing duct, resembling a mammary intraductal papilloma. In the surrounding lymphoid tissue small groups of duct-like structures were additionally noted. Immunostaining with a panel of myoepithelial markers in conjunction with oestrogen receptor produced a mixed heterogeneous staining pattern in both the papillomatous lesion and the peripheral duct-like structures. This confirmed the diagnosis of a benign intraductal papilloma within an axillary lymph node, considered to have arisen from ectopic breast tissue. This case demonstrates that intranodal ectopic breast tissue has the potential to undergo benign proliferative change albeit extremely rarely. Therefore this possibility must be considered to ensure the correct diagnosis is made. In addition, to the best of our knowledge, this is the first case report which has described recurrent intraductal papillomas and the subsequent development of an intraductal papilloma within an ipsilateral axillary lymph node, in

  13. Thread sign in biliary intraductal papillary mucinous neoplasm: a novel specific finding for MRI

    International Nuclear Information System (INIS)

    Hong, Gil-Sun; Byun, Jae Ho; Kim, Jin Hee; Kim, Hyoung Jung; Lee, Seung Soo; Lee, Moon-Gyu; Hong, Seung-Mo

    2016-01-01

    To evaluate thread sign of biliary intraductal papillary mucinous neoplasm (B-IPMN) on magnetic resonance imaging (MRI). Thread sign was defined as intraductal linear or curvilinear hypointense striations. Two radiologists independently evaluated the presence and location of thread sign on MR cholangiography (thin-slice, thick-slab and 3D MRC) and axial MR images (T2 TSE, T2 HASTE and DWI) in patients with B-IPMN (n = 38) and in matched control groups with benign (n = 36) or malignant (n = 35) biliary diseases. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of thread sign for diagnosing B-IPMN were evaluated. Thread sign was observed only in patients with B-IPMN on MRC (44.7-52.6 % [17/38-20/38], P < 0.001) and axial MR images (31.6 % [12/38], P < 0.001), except in one patient with recurrent pyogenic cholangitis on MRC (2.8 %, 1/36). The sensitivity, specificity, accuracy, PPV and NPV of thread sign for diagnosing B-IPMN on MRC were 0.53, 0.99, 0.83, 0.95 and 0.80, respectively (reader 1) and 0.45, 1.0, 0.81, 1.0 and 0.77, respectively (reader 2). Thread sign was detected mainly at the extrahepatic bile duct (52.6 %, 20/38). B-IPMN can manifest thread sign, a novel specific MR finding, mainly at the extrahepatic bile duct on MRI, especially on MRC. (orig.)

  14. Bile Duct Exploration

    Science.gov (United States)

    ... Home / Health Library / Diagnostics & Testing / Bile Duct Exploration Bile Duct Exploration Common bile duct exploration is a ... Test Details Results and Follow-Up What is bile, and what is bile duct exploration? Bile is ...

  15. Diagnosis of intraductal spread of breast cancer by high-resolution MR imaging. Correlation between MR imaging and pathohistological findings

    International Nuclear Information System (INIS)

    Date, Shuji

    1998-01-01

    The main purpose of this study was to investigate pathohistological factors that affect the MR findings of intraductal spread (IDS) of breast cancer. The subjects of the present study were 42 breast cancer patients who were examined by MR imaging. Fat-suppressed high-resolution T1-weighted spin-echo images (350/13/1 (TR/TE/excitations), 16-cm FOV, 5-mm section thickness, and 512 x 256 matrix) were obtained one minute after the intravenous administration of Gd-DTPA. In this protocol, contrast determination time was 1 min 48 sec. Of the 42 cases, IDS was found to be located more than 1 cm from the primary focus in 22 cases (52%). Rates of sensitivity, specificity and accuracy of MR imaging for the detection of IDS were 82%, 80%, and 81%, respectively. The probable cause of misdiagnosis was parenchymal enhancement due to severe fibrocystic disease and normal menstrual cycle. In 21 of 42 cases, the MR findings were precisely correlated with the pathohistologic findings of almost the same cross-section. The MR findings of IDS varied greatly with observation of linear, band-like, branch-like, plate-like and minute ring enhancements. These findings closely reflected the size, aggregation pattern, and distribution of intraductal lesions. In particular, minute ring enhancement was only observed in 4 comedo-type lesions. This pattern of enhancement is considered to reflect elevated intraductal cellular density with necrosis in the central region. (author)

  16. Diagnosis of intraductal spread of breast cancer by high-resolution MR imaging. Correlation between MR imaging and pathohistological findings

    Energy Technology Data Exchange (ETDEWEB)

    Date, Shuji [Hiroshima City Hospital (Japan)

    1998-04-01

    The main purpose of this study was to investigate pathohistological factors that affect the MR findings of intraductal spread (IDS) of breast cancer. The subjects of the present study were 42 breast cancer patients who were examined by MR imaging. Fat-suppressed high-resolution T1-weighted spin-echo images (350/13/1 (TR/TE/excitations), 16-cm FOV, 5-mm section thickness, and 512 x 256 matrix) were obtained one minute after the intravenous administration of Gd-DTPA. In this protocol, contrast determination time was 1 min 48 sec. Of the 42 cases, IDS was found to be located more than 1 cm from the primary focus in 22 cases (52%). Rates of sensitivity, specificity and accuracy of MR imaging for the detection of IDS were 82%, 80%, and 81%, respectively. The probable cause of misdiagnosis was parenchymal enhancement due to severe fibrocystic disease and normal menstrual cycle. In 21 of 42 cases, the MR findings were precisely correlated with the pathohistologic findings of almost the same cross-section. The MR findings of IDS varied greatly with observation of linear, band-like, branch-like, plate-like and minute ring enhancements. These findings closely reflected the size, aggregation pattern, and distribution of intraductal lesions. In particular, minute ring enhancement was only observed in 4 comedo-type lesions. This pattern of enhancement is considered to reflect elevated intraductal cellular density with necrosis in the central region. (author)

  17. Concurrent fibroadenoma and intraductal papilloma - A recurring complex lesion in a premenarcheal girl.

    Science.gov (United States)

    Alessandrini, Lara; Gobbi, Dalia; Zanon, Giovanni Franco; Dall'Igna, Patrizia; Cecchetto, Giovanni; Alaggio, Rita

    2013-02-15

    Breast diseases are rare in childhood and adolescence, most lesions being fibroadenomas and papillomas. We report the case of an 11-year old girl with a complex breast lesion with hybrid features of fibroadenoma and intraductal papilloma with an early recurrence. Microscopically, the lesion was composed of dilated ducts showing intraluminal papillary projections with small to broad fibrovascular stalks. The typical leaf-like appearance of fibroadenoma was determined by the presence at the periphery of ducts compressed and distorted by the prominent stromal component. Despite its florid epithelial hyperplasia and mild cytological atypia (more evident in the relapse), immunohistochemical staining for p63 and smooth muscle actin highlighted a continuum outer myoepithelial layer, confirming the non-invasive appearance of the lesion. Two pathogenetic links have been hypothesized: one is based on the morphological continuum between these two entities, which may represent different evolutive stages in the same lesion; the other is based on epithelial/mesenchymal interactions. The possible malignant transformation of such complex lesion is also discussed, along with its differential diagnoses. The relevance of this case lies in its rarity, as well as in the therapeutic strategies related to its biological potential and to the necessity of a conservative treatment, due to the young age of the patient. Copyright © 2012. Published by Elsevier GmbH.

  18. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Doros, Attila [Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)

    2013-07-11

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  19. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    International Nuclear Information System (INIS)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-01-01

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies

  20. Percutaneous intraductal radiofrequency ablation for clearance of occluded metal stent in malignant biliary obstruction: feasibility and early results.

    Science.gov (United States)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-02-01

    The major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter. Nine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal-external biliary drainage. All nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50-488) days and a median stent patency of 102.5 (range 50-321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation. In this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  1. A comparison of imaging methods for the diagnosis of gallbladder and biliary duct carcinomas

    International Nuclear Information System (INIS)

    Kersjes, W.; Koester, O.; Heuer, M.; Schneider, B.; Bonn Univ.

    1990-01-01

    Fourteen patients with carcinomas of the gallbladder and eight patients with biliary duct carcinomas were examined by CT, sonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiography (ERC) and angiography. The results were compared retrospectively. Sonography proved suitable as a screening method. For accurate demonstration, this should be supplemented by C.T.. PTC and ERC demonstrate intraductal extension of biliary carcinomas and of gallbladder carcinomas infiltrating the bile ducts. The value of angiography consists merely in the pre-operative demonstration of the vascular anatomy. (orig.) [de

  2. Bile Duct Cancer (Cholangiocarcinoma)

    Science.gov (United States)

    ... Home > Types of Cancer > Bile Duct Cancer (Cholangiocarcinoma) Bile Duct Cancer (Cholangiocarcinoma) This is Cancer.Net’s Guide to Bile Duct Cancer (Cholangiocarcinoma). Use the menu below to ...

  3. Effects of pancreatic intraductal injection of a radioisotope in dogs

    International Nuclear Information System (INIS)

    Devonec, M.; Faure, J.L.; Blanc-Brunat, N.; Dubernard, J.M.; Traeger, J.

    1980-01-01

    The effects on exocrine and endocrine pancreatic functions of local irradiation by the intraductal injection of Rhenium 186 were investigated as an alternative to neoprene for exocrine secretion suppression. The results indicate that Rhenium 186 irradiation suppressed exocrine secretion of the pancreas while conserving the endocrine function. Although some edema and fibrosis were observed, the effects were not excessive

  4. MRI ductography of contrast agent distribution and leakage in normal mouse mammary ducts and ducts with in situ cancer.

    Science.gov (United States)

    Markiewicz, Erica; Fan, Xiaobing; Mustafi, Devkumar; Zamora, Marta; Conzen, Suzanne D; Karczmar, Gregory S

    2017-07-01

    High resolution 3D MRI was used to study contrast agent distribution and leakage in normal mouse mammary glands and glands containing in situ cancer after intra-ductal injection. Five female FVB/N mice (~19weeks old) with no detectable mammary cancer and eight C3(1) SV40 Tag virgin female mice (~15weeks old) with extensive in situ cancer were studied. A 34G, 45° tip Hamilton needle with a 25μL Hamilton syringe was inserted into the tip of the nipple and approximately 15μL of a Gadodiamide was injected slowly over 1min into the nipple and throughout the duct on one side of the inguinal gland. Following injection, the mouse was placed in a 9.4T MRI scanner, and a series of high resolution 3D T1-weighted images was acquired with a temporal resolution of 9.1min to follow contrast agent leakage from the ducts. The first image was acquired at about 12min after injection. Ductal enhancement regions detected in images acquired between 12 and 21min after contrast agent injection was five times smaller in SV40 mouse mammary ducts (pcontrast agent from the SV40 ducts. The contrast agent washout rate measured between 12min and 90min after injection was ~20% faster (p<0.004) in SV40 mammary ducts than in FVB/N mammary ducts. These results may be due to higher permeability of the SV40 ducts, likely due to the presence of in situ cancers. Therefore, increased permeability of ducts may indicate early stage breast cancers. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Evaluation of the International Consensus Guidelines for the Surgical Resection of Intraductal Papillary Mucinous Neoplasms.

    Science.gov (United States)

    Tsukagoshi, Mariko; Araki, Kenichiro; Saito, Fumiyoshi; Kubo, Norio; Watanabe, Akira; Igarashi, Takamichi; Ishii, Norihiro; Yamanaka, Takahiro; Shirabe, Ken; Kuwano, Hiroyuki

    2018-04-01

    International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012. We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications. Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value. The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%. The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.

  6. Intraductal papillary mucinous neoplasm of the pancreas (IPMN: clinico-pathological correlations and surgical indications

    Directory of Open Access Journals (Sweden)

    Cantù Massimiliano

    2010-04-01

    Full Text Available Abstract Background Intraductal papillary mucinous neoplasms (IPMNs are increasingly recognized entities, whose management remains sometimes controversial, due to the high rate of benign lesions and on the other side to the good survival after resection of malignant ones. Methods Retrospective analysis of a prospectively collected Western series of IPMN. Results Forty cases of IPMN were analysed (1992-2007. Most patients were symptomatic (72.5%; cholangio-MRI had the best diagnostic accuracy both for the tumour nature (83.3% and for the presence of malignancy (57.1%. ERCP was done in 8 cases (20%, and the results were poor. Thirteen patients were treated by pancreatic resection and 27 were maintained in follow-up. Total pancreatectomy was performed in 46% of the cases; in situ and invasive carcinoma were recognized in 15.4% and 38.4% of the cases, respectively. The mean follow-up was 42 months (range 12-72. One only patients with nodal metastases died 16 months after the operation for disease progression, while 91.6% of the operated patients are disease free. Out of the 27 not resected patients, 2 out of 4 presenting a lesion at high risk for malignancy died, while the remaining are in good conditions and disease free, with a mean follow-up of 31 months. Conclusion Therapeutic indication for IPMNs is mainly based upon radiological evaluation of the risk of malignancy. While the main duct tumours should be resected, preserving whenever possible a portion of the gland, the secondary ducts tumours may be maintained under observation, in absence of radiological elements of suspicion such as size larger than 3 cm, or a wall greater than 3 mm or nodules or papillae in the context of the cyst.

  7. [Clinical value of MRI united-sequences examination in diagnosis and differentiation of morphological sub-type of hilar and extrahepatic big bile duct cholangiocarcinoma].

    Science.gov (United States)

    Yin, Long-Lin; Song, Bin; Guan, Ying; Li, Ying-Chun; Chen, Guang-Wen; Zhao, Li-Ming; Lai, Li

    2014-09-01

    To investigate MRI features and associated histological and pathological changes of hilar and extrahepatic big bile duct cholangiocarcinoma with different morphological sub-types, and its value in differentiating between nodular cholangiocarcinoma (NCC) and intraductal growing cholangiocarcinoma (IDCC). Imaging data of 152 patients with pathologically confirmed hilar and extrahepatic big bile duct cholangiocarcinoma were reviewed, which included 86 periductal infiltrating cholangiocarcinoma (PDCC), 55 NCC, and 11 IDCC. Imaging features of the three morphological sub-types were compared. Each of the subtypes demonstrated its unique imaging features. Significant differences (P big bile duct cholangiocarcinoma. MRI united-sequences examination can accurately describe those imaging features for differentiation diagnosis.

  8. Interrogation of the rat mammary gland using intraductal impedance spectroscopy

    International Nuclear Information System (INIS)

    Young, E F; Quinn, D A; Davies, R J

    2010-01-01

    Extant technologies for the detection of breast cancer exploit changes in the morphology of the mammary ductal epithelial network and can involve ionizing radiation. Intraductal surveillance of mammary epithelium has the potential to allow for earlier detection based on changes in function of the epithelium. This study investigated the feasibility of using intraductal impedance spectroscopy (IIS) to assess changes in resistance in the mammary epithelium in a small group of female rats in resting, pregnant and ultimately lactating states. In resting rats, intraductal surveillance was able to detect only a single resistive capacitance (RC). In pregnant animals, a second RC became evident in the frequency range between 1 and 190 Hz. The real resistance of this low frequency RC increased when measurements were made after the animals had begun lactating. Equivalent circuit modeling revealed this increase to be a 1.7-fold change from pregnancy to lactation. A model of tight junction closure in the context of ductal expansion is proposed. These results suggest that physiologic measurements can be made in rodent mammary epithelium using this technique allowing for assessment of function in normal and disease states

  9. A novel duct-lobular segmentectomy for breast tumors with nipple discharge using near-infrared indocyanine green fluorescence imaging

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Ohno

    2013-10-01

    Full Text Available A 44-year-old woman was referred to our hospital with pathological nipple discharge from her left breast. Ultrasonography revealed a solid tumor beneath her left areola that measured 17 mm in diameter with a dilated mammary duct. Contrast-enhanced magnetic resonance imaging showed an early-enhanced cystic tumor and a dilated mammary duct. We performed a duct-lobular segmentectomy using near-infrared indocyanine green (ICG-fluorescence imaging. Under general anesthesia, a silicone tube was inserted into an orifice of a fluid-discharging mammary duct, and 1 mL dye-fluorescence liquid containing ICG and indigo carmine was injected into the mammary duct. A periareolar incision was made, and the fluorescence image of the demarcated mammary duct segment was obtained. The mammary duct segment was dissected, along with the demarcation line. The cystic lesion and dilated mammary duct were fully resected, and the pathological diagnosis was intraductal papilloma of the breast. We report that near-infrared ICG fluorescence could be applied for imaging of the mammary duct segment, and the fluorescence image allowed for easier duct-lobular segmentectomy for nipple discharge.

  10. Bile duct stricture

    Science.gov (United States)

    ... duct, the tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion. ... causes of this condition include: Cancer of the bile duct, liver or pancreas Damage and scarring due to a ...

  11. High-resolution magnetic resonance of the extracranial facial nerve and parotid duct: demonstration of the branches of the intraparotid facial nerve and its relation to parotid tumours by MRI with a surface coil

    International Nuclear Information System (INIS)

    Takahashi, N.; Okamoto, K.; Ohkubo, M.; Kawana, M.

    2005-01-01

    AIM: To investigate the usefulness of high-resolution MR imaging in the evaluation of the extracranial facial nerve, compared with surgical findings. MATERIALS AND METHODS: Thirteen patients with benign parotid tumours were studied on a 1.5-T MR system with a 3 in circular surface coil. High-resolution T1-weighted spin-echo, T2-weighted fast spin-echo, and three-dimensional gradient-recalled acquisition in the steady state (GRASS) images were obtained in the axial planes. Oblique reformatted images were generated. Tumours, parotid ducts and facial nerves were identified on these images. The relationship of the tumours to the facial nerves was confirmed at surgery. RESULTS: Facial nerves appeared as linear structures of low intensity on all pulse sequences. The main trunks and cervicofacial and temporofacial divisions of the facial nerves were identified in 100%, 84.1% and 53.8% of GRASS images, respectively. Parotid ducts appeared as structures of low intensity on T1-weighted (66.6%) and GRASS images (81.8%), and as structures of very high intensity on T2-weighted images (91.7%). The relationships of the tumours to the facial nerves were correctly diagnosed in 11 (91.7%) of 12 cases. CONCLUSION: High-resolution MR imaging depicts the extracranial facial nerve and the parotid duct, and is useful for preoperative evaluation of parotid gland tumours

  12. High-resolution magnetic resonance of the extracranial facial nerve and parotid duct: demonstration of the branches of the intraparotid facial nerve and its relation to parotid tumours by MRI with a surface coil

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, N. [Department of Radiology, Niigata University Faculty of Medicine, Niigata (Japan) and Department of Radiology, Niigata City General Hospital, Niigata (Japan)]. E-mail: nandtr@hosp.niigata.niigata.jp; Okamoto, K. [Department of Radiology, Niigata University Faculty of Medicine, Niigata (Japan); Ohkubo, M. [Department of Radiotechnology, Niigata University Faculty of Medicine, Niigata (Japan); Kawana, M. [Department of Otorhinolaryngology, Niigata University Faculty of Medicine, Niigata (Japan)

    2005-03-01

    AIM: To investigate the usefulness of high-resolution MR imaging in the evaluation of the extracranial facial nerve, compared with surgical findings. MATERIALS AND METHODS: Thirteen patients with benign parotid tumours were studied on a 1.5-T MR system with a 3 in circular surface coil. High-resolution T1-weighted spin-echo, T2-weighted fast spin-echo, and three-dimensional gradient-recalled acquisition in the steady state (GRASS) images were obtained in the axial planes. Oblique reformatted images were generated. Tumours, parotid ducts and facial nerves were identified on these images. The relationship of the tumours to the facial nerves was confirmed at surgery. RESULTS: Facial nerves appeared as linear structures of low intensity on all pulse sequences. The main trunks and cervicofacial and temporofacial divisions of the facial nerves were identified in 100%, 84.1% and 53.8% of GRASS images, respectively. Parotid ducts appeared as structures of low intensity on T1-weighted (66.6%) and GRASS images (81.8%), and as structures of very high intensity on T2-weighted images (91.7%). The relationships of the tumours to the facial nerves were correctly diagnosed in 11 (91.7%) of 12 cases. CONCLUSION: High-resolution MR imaging depicts the extracranial facial nerve and the parotid duct, and is useful for preoperative evaluation of parotid gland tumours.

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

    Science.gov (United States)

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

    2011-06-01

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

  14. Biological similarities and differences between pancreatic intraepithelial neoplasias and intraductal papillary mucinous neoplasms.

    Science.gov (United States)

    Moriya, Toshiyuki; Kimura, Wataru; Semba, Shuho; Sakurai, Fumiaki; Hirai, Ichiro; Ma, Jinfeng; Fuse, Akira; Maeda, Kunihiko; Yamakawa, Mitsunori

    2005-01-01

    Ever since the classification of pancreatic intraepithelial neoplasia (PanIN) was published, studies on the precursor lesions of pancreatic cancer have been advancing along a new directions, using standardized terminology. There are few studies that have examined the biological differences between PanIN and intraductal papillary mucinous neoplasm (IPMN) in detail. PanIN and IPMN, which are similar in morphology, were compared using various indicators, with the aim of identifying the similarities and differences between the two. A total of 46 PanINs and 37 ducts with IPMN were identified in 19 patients with invasive ductal carcinoma and 18 patients with IPMN. These PanINs and IPMNs were examined immunohistologically with respect to the expression patterns of HER2/neu, DPC4/Smad4, Akt/PKB, p53, cyclin A, Ki67, MUC1, and MUC2. Significant differences in the expression of MUC1 and MUC2 were observed between IPMNadenoma and PanIN-2 and between CIS and PanIN-3 (MUC1: p = 0.001 and p = 0.005, respectively; MUC2: p = 0.002 and p Smad4, and Akt/PKB, along with progression in the process of multistage carcinogenesis. Although the expression levels of these factors reflected the grade of atypism, they did not reflect any differences in the grade of biological malignancy between IPMN and PanIN. On the other hand, MUC1 and MUC2 may serve as indicators of the direction of differentiation, i.e., either progression to IDAC or IPMN. Positivity for MUC1 was believed to suggest differentiation into IDAC, and positivity for MUC2 appeared to be indicative of differentiation into IPMN. Such indication of the direction of differentiation seemed to appear in PanIN1-2, even before abnormalities of HER2/neu, Akt/PKB, DPC4/Smad4, p53, and cyclin A expression began to be detected.

  15. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    Directory of Open Access Journals (Sweden)

    Masatoshi Yamada

    2016-01-01

    Full Text Available Background: Intraductal proliferative lesions (IDPLs of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH and low-grade ductal carcinoma in situ (LG-DCIS. In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH, ADH, LG-DCIS, intermediate-grade (IM-DCIS, and high-grade (HG-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA and a support vector machine. Results: High diagnostic accuracy (81.8–99.3% was achieved between pathologists' diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer.

  16. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    Science.gov (United States)

    Yamada, Masatoshi; Saito, Akira; Yamamoto, Yoichiro; Cosatto, Eric; Kurata, Atsushi; Nagao, Toshitaka; Tateishi, Ayako; Kuroda, Masahiko

    2016-01-01

    Background: Intraductal proliferative lesions (IDPLs) of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH) and low-grade ductal carcinoma in situ (LG-DCIS). In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH), ADH, LG-DCIS, intermediate-grade (IM)-DCIS, and high-grade (HG)-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA) and a support vector machine. Results: High diagnostic accuracy (81.8–99.3%) was achieved between pathologists’ diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer. PMID:26955499

  17. Molecular pathology of intraductal papillary mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Paini, Marina; Crippa, Stefano; Partelli, Stefano; Scopelliti, Filippo; Tamburrino, Domenico; Baldoni, Andrea; Falconi, Massimo

    2014-08-07

    Since the first description of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas in the eighties, their identification has dramatically increased in the last decades, hand to hand with the improvements in diagnostic imaging and sampling techniques for the study of pancreatic diseases. However, the heterogeneity of IPMNs and their malignant potential make difficult the management of these lesions. The objective of this review is to identify the molecular characteristics of IPMNs in order to recognize potential markers for the discrimination of more aggressive IPMNs requiring surgical resection from benign IPMNs that could be observed. We briefly summarize recent research findings on the genetics and epigenetics of intraductal papillary mucinous neoplasms, identifying some genes, molecular mechanisms and cellular signaling pathways correlated to the pathogenesis of IPMNs and their progression to malignancy. The knowledge of molecular biology of IPMNs has impressively developed over the last few years. A great amount of genes functioning as oncogenes or tumor suppressor genes have been identified, in pancreatic juice or in blood or in the samples from the pancreatic resections, but further researches are required to use these informations for clinical intent, in order to better define the natural history of these diseases and to improve their management.

  18. Blocked Tear Duct

    Science.gov (United States)

    ... of the nose (lacrimal sac). From there tears travel down a duct (the nasolacrimal duct) draining into your nose. Once in the nose, tears are reabsorbed. A blockage can occur at any point in the tear drainage system, from the puncta ...

  19. Bifurcation and stability of forced convection in tightly coiled ducts: multiplicity

    International Nuclear Information System (INIS)

    Wang Liqiu; Pang, Ophelia; Cheng Lin

    2005-01-01

    A numerical study is made on the fully developed bifurcation structure of the forced convection in tightly coiled ducts of square cross-section. In addition to the examination of structural changes of three known solution branches found in loosely coiled ducts, three new solution branches are found. These new branches are isolated from the three known branches. The flows on these new branches are in a symmetric 4-cell state, a symmetric 8-cell state, an asymmetric 2-cell state, an asymmetric 5-cell state, an asymmetric 7-cell state, or an asymmetric 8-cell structure

  20. Anatomic relationship of intrahepatic bile ducts to portal veins revisited

    International Nuclear Information System (INIS)

    Bret, P.M.; Stempel, J.; Atri, M.; Lough, J.O.; Illescas, F.F.

    1987-01-01

    It is well accepted that intrahepatic bile ducts lie in front of corresponding portal vein branches. Since the authors' clinical experience with US was different, they studied 18 normal necropsy cadaver livers. The common bile duct, main portal vein, and hepatic artery were cannulated and injected respectively with air, dilute contrast medium, and mineral oil. The livers were then examined in anatomic position with CT. In the left lobe of the liver, the bile ducts were anterior to the portal vein in seven cases, posterior in seven cases, and were tortuous both anterior and posterior in three cases. In the right lobe, the bile ducts were anterior in nine cases, posterior in five cases, tortuous in one case, and not seen in two cases. In the porta hepatis, the bile ducts were anterior in eight cases, posterior in one case, tortuous in five cases, and not seen in three cases. Histologic specimens confirmed the anterior and posterior location of the bile ducts relative to the portal veins. In conclusion, intrahepatic bile ducts can be either anterior or posterior to the corresponding portal vein branches

  1. Can intraductal ultrasonography (IDUS) predicting the longitudinal extension of intraductal papillary mucinous tumor (IPMT) of the pancreas?

    International Nuclear Information System (INIS)

    Cho, Young Deok; Jang, Jae Young; Cheon, Young Koog; Moon, Jung Ho; Kim, Yun Soo; Lee, Moon Sung; Hur, Kyung Yul; Shim, Chan Sup

    2002-01-01

    The treatment of the choice of IPMT is a partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMT. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting extension of IPMT and selecting the resection methods of pancreas. From January 1997 to August 2001, there were 12 consequent patients, including 5 men and 7 women, with a median age of 54 years (range, 37-66) who underwent a resection of IPMT. A preoperative assessment of IPMT by IDUS was performed in all patients. According to the preoperative localization of IPMT by IDUS, various type of limited pancreatic resections were planned. The frozen sectional histologic examination of pancreatic cut surface was performed in all patient. In the case of cut surface tumor positive, a modification of the planned resection was done.

  2. Pancreatic intraepithelial neoplasia in association with intraductal papillary mucinous neoplasms of the pancreas: implications for disease progression and recurrence.

    Science.gov (United States)

    Biankin, Andrew V; Kench, James G; Biankin, Sandra A; Lee, C-Soon; Morey, Adrienne L; Dijkman, Floriaan P; Coleman, Maxwell J; Sutherland, Robert L; Henshall, Susan M

    2004-09-01

    The development of pancreatic cancer (PC) several years after curative resection for noninvasive intraductal papillary mucinous neoplasm (IPMN) and the presence of PC distant from IPMN suggest that PC may develop independently of the IPMN. Here, we identified pancreatic intraepithelial neoplasia (PanIN) lesions, the putative precursors of PC, in the ducts of pancreata resected for IPMN and assessed the frequency of molecular aberrations common to PanIN and PC, within these lesions. The protein expression of p53, p21(WAF1/CIP1), cyclin D1, p16(INK4A) and DPC4/Smad4 were examined by immunohistochemistry in 267 PanIN lesions from a cohort of 23 patients with IPMN. Overexpression of p21(WAF1/CIP1) was present in PanIN-1A and -1B lesions and increased in frequency in PanIN-2 and PanIN-3. Overexpression of p53 and cyclin D1, and loss of p16(INK4A) expression were detected in PanIN-2 and PanIN-3 lesions. Loss of DPC4/Smad4 expression occurred only in the PanIN-3 lesions. PanIN lesions that were more dysplastic than the coincident IPMN were identified in 5 of 12 patients, and 2 of these contained a greater number of aberrations in protein expression than the IPMN. PanIN lesions seen in association with IPMN demonstrate molecular and histologic changes identical to PanIN lesions found in association with PC and, in some cases, are more advanced than the associated IPMN. These data suggest that PanIN lesions found in the ducts of a pancreas with IPMN may be relevant to the development of PC either coincident with IPMN or in the remnant pancreas after curative resection of IPMN.

  3. Modified nasolacrimal duct stenting

    International Nuclear Information System (INIS)

    Tian Min; Jin Mei; Chen Huanjun; Li Yi

    2008-01-01

    Objective: Traditional nasolacrimal duct stenting possesses some shortcoming including difficulty of pulling ball head guide wire from the nasal cavity with turbinate hypertrophy and nasal septal deviation. The new method of nose-oral tube track establishment can overcome the forementioned and increase the successful rate. Methods: 5 F catheter and arterial sheath were modified to be nasolacrimal duct stent delivery device respectively. Antegrade dacryocystography was taken firstly to display the obstructed site and followed by the modified protocol of inserting the guide wire through nasolacrimal duct and nasal cavity, and establishing the stent delivery track for retrograde stent placement. Results: 5 epiphora patients with failure implantation by traditional method were all succeeded through the modified stenting (100%). During 6-mouth follow-up, no serious complications and reocclusion occurred. Conclusion: The establishment of eye-nose-mouth-nose of external nasal guide wire track can improve the successful rate of nasolacrimal duct stenting. (authors)

  4. Bile duct obstruction

    Science.gov (United States)

    ... Tumors that have spread to the biliary system Liver and bile duct worms (flukes) The risk factors include: History of ... Increased bilirubin level Increased alkaline phosphatase level Increased liver enzymes The ... CT scan Endoscopic retrograde cholangiopancreatography ( ...

  5. Ducted fuel injection

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Charles J.

    2018-03-06

    Various technologies presented herein relate to enhancing mixing inside a combustion chamber to form one or more locally premixed mixtures comprising fuel and charge-gas with low peak fuel to charge-gas ratios to enable minimal, or no, generation of soot and other undesired emissions during ignition and subsequent combustion of the locally premixed mixtures. To enable sufficient mixing of the fuel and charge-gas, a jet of fuel can be directed to pass through a bore of a duct causing charge-gas to be drawn into the bore creating turbulence to mix the fuel and the drawn charge-gas. The duct can be located proximate to an opening in a tip of a fuel injector. The duct can comprise of one or more holes along its length to enable charge-gas to be drawn into the bore, and further, the duct can cool the fuel and/or charge-gas prior to combustion.

  6. Adult bile duct strictures: differentiating benign biliary stenosis from cholangiocarcinoma.

    Science.gov (United States)

    Nguyen Canh, Hiep; Harada, Kenichi

    2016-12-01

    Biliary epithelial cells preferentially respond to various insults under chronic pathological conditions leading to reactively atypical changes, hyperplasia, or the development of biliary neoplasms (such as biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and cholangiocarcinoma). Moreover, benign biliary strictures can be caused by a variety of disorders (such as IgG4-related sclerosing cholangitis, eosinophilic cholangitis, and follicular cholangitis) and often mimic malignancies, despite their benign nature. In addition, primary sclerosing cholangitis is a well-characterized precursor lesion of cholangiocarcinoma and many other chronic inflammatory disorders increase the risk of malignancies. Because of these factors and the changes in biliary epithelial cells, biliary strictures frequently pose a diagnostic challenge. Although the ability to differentiate neoplastic from non-neoplastic biliary strictures has markedly progressed with the advance in radiological modalities, brush cytology and bile duct biopsy examination remains effective. However, no single modality is adequate to diagnose benign biliary strictures because of the low sensitivity. Therefore, understanding the underlying causes by compiling the entire clinical, laboratory, and imaging data; considering the under-recognized causes; and collaborating between experts in various fields including cytopathologists with multiple approaches is necessary to achieve an accurate diagnosis.

  7. Hepatobiliary cystadenoma can protrude and grow into the bile ducts.

    Science.gov (United States)

    Gadzijev, E M; Pleskovic, A; Stanisavljevic, D; Ferlan-Marolt, V; Trotovsek, B

    1998-01-01

    To evaluate the phenomenon and the potential reasons for protrusion and growth of hepatobiliary cystadenoma into the extrahepatic bile ducts in our patients, accomplished by a review of the data regarding hepatobiliary cystadenomas published elsewhere. In a retrospective open study conducted over the last eight years, five patients with hepatobiliary cystadenoma and one patient with hepatobiliary cystadenocarcinoma were operated on. All the patients were females aged between 25 to 61 years. Diagnostic procedures, laboratory, operative and histopathological findings and treatment were evaluated. Most of our patients were found to have hepatobiliary cystadenoma located in the left surgical liver. In three out of five patients with HBC mesenchymal stroma was histologically detected. In two of the three, protrusion and growth into the extrahepatic bile ducts was found. Considering the pathogenesis, location and the morphology of HBC, the mesenchymal stroma may present the competent potential for intraductal progression of the tumor. Radical excision should be performed for successful treatment of hepatobiliary cystadenomas, because of the potential for reoccurrence.

  8. Pancreatic duct stones in patients with chronic pancreatitis: surgical outcomes.

    Science.gov (United States)

    Liu, Bo-Nan; Zhang, Tai-Ping; Zhao, Yu-Pei; Liao, Quan; Dai, Meng-Hua; Zhan, Han-Xiang

    2010-08-01

    Pancreatic duct stone (PDS) is a common complication of chronic pancreatitis. Surgery is a common therapeutic option for PDS. In this study we assessed the surgical procedures for PDS in patients with chronic pancreatitis at our hospital. Between January 2004 and September 2009, medical records from 35 patients diagnosed with PDS associated with chronic pancreatitis were retrospectively reviewed and the patients were followed up for up to 67 months. The 35 patients underwent ultrasonography, computed tomography, or both, with an overall accuracy rate of 85.7%. Of these patients, 31 underwent the modified Puestow procedure, 2 underwent the Whipple procedure, 1 underwent simple stone removal by duct incision, and 1 underwent pancreatic abscess drainage. Of the 35 patients, 28 were followed up for 4-67 months. There was no postoperative death before discharge or during follow-up. After the modified Puestow procedure, abdominal pain was reduced in patients with complete or incomplete stone clearance (P>0.05). Steatorrhea and diabetes mellitus developed in several patients during a long-term follow-up. Surgery, especially the modified Puestow procedure, is effective and safe for patients with PDS associated with chronic pancreatitis. Decompression of intraductal pressure rather than complete clearance of all stones predicts postoperative outcome.

  9. Comparison of intraductal spread on dynamic contrast-enhanced MRI with clinicopathologic features in breast cancer

    International Nuclear Information System (INIS)

    Komatsu, Shuhei; Lee, Chol-Joo; Hosokawa, Yohei; Ichikawa, Daisuke; Hamashima, Takashi; Shirono, Koichi; Okabe, Harumi; Kurioka, Hideaki; Oka, Takahiro

    2004-01-01

    Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a new diagnostic technology in various breast cancer treatments. However, little is known about the correlation between intraductal spread on CE-MRI and clinicopathologic features. This study was designed to evaluate these correlations for the surgical planning of breast cancer. Twenty-six breast cancer lesions (in 26 female patients) treated by breast conserving surgery between March 2001 and March 2003 were evaluated retrospectively. CE-MRI was performed with a 1.5 T unit using a dedicated bilateral breast coil. In detecting intraductal spread of breast cancer, the sensitivity, specificity and accuracy of CE-MRI were 82.4%, 60.0% and 77.3%, respectively. On mammography (MMG), these were 21.1%, 100.0% and 42.3%, respectively. Therefore, CE-MRI has a higher sensitivity and accuracy, although with a lower specificity than MMG. Compared with breast cancer lesions without intraductal spread on CE-MRI, lesions with intraductal spread on CE-MRI were found more frequently in larger-sized tumors (P=0.0088). Preoperative evaluation for intraductal spread by CE-MRI should be more useful than by MMG for breast cancer. When making the surgical decision regarding excision range, particular attention should be paid to this consideration for patients with larger-sized cancer tumors. (author)

  10. Curved-Duct

    Directory of Open Access Journals (Sweden)

    Je Hyun Baekt

    2000-01-01

    Full Text Available A numerical study is conducted on the fully-developed laminar flow of an incompressible viscous fluid in a square duct rotating about a perpendicular axis to the axial direction of the duct. At the straight duct, the rotation produces vortices due to the Coriolis force. Generally two vortex cells are formed and the axial velocity distribution is distorted by the effect of this Coriolis force. When a convective force is weak, two counter-rotating vortices are shown with a quasi-parabolic axial velocity profile for weak rotation rates. As the rotation rate increases, the axial velocity on the vertical centreline of the duct begins to flatten and the location of vorticity center is moved near to wall by the effect of the Coriolis force. When the convective inertia force is strong, a double-vortex secondary flow appears in the transverse planes of the duct for weak rotation rates but as the speed of rotation increases the secondary flow is shown to split into an asymmetric configuration of four counter-rotating vortices. If the rotation rates are increased further, the secondary flow restabilizes to a slightly asymmetric double-vortex configuration. Also, a numerical study is conducted on the laminar flow of an incompressible viscous fluid in a 90°-bend square duct that rotates about axis parallel to the axial direction of the inlet. At a 90°-bend square duct, the feature of flow by the effect of a Coriolis force and a centrifugal force, namely a secondary flow by the centrifugal force in the curved region and the Coriolis force in the downstream region, is shown since the centrifugal force in curved region and the Coriolis force in downstream region are dominant respectively.

  11. Patent arterial duct

    Directory of Open Access Journals (Sweden)

    Martin Robin P

    2009-07-01

    Full Text Available Abstract Patent arterial duct (PAD is a congenital heart abnormality defined as persistent patency in term infants older than three months. Isolated PAD is found in around 1 in 2000 full term infants. A higher prevalence is found in preterm infants, especially those with low birth weight. The female to male ratio is 2:1. Most patients are asymptomatic when the duct is small. With a moderate-to-large duct, a characteristic continuous heart murmur (loudest in the left upper chest or infraclavicular area is typical. The precordium may be hyperactive and peripheral pulses are bounding with a wide pulse pressure. Tachycardia, exertional dyspnoea, laboured breathing, fatigue or poor growth are common. Large shunts may lead to failure to thrive, recurrent infection of the upper respiratory tract and congestive heart failure. In the majority of cases of PAD there is no identifiable cause. Persistence of the duct is associated with chromosomal aberrations, asphyxia at birth, birth at high altitude and congenital rubella. Occasional cases are associated with specific genetic defects (trisomy 21 and 18, and the Rubinstein-Taybi and CHARGE syndromes. Familial occurrence of PAD is uncommon and the usual mechanism of inheritance is considered to be polygenic with a recurrence risk of 3%. Rare families with isolated PAD have been described in which the mode of inheritance appears to be dominant or recessive. Familial incidence of PAD has also been linked to Char syndrome, familial thoracic aortic aneurysm/dissection associated with patent arterial duct, and familial patent arterial duct and bicuspid aortic valve associated with hand abnormalities. Diagnosis is based on clinical examination and confirmed with transthoracic echocardiography. Assessment of ductal blood flow can be made using colour flow mapping and pulsed wave Doppler. Antenatal diagnosis is not possible, as PAD is a normal structure during antenatal life. Conditions with signs and symptoms of

  12. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Sippola, Mark Raymond [Univ. of California, Berkeley, CA (United States)

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 μm were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on the

  13. Epithelial proliferation in small ducts of salivary cystadenoma resembling atypical ductal hyperplasia of breast.

    Science.gov (United States)

    Fahim, Lisa; Weinreb, Ilan; Alexander, Cherupushpam; Perez Ordoñez, Bayardo

    2008-09-01

    Salivary gland cystadenomas are cystic neoplasms with diverse architecture and cytology. Cystadenomas may have a considerable intracystic epithelial component, but an epithelial proliferation in small ducts and cysts resembling atypical ductal hyperplasia of breast has not been documented. The patient was a 68-year-old man with a slow growing right submandibular mass. He has no recurrence 13 months after resection. The tumor was polycystic and measured 3.0 x 2.5 x 2.5 cm. The epithelium of the larger cysts was composed of flat, cuboidal, columnar, and apocrine-like cells. Many of the larger cysts showed "Roman bridges", epithelial tufting, and papillae. The smaller cysts and ducts had apocrine-like cells forming secondary glandular lumens. The ductal cells were surrounded by clear myoepithelial cells. Nuclear pleomorphism and hyperchromasia was seen in the apocrine-like cells. Adjacent to the larger cysts, there was an adenomatoid proliferation of small ducts surrounded by myoepithelial cells. No mitotic activity, necrosis, or stromal invasion was identified. The ductal cells were diffusely positive for keratin 7 and androgen receptors with focal expression of keratin 19 and high-molecular weight keratin. S-100, estrogen and progesterone receptors, and BRST-2 were negative in the ductal cells. Recognition of a prominent intraductal epithelial component in cystadenomas is important to avoid a misdiagnosis of cystadenocarcinoma or low-grade salivary duct carcinoma. Cystadenomas join the list of salivary gland lesions with microscopic similarities to primary lesions of the breast.

  14. Vitellointestinal Duct Anomalies in Infancy

    OpenAIRE

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: paten...

  15. Anatomic variation in intrahepatic bile ducts: an analysis of intraoperative cholangiograms in 300 consecutive donors for living donor liver transplantation

    International Nuclear Information System (INIS)

    Choi, Jin Woo; Kim, Tae Kyoung; Kim, Kyoung Won; Kim, Ah Young; Kim, Pyo Nyun; Ha, Hyun Kwon; Lee, Moon Gyu

    2003-01-01

    To describe the anatomical variation occurring in intrahepatic bile ducts (IHDs) in terms of their branching patterns, and to determine the frequency of each variation. The study group consisted of 300 consecutive donors for liver transplantation who underwent intraoperative cholangiography. Anatomical variation in IHDs was classified according to the branching pattern of the right anterior and right posterior segmental duct (RASD and RPSD, respectively), and the presence or absence of the first-order branch of the left hepatic duct (LHD), and of an accessory hepatic duct. The anatomy of the intrahepatic bile ducts was typical in 63% of cases (n=188), showed triple confluence in 10% (n=29), anomalous drainage of the RPSD into the LHD in 11% (n=34), anomalous drainage of the RPSD into the common hepatic duct (CHD) in 6% (n=19), anomalous drainage of the RPSD into the cystic duct in 2% (n=6), drainage of the right hepatic duct (RHD) into the cystic duct (n=1), the presence of an accessory duct leading to the CHD or RHD in 5% (n=16), individual drainage of the LHD into the RHD or CHD in 1% (n=4), and unclassified or complex variation in 1% (n=3)

  16. Anatomic variations in intrahepatic bile ducts in a north Indian population.

    Science.gov (United States)

    Sharma, Vijay; Saraswat, Vivek Anand; Baijal, Sanjay Saran; Choudhuri, Gourdas

    2008-07-01

    In the present study, we described the anatomical variations in the branching patterns of intrahepatic bile ducts (IHD) and determined the frequency of each variation in north Indian patients. There are no data from India. The study group consisted of 253 consecutive patients (131 women) undergoing endoscopic retrograde cholangiograms for different indications. Anatomical variations in IHD were classified according to the branching pattern of the right anterior segmental duct (RASD) and the right posterior segmental duct (RPSD), presence or absence of first-order branch of left hepatic duct (LHD) and of an accessory hepatic duct. Anatomy of the IHD was typical in 52.9% of cases (n = 134), showing triple confluence in 11.46% (n = 29), anomalous drainage of the RPSD into the LHD in 18.2% (n = 46), anomalous drainage of the RPSD into the common hepatic duct (CHD) in 7.1% (n = 18), drainage of the right hepatic duct (RHD) into the cystic duct 0.4% (n = 1), presence of an accessory duct leading to the CHD or RHD in 4.7% (n = 12), individual drainage of the LHD into the RHD or CHD in 2.4% (n = 6), and unclassified or complex variations in 2.7% (n = 7). None had anomalous drainage of RPSD into the cystic duct. The branching pattern of IHD was atypical in 47% patients. The two most common variations were drainage of the RPSD into the LHD (18.2%) and triple confluence of the RASD, RPSD, and LHD (11.5%).

  17. Magnetohydrodynamics in rectangular ducts

    International Nuclear Information System (INIS)

    Lenhart, L.

    1994-04-01

    Magnetohydrodynamic flow in straight ducts or bends is a key issue, which has to be investigated for developing self-cooled liquid metal blankets of fusion reactors. The code presented solves the full set of governing equations and simulates all phenomena of such flows, including inertial effects. The range of application is limited by computer storage only. (orig./WL)

  18. Total rupture of hydatid cyst of liver in to common bile duct: a case report.

    Science.gov (United States)

    Robleh, Hassan; Yassine, Fahmi; Driss, Khaiz; Khalid, Elhattabi; Fatima-Zahra, Bensardi; Saad, Berrada; Rachid, Lefriyekh; Abdalaziz, Fadil; Najib, Zerouali Ouariti

    2014-01-01

    Rupture of hydatid liver cyst into biliary tree is frequent complications that involve the common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient who presented with acute cholangitis was diagnosed as a case of totally rupture of hydatid cyst on Abdominal CT Scan. Rupture of hydatid cyst of liver into common bile duct and the gallbladder was confirmed on surgery. Treated by cholecystectomy and T-tube drainage of Common bile duct.

  19. Molecular genetics of intraductal papillary-mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Furukawa, Toru

    2007-01-01

    Intraductal papillary-mucinous neoplasms of the pancreas show characteristic clinicopathological and molecular pathobiological features which are distinct from those of conventional ductal adenocarcinomas. Alterations of KRAS, AKT/PKB, CDKN2A, TP53, SMAD4, STK11/LKB1, and DUSP6, and other molecular alterations, including global expression studies as well as their clinical implications, are discussed.

  20. Reciprocity principle in duct acoustics

    Science.gov (United States)

    Cho, Y.-C.

    1979-01-01

    Various reciprocity relations in duct acoustics have been derived on the basis of the spatial reciprocity principle implied in Green's functions for linear waves. The derivation includes the reciprocity relations between mode conversion coefficients for reflection and transmission in nonuniform ducts, and the relation between the radiation of a mode from an arbitrarily terminated duct and the absorption of an externally incident plane wave by the duct. Such relations are well defined as long as the systems remain linear, regardless of acoustic properties of duct nonuniformities which cause the mode conversions.

  1. EKSTRAHEPATIC BILE DUCT CANCER

    OpenAIRE

    Aleš Tomažič; Dragan Stanisavljevič; Valentin Sojar; Blaž Trotovšek

    2003-01-01

    Background. Malignant strictures involving the bile ducts remain a major challenge in biliary surgery. It is an uncommon cancer. The etiology is unknown, most cases are sporadic, but several conditions confer an incrised risk of developing cholangiocarcinoma.Clinical presentation and preoperative evaluation. The early simptoms are nonspecific. In the past computed tomography, percutaneous transhepatic cholangiography and angiography were considered standard investigations, but currently magne...

  2. Noise suppression in duct

    International Nuclear Information System (INIS)

    Ahmed, A.; Barfeh, M.A.G.

    2001-01-01

    In air-conditioning system the noise generated by supply fan is carried by conditioned air through the ductwork. The noise created in ductwork run may be transmission, regenerative and ductborne. Transmission noise is fan noise, regenerative noise is due to turbulence in flow and ductborne noise is the noise radiating from duct to surroundings. Some noise is attenuated in ducts also but if noise level is high then it needs to be attenuated. A simple mitre bend can attenuate-noise. This principle is extended to V and M-shape ducts with inside lining of fibreglass, which gave maximum attenuation of 77 dB and 62 dB respectively corresponding to 8 kHz frequency as compared to mitre, bend giving maximum 18 dB attenuation. Sound level meter measured sound levels with octave band filter and tests were conducted in anechoic room. A V-shape attenuator can be used at fan outlet and high frequency noise can be minimized greatly. (author)

  3. Rare bile duct anomaly: B3 duct draining to gallbladder

    Directory of Open Access Journals (Sweden)

    Seung Eun Lee

    2016-01-01

    Full Text Available A 10-year-old girl presented with recurrent right upper abdominal pain and dyspepsia. Magnetic resonance cholangiopancreatography revealed a dilated common channel of intrahepatic bile duct of segment 3 (B3 and segment 4 (B4 drained into the gallbladder directly. The patient underwent laparoscopic cholecystectomy and Roux-en Y hepaticojejunostomy (B3-jejunostomy. Among the anatomical variability of the biliary system, the cholecystohepatic ducts are controversial in existence and incidence. We report a very rare variant of a cholecystohepatic duct in which the B3 duct drained into gallbladder directly and to the best of our knowledge this is the first report.

  4. Pancreatic Serous Cystadenoma with Compression of the Main Pancreatic Duct: An Unusual Entity

    Directory of Open Access Journals (Sweden)

    Stéphanie Truant

    2011-01-01

    Full Text Available Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. CT and MRI showed a 10 cm-polycystic tumor with upstream dilatation of the main pancreatic duct (MPD, suggestive of intraductal papillary mucinous tumor (IPMT. Ultrasonographic aspect and EUS-guided fine-needle aspiration gave arguments for serous cystadenoma. ERCP showed a communication between cysts and the dilated MPD, compatible with IPMT. The patient underwent left pancreatectomy with splenectomy. Pathological examination concluded in a serous cystadenoma, with only a ductal obstruction causing proximal dilatation.

  5. Radiation resistant ducted superconductive coil

    International Nuclear Information System (INIS)

    Schleich, A.

    1976-01-01

    The radiation-resistant ducted superconductive coil consists of a helically wound electrical conductor constituted by an electrically conductive core of superconductive material provided with a longitudinally extending cooling duct. The core is covered with a layer of inorganic insulating material and the duct is covered by an electrically conductive metallic gas-tight sheath. The metallic sheaths on adjacent turns of the coil are secured together. 2 Claims, 4 Drawing Figures

  6. Duct having oscillatory side wall

    Science.gov (United States)

    Sprouse, Kenneth M.

    2018-04-03

    A pump system includes a particulate consolidator pump that has a pump outlet. A duct is coupled to the pump outlet. The duct has a wall that is coupled with an oscillator. The oscillator is operable to oscillate the wall at a controlled frequency. The controlled frequency is selected with respect to breaking static bridging of particulate in the duct due, at least in part, to consolidation of the particulate from a downstream check valve.

  7. Primary cystic pancreatic neoplasms and tumor-like conditions. MR cholangiopancreatographic evaluation of lesions and Wirsung's duct

    International Nuclear Information System (INIS)

    Garcia, Adriana; Spina, Juan C. h; Rogondino, Jose; Chacon, Carolina; Gutierrez, Silvia

    2003-01-01

    Objective: To evaluate the contribution of single shot fast spin echo (SSFSE) in the diagnosis of cystic lesions in the pancreas, and their relation to Wirsung's duct. Material and methods: In 66 patients (33 women and 33 men; mean age: 66 years) cystic pancreatic lesions were retrospectively analyzed. The SSFSE technique was used, including an evaluation of Wirsung's duct. Conventional pancreatic sequences were added. The following lesion features were assessed: location, number, size, relation to Wirsung's duct, nature of the cystic image and signal intensity of the neoplasm or tumor-like condition. Surgical and anatomopathological correlation was obtained in 31/66 cases (47%). Results: The cystic lesions were divided in 2 groups: A) cystic lesions related to Wirsung's duct, 30 patients: all lesions measured less than 30 mm in size. Seven patients underwent surgical treatment; in 22 cases surgery was not indicated. One patient refused surgery. A mucinous papilliferous intraductal tumor was diagnosed in 3 cases, ampullar carcinoma in 1 case, pancreatic carcinoma, 1 case, autoimmune pancreatitis, 1 case, and cystic duct dilatation due to benign fibrous stenosis, 1 case. B) Cystic lesions not related to Wirsung's duct (36 patients): 7 serous cystadenomas, 7 adenocarcinomas with a cystic component, 1 mucinous cystadenoma, 1 duodenal diverticulum, 7 pseudocysts and 1 neuroendocrine tumor. In 12 patients surgery was not carried out due to clinical contraindication or patient's refusal. Conclusion: SSFSE allowed a clear differentiation between cystic lesions related (Group A) and non-related (Group B) to Wirsung's duct. The diagnosis could not be achieved by usual MRI sequences. However, benign and malignant lesions were observed in both groups. In all cases SSFSE afforded useful data either for surgical treatment or clinical follow-up. (author)

  8. Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin-Young; Choi, Sun Young [Yonsei University Health System, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea); Lee, Jeong Min; Kim, Soo Jin; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Seoul (Korea); Lee, Min Woo [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea); Kim, Ji Yang [Seoul National University Hospital, Healthcare System Gangnam Center, Seoul (Korea)

    2009-09-15

    The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN). Thirty-four patients (22 men, 12 women; age range, 45-80 years) with IPMN (n = 40) were examined with MRP on 2D and 3D sequences. Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy. The readers assigned their confidence level (1-5) for predicting ductal communication of the lesion. The results of MRP were compared with endoscopic retrograde pancreatography and surgical and histopathologic findings. Studies obtained with 3D MRP were of significantly higher technical quality than those obtained with 2D MRP. Although 3D MRP showed higher area under the ROC curve (Az) values for predicting ductal communication of the lesion, there was no statistical significance between Az values of 2D and 3D MRP (Az for 2D = 0.821, 0.864 for readers 1 and 2, respectively, and Az for 3D= 0.964, 0.921). Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D). 3D MRP showed superior image quality to that of 2D MRP but did not increase the diagnostic accuracy for predicting ductal communication of the lesion. (orig.)

  9. Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas

    International Nuclear Information System (INIS)

    Choi, Jin-Young; Choi, Sun Young; Lee, Jeong Min; Kim, Soo Jin; Han, Joon Koo; Choi, Byung Ihn; Lee, Min Woo; Kim, Ji Yang

    2009-01-01

    The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN). Thirty-four patients (22 men, 12 women; age range, 45-80 years) with IPMN (n = 40) were examined with MRP on 2D and 3D sequences. Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy. The readers assigned their confidence level (1-5) for predicting ductal communication of the lesion. The results of MRP were compared with endoscopic retrograde pancreatography and surgical and histopathologic findings. Studies obtained with 3D MRP were of significantly higher technical quality than those obtained with 2D MRP. Although 3D MRP showed higher area under the ROC curve (Az) values for predicting ductal communication of the lesion, there was no statistical significance between Az values of 2D and 3D MRP (Az for 2D = 0.821, 0.864 for readers 1 and 2, respectively, and Az for 3D= 0.964, 0.921). Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D). 3D MRP showed superior image quality to that of 2D MRP but did not increase the diagnostic accuracy for predicting ductal communication of the lesion. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Yasuda Yoshikazu

    2005-10-01

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

  11. Transcystic duct treatment of common bile duct stones

    International Nuclear Information System (INIS)

    Amberg, J.R.; Chun, G.

    1981-01-01

    Successful removal of 2 retained common bile duct stones following cholecystostomy is described. With the use of the steerable catheter and the wire basket, one stone was crushed and the second was extracted in retrograde fashion through the cystic duct and gallbladder. (orig.)

  12. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chena [Dept. of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul (Korea, Republic of); Kim, Jo Eun; Huh, Kyoung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2017-06-15

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  13. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report.

    Science.gov (United States)

    Lee, Chena; Kim, Jo-Eun; Huh, Kyoung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul

    2017-06-01

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  14. Prognostic factors and diagnosis of extent of the bile duct cancer

    International Nuclear Information System (INIS)

    Kai, Masahiro; Chijiiwa, Kazuo; Otani, Kazuhiro; Ouchida, Jiro; Kondo, Kazuhiro; Nagano, Motoaki; Hiyoshi, Masahide; Imamura, Naoya

    2009-01-01

    To improve the survival of the patients with extrahepatic bile duct cancer, the factors influencing survival and the accuracy of preoperative diagnosis were examined. The factors influencing survival were retrospectively analyzed in 115 patients (mid and lower; n=61, hilar and superior; n=44, diffusely spread; n=10) with extrahepatic bile duct cancer who underwent surgical resection from 1990 to 2008. The preoperative diagnosis of the tumor extension using multi detector row CT (MDCT), endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS) and endoscopic ultrasonography (EUS) was compared with the final pathological diagnosis in patients underwent surgical resection (mid and lower; n=32, hilar and superior; n=11, diffusely spread; n=8) from 2003 to 2008. In patients with mid and lower bile duct cancer (n=61), lymph node metastasis and surgical margin were the independent prognostic factors in the multivariate analysis. Whereas none was found in hilar and superior bile duct cancer (n=44). The sensitivity, specificity and accuracy of the preoperative diagnosis for the depth of tumor invasion (serosal and/or pancreas invasion) was 66.7%, 69.4% and 68.6%, and for the liver invasion was 100%, 88.0%, 88.2%, and for the lymph node metastasis was 76.9%, 71.0%, 72.5%, respectively. More than a few cases were under diagnosed the tumor extension. In patients with mid and lower bile duct cancer, the accuracy of preoperative diagnosis for the depth of tumor invasion (serosal and/or pancreas) was 59.4%. In patients with hilar and superior bile duct cancer, the accuracy of preoperative diagnosis for the serosal and hepatic invasion is 81.8% and 54.5%. Positive surgical margin was 9.1% for hilar and superior, 9.4% for mid and lower and 50.0% for diffusely spread bile duct cancer. Especially, The horizontal spread was difficult to evaluate in patients with diffusely spread bile duct cancer. From 2003 to 2008, the rate of positive surgical margin

  15. Propagation of sound waves in ducts

    DEFF Research Database (Denmark)

    Jacobsen, Finn

    2000-01-01

    Plane wave propagation in ducts with rigid walls, radiation from ducts, classical four-pole theory for composite duct systems, and three-dimentional waves in wave guides of various cross-sectional shape are described.......Plane wave propagation in ducts with rigid walls, radiation from ducts, classical four-pole theory for composite duct systems, and three-dimentional waves in wave guides of various cross-sectional shape are described....

  16. Characterization of Insulin-Immunoreactive Cells and Endocrine Cells Within the Duct System of the Adult Human Pancreas.

    Science.gov (United States)

    Li, Rong; Zhang, Xiaoxi; Yu, Lan; Zou, Xia; Zhao, Hailu

    2016-01-01

    The adult pancreatic duct system accommodates endocrine cells that have the potential to produce insulin. Here we report the characterization and distribution of insulin-immunoreactive cells and endocrine cells within the ductal units of adult human pancreas. Sequential pancreas sections from 12 nondiabetic adults were stained with biomarkers of ductal epithelial cells (cytokeratin 19), acinar cells (amylase), endocrine cells (chromogranin A; neuron-specific enolase), islet hormones (insulin, glucagon, somatostatin, pancreatic polypeptide), cell proliferation (Ki-67), and neogenesis (CD29). The number of islet hormone-immunoreactive cells increased from large ducts to the terminal branches. The insulin-producing cells outnumbered endocrine cells reactive for glucagon, somatostatin, or pancreatic polypeptide. The proportions of insulin-immunoreactive count compared with local islets (100% as a baseline) were 1.5% for the main ducts, 7.2% for interlobular ducts, 24.8% for intralobular ducts, 67.9% for intercalated ducts, and 348.9% for centroacinar cells. Both Ki-67- and CD29-labeled cells were predominantly localized in the terminal branches around the islets. The terminal branches also showed cells coexpressing islet hormones and cytokeratin 19. The adult human pancreatic ducts showed islet hormone-producing cells. The insulin-reactive cells predominantly localized in terminal branches where they may retain potential capability for β-cell neogenesis.

  17. Silver zeolite antimicrobial activity in aluminium heating, ventilation and air conditioning system ducts.

    Science.gov (United States)

    Rizzetto, R; Mansi, A; Panatto, D; Rizzitelli, E; Tinteri, C; Sasso, T; Gasparini, R; Crovari, P

    2008-03-01

    Air pollution in confined environments is a serious health problem, in that most people spend long periods indoors (in homes, offices, classrooms etc.). Some people (children, the elderly, heart disease patients, asthmatic or allergic subjects) are at greater risk because of their conditions of frailty. The growing use of air-conditioning systems in many public and private buildings aggravates this health risk, especially when these systems are not correctly installed or regularly serviced. The aim of our study was to verify the capacity of Ag+ ions to stop the growth of bacteria and moulds inside the ducts of Heating, Ventilation and Air Conditioning system ducts (HVAC) systems when these ducts were lined with active Ag+ ions zeolite-coated panels. A Y-shaped HVAC model with two branches was used; one branch was made of traditional galvanized iron, as was the whole system, while the other was lined with active Ag+ zeolite-coated polyurethane panels. During the test, samples of dust present inside both ducts were collected and seeded in liquid and solid media to detect bacteria and moulds. The presence of bacteria was also sought in the air emerging from the outlets of both ducts. Tests made on samples of particulate collected from the two different ducts revealed a lower total bacterial load in the samples collected from the Ag+ zeolite-coated duct than in the samples from the traditional Zn galvanized duct. In addition, the values of bacterial load found in the air emerging from the Ag+ ions zeolite-lined duct were 5 times lower than those found in the air from the traditional galvanized iron duct. The utilization of Ag+ zeolite-coated panels in air-conditioning systems could improve the quality of the emerging air in comparison with traditional installations in galvanized iron. This innovation could prove particularly advantageous in the event of accidents during the installation of air-conditioning systems or of contaminated aerosols coming from outside.

  18. The impact of duct-to-duct interaction on the hex duct dilation

    International Nuclear Information System (INIS)

    Lee, M.J.; Chang, L.K.; Lahm, C.E.; Porter, D.L.

    1992-01-01

    Dilation of the hex duct is an important factor in the operational lifetime of fuel subassemblies in liquid metal fast reactors. It is caused primarily by the irradiation-enhanced creep and void swelling of the hex duct material. Excessive dilation may jeopardize subassembly removal from the core or cause a subassembly storage problem where the grid size of the storage basket is limited. Dilation of the hex duct in Experimental Breeder Reactor II (EBR-II) limits useful lifetime because of these storage basket limitations. It is, therefore, important to understand the hex duct dilation behavior to guide the design and in-core management of fuel subassemblies in a way that excessive duct deformation can be avoided. To investigate the dilation phenomena, finite-element models of the hex duct have been developed. The inelastic analyses were performed using the structural analysis code, ANSYS. Both Type 316 and D9 austenitic stainless steel ducts are considered. The calculated dilations are in good agreement with profilometry measurements made after irradiation. The analysis indicates that subassembly interaction is an important parameter in addition to neutron fluence and temperature in determining hex duct dilation. 5 refs

  19. Villous adenoma of the common hepatic duct: the importance of contrast-enhanced ultrasound and endoscopic retrograde cholangiopancreatography for relevant diagnosis. A case report and review of the literature.

    Science.gov (United States)

    Tefas, Cristian; Tanţău, Marcel; Szenftleben, Alexandru; Chiorean, Liliana; Badea, Radu

    2015-12-01

    Adenomas are frequently encountered in the lower digestive tract but are rarely diagnosed in the biliary tree. We report a case of villous adenoma of the common hepatic duct. A 58-year old male was admitted with a four week history of intermittent upper right quadrant pain. Gray scale and contrast-enhanced abdominal ultrasound showed a mass inside the common hepatic duct with arterial enhancement and slow wash-out during the late venous phase. Subsequent endoscopic retrograde cholangiopancreatography and intraductal ultrasound confirmed the presence of the lesion. The final histopathological examination showed villous adenoma of the common hepatic duct with high-grade dysplasia. Contrast enhanced ultrasonography used in conjecture with endoscopic retrograde cholangiopancreatography can help in differentiating biliary tumors.

  20. Intraductal Carcinoma of the Prostate on Diagnostic Needle Biopsy Predicts Prostate Cancer Mortality: A Population-Based Study.

    Science.gov (United States)

    Saeter, Thorstein; Vlatkovic, Ljiljana; Waaler, Gudmund; Servoll, Einar; Nesland, Jahn M; Axcrona, Karol; Axcrona, Ulrika

    2017-06-01

    Intraductal carcinoma of the prostate (IDC-P) is a distinct histopathologic feature associated with high-grade, advanced prostate cancer. Although studies have shown that IDC-P is a predictor of progression following surgical or radiation treatment for prostate cancer, there are sparse data regarding IDC-P on diagnostic needle biopsy as a prognosticator of prostate cancer mortality. This was a population-based study of all prostate cancer patients diagnosed using needle biopsy and without evidence of systemic disease between 1991 and 1999 within a defined geographic region of Norway. Patients were identified by cross-referencing the Norwegian Cancer Registry. Of 318 eligible patients, 283 had biopsy specimens available for central pathology review. Clinical data were obtained from medical charts. We examined whether IDC-P on diagnostic needle biopsy was associated with adverse clinicopathological features and prostate cancer mortality. Patients with IDC-P on diagnostic needle biopsy had a more advanced stage and a higher Gleason score compared to patients without IDC-P. IDC-P was also associated with an intensively reactive stroma. The 10-year prostate cancer-specific survival was 69% for patients with IDC-P on diagnostic needle biopsy and 89% for patients without IDC-P (Log rank P-value prostate cancer mortality after adjustments for clinical prognostic factors and treatment. After adjustment for the newly implemented Grade Group system of prostate cancer, IDC-P showed a strong tendency toward statistical significance. However, IDC-P did not remain a statistically significant predictor in the multivariable analysis. IDC-P on diagnostic needle biopsy is an indicator of prostate cancer with a high risk of mortality. Accordingly, a diagnosis of IDC-P on needle biopsy should be reported and considered a feature of high-risk prostate cancer. Moreover, the association between IDC-P and reactive stroma provides evidence in support of the idea that stromal factors

  1. The role of multi-detector-row computed tomograph in the diagnosis of intraductal papillary-mucinous tumors of the pancreas in comparison to endoscopic retrograde pancreatography, endoscopic ultrasonography, magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    Arikawa, Shunji; Uchida, Masafumi; Shinagawa, Masaharu

    2007-01-01

    Thirty patients with intraductal papillary-mucinous tumor (IPMT) of the pancreas underwent multidetector-row CT (MD-CT) in addition to endoscopic retrograde pancreatography (ERP), and, in 27 cases magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS). The usefulness of MD-CT was investigated by comparing various imaging methods of the communication from the main pancreatic duct (MPD) to patulous/bulging papilla in addition to the indices for benign or malignant disease, the degree of dilation of the MPD, localization and size of cystic lesions, and presence or absence of neoplastic lesions, such as thickened walls and septa, intramural nodule, solid mass. With MD-CT, dilation of the MPD and localization and size of cystic lesions were accurately assessed, even in patients with obstruction of the main pancreatic duct in whom ERP was difficult to perform regardless of the presence or absence of massive amount of mucus. MD-CT with reconstructive imaging, such as multiplanar reformation (MPR) imaging and curred planar reformation (CPR) imaging, allowed us to assess communication with the MPD and patulous/bulging papilla easier than MRCP. In our study, MD-CT was useful in the evaluation of thickened walls and septa that are predictive factors of malignancy in IPMT. (author)

  2. Postoperative Biliary Leak Treated with Chemical Bile Duct Ablation Using Absolute Ethanol: A Report of Two Cases.

    Science.gov (United States)

    Sasaki, Maho; Hori, Tomohide; Furuyama, Hiroaki; Machimoto, Takafumi; Hata, Toshiyuki; Kadokawa, Yoshio; Ito, Tatsuo; Kato, Shigeru; Yasukawa, Daiki; Aisu, Yuki; Kimura, Yusuke; Takamatsu, Yuichi; Kitano, Taku; Yoshimura, Tsunehiro

    2017-08-08

    BACKGROUND Postoperative bile duct leak following hepatobiliary and pancreatic surgery can be intractable, and the postoperative course can be prolonged. However, if the site of the leak is in the distal bile duct in the main biliary tract, the therapeutic options may be limited. Injection of absolute ethanol into the bile duct requires correct identification of the bile duct, and balloon occlusion is useful to avoid damage to the surrounding tissues, even in cases with non-communicating biliary fistula and bile leak. CASE REPORT Two cases of non-communicating biliary fistula and bile leak are presented; one case following pancreaticoduodenectomy (Whipple's procedure), and one case following laparoscopic cholecystectomy. Both cases were successfully managed by chemical bile duct ablation with absolute ethanol. In the first case, the biliary leak occurred from a fistula of the right posterior biliary tract following pancreaticoduodenectomy. Cannulation of the leaking bile duct and balloon occlusion were achieved via a percutaneous route, and seven ablation sessions using absolute ethanol were required. In the second case, perforation of the bile duct branch draining hepatic segment V occurred following laparoscopic cholecystectomy. Cannulation of the bile duct and balloon occlusion were achieved via a transhepatic route, and seven ablation sessions using absolute ethanol were required. CONCLUSIONS Chemical ablation of the bile duct using absolute ethanol is an effective treatment for biliary leak following hepatobiliary and pancreatic surgery, even in cases with non-communicating biliary fistula. Identification of the bile duct leak is required before ethanol injection to avoid damage to the surrounding tissues.

  3. Vitellointestinal Duct Anomalies in Infancy.

    Science.gov (United States)

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5-9 of intrauterine life. This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality.

  4. Efficacy of percutaneous intraductal radiofrequency ablation combined with biliary stenting in treatment of malignant biliary obstruction

    Directory of Open Access Journals (Sweden)

    ZHANG Kai

    2015-05-01

    Full Text Available ObjectiveTo investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation (palliative therapy in the treatment of malignant obstructive jaundice. MethodsThis study included 20 patients with unresectable malignant obstructive jaundice, who were treated in the First Affiliated Hospital of Zhengzhou University from January 2013 to March 2014. Nine of them (test group underwent percutaneous intraductal radiofrequency ablation plus metallic biliary stent placement. The other 11 similar cases (control group underwent metallic biliary stent placement alone after successful percutaneous transhepatic cholangiography. Operative complications and remission of jaundice were observed, and the stent patency after at 3 and 6 months after operation was evaluated and compared between the two groups. ResultsAll patients were followed completely by outpatient or telephone. The stent patency rate at 3 months after operation was 9/9 in the test group and 8/11 in the control group (χ2=2.888, P=0.218, and the stent patency rates at 6 months were 7/8 and 3/11, respectively (χ2=6.739, P=0.02. During follow-up, one case in the test group died of gastrointestinal bleeding at 113 d after operation; one case in the control group died of liver failure at 57 d after operation and one case died of disseminated intravascular coagulation at 142 d. ConclusionPercutaneous intraductal radiofrequency ablation is safe and feasible in the treatment of malignant biliary obstruction, and the preliminary efficacy in prolonging the patency of self-expanding metallic stent is satisfactory. However, this therapy needs to be further verified via large-sample randomized controlled studies.

  5. Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications.

    Science.gov (United States)

    Henry, P C; Evans, A J

    2009-07-01

    Intraductal carcinoma of the prostate (IDCP) has been described as a lesion associated with poor prognostic features in prostate cancer. Its recognition and reporting in prostate specimens, particularly in needle biopsies, is critical as it carries significant implications for patient management. Recent histological definitions have been proposed to assist in the recognition of IDCP and to help distinguish it from lesions with similar appearance, but different clinical behaviour. In this review, a historical overview of the description of IDCP will be presented followed by a summary of the current histological diagnostic criteria and the recommendations for management and reporting of IDCP.

  6. Retrieval of Surgical Clip from Common Bile Duct by Endoscopic Retrograde Cholangiopancreatography: A Rare Complication of Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Shahid Rasool

    2017-04-01

    Full Text Available Laparoscopic cholecystectomy has become the standard procedure for the surgical management of symptomatic cholelithiasis. Laparoscopic cholecystectomy is generally considered a safe procedure although a few complications such as major bleeding, wound infection, bile leakage, biliary and bowel injury are well known. We are reporting a case of a thirty-seven year old male who presented with abdominal pain, three weeks after laparoscopic cholecystectomy. Abdominal ultrasound revealed a filling defect in common bile duct with deranged liver function tests. With an impression of choledocholithiasis, his endoscopic retrograde cholangiopancreatography (ERCP was done which revealed a surgical clip impacted in the ampulla. The surgical clip was retrieved successfully by ERCP. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy. Appropriate management requires timely identification and retrieval during ERCP.

  7. Clinical implications of bile duct injury after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Wang Maoqiang; Tang Wenjie; Lin Hanying; Ye Huiyi; Dai Guanghai; Wang Zhiqiang

    2005-01-01

    of distal arterial branches (P<0.01). Conclusions: Knowledge of imaging findings of TACE-induced bile duct injuries can help interventional radiologists to have prompt correct diagnosis. Adjustment in the amounts of iodized oil and chemotherapeutic agents (ie, cisplatin) in patients with high risk factors may reduce ischemic biliary injuries after TACE. (authors)

  8. Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP.

    Science.gov (United States)

    Boninsegna, Enrico; Manfredi, Riccardo; Negrelli, Riccardo; Avesani, Giacomo; Mehrabi, Sara; Pozzi Mucelli, Roberto

    To define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis. S-MRCPs of 35 patients with pancreatitis and 14 with adenocarcinoma were evaluated. Adenocarcinoma caused higher prevalence of complete stenosis (14/14-100% vs 17/35-49%), dilated side-branches (14/14-100% vs 18/35-51%) and lower prevalence of duct-penetrating sign (0/14-0% vs 31/35-89%). The number of stenoses was higher in benign conditions (mean 1.4 Vs 1). Upstream MPD diameter was higher in cancer-induced stenoses (4.5 vs 2.9mm). Single complete stenosis with dilated side branches, increased MPD caliber and absent duct-penetrating sign are suggestive of malignancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Skene's gland duct cysts: The utility of vaginal/transperineal imaging ...

    African Journals Online (AJOL)

    : P F Kruger (pkruger@urogynaecology.co.za). Periurethral glands, or Skene's glands, are branched, tubular glands that are adjacent to the distal urethra. Usually Skene's ducts run parallel to the long axis of the urethra for approximately 1 cm ...

  10. Magnetic Resonance Evaluation of the Presence of an Extensive Intraductal Component in Breast Cancer

    International Nuclear Information System (INIS)

    Ikeda, O.; Nishimura, R.; Miyayama, H.; Yasunaga, T.; Ozaki, Y.; Tsuji, A.; Yamashita, Y.

    2004-01-01

    Purpose: To determine whether the presence of extensive intraductal components (EIC) in breast carcinomas can be accurately evaluated on magnetic resonance (MR) images. Material and Methods: Ninety-three women with breast cancer, aged between 32 and 79 years (mean 54 years), underwent three-dimensional dynamic MR imaging (dyMRI) with fat suppression and magnetization transfer contrast before breast-conserving surgery. The tumors were classified on dyMRI as circumscribed, microlobulated, and/or speculated, and their size was measured. Spotty or linear continuous enhancement (SLE) from the main tumor to the nipple and segmental enhancement surrounding the main tumor (SE) were considered indicative of intraductal tumor spread. The correlation between preoperative MRI and macroscopic and microscopic findings was examined. Results: On MR images, the tumor sizes ranged from 0.8 to 3.4 cm. These measurements coincided with histologic measurements in circumscribed tumors. However, in tumors with microlobulated or spiculated borders, tumor size tended to be underestimated on MR images. Of 93 patients, 59 (63.4%) had histologically confirmed EIC; 42 of the 59 cancers (71.2%) manifested SLE or SE on MR images. The sensitivity, specificity, and accuracy of MR imaging in detecting EIC were 71%, 85%, and 76%, respectively. Conclusion: MR imaging facilitates the detection of EIC in breast masses. This information is valuable for the planning of breast-conserving surgery

  11. Should you get your heating ducts cleaned?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    Canada Mortgage and Housing Corporation conducted research into duct cleaning during which time several houses were tested for hot air furnace duct performance before and after cleaning. Duct cleaning is a major industry which claims that cleaning of ducts will provide you with better indoor air quality, reduce household molds and allergens, get rid of house dust, result in more airflow and better delivery of warm air and reduce energy costs. This report does not substantiate those claims. Researchers found little or no discernible differences in the concentrations of house airborne particles or in duct airflows due to duct cleaning. This is because ducts are metal passages that cannot create dust. Most household dusts come from outdoors that has been tracked in or blows through windows and other openings. While duct cleaning may be justifiable personally, it does not change the quality of the air you breathe, nor will it significantly affect airflow or heating costs. Some filters effectively clean the air in the ducts but they do not create a dust-free environment because of the above-mentioned dust sources. The only time that duct cleaning may make sense is if you have water in your ducts that can result in mold growth, if you are moving into a newly constructed house to remove drywall dust, if your are having trouble with furnace airflow, or if you see an accumulation of debris in the return air ducts. It was emphasized that broadcast spraying of biocides within the duct system should not be performed.

  12. Vascular patterns in nodules of intraductal papillary mucinous neoplasms depicted under contrast-enhanced ultrasonography are helpful for evaluating malignant potential

    International Nuclear Information System (INIS)

    Kurihara, Naoko; Kawamoto, Hirofumi; Kobayashi, Yoshiyuki; Okamoto, Yuko; Yamamoto, Naoki; Tsutsumi, Koichiro; Fujii, Masakuni; Kato, Hironari; Yamamoto, Kazuhide

    2012-01-01

    Objectives: The purpose of this study is to evaluate the feasibility of contrast-enhanced ultrasonography (CE-US) to differentiate between benign and malignant intraductal papillary mucinous neoplasms (IPMN). Patients and methods: Contrast-enhanced ultrasonography with a contrast agent was performed on 22 consecutive patients with IPMN suspected of being malignant. This revealed 10 carcinomas, 1 borderline lesion and 11 adenomas. All patients underwent surgery, and the histological diagnosis was confirmed by examination of resected specimens. CE-US was performed using a contrast agent. The detection rates of mural nodules were compared between CE-US and contrast-enhanced computed tomography (CE-CT), and the imaging of mural nodules depicted under CE-US was analyzed. Results: Seventeen of 22 resected specimens (77.3%) had mural nodules. There was no significant difference in the detection rate between CE-US (n = 15; 88.2%) and CE-CT (n = 12; 70.6%). In 12 (80.0%) of these patients, CE-US revealed small vessels in the mural nodule. The spotty or linear-shaped pattern was detected in 4 patients and the branch-shaped pattern in 8. The branch-shaped pattern lesion was associated with carcinoma. These mural nodules were 10 mm or more in height. In the perfusion image phase, cystic walls and mural nodules were also enhanced in all cases. Conclusion: The vessel shapes of the mural nodules depicted under CE-US were associated with size and pathological findings. These results suggested that CE-US with a contrast agent is a powerful modality with which to evaluate the malignant potential of IPMN.

  13. Treatment Options for Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with bile duct cancer. Different types of treatments are available ...

  14. Treatment Option Overview (Extrahepatic Bile Duct Cancer)

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with bile duct cancer. Different types of treatments are available ...

  15. General Information about Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with bile duct cancer. Different types of treatments are available ...

  16. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction systems ducts and air duct systems. 29.1103 Section 29.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Induction System § 29.1103 Induction systems ducts and air duct...

  17. Thoracic duct lymphography by subcutaneous contrast agent ...

    African Journals Online (AJOL)

    A second lymphography revealed a collateral thoracic duct that was not detected during the first lymphography. The collateral duct was ligated and chylothorax was resolved after the second surgery. The lymphography applied in this study was minimally-invasive and easily provided images of the thoracic duct in a dog with ...

  18. Wind Turbine With Concentric Ducts

    Science.gov (United States)

    Muhonen, A. J.

    1983-01-01

    Wind Turbine device is relatively compact and efficient. Converging inner and outer ducts increase pressure difference across blades of wind turbine. Turbine shaft drives alternator housed inside exit cone. Suitable for installation on such existing structures as water towers, barns, houses, and commercial buildings.

  19. Bundle Branch Block

    Science.gov (United States)

    ... known cause. Causes can include: Left bundle branch block Heart attacks (myocardial infarction) Thickened, stiffened or weakened ... myocarditis) High blood pressure (hypertension) Right bundle branch block A heart abnormality that's present at birth (congenital) — ...

  20. Neuro-Oncology Branch

    Science.gov (United States)

    ... BTTC are experts in their respective fields. Neuro-Oncology Clinical Fellowship This is a joint program with ... can increase survival rates. Learn more... The Neuro-Oncology Branch welcomes Dr. Mark Gilbert as new Branch ...

  1. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    1999-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere....

  2. The evaluation of extensive intraductal component (EIC) in breast carcinoma using MR mammography

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Yasuhiro; Mineta, Masayuki; Yamada, Tomonori [Asahikawa Medical Univ. (Japan)] [and others

    1997-10-01

    Twenty-one patients with breast cancer underwent MR mammography (MRM) for evaluation of extensive intraductal component (EIC). Linear or small nodular structures continuing to main tumor, irregular margin, and early stain on dynamic scan were considered to be suggestive of EIC. The sensitivity, specificity and accuracy of detecting EIC were 88.9%, 91.7% and 90.5%, respectively. Misleading structures or pathological conditions to distinguish from EIC on MRM were interstitial connective tissue, interstitial spreading of the cancer, mastitis, and vessels. Although MRM appears to be very useful in evaluating EIC of the breast cancer, it is necessary for the radiologist to understand that there are several misleading signal intensities or abnormal enhancement to discriminate from EIC. (author)

  3. Intraductal papillary mucinous neoplasms of the pancreas: reporting clinically relevant features.

    Science.gov (United States)

    Del Chiaro, Marco; Verbeke, Caroline

    2017-05-01

    Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management. The need for detailed reporting is therefore increasing. This review discusses the panoply of gross and microscopic features of IPMN as well as the recommendations from recent consensus meetings regarding the pathology reporting on this tumour entity. © 2016 John Wiley & Sons Ltd.

  4. Autoimmune pancreatitis type-1 associated with intraduct papillary mucinous neoplasm: report of two cases.

    Science.gov (United States)

    Vaquero, Eva C; Salcedo, Maria T; Cuatrecasas, Míriam; De León, Hannah; Merino, Xavier; Navarro, Salvador; Ginès, Angels; Abu-Suboh, Monder; Balsells, Joaquim; Fernández-Cruz, Laureano; Molero, Xavier

    2014-01-01

    Chronic pancreatitis lesions usually embrace both intraduct papillary mucinous neoplasm (IPMN) and pancreatic ductal adenocarcinoma (PDAC). Patients at genetically-determined high risk of PDAC often harbor IPMN and/or chronic pancreatitis, suggesting IPMN, chronic pancreatitis and PDAC may share pathogenetic mechanisms. Chronic autoimmune pancreatitis (AIP) may also herald PDAC. Concurrent IPMN and AIP have been reported in few patients. Here we describe two patients with IPMN who developed type-1 AIP fulfilling the Honolulu and Boston diagnostic criteria. AIP diffusively affected the whole pancreas, as well as peripancreatic lymph nodes and the gallbladder. Previous pancreatic resection of focal IPMN did not show features of AIP. One of the patients carried a CFTR class-I mutation. Of notice, serum IgG4 levels gradually decreased to normal values after IPMN excision. Common risk factors to IPMN and AIP may facilitate its coincidental generation. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  5. [Immunoexpression of c-erbB-2 in intraductal proliferative lesions of the female breast].

    Science.gov (United States)

    Oliveira, Agliberto Barbosa de; De Luca, Laurival Antônio; Carvalho, Grigna Teixeira; Arias, Victor Eduardo Arua; Carvalho, Lídia Raquel de; Assunção, Maria do Carmo

    2004-01-01

    Genetic modifications are related to genesis and development of cancer. Neoplasias in various organs express the c-erbB-2 oncogene. In intraductal proliferations of the breast it has been assessed as a risk factor for subsequent development of carcinoma. The c-erbB-2 immunoexpression in intraductal epithelial proliferations and the relationship with histopathological characteristics of ductal carcinoma in situ (DCIS) were evaluated. File material from 88 women, which were tissue samples formalin-fixed, paraffin-embedded blocks, was used. Of these 51 presented with DCIS and 37 with ductal hyperplasia without atypia. Ages of the women ranged from 35 to 76 years. All cases were reviewed and nuclear grade, presence of necrosis, preponderance of histological subtype and its extension were verified. Specimens were obtained for the c-erB-2 immunohistochemical study of 84 of the women in question. No expression of the oncogene was verified in the hyperplasias without atypias and in tissues adjacent to all tissue samples. Expression of c-erbB-2 was verified in 9 (19.1%) of the DCIS (p = 0.0001). Immunoexpression was not related to the extension of the lesions. The c-erbB-2 immunoexpression in DCIS was correlated to the histological subtype (p = 0.019), necrosis (p = 0.0066), nuclear grade (p = 0.0084) and Van Nuys Classification (p = 0.039). Expression of c-erbB-2 was significant in proliferative lesions with risk (DCIS) and was correlated to histopathological characteristics: high nuclear grade, presence of necrosis and comedy subtype. There was no expression in the hyperplasias without atypias and adjacent tissues.

  6. Three-dimensional reconstructions of intrahepatic bile duct tubulogenesis in human liver

    DEFF Research Database (Denmark)

    Vestentoft, Peter S; Jelnes, Peter; Hopkinson, Branden M

    2011-01-01

    BACKGROUND: During liver development, intrahepatic bile ducts are thought to arise by a unique asymmetric mode of cholangiocyte tubulogenesis characterized by a series of remodeling stages. Moreover, in liver diseases, cells lining the Canals of Hering can proliferate and generate new hepatic...... in normal liver and in the extensive ductular reactions originating from intrahepatic bile ducts and branching into the parenchyma of the acetaminophen intoxicated liver. In the developing human liver, three-dimensional reconstructions using multiple marker proteins confirmed that the human intrahepatic...

  7. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2002-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch ...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere. (C) 2001 Elsevier Science B.V. All rights reserved.......A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...

  8. HAARP-Induced Ionospheric Ducts

    International Nuclear Information System (INIS)

    Milikh, Gennady; Vartanyan, Aram

    2011-01-01

    It is well known that strong electron heating by a powerful HF-facility can lead to the formation of electron and ion density perturbations that stretch along the magnetic field line. Those density perturbations can serve as ducts for ELF waves, both of natural and artificial origin. This paper presents observations of the plasma density perturbations caused by the HF-heating of the ionosphere by the HAARP facility. The low orbit satellite DEMETER was used as a diagnostic tool to measure the electron and ion temperature and density along the satellite orbit overflying close to the magnetic zenith of the HF-heater. Those observations will be then checked against the theoretical model of duct formation due to HF-heating of the ionosphere. The model is based on the modified SAMI2 code, and is validated by comparison with well documented experiments.

  9. A case report: Cavitary infarction caused by pulmonary tumor thrombotic microangiopathy in a patient with pancreatic intraductal papillary mucinous neoplasm

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyoung Kyg; Kwon, Woon Jung; Choi, Seong Hoon; Lee, Jong Hwa; Cha, Hee Jeong [Ulsan University Hospital, University of Ulsan School of Medicine, Ulsan (Korea, Republic of)

    2015-08-15

    Pulmonary tumor embolism is commonly discovered at autopsy, but is rarely suspected ante-mortem. Microangiopathy is an uncommon and distinct form of simple tumor pulmonary embolism. Here, we present a 52-year-old male with tumor thrombotic microangiopathy and pulmonary infarction, which might have originated from intraductal papillary mucinous tumor of the pancreas. Multiple wedge-shaped consolidations were found initially and aggravated with cavitation. These CT features of pulmonary infarction were pathologically confirmed to result from pulmonary tumor thrombotic microangiopathy.

  10. Somatic mutations in PIK3CA and activation of AKT in intraductal tubulopapillary neoplasms of the pancreas.

    Science.gov (United States)

    Yamaguchi, Hiroshi; Kuboki, Yuko; Hatori, Takashi; Yamamoto, Masakazu; Shiratori, Keiko; Kawamura, Shunji; Kobayashi, Makio; Shimizu, Michio; Ban, Shinichi; Koyama, Isamu; Higashi, Morihiro; Shin, Nobuhiro; Ishida, Kazuyuki; Morikawa, Takanori; Motoi, Fuyuhiko; Unno, Michiaki; Kanno, Atsushi; Satoh, Kennichi; Shimosegawa, Tooru; Orikasa, Hideki; Watanabe, Tomoo; Nishimura, Kazuhiko; Harada, Youji; Furukawa, Toru

    2011-12-01

    Intraductal tubulopapillary neoplasm (ITPN) is a recently recognized rare variant of intraductal neoplasms of the pancreas. Molecular aberrations underlying the neoplasm remain unknown. We investigated somatic mutations in PIK3CA, PTEN, AKT1, KRAS, and BRAF. We also investigated aberrant expressions of phosphorylated AKT, phosphatase and tensin homolog (PTEN), tumor protein 53 (TP53), SMAD4, and CTNNB1 in 11 cases of ITPNs and compared these data with those of 50 cases of intraductal papillary mucinous neoplasm (IPMN), another distinct variant of pancreatic intraductal neoplasms. Mutations in PIK3CA were found in 3 of 11 ITPNs but not in IPMNs (P = 0.005; Fisher exact test). In contrast, mutations in KRAS were found in none of the ITPNs but were found in 26 of the 50 IPMNs (P = 0.001; Fisher exact test). PIK3CA mutations were associated with strong expression of phosphorylated AKT (P AKT was apparent in most ITPNs but only in a few IPMNs (P SMAD4, and CTNNB1 were not statistically different between these neoplasms. Mutations in PIK3CA and the expression of phosphorylated AKT were not associated with age, sex, tissue invasion, and patients' prognosis in ITPNs. These results indicate that activation of the phosphatidylinositol 3-kinase pathway may play a crucial role in ITPNs but not in IPMNs. In contrast, the mutation in KRAS seems to play a major role in IPMNs but not in ITPNs. The activated phosphatidylinositol 3-kinase pathway may be a potential target for molecular diagnosis and therapy of ITPNs.

  11. Quadcopter thrust optimization with ducted-propeller

    Directory of Open Access Journals (Sweden)

    Kuantama Endrowednes

    2017-01-01

    Full Text Available In relation to quadcopter body frame model, propeller can be categorized into propeller with ducted and without ducted. This study present differences between those two using CFD (Computational Fluid Dynamics method. Both categories utilize two blade-propeller with diameter of 406 (mm. Propeller rotation generates acceleration per time unit on the volume of air. Based on the behavior of generated air velocity, ducted propeller can be modeled into three versions. The generated thrust and performance on each model were calculated to determine the best model. The use of ducted propeller increases the total weight of quadcopter and also total thrust. The influence of this modeling were analyzed in detail with variation of angular velocity propeller from 1000 (rpm to 9000 (rpm. Besides the distance between propeller tip and ducted barrier, the size of ducted is also an important part in thrust optimization and total weight minimization of quadcopter.

  12. Thermal neutrons streaming in straight duct

    International Nuclear Information System (INIS)

    Jehouani, A.; Boulkheir, M.; Ichaoui, R.

    2000-01-01

    The neutron streaming in duct is due to two phenomena: a) direct propagation and b) reflection on duct wall. We have used the Monte Carlo method to evaluate the ratio of the reflected neutrons flux by the duct wall to the total flux at the exit of the duct for iron and aluminium. Ten neutrons energy groups are considered between 10 -5 eV and 10 eV. A Fortran program is developed to evaluate the neutron double differential albedo. It is shown that the two following approximations are largely justified: i) Three collisions in the duct wall are sufficient to attain the asymptotic limit of the multiscattered neutron double differential albedo ii) The points of entry and exit of the neutron in the duct wall may be considered the same for the multiscattered neutrons. For a punctual source at the mouth of the duct, we have determined the direct and the reflected part of the total thermal neutron flux at the exit of the duct for different lengths and different radius of the duct. For a punctual source, we have found that the major contribution to the total flux of neutrons at the exit is due to the neutron reflection by walls and the reflection contribution decreases when the neutron energy decreases. For a constant length of the duct, the reflected part decreases when the duct radius increases while for the disk shaped source we have found the opposite phenomena. The transmitted neutron flux distribution at the exit of the duct are determined for disk shaped source for different neutron energy and for different distance from the exit center. (author)

  13. Molecular Mechanisms of Bile Duct Development

    OpenAIRE

    Zong, Yiwei; Stanger, Ben Z.

    2010-01-01

    The mammalian biliary system, consisting of the intrahepatic and extrahepatic bile ducts, is responsible for transporting bile from the liver to the intestine. Bile duct dysfunction, as is seen in some congenital biliary diseases such as Alagille syndrome and biliary atresia, can lead to the accumulation of bile in the liver, preventing the excretion of detoxification products and ultimately leading to liver damage. Bile duct formation requires coordinated cell-cell interactions, resulting in...

  14. Persistent Mullerian Duct Syndrome with Transverse Testicular ...

    African Journals Online (AJOL)

    Eastham JA, McEvoy K, Sullivan R, Chandrasoma P. A case of simultaneous bilateral nonseminomatous testicular tumors in persistent müllerian duct syndrome. J Urol 1992;148:407-8. 8. Shinmura Y, Yokoi T, Tsutsui Y. A case of clear cell adenocarcinoma of the müllerian duct in persistent müllerian duct syndrome: The first ...

  15. Parotid salivary duct stenosis following caudal maxillectomy.

    Science.gov (United States)

    Mestrinho, Lisa A; Faísca, Pedro B; Niza, Maria M R E

    2014-01-01

    Parotid salivary duct dilation was diagnosed in a 9-year-old male dog. The dog had undergone caudal maxillectomy on the ipsilateral side 2-years prior to presentation. Treatment consisted of parotid salivary duct excision and superficial parotidectomy that lead to the resolution of clinical signs. Transient facial neuropraxia was observed immediately after surgery and resolved spontaneously after 2-weeks. Parotid salivary duct dilation should be considered as a chronic postoperative complication following caudal maxillectomy.

  16. Nasopalatine duct cyst: A case report

    Directory of Open Access Journals (Sweden)

    Saikrishna Pasupuleti

    2015-01-01

    Full Text Available Nasopalatine duct cyst (NPDC is the most common non-odontogenic cyst of oral cavity. Clinically, Nasopalatine duct cyst manifests as an asymptomatic swelling of the palate or the upper lip. Radiographically, it is seen as a heart-shaped radiolucency and can be confused with periapical pathology. The aim of this article is to report a case of a nasopalatine duct cyst in a 36-year-old patient which was misinterpreted for a periapical cyst. Diagnosis of a Nasopalatine duct cyst can be given through clinical, radiographical, and histopathological examination.

  17. Biliary tract variations of the left liver with special reference to the left medial sectional bile duct in 500 patients.

    Science.gov (United States)

    Furusawa, Norihiko; Kobayashi, Akira; Yokoyama, Takahide; Shimizu, Akira; Motoyama, Hiroaki; Kanai, Keita; Arakura, Norikazu; Yamada, Akira; Kitou, Yoshihiro; Miyagawa, Shin-Ichi

    2015-08-01

    Among the intrahepatic bile ducts, the biliary system of the left medial sectional bile duct (B4) is known to have relatively complex patterns. The records of 500 patients who had been diagnosed as having hepato-pancreatico-biliary disease were retrospectively studied for anatomical biliary variations of the left liver with special reference to the drainage system of B4 using magnetic resonance images. The left hepatic duct was present in 494 patients (98.8%), whereas it was lacking in 6 patients (1.2%), and these patients exhibited the following B4 confluence patterns: B4 drained into the common hepatic duct in 2 patients (.4%), the right anterior sectional bile duct in 3 patients (.6%), and the right posterior sectional bile duct in 1 patient (.2%). The left hepatic duct was absent more frequently in patients with portal venous variations than in patients with a common branching pattern (8.2% vs .4%, P = .0011). The presently reported data are useful for obtaining a better understanding of the surgical anatomy of the biliary system of the left liver. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Entanglement branching operator

    Science.gov (United States)

    Harada, Kenji

    2018-01-01

    We introduce an entanglement branching operator to split a composite entanglement flow in a tensor network which is a promising theoretical tool for many-body systems. We can optimize an entanglement branching operator by solving a minimization problem based on squeezing operators. The entanglement branching is a new useful operation to manipulate a tensor network. For example, finding a particular entanglement structure by an entanglement branching operator, we can improve a higher-order tensor renormalization group method to catch a proper renormalization flow in a tensor network space. This new method yields a new type of tensor network states. The second example is a many-body decomposition of a tensor by using an entanglement branching operator. We can use it for a perfect disentangling among tensors. Applying a many-body decomposition recursively, we conceptually derive projected entangled pair states from quantum states that satisfy the area law of entanglement entropy.

  19. An experimental microangiographic study on injured liver acinus by ligation of common bile duct

    International Nuclear Information System (INIS)

    Park, Jong Yeon; Kim, Yoon Gyu; Moon, Ki Ho; Lee, Suek Hong; Kim, Byung Soo; Han, Gun Taik

    1994-01-01

    The purpose of this study was to evaluate the morphologic changes of the injured hepatic acini following ligation of common bile duct and to investigate the pathophysiologic process of hepatic failure and biliary liver cirrhosis in the extrahepatic cholestasis. The common bile ducts of 18 rabbits were ligated partially. The rabbits were killed and selective microangiography was carried out with infusion of barium suspensio via portal vein 4 to 24 weeks after ligation. Selective microangiography was also carried out in two normal rabbits. The microangiographic findings were evaluated and correlated with histopathologic features. The sinusoids of the liver acinus showed distortion, varying degrees of luminal widening, and irregularities in architecture. Terminal branches of the portal vein (TPV) showed increased number of branches, luminal narrowing, tortuosity, distortion, and beaded appearance. Peribiliary plexi were found as thin curvilinear, barium-filled structures along the wall of the dilated bile duct. The microangiographic findings were well correlated with histopathologic findings. The grades of microangiographic and histopathologic findings were poorly correlated with the duration of the ligation of CBD. Changes in microvasculature of the liver scinus following partial ligation of common bile duct were demonstrated by microangiography. Although the microvascular changes were evoked secondary to the injury, they might have some active roles in the pathophysiologic process in the liver

  20. Measure Guideline: Sealing and Insulating of Ducts in Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R.; Puttagunta, S.

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  1. Measure Guideline. Sealing and Insulating Ducts in Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Puttagunta, S. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2011-12-01

    This document begins with a discussion on potential cost and performance benefits of duct sealing and insulating. It continues with a review of typical duct materials and components and the overall procedures for assessing and improving the duct system.

  2. Poisson branching point processes

    International Nuclear Information System (INIS)

    Matsuo, K.; Teich, M.C.; Saleh, B.E.A.

    1984-01-01

    We investigate the statistical properties of a special branching point process. The initial process is assumed to be a homogeneous Poisson point process (HPP). The initiating events at each branching stage are carried forward to the following stage. In addition, each initiating event independently contributes a nonstationary Poisson point process (whose rate is a specified function) located at that point. The additional contributions from all points of a given stage constitute a doubly stochastic Poisson point process (DSPP) whose rate is a filtered version of the initiating point process at that stage. The process studied is a generalization of a Poisson branching process in which random time delays are permitted in the generation of events. Particular attention is given to the limit in which the number of branching stages is infinite while the average number of added events per event of the previous stage is infinitesimal. In the special case when the branching is instantaneous this limit of continuous branching corresponds to the well-known Yule--Furry process with an initial Poisson population. The Poisson branching point process provides a useful description for many problems in various scientific disciplines, such as the behavior of electron multipliers, neutron chain reactions, and cosmic ray showers

  3. Molecular biomarkers for progression of intraductal papillary mucinous neoplasm of the pancreas.

    Science.gov (United States)

    Kuboki, Yuko; Shimizu, Kyoko; Hatori, Takashi; Yamamoto, Masakazu; Shibata, Noriyuki; Shiratori, Keiko; Furukawa, Toru

    2015-03-01

    We aimed to identify molecular biomarkers for assessing the progression of intraductal papillary mucinous neoplasm of the pancreas (IPMN). We retrospectively investigated molecular aberrations and their associations with clinicopathological features in 172 IPMNs. GNAS and KRAS mutations were detected in 48% and 56% of IPMNs, respectively. No mutations of EGFR, PIK3CA GNAO1, GNAQ, or GNAI2 were observed. Significant associations were observed between IPMN morphological types and GNAS mutations, KRAS mutations, the expression of phosphorylated MAPK (pMAPK), AKT, and phosphorylated AKT (pAKT), nuclear accumulation of β-catenin, SMAD4 loss, and TP53 overexpression; histological grades and the expression of EGFR, pMAPK, AKT, and pAKT, the nuclear β-catenin, SMAD4 loss, and TP53 overexpression; invasive phenotypes and KRAS mutations, the nuclear β-catenin, and SMAD4 loss; and prognosis and SMAD4 loss and TP53 overexpression. Multivariate analysis to compare prognostic impacts of multiple molecular features revealed that TP53 overexpression was an independent prognostic factor (P = 0.030; hazard ratio, 5.533). These results indicate that mutations in GNAS and KRAS, the expression of EGFR and pMAPK, the nuclear β-catenin, SMAD4 loss, and TP53 overexpression may be relevant for assessing the clinical course of IPMN, including its progression into different morphological types, invasion, and prognosis.

  4. The Management Strategy of Benign Solitary Intraductal Papilloma on Breast Core Biopsy.

    Science.gov (United States)

    Ko, Dayoung; Kang, Eunyoung; Park, So Yeon; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Chae, Sumin; Jang, Yerang; Kim, Hye Jin; Kim, Sung-Won; Kim, Eun-Kyu

    2017-08-01

    Intraductal papilloma (IDP) is well-known as one of the common benign breast lesions requiring excision. However, treatment of IDP without atypia is controversial. The aim of our study was to determine the proper management of solitary IDP by core needle biopsy (CNB). We retrospectively reviewed patients with solitary IDP confirmed by CNB from March 2003 to March 2015. We collected data about final pathology after excision, as well as clinical, histologic, and radiologic findings at initial diagnosis. The final pathology was categorized as benign or malignant. We evaluated the rate of upgrade to malignancy and factors associated with malignancy. We identified 405 patients who presented benign solitary IDP by CNB. The mean age was 46.1 years (range, 15-86 years). In total, 135 patients underwent surgical excision, and 211 underwent vacuum-assisted excision. Of 346 patients, malignant lesions were found in 8 patients (2.3%): 7 underwent surgical excision, and 1 underwent vacuum-assisted excision. Only the size of IDP was significantly associated with cancer upgrade (P = .003). Our study shows that overall malignancy upgrade rate of benign solitary IDP after excision is very low (2.3%). Even when the size of IDP was less than 1 cm, the upgrade rate to cancer was only 0.9%. Therefore, for patients with small solitary IDP, we recommend close follow-up with ultrasound instead of excision. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Ducted wind turbine optimization : A numerical approach

    NARCIS (Netherlands)

    Dighe, V.V.; De Oliveira Andrade, G.L.; van Bussel, G.J.W.

    2017-01-01

    The practice of ducting wind turbines has shown a beneficial effect on the overall performance, when compared to an open turbine of the same rotor diameter1. However, an optimization study specifically for ducted wind turbines (DWT’s) is missing or incomplete. This work focuses on a numerical

  6. Visualization of the thoracic duct by lymphoscintigraphy

    International Nuclear Information System (INIS)

    Baulieu, F.; Baulieu, J.L.; Itti, R.; Tours Univ., 37

    1987-01-01

    Imaging of the thoracic duct is usually performed by radiological lymphography. However, this procedure, which uses an oil based dye injected directly into the lymph channels, has some adverse effects. In this paper we note that lymphoscintigraphy, a physiological and non invasive method, may visualize thoracic duct abnormalities, and might be particularly usefull when radiological lymphography is contraindicated. (orig.)

  7. Vacuum exhaust duct used for thermonuclear device

    International Nuclear Information System (INIS)

    Tachikawa, Nobuo; Kondo, Mitsuaki; Honda, Tsutomu.

    1990-01-01

    The present invention concerns a vacuum exhaust duct used for a thermonuclear device. A cylindrical metal liners is lined with a gap to the inside of a vacuum exhaust duct main body. Bellows are connected to both ends of the metal liners and the end of the bellows is welded to the vacuum exhaust duct main body. Futher, a heater is mounted to the metal liner on the side of the vacuum exhaust duct main body, and the metal liner is heated by the heater to conduct baking for the vacuum exhaust duct main body. Accordingly, since there is no requirement for elevating the temperature of the vacuum exhaust duct upon conducting baking, the vacuum exhaust duct scarcely suffers substantial deformation due to heat expansion. Further, there is also no substantial deformation for the bellows disposed between the outer circumference of the vacuum vessel and a portion of a vacuum exhaust duct, so that the durability of the bellows is greatly improved. (I.S.)

  8. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

  9. Cholangiographic evaluation of bile duct carcinoma

    International Nuclear Information System (INIS)

    Nichols, D.A.; MacCarty, R.L.; Gaffey, T.A.

    1983-01-01

    Cholangiograms and clinical histories of 82 patients with biopsy-proved bile duct carcinoma were reviewed. The carcinomas were classified according to morphologic findings and clinical outcome. Ulcerative colitis and antecedent inflammatory disease of the biliary tree, particularly primary sclerosing cholangitis, seem to predispose to the development of bile duct carcinoma. Focal stenotic lesions were the most common morphologic type (62/82). Polypoid carcinomas and diffuse sclerosing carcinomas were less common and of about equal frequency. Prognosis was best for patients with polypoid carcinomas and worst for those with diffuse sclerosing carcinomas. In 69 cases (84%), the tumors involved the intrahepatic or proximal extrahepatic ducts, makin curative resection difficult or impossible. Patients with carcinomas limited to the more distal extrahepatic bile ducts had a longer average survival and a higher probability of surgical cure. Proper management of patients with bile duct carcinoma requires a complete and accurate cholangiographic evaluation of the morphology, location, and extent of the disease

  10. Branching processes in biology

    CERN Document Server

    Kimmel, Marek

    2015-01-01

    This book provides a theoretical background of branching processes and discusses their biological applications. Branching processes are a well-developed and powerful set of tools in the field of applied probability. The range of applications considered includes molecular biology, cellular biology, human evolution and medicine. The branching processes discussed include Galton-Watson, Markov, Bellman-Harris, Multitype, and General Processes. As an aid to understanding specific examples, two introductory chapters, and two glossaries are included that provide background material in mathematics and in biology. The book will be of interest to scientists who work in quantitative modeling of biological systems, particularly probabilists, mathematical biologists, biostatisticians, cell biologists, molecular biologists, and bioinformaticians. The authors are a mathematician and cell biologist who have collaborated for more than a decade in the field of branching processes in biology for this new edition. This second ex...

  11. Branching trajectory continual integral

    International Nuclear Information System (INIS)

    Maslov, V.P.; Chebotarev, A.M.

    1980-01-01

    Heuristic definition of the Feynman continual integral over branching trajectories is suggested which makes it possible to obtain in the closed form the solution of the Cauchy problem for the model Hartree equation. A number of properties of the solution is derived from an integral representation. In particular, the quasiclassical asymptotics, exact solution in the gaussian case and perturbation theory series are described. The existence theorem for the simpliest continual integral over branching trajectories is proved [ru

  12. Branches of the landscape

    International Nuclear Information System (INIS)

    Dine, Michael; O'Neil, Deva; Sun Zheng

    2005-01-01

    With respect to the question of supersymmetry breaking, there are three branches of the flux landscape. On one of these, if one requires small cosmological constant, supersymmetry breaking is predominantly at the fundamental scale; on another, the distribution is roughly flat on a logarithmic scale; on the third, the preponderance of vacua are at very low scale. A priori, as we will explain, one can say little about the first branch. The vast majority of these states are not accessible even to crude, approximate analysis. On the other two branches one can hope to do better. But as a result of the lack of access to branch one, and our poor understanding of cosmology, we can at best conjecture about whether string theory predicts low energy supersymmetry or not. If we hypothesize that are on branch two or three, distinctive predictions may be possible. We comment of the status of naturalness within the landscape, deriving, for example, the statistics of the first branch from simple effective field theory reasoning

  13. Adjuvant Chemoradiotherapy After Pancreatic Resection for Invasive Carcinoma Associated With Intraductal Papillary Mucinous Neoplasm of the Pancreas

    International Nuclear Information System (INIS)

    Swartz, Michael J.; Hsu, Charles C.; Pawlik, Timothy M.; Winter, Jordan; Hruban, Ralph H.; Guler, Mehmet; Schulick, Richard D.; Cameron, John L.; Laheru, Daniel A.; Wolfgang, Christopher L.; Herman, Joseph M.

    2010-01-01

    Purpose: Intraductal papillary mucinous neoplasms are mucin-producing cystic neoplasms of the pancreas. One-third are associated with invasive carcinoma. We examined the benefit of adjuvant chemoradiotherapy (CRT) for this cohort. Methods and Materials: Patients who had undergone pancreatic resection at Johns Hopkins Hospital between 1999 and 2004 were reviewed. Of these patients, 83 with a resected pancreatic mass were found to have an intraductal papillary mucinous neoplasm with invasive carcinoma, 70 of whom met inclusion criteria for the present analysis. Results: The median age at surgery was 68 years. The median tumor size was 3.3 cm, and invasive carcinoma was present at the margin in 16% of the patients. Of the 70 patients, 50% had metastases to the lymph nodes and 64% had Stage II disease. The median survival was 28.0 months, and 2- and 5-year survival rate was 57% and 45%, respectively. Of the 70 patients, 40 had undergone adjuvant CRT. Those receiving CRT were more likely to have lymph node metastases, perineural invasion, and Stage II-III disease. The 2-year survival rate after surgery with vs. without CRT was 55.8% vs. 59.3%, respectively (p = NS). Patients with lymph node metastases or positive surgical margins benefited significantly from CRT (p = .047 and p = .042, respectively). On multivariate analysis, adjuvant CRT was associated with improved survival, with a relative risk of 0.43 (95% confidence interval, 0.19-0.95; p = .044) after adjusting for major confounders. Conclusion: Adjuvant CRT conferred a 57% decrease in the relative risk of mortality after pancreaticoduodenectomy for intraductal papillary mucinous neoplasms with an associated invasive component after adjusting for major confounders. Patients with lymph node metastases or positive margins appeared to particularly benefit from CRT after definitive surgery.

  14. PATHOLOGIC EVALUATION AND REPORTING OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS (IPMNs) OF THE PANCREAS AND OTHER TUMORAL INTRAEPITHELIAL NEOPLASMS OF PANCREATOBILIARY TRACT: RECOMMENDATIONS OF VERONA CONSENSUS MEETING

    Science.gov (United States)

    Adsay, Volkan; Mino-Kenudson, Mari; Furukawa, Toru; Basturk, Olca; Zamboni, Giuseppe; Marchegiani, Giovanni; Bassi, Claudio; Salvia, Roberto; Malleo, Giuseppe; Paiella, Salvatore; Wolfgang, Christopher L.; Matthaei, Hanno; Offerhaus, G. Johan; Adham, Mustapha; Bruno, Marco J.; Reid, Michelle; Krasinskas, Alyssa; Klöppel, Günter; Ohike, Nobuyuki; Tajiri, Takuma; Jang, Kee-Taek; Roa, Juan Carlos; Allen, Peter; Castillo, Carlos Fernández-del; Jang, Jin-Young; Klimstra, David S.; Hruban, Ralph H.

    2015-01-01

    Background There are no established guidelines for pathologic diagnosis/reporting of IPMNs. Design An international multidisciplinary group brought together by the Verona Pancreas Group in Italy-2013, was tasked to devise recommendations. Results 1) Crucial to rule out invasive carcinoma with extensive (if not complete) sampling. 2) Invasive component is to be documented in a full synoptic report including its size, type, grade, stage. 3) The term “minimally invasive” should be avoided; instead, invasion size with stage and substaging of T1 (1a, b, c; ≤0.5, >0.5–≤1, >1 cm), is to be documented. 4) Largest diameter of the invasion, not the distance from the nearest duct, is to be used. 5) A category of “indeterminate/(suspicious) for invasion” is acceptable for rare cases. 6) The term “malignant” IPMN should be avoided. 7) The highest grade of dysplasia in the non-invasive component is to be documented separately. 8) Lesion size is to be correlated with imaging findings in cysts with rupture. 9) The main duct diameter, and if possible, its involvement is to be documented; however, it is not required to provide main vs branch duct classification in the resected tumor. 10) Subtyping as gastric/intestinal/pancreatobiliary/oncocytic/mixed is of value. 11) Frozen section is to be performed highly selectively, with appreciation of its shortcomings. 12) These principles also apply to other similar tumoral intraepithelial neoplasms (mucinous cystic neoplasms, intra-ampullary, intra-biliary/cholecystic). Conclusion These recommendations will ensure proper communication of salient tumor characteristics to the management teams, accurate comparison of data between analyses, and development of more effective management algorithms. PMID:25775066

  15. High-frequency data observations from space shuttle main engine low pressure fuel turbopump discharge duct flex joint tripod failure investigation

    Science.gov (United States)

    Zoladz, T. F.; Farr, R. A.

    1991-01-01

    Observations made by Marshall Space Flight Center (MSFC) engineers during their participation in the Space Shuttle Main Engine (SSME) low pressure fuel turbopump discharge duct flex joint tripod failure investigation are summarized. New signal processing techniques used by the Component Assessment Branch and the Induced Environments Branch during the failure investigation are described in detail. Moreover, nonlinear correlations between frequently encountered anomalous frequencies found in SSME dynamic data are discussed. A recommendation is made to continue low pressure fuel (LPF) duct testing through laboratory flow simulations and MSFC-managed technology test bed SSME testing.

  16. Bile Duct Adenoma with Oncocytic Features

    Directory of Open Access Journals (Sweden)

    E. J. Johannesen

    2014-01-01

    Full Text Available Bile duct adenomas are benign bile duct proliferations usually encountered as an incidental finding. Oncocytic bile duct neoplasms are rare and the majority are malignant. A 61-year-old male with a diagnosis of colorectal adenocarcinoma was undergoing surgery when a small white nodule was discovered on the surface of the right lobe of his liver. This lesion was composed of cytologically bland cells arranged in tightly packed glands. These cells were immunopositive for cytokeratin 7, negative for Hep Par 1, contained mucin, and had a Ki67 proliferation index of 8%. The morphology, immunophenotype, presence of mucin, and normal appearing bile ducts, as well as the increased Ki67 proliferation rate, were consistent with a bile duct adenoma with oxyphilic (oncocytic change. Oncocytic tumors in the liver are rare; the first described in 1992. Only two bile duct adenomas with oncocytic change have been reported and neither of them had reported mucin production or the presence of normal appearing bile ducts within the lesion.

  17. Financial Aspects of Bile Duct Injuries.

    Science.gov (United States)

    Palaz Alı, Ozgkıour; Ibis, Abdil Cem; Gurtekin, Basak

    2017-11-04

    BACKGROUND Major bile duct injury is the most worrisome complication of cholecystectomy. There is no detailed data about the incidence or treatment-related costs of bile duct injuries in Turkey. We aimed to determine prevalence and therapeutic costs of patients with major biliary duct injuries managed in our department, and further estimate a projection of these parameters at the national level. MATERIAL AND METHODS All patients admitted due to bile duct injury during cholecystectomy from 2011 to 2014 were included. Healthcare costs were calculated by summing of their all treatment-related costs in Istanbul Medical Faculty. We collected 2014-2015 data on number of patients diagnosed with cholecystitis in Turkey, the number of cholecystectomies, and the number of the interventions performed following these initial surgeries, which were obtained from the Turkish Social Security Institution. RESULTS Forty-nine patients were enrolled and bilioenteric diversion was performed in 39 patients: 20.4% of patients had Bismuth II, 38.8% had Bismuth III, and 40.8% had Bismuth IV biliary stricture. Comparison of stricture types with total costs, days of hospitalization, and outpatient clinic costs revealed significant differences. Mean total cost of corrective surgeries was 9199 TRY. We estimated that 1.5% to 2.4% of patients who underwent cholecystectomy in Turkey have bile duct injury (including 0.3% with major bile duct injury). CONCLUSIONS New preventive strategies should be used to avoid bile duct injuries, which have a huge financial impact on the national economy.

  18. Branches of the Facial Artery.

    Science.gov (United States)

    Hwang, Kun; Lee, Geun In; Park, Hye Jin

    2015-06-01

    The aim of this study is to review the name of the branches, to review the classification of the branching pattern, and to clarify a presence percentage of each branch of the facial artery, systematically. In a PubMed search, the search terms "facial," AND "artery," AND "classification OR variant OR pattern" were used. The IBM SPSS Statistics 20 system was used for statistical analysis. Among the 500 titles, 18 articles were selected and reviewed systematically. Most of the articles focused on "classification" according to the "terminal branch." Several authors classified the facial artery according to their terminal branches. Most of them, however, did not describe the definition of "terminal branch." There were confusions within the classifications. When the inferior labial artery was absent, 3 different types were used. The "alar branch" or "nasal branch" was used instead of the "lateral nasal branch." The angular branch was used to refer to several different branches. The presence as a percentage of each branch according to the branches in Gray's Anatomy (premasseteric, inferior labial, superior labial, lateral nasal, and angular) varied. No branch was used with 100% consistency. The superior labial branch was most frequently cited (95.7%, 382 arteries in 399 hemifaces). The angular branch (53.9%, 219 arteries in 406 hemifaces) and the premasseteric branch were least frequently cited (53.8%, 43 arteries in 80 hemifaces). There were significant differences among each of the 5 branches (P < 0.05) except between the angular branch and the premasseteric branch and between the superior labial branch and the inferior labial branch. The authors believe identifying the presence percentage of each branch will be helpful for surgical procedures.

  19. Variability of intraductal papillomas of the mammary gland: Clinical, roentgenologic and morphologic investigations

    International Nuclear Information System (INIS)

    Rummel, W.

    1974-01-01

    The radiodiagnostical method of choice is the galactographic technique. However, a specific X-ray image of the papilloma does not exist. The galactographic technique has to be adapted to the surgical and histologic one. Only by combining these three techniques good results can be achieved. It is not possible to draw conclusions from the colour of the pathologic discharge about the type and character of the pathologic process. Contrary to the findings documented in the literature, we were able to diagnose with our technique not only small tumours, but also tumours situated in the periphery of the lactiferous duct. Because of our investigations it is no longer possible to maintain and keep the strict division of the proliferative changes occurring at the lactiferous duct walls. In this study, the most significant morphologic results are described in detail. In all patients with pathologic discharge of the mammary gland, the so-called papillo-carcinoma was found only in one case. As clinical consequence it has therefore to be demanded that in all women with the symptom of pathologic mamillary discharge first of all the origin of this discharge has to be localised by means of galactography. Only the individual morphologic picture of a proliferative change of the lactiferous duct provides some prognostic value. The prerequisites for such an individual assessment are differentiated roentgenologic, surgical and histological techniques. (orig./MG) [de

  20. Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy.

    Science.gov (United States)

    Koch, Michael; Schapher, Mirco; Mantsopoulos, Konstantinos; von Scotti, Felix; Goncalves, Miguel; Iro, Heinrich

    2017-12-15

    To assess results after treatment of difficult/complex sialolithiasis with extracorporeal shock-wave lithotripsy (ESWL) and intraductal pneumatic lithotripsy (IPL). Retrospective study in a tertiary referral center. Altogether, 63 stones were diagnosed in 38 patients with difficult/complex sialolithiasis. Forty-nine stones were treated with fragmentation using both ESWL and IPL. Stones accessible with the sialendoscope were treated primarily with IPL in multiple sialolithiasis. Seventy-one ESWL procedures and 57 IPL were performed in our patients. Forty-nine stones were treated by 67 ESWL procedures and 52 IPL. ESWL converted sialoliths from sialendoscopically untreatable into sialendoscopically treatable cases in 94.7%; the treatment then was completed by a total of 52 IPL procedures. ESWL was performed before IPL (81.6%), in combination with IPL (7.9%) and after (10.5%). Complete fragmentation was achieved in 97.9%. Four stones each were treated with ESWL and IPL alone in multiple sialolithiasis. Altogether, 53 stones were treated by 57 IPL procedures. Complete fragmentation was achieved in 98.1% of the 53 stones. ESWL and IPL were the dominant treatment modalities in 84.1% of all 63 stones treated. Of all 38 patients, 92.1% became stone-free and all became symptom-free. All the glands were preserved. Multiple stones were treated in 34.2% of the patients; of these, 92.3% became stone-free. These results show that patients with difficult and complex sialolithiasis can be treated with high success rates of > 90% using a multimodal, minimally invasive, and gland-preserving treatment approach. ESWL and IPL played a key role in this multimodal treatment regime in > 80% of stones. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. [Salivary gland drainage into the thyroglossal duct].

    Science.gov (United States)

    Siem, G; Natvig, K; Kolbenstvedt, A; Lømo, J

    2001-01-20

    Failure in regression of the thyroglossal duct is one of the most common reasons for midline swellings in the neck. Several authors have described recurrent thyroglossal duct remnants with persisting draining sinuses. However, few have described accessory salivary glands that drain into the thyroglossal duct. In this article we report two such cases with midline salivary glands in the floor of the mouth. These two patients were subsequently successfully treated with radical tissue resection in the area between the hyoid bone and foramen cecum. Preoperative fistulography or sinography was useful to demonstrate the ductal ramification of the salivary glands, and use of methylene blue during surgery proved of significant value for the result.

  2. Cell clusters overlying focally disrupted mammary myoepithelial cell layers and adjacent cells within the same duct display different immunohistochemical and genetic features: implications for tumor progression and invasion

    International Nuclear Information System (INIS)

    Man, Yan-gao; Vinh, Tuyethoa N; Strauss, Brian L; Tai, Lisa; Barner, Ross; Vang, Russell; Saenger, Jeffrey S; Shekitka, Kris M; Bratthauer, Gary L; Wheeler, Darren T; Liang, Chang Y

    2003-01-01

    Our previous studies detected focal disruptions in myoepithelial cell layers of several ducts with carcinoma in situ. The cell cluster overlying each of the myoepithelial disruptions showed a marked reduction in or a total loss of immunoreactivity for the estrogen receptor (ER). This is in contrast to the adjacent cells within the same duct, which were strongly immunoreactive for the ER. The current study attempts to confirm and expand previous observations on a larger scale. Paraffin sections from 220 patients with ER-positive intraductal breast tumors were double immunostained with the same protocol previously used. Cross-sections of ducts lined by ≥ 40 epithelial cells were examined for myoepithelial cell layer disruptions and for ER expression. In five selected cases, ER-negative cells overlying the disrupted myoepithelial cell layer and adjacent ER-positive cells within the same duct were separately microdissected and assessed for loss of heterozygosity and microsatellite instability. Of the 220 cases with 5698 duct cross-sections examined, 94 showed disrupted myoepithelial cell layers with 405 focal disruptions. Of the 94 cases, 79 (84%) contained only ER-negative cell clusters, nine (9.6%) contained both ER-negative and ER-positive cell clusters, and six (6.4%) contained only ER-positive cell clusters overlying disrupted myoepithelial cell layers. Of the 405 disruptions, 350 (86.4%) were overlain by ER-negative cell clusters and 55 (13.6%) were overlain by ER-positive cell clusters (P < 0.01). Microdissected ER-negative and ER-positive cells within the same duct from all five selected cases displayed a different frequency or pattern of loss of heterozygosity and/or microsatellite instability at 10 of the 15 DNA markers. Cells overlying focally disrupted myoepithelial layers and their adjacent counterparts within the same duct displayed different immunohistochemical and molecular features. These features potentially represent an early sign of the formation

  3. VD-411 branch driver

    International Nuclear Information System (INIS)

    Gorbunov, N.V.; Karev, A.G.; Mal'tsev, Eh.I.; Morozov, B.A.

    1985-01-01

    The VD-411 branch driver for CAMAC moduli control by the SM-4 computer is described. The driver realizes data exchange with moduli disposed in 28 crates grouped in 4 branches. Data exchange can be carried out either in the program regime or in the regime of direct access to the memory. Fulfilment of 11 block regimes and one program regime is provided for. A possibility of individual programming of exchange methods in block regimes is left for users for organisation of quicker and most flexible data removal from the CAMAC moduli. In the regime of direct access the driver provides data transmission at the size up to 64 Kwords placing it in the computer memory of 2 M byte. High rate of data transmission and the developed system of interruptions ensure efficient utilization of the VD-411 branch driver at data removal from facilities in high energy physics experiments

  4. Reference values of MRI measurements of the common bile duct and pancreatic duct in children

    Energy Technology Data Exchange (ETDEWEB)

    Gwal, Kriti; Bedoya, Maria A.; Patel, Neal; Darge, Kassa; Anupindi, Sudha A. [University of Pennsylvania Perelman School of Medicine, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Rambhatla, Siri J. [Beth Israel Medical Center, Department of Pediatrics, Newark, NJ (United States); Sreedharan, Ram R. [University of Pennsylvania, Departments of Gastroenterology, Hepatology and Nutrition, The Children' s Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, PA (United States)

    2015-08-15

    Magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) is now an essential imaging modality for the evaluation of biliary and pancreatic pathology in children, but there are no data depicting the normal diameters of the common bile duct (CBD) and pancreatic duct. Recognition of abnormal duct size is important and the increasing use of MRCP necessitates normal MRI measurements. To present normal MRI measurements for the common bile duct and pancreatic duct in children. In this retrospective study we searched all children ages birth to 10 years in our MR urography (MRU) database from 2006 until 2013. We excluded children with a history of hepatobiliary or pancreatic surgery. We stratified 204 children into five age groups and retrospectively measured the CBD and the pancreatic duct on 2-D axial and 3-D coronal T2-weighted sequences. We performed statistical analysis, using logistic and linear regressions to detect the age association of the visibility and size of the duct measurements. We used non-parametric tests to detect gender and imaging plane differences. Our study included 204 children, 106 (52%) boys and 98 (48%) girls, with a median age of 33 months (range 0-119 months). The children were distributed into five age groups. The common bile duct was visible in all children in all age groups. The pancreatic duct was significantly less visible in the youngest children, group 1 (54/67, 80.5%; P = 0.003) than in the oldest children, group 5 (22/22, 100%). In group 2 the pancreatic duct was seen in 19/21 (90.4%), in group 3 52/55 (94.5%), and in group 4 39/39 (100%). All duct measurements increased with age (P < 0.001; r-value > 0.423), and the incremental differences between ages were significant. The measurement variations between the axial and coronal planes were statistically significant (P < 0.001); however these differences were fractions of millimeters. For example, in group 1 the mean coronal measurement of the CBD was 2.1 mm and the axial

  5. Reference values of MRI measurements of the common bile duct and pancreatic duct in children

    International Nuclear Information System (INIS)

    Gwal, Kriti; Bedoya, Maria A.; Patel, Neal; Darge, Kassa; Anupindi, Sudha A.; Rambhatla, Siri J.; Sreedharan, Ram R.

    2015-01-01

    Magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) is now an essential imaging modality for the evaluation of biliary and pancreatic pathology in children, but there are no data depicting the normal diameters of the common bile duct (CBD) and pancreatic duct. Recognition of abnormal duct size is important and the increasing use of MRCP necessitates normal MRI measurements. To present normal MRI measurements for the common bile duct and pancreatic duct in children. In this retrospective study we searched all children ages birth to 10 years in our MR urography (MRU) database from 2006 until 2013. We excluded children with a history of hepatobiliary or pancreatic surgery. We stratified 204 children into five age groups and retrospectively measured the CBD and the pancreatic duct on 2-D axial and 3-D coronal T2-weighted sequences. We performed statistical analysis, using logistic and linear regressions to detect the age association of the visibility and size of the duct measurements. We used non-parametric tests to detect gender and imaging plane differences. Our study included 204 children, 106 (52%) boys and 98 (48%) girls, with a median age of 33 months (range 0-119 months). The children were distributed into five age groups. The common bile duct was visible in all children in all age groups. The pancreatic duct was significantly less visible in the youngest children, group 1 (54/67, 80.5%; P = 0.003) than in the oldest children, group 5 (22/22, 100%). In group 2 the pancreatic duct was seen in 19/21 (90.4%), in group 3 52/55 (94.5%), and in group 4 39/39 (100%). All duct measurements increased with age (P < 0.001; r-value > 0.423), and the incremental differences between ages were significant. The measurement variations between the axial and coronal planes were statistically significant (P < 0.001); however these differences were fractions of millimeters. For example, in group 1 the mean coronal measurement of the CBD was 2.1 mm and the axial

  6. Transmission of wave energy in curved ducts

    Science.gov (United States)

    Rostafinski, W.

    1973-01-01

    A formation of wave energy flow was developed for motion in curved ducts. A parametric study over a range of frequencies determined the ability of circular bends to transmit energy for the case of perfectly rigid walls.

  7. Submandibular duct sialolithiasis an unusual presentation

    International Nuclear Information System (INIS)

    Shafi, M.; Jafferi, S.; Jafferi, S.

    2006-01-01

    Multiple calculi in a submandibular gland duct is an uncommon occurrence. One such case occurring in a young boy of 25 years is reported here where thirteen very small stones of 1-3 mm of maximum diameter were lined up in the Wharton's duct in such a way that they were difficult to appreciate on inspection and palpation. Successful exploration was done in two steps. (author)

  8. Hollow-duct radiation delivery system investigation

    Directory of Open Access Journals (Sweden)

    Kramer D.

    2013-05-01

    Full Text Available Investigation of hollow-duct structure for high-power laser-diode-array radiation delivery into the end-pumped large-aperture gain media is reported. A ray tracing method has been used to evaluate the performance of the structure designed for maximum transmission efficiency and output beam profile homogeneity. Variable hollow-duct lengths as well as emanating angles of laser-diode-array have been taken into account.

  9. Intraductal papillary components in invasive ductal carcinoma of the pancreas are associated with long-term survival of patients.

    Science.gov (United States)

    Fukushima, N; Sakamoto, M; Mukai, K; Kanai, Y; Shimada, K; Kosuge, T; Hirohashi, S

    2001-08-01

    Most patients with pancreatic ductal carcinoma have a poor prognosis. However, in certain cases, 5-year survival can be achieved after surgical resection. Analysis of the pathologic findings associated with good survival rates will assist in identifying the optimum treatment. The clinicopathologic features of 67 patients who underwent surgical resection of ductal adenocarcinoma of the pancreas between 1990 and 1996 were reviewed and correlated with survival rates. There were 42 men and 25 women, with a mean age of 62.1 years (range, 44 to 82 years). The mean greatest diameter of the tumor was 4.3 cm (range, 1.5 to 11 cm). Nineteen patients (29.4%) survived more than 3 years, and 9 (13.2%) survived more than 5 years after surgical resection. The intraductal papillary component (IDPC) of the carcinoma was the main focus of the pathologic observations. IDPC was defined as intraductal papillary proliferative lesions seen in the tumor nodule with proliferative cells consistent with carcinomatous cellular atypia. IDPC was clearly present (++) in 24 patients and vaguely present (+) in 9 patients. Using the Mantel-Cox test, a statistically significant correlation was found between the presence of IDPC (either + or ++) and postoperative patient survival (P =.002). IDPC is a morphologic feature associated with longer patient survival and should be taken into consideration in assessing the pathway of tumor progression.

  10. Breast Intraductal Papillomas without Atypia in Radiologic-Pathologic Concordant Core Needle Biopsies: Predictors of Upgrade to Carcinoma at Excision

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana; Brennan, Sandra; Murray, Melissa P.; Bowser, Zenica; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth; Brogi, Edi

    2016-01-01

    Background The surgical management of breast intraductal papilloma without atypia (IDP) identified at core needle biopsy (CNB) is controversial. We assessed the rate of upgrade to carcinoma at surgical excision, and identified parameters predictive of upgrade. Methods We identified women with CNB diagnosis of intraductal papilloma without atypia or carcinoma at our center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. We correlated the radiologic and clinicopathologic features of patients with CNB diagnosis of IDP with upgrade to carcinoma at surgical excision. Results Our study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent excision. The upgrade rate was 2.3% (4/171). The upgrade lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥8 mm away. Twenty-four women (25 IDPs) did not undergo excision, and had stable imaging at follow-up (median of 23.5 months). Conclusions The upgrade rate at excision of IDP diagnosed at CNB with radiologic-pathologic concordance is 2.3%. Our findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. PMID:27315013

  11. A Comparison of Simulation Capabilities for Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Miller, William A [ORNL; Smith, Matt K [ORNL; Gu, Lixing [Florida Solar Energy Center (FSEC); New, Joshua Ryan [ORNL

    2014-11-01

    Typically, the cheapest way to install a central air conditioning system in residential buildings is to place the ductwork in the attic. Energy losses due to duct-attic interactions can be great, but current whole-house models are unable to capture the dynamic multi-mode physics of the interactions. The building industry is notoriously fragmented and unable to devote adequate research resources to solve this problem. Builders are going to continue to put ducts in the attic because floor space is too expensive to closet them within living space, and there are both construction and aesthetic issues with other approaches such as dropped ceilings. Thus, there is a substantial need to publicly document duct losses and the cost of energy used by ducts in attics so that practitioners, builders, homeowners and state and federal code officials can make informed decisions leading to changes in new construction and additional retrofit actions. Thus, the goal of this study is to conduct a comparison of AtticSim and EnergyPlus simulation algorithms to identify specific features for potential inclusion in EnergyPlus that would allow higher-fidelity modeling of HVAC operation and duct transport of conditioned air. It is anticipated that the resulting analysis from these simulation tools will inform energy decisions relating to the role of ducts in future building energy codes and standards.

  12. Tracheobronchial Branching Anomalies

    International Nuclear Information System (INIS)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick; Park, A Young

    2010-01-01

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  13. Intermittency in branching models

    International Nuclear Information System (INIS)

    Chiu, C.B.; Texas Univ., Austin; Hwa, R.C.; Oregon Univ., Eugene

    1990-01-01

    The intermittency properties of three branching models have been investigated. The factorial moments show power-law behavior as function of small rapidity width. The slopes and energy dependences reveal different characteristics of the models. The gluon model has the weakest intermittency. (orig.)

  14. State-set branching

    DEFF Research Database (Denmark)

    Jensen, Rune Møller; Veloso, Manuela M.; Bryant, Randal E.

    2008-01-01

    In this article, we present a framework called state-set branching that combines symbolic search based on reduced ordered Binary Decision Diagrams (BDDs) with best-first search, such as A* and greedy best-first search. The framework relies on an extension of these algorithms from expanding a sing...

  15. Tracheobronchial Branching Anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of); Park, A Young [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2010-04-15

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  16. Does Ultrasound-Guided Directional Vacuum-Assisted Removal Help Eliminate Abnormal Nipple Discharge in Patients with Benign Intraductal Single Mass?

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min; Cho, Na Ri Ya; Moon, Woo Kyung [Seoul National University Hospital, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University Hospital, Seoul (Korea, Republic of); Chung, Se Yeong [Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Jang, Mi Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2009-12-15

    To evaluate whether the removal of an intraductal mass using an ultrasound (US)-guided directional vacuum-assisted device can eliminate symptoms in patients presenting with abnormal nipple discharge. Between March 2004 and October 2006, 36 patients who presented with abnormal nipple discharge, underwent US-guided, 11-gauge vacuum-assisted biopsy for a benign intraductal single mass on US. The ability of the procedure to eliminate nipple discharge was evaluated by physical examination during follow-up US. Lesion characteristics, biopsy variables, and histologic features were analyzed to identify factors affecting symptom resolution. Of the 36 lesions, 25 (69%) were intraductal papillomas, 10 (28%) were fibrocystic changes, and one (3%) was a fibroadenoma. The nipple discharge disappeared in 69% (25 of 36) of the women at a mean follow-up time of 25 months (range 12-42 month). There was no difference in the lesion characteristics, biopsy variables, and the histologic features between groups that eliminated the symptom compared those with persistent nipple discharge. US-guided directional vacuum-assisted removal of an intraductal mass appears to eliminate nipple discharge in only 69% of patients and thus, it should not be considered as an alternative to surgical excision.

  17. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    International Nuclear Information System (INIS)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun; Kim, Eun Kyung

    2000-01-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  18. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    International Nuclear Information System (INIS)

    Wu, Tian-tian; Li, Wei-min; Li, Hu-cheng; Ao, Guo-kun; Zheng, Fang; Lin, Hu

    2017-01-01

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  19. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com [The 307th Hospital of PLA, General Surgery Department (China); Ao, Guo-kun, E-mail: guokun-ao-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China); Zheng, Fang, E-mail: fang-zheng-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Lin, Hu, E-mail: hu-lin-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China)

    2017-02-15

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  20. A radiographic study of nasopalatine duct cysts

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Chan Duck; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral Radiology, College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    1993-02-15

    The purpose of this study was to evaluate the clinical and radiographic features of 35 cases of nasopalatine duct cyst by means of the analysis of periapical and/or occlusal radiograms in 35 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chonbuk National University. The obtained results were as follows: 1. The incidence of nasopalatine duct cysts was higher in males (74.3%) than in females (25.7%). 2. The nasopalatine duct cysts were the most frequently occurred in the 4th decades (34.3%). The 6th and 7th decades (17.1%, 17.1%) were next in order to frequency followed by the 5th decades (14.3%), the 3rd decades (8.6%), the 2nd decades (5.7%), and 8th decades (2.9%). 3. In the signs and symptoms of nasopalatine duct cysts, 25.7% were swelling, 17.1% were swelling and tenderness, 20.0% were swelling and pain, and 37.2% were a symptom. 4. In the shape of nasopalatine duct cysts, 40.0% were round type, 48.6% 11.8% were heart type. 5. In symmetry of the nasopalatine duct cysts, 11.4% were 6-10 mm, 48.6% were 11-20 mm, 25.7% were 21-30 mm, and 14.3% were 31-40 mm. 6. In the periphery of nasopalatine duct cysts, 82.9% were distinct, 17.1% were relatively distinct. 7. In the change of root, 51.5% were intact, 17.1% were root divergence, 20.0% were root resorption, and 11.4% were root divergence and resorption.

  1. A radiographic study of nasopalatine duct cysts

    International Nuclear Information System (INIS)

    Jun, Chan Duck; Hwang, Eui Hwan; Lee, Sang Rae

    1993-01-01

    The purpose of this study was to evaluate the clinical and radiographic features of 35 cases of nasopalatine duct cyst by means of the analysis of periapical and/or occlusal radiograms in 35 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chonbuk National University. The obtained results were as follows: 1. The incidence of nasopalatine duct cysts was higher in males (74.3%) than in females (25.7%). 2. The nasopalatine duct cysts were the most frequently occurred in the 4th decades (34.3%). The 6th and 7th decades (17.1%, 17.1%) were next in order to frequency followed by the 5th decades (14.3%), the 3rd decades (8.6%), the 2nd decades (5.7%), and 8th decades (2.9%). 3. In the signs and symptoms of nasopalatine duct cysts, 25.7% were swelling, 17.1% were swelling and tenderness, 20.0% were swelling and pain, and 37.2% were a symptom. 4. In the shape of nasopalatine duct cysts, 40.0% were round type, 48.6% 11.8% were heart type. 5. In symmetry of the nasopalatine duct cysts, 11.4% were 6-10 mm, 48.6% were 11-20 mm, 25.7% were 21-30 mm, and 14.3% were 31-40 mm. 6. In the periphery of nasopalatine duct cysts, 82.9% were distinct, 17.1% were relatively distinct. 7. In the change of root, 51.5% were intact, 17.1% were root divergence, 20.0% were root resorption, and 11.4% were root divergence and resorption.

  2. Main Bile Duct Stricture Occurring After Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Nakashima, Yoshiko; Ikeno, Hiroshi; Orito, Nobuaki; Notsumata, Kazuo; Watanabe, Hiroyuki; Toya, Daisyu; Tanaka, Nobuyoshi; Matsui, Osamu

    2010-01-01

    The purpose of this study was to evaluate the clinical course of main bile duct stricture at the hepatic hilum after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Among 446 consecutive patients with HCC treated by TACE, main bile duct stricture developed in 18 (4.0%). All imaging and laboratory data, treatment course, and outcomes were retrospectively analyzed. All patients had 1 to 2 tumors measuring 10 to 100 mm in diameter (mean ± SD 24.5 ± 5.4 mm) near the hepatic hilum fed by the caudate arterial branch (A1) and/or medial segmental artery (A4) of the liver. During the TACE procedure that caused bile duct injury, A1 was embolized in 8, A4 was embolized in 5, and both were embolized in 5 patients. Nine patients (50.0%) had a history of TACE in either A1 or A4. Iodized oil accumulation in the bile duct wall was seen in all patients on computed tomography obtained 1 week later. Bile duct dilatation caused by main bile duct stricture developed in both lobes (n = 9), in the right lobe (n = 3), in the left lobe (n = 4), in segment (S) 2 (n = 1), and in S3 (n = 1). Serum levels of alkaline phosphatase and γ-glutamyltranspeptidase increased in 13 patients. Biloma requiring drainage developed in 2 patients; jaundice developed in 4 patients; and metallic stents were placed in 3 patients. Complications after additional TACE sessions, including biloma (n = 3) and/or jaundice (n = 5), occurred in 7 patients and were treated by additional intervention, including metallic stent placement in 2 patients. After initial TACE of A1 and/or A4, 8 patients (44.4%), including 5 with uncontrollable jaundice or cholangitis, died at 37.9 ± 34.9 months after TACE, and 10 (55.6%) have survived for 38.4 ± 37.9 months. Selective TACE of A1 and/or A4 carries a risk of main bile duct stricture at the hepatic hilum. Biloma and jaundice are serious complications associated with bile duct strictures.

  3. Branching structure and strain hardening of branched metallocene polyethylenes

    International Nuclear Information System (INIS)

    Torres, Enrique; Li, Si-Wan; Costeux, Stéphane; Dealy, John M.

    2015-01-01

    There have been a number of studies of a series of branched metallocene polyethylenes (BMPs) made in a solution, continuous stirred tank reactor (CSTR) polymerization. The materials studied vary in branching level in a systematic way, and the most highly branched members of the series exhibit mild strain hardening. An outstanding question is which types of branched molecules are responsible for strain hardening in extension. This question is explored here by use of polymerization and rheological models along with new data on the extensional flow behavior of the most highly branched members of the set. After reviewing all that is known about the effects of various branching structures in homogeneous polymers and comparing this with the structures predicted to be present in BMPs, it is concluded that in spite of their very low concentration, treelike molecules with branch-on-branch structure provide a large number of deeply buried inner segments that are essential for strain hardening in these polymers

  4. Branching structure and strain hardening of branched metallocene polyethylenes

    Energy Technology Data Exchange (ETDEWEB)

    Torres, Enrique; Li, Si-Wan; Costeux, Stéphane; Dealy, John M., E-mail: john.dealy@mcgill.ca [Department of Chemical Engineering, McGill University, Montreal, Quebec H3A 0C4 (Canada)

    2015-09-15

    There have been a number of studies of a series of branched metallocene polyethylenes (BMPs) made in a solution, continuous stirred tank reactor (CSTR) polymerization. The materials studied vary in branching level in a systematic way, and the most highly branched members of the series exhibit mild strain hardening. An outstanding question is which types of branched molecules are responsible for strain hardening in extension. This question is explored here by use of polymerization and rheological models along with new data on the extensional flow behavior of the most highly branched members of the set. After reviewing all that is known about the effects of various branching structures in homogeneous polymers and comparing this with the structures predicted to be present in BMPs, it is concluded that in spite of their very low concentration, treelike molecules with branch-on-branch structure provide a large number of deeply buried inner segments that are essential for strain hardening in these polymers.

  5. The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.

  6. ITER L 6 equatorial maintenance duct remote handling study

    International Nuclear Information System (INIS)

    Millard, J.

    1996-09-01

    The status and conclusions of a preliminary study of equatorial maintenance duct remote handling is reported. Due to issues with the original duct design a significant portion of the study had to be refocused on equatorial duct layout studies. The study gives an overview of some of the options for design of these ducts and the impact of the design on the equipment to work in the duct. To develop a remote handling concept for creating access through the ducts the following design tasks should be performed: define the operations sequences for equatorial maintenance duct opening and closing; review the remote handling requirements for equatorial maintenance duct opening and closing; design concept for door and pipe handling equipment and to propose preliminary procedures for material handling outsides the duct. 35 figs

  7. Right bundle branch block

    DEFF Research Database (Denmark)

    Bussink, Barbara E; Holst, Anders Gaarsdal; Jespersen, Lasse

    2013-01-01

    AimsTo determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population.Methods and resultsWe followed 18 441 participants included...... in the Copenhagen City Heart Study examined in 1976-2003 free from previous myocardial infarction (MI), chronic heart failure, and left bundle branch block through registry linkage until 2009 for all-cause mortality and cardiovascular outcomes. The prevalence of RBBB/IRBBB was higher in men (1.4%/4.7% in men vs. 0.......5%/2.3% in women, P block was associated with significantly...

  8. Generalized Markov branching models

    OpenAIRE

    Li, Junping

    2005-01-01

    In this thesis, we first considered a modified Markov branching process incorporating both state-independent immigration and resurrection. After establishing the criteria for regularity and uniqueness, explicit expressions for the extinction probability and mean extinction time are presented. The criteria for recurrence and ergodicity are also established. In addition, an explicit expression for the equilibrium distribution is presented.\\ud \\ud We then moved on to investigate the basic proper...

  9. Tau leptonic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Garrido, L; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Montret, J C; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    A sample of 62249 \\tau-pair events is selected from data taken with the ALEPH detector in 1991, 1992 and 1993. The measurement of the branching fractions for \\tau decays into electrons and muons is presented with emphasis on the study of systematic effects from selection, particle identification and decay classification. Combined with the most recent ALEPH determination of the \\tau lifetime, these results provide a relative measurement of the leptonic couplings in the weak charged current for transverse W bosons.

  10. Characterization of flow in a scroll duct

    Science.gov (United States)

    Begg, E. K.; Bennett, J. C.

    1985-01-01

    A quantitative, flow visualization study was made of a partially elliptic cross section, inward curving duct (scroll duct), with an axial outflow through a vaneless annular cutlet. The working fluid was water, with a Re(d) of 40,000 at the inlet to the scroll duct, this Reynolds number being representative of the conditions in an actual gas turbine scroll. Both still and high speed moving pictures of fluorescein dye injected into the flow and illuminated by an argon ion laser were used to document the flow. Strong secondary flow, similar to the secondary flow in a pipe bend, was found in the bottom half of the scroll within the first 180 degs of turning. The pressure field set up by the turning duct was strong enough to affect the inlet flow condition. At 90 degs downstream, the large scale secondary flow was found to be oscillatory in nature. The exit flow was nonuniform in the annular exit. By 270 degs downstream, the flow appeared unorganized with no distinctive secondary flow pattern. Large scale structures from the upstream core region appeared by 90 degs and continued through the duct to reenter at the inlet section.

  11. Squamous metaplasia of lactiferous ducts (SMOLD)

    International Nuclear Information System (INIS)

    Lo, G.; Dessauvagie, B.; Sterrett, G.; Bourke, A.G.

    2012-01-01

    The aim of this review is to illustrate the mammographic and sonographic appearances of squamous metaplasia of the lactiferous ducts (SMOLD) and to discuss the disease processes of this uncommon breast disease, which shows a strong correlation with smoking. The most common mammographic appearance is of a retro-areolar asymmetrical density. Ultrasonography of the symptomatic breast typically shows a retro-areolar, predominately medial, ill-defined, hypoechoic lesion with either abscess or sinus/fistula formation. Duct dilatation and continuity with lactiferous ducts is commonly seen. Increased vascularity is occasionally seen on colour Doppler ultrasound. Pathology tissue confirmation is always required and this can be by histology of a core biopsy or excision specimen, or fine-needle aspiration (FNA) cytology. Occasionally smears of an associated abundant nipple or sinus discharge may be of value.

  12. Salivary duct carcinoma: a Danish national study

    DEFF Research Database (Denmark)

    Breinholt, Helle; Elhakim, Mohammad Talal; Godballe, Christian

    2016-01-01

    BACKGROUND: To present the first national series of salivary duct carcinoma patients, including survival rates and an analysis of prognostic factors. METHODS: By merging three Danish nationwide registries that encompass an entire population, 34 patients diagnosed with salivary duct carcinoma from......-rank test. RESULTS: Salivary duct carcinoma showed an incidence of 0.04/100.000 inhabitants/year. Distant recurrence was seen in 52% of patients. Five-year overall survival, disease-specific survival and recurrence-free survival were 32%, 42% and 35%, respectively. Univariate analyses suggested that overall...... carcinoma incidence averages to two episodes per year in the entire Kingdom of Denmark. With half of patients in this study experiencing distant recurrences and only a third surviving at 5 years, prognosis is dismal. Advanced overall stage, vascular invasion and involved resection margins all seem...

  13. Combination of Juvenile Papillomatosis, Juvenile Fibroadenoma and Intraductal Carcinoma of the Breast in a 15-Year-old Girl.

    Science.gov (United States)

    Sedloev, Theophil; Bassarova, Assia; Angelov, Kostadin; Vasileva, Mariela; Asenov, Yavor

    2015-09-01

    The association of juvenile papillomatosis with carcinoma is proven, but very rare, as there exist several reported cases. A 15-year-old girl with no family history of breast cancer presented with two masses in the left breast. The excisional biopsy on both lumps revealed juvenile fibroadenoma and juvenile papillomatosis epithelial proliferation multiple cystic expanded channels. In some of these channels, cytological features of intraductal carcinoma were observed. We performed a full immunohistochemical examination of the juvenile papillomatosis. The patient refused any further surgical or adjuvant treatment. There are no signs of recurrence in the 15 year follow-up. This case is a diagnostic and therapeutic challenge, taking into account the patient's age and the controversial treatment recommendations. Good collaboration between surgeons and pathologists is essential for an accurate diagnostic process and aims to avoid under- or overtreatment. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  14. Evaluation of PEGIT duct connection system

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Iain S.; Brenner, Douglas E.; Sherman, Max H.; Dickerhoff, Darryl J.

    2003-08-01

    Most air duct system components are assembled in the field and are mechanically fastened by sheet metal screws (for sheet metal-to-sheet metal) or by drawbands (for flex duct-to-sheet metal). Air sealing is separate from this mechanical fastening and is usually achieved using tape or mastic products after mechanical fastening. Field observations have shown that mechanical fastening rarely meets code or manufacturers requirements and that sealing procedures are similarly inconsistent. To address these problems, Proctor Engineering Group (PEG) is developing a system of joining ducts (called PEGIT) that combines the mechanical fastening and sealing into a single self-contained procedure. The PEGIT system uses a shaped flexible seal between specially designed sheet metal duct fittings to both seal and fasten duct sections together. Figure 1 shows the inner duct fitting complete with rubber seal. This seal provides the air seal for the completed fitting and is shaped to allow the inner and outer fittings to slide together, and then to lock the fittings in place. The illustration in Figure 2 shows the approximate cross section of the rubber seal that shows how the seal has a lip that is angled backwards. This angled lip allows the joint to be pushed together by folding flat but then its long axis makes it stiff in the pulling apart direction. This study was undertaken to assist PEG in some of the design aspects of this system and to test the performance of the PEGIT system. This study was carried out in three phases. The initial phase evaluated the performance of a preliminary seal design for the PEGIT system. After the first phase, the seal was redesigned and this new seal was evaluated in the second phase of testing. The third phase performed more detailed testing of the second seal design to optimize the production tolerances of the sheet metal fittings. This report summarizes our findings from the first two phases and provides details about the third phase of testing.

  15. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  16. Fluid flow in a spiral microfluidic duct

    Science.gov (United States)

    Harding, Brendan; Stokes, Yvonne

    2018-04-01

    We consider the steady, pressure driven flow of a viscous fluid through a microfluidic device having the geometry of a planar spiral duct with a slowly varying curvature and height smaller than width. For this problem, it is convenient to express the Navier-Stokes equations in terms of a non-orthogonal coordinate system. Then, after applying appropriate scalings, the leading order equations admit a relatively simple solution in the central region of the duct cross section. First-order corrections with respect to the duct curvature and aspect ratio parameters are also obtained for this region. Additional correction terms are needed to ensure that no slip and no penetration conditions are satisfied on the side walls. Our solutions allow for a top wall shape that varies with respect to the radial coordinate which allows us to study the flow in a variety of cross-sectional shapes, including trapezoidal-shaped ducts that have been studied experimentally. At leading order, the flow is found to depend on the local height and slope of the top wall within the central region. The solutions are compared with numerical approximations of a classical Dean flow and are found to be in good agreement for a small duct aspect ratio and a slowly varying and small curvature. We conclude that the slowly varying curvature typical of spiral microfluidic devices has a negligible impact on the flow in the sense that locally the flow does not differ significantly from the classical Dean flow through a duct having the same curvature.

  17. The Canadian residential duct and chimney survey

    Energy Technology Data Exchange (ETDEWEB)

    Fugler, D.

    2003-12-01

    A study was conducted in 1989 to better understand the thermal performance of ducts and chimneys in houses. The objective was to address the problems associated with insufficient airflow and backdrafting of combustion gases resulting from malfunctioning fans, furnaces and fireplaces. The Duct Test Rig was used to measure and recorded airflows and heat losses in a variety of ducts and chimneys in a representative mix of houses in Vancouver, Kelowna, Winnipeg, Calgary, Toronto, London, Montreal, Quebec City, Halifax, Fredericton and Ottawa. Bath, kitchen, clothes dryer and central vacuum exhaust fans were tested to determine how performance is affected by fan age, accumulations of dust, grease, bugs and installation methods. Results indicate that there is no statistical difference between axial or centrifugal fans. The greatest problem appeared to be with low flows, high leakage rates, and poor conditions of bathroom fans. Many kitchen fans were found to be blocked at the inlet by cooking grease. The exhaust flows depended greatly on the condition of the backdraft damper. Dryer exhaust airflow was typically less than the 75 L/s specified by manufacturers, but even old dryers performed relatively well. All types of chimneys were tested for different positive hood pressures, airflow lost through leakage, and thermal characteristics. Airflow was found to vary depending on the type and area of the flue and the presence of a cap. For heating systems, the low duct efficiency was due mostly to duct leakage, radiation losses and restrictive ducts and registers. The findings of this testing program are still valid today. 3 tabs.

  18. Usefulness of breast MRI for diagnosing an extensive intraductal component of breast cancer: comparison with mammography and ultrasonography

    International Nuclear Information System (INIS)

    Kim, Tae Hee; Kang, Doo Kyung; Jung, Yong Sik; Yim, Hyun Ee

    2006-01-01

    An extensive intraductal component of breast cancer is a principal risk factor for local recurrence, and this is difficult to diagnose with performing only mammography. We investigated the usefulness of breast MRI for evaluating an extensive intraductal component of breast cancer, and we compared this modality with mammography and ultrasonography (US). From March 2003 to July 2004, 90 patients underwent breast MRI among all the patients who were suffering with breast cancer and for whom and EIC was ultimately revealed to be present or not. A total 83 patients with stage I and II breast cancer were finally included in this study. EIC positivity was defined according to the imaging data as follows: 1) microcalcifications beyond the tumor shadow or malignant microcalcifications without a tumor mass on mammography, 2) tubular hypoechoic structures adjacent to the tumor or architectural distortion with calcifications beyond the tumor on US, and 3) linear or ductal enhancement, segmental or regional clumped enhancement, and spotty nodular or reticular enhancement adjacent to the tumor on MRI. EIC was present in 41 patients and this finding was negative in 42 patients. The results were then compared those results from mammography and US. The sensitivities of detecting EIC by mammography, US and MRI were 48.6%, 67.5% and 80.5%, respectively, and the corresponding specificities were 92.3%, 73.2% and 69.0%, respectively. In the cases that were suspected to be EIC positive on more than two imaging modality, the positive predictive value (PPV) was 78.1%. In cases that were suspected of being EIC positive on just one imaging modality, the negative predictive value (NPV) was 75.0%. Breast MRI provides good information about an EIC of breast cancer and it is a more sensitive study than mammography and US, yet the specificity for the detection of EIC is highest on mammography. A combined evaluation by mammography, US and MRI is the most accurate way to diagnose an EIC of breast

  19. Bundle duct interaction studies for fuel assemblies

    International Nuclear Information System (INIS)

    Hsia, H.T.S.; Kaplan, S.

    1981-06-01

    It is known that the wire-wrapped rods and duct in an LMFBR are undergoing a gradual structural distortion from the initially uniform geometry under the combined effects of thermal expansion and irradiation induced swelling and creep. These deformations have a significant effect on flow characteristics, thus causing changes in thermal behavior such as cladding temperature and temperature distribution within a bundle. The temperature distribution may further enhance or retard irradiation induced deformation of the bundle. This report summarizes the results of the continuing effort in investigating the bundle-duct interaction, focusing on the need for the large development plant

  20. Acoustic power balance in lined ducts

    Science.gov (United States)

    Eversman, W.

    1979-01-01

    It is shown that the two common definitions of acoustic energy density and intensity in uniform unlined ducts carrying uniform flow are compatible to the extent that both energy densities can be used in an appropriate variational principle to derive the convected wave equation. When the duct walls are lined both energy densities must be modified to account for the wall energy density. This results in a new energy conservation equation which utilizes a modified definition of axial power and accounts for wall dissipation. Computations in specific cases demonstrate the validity of the modified acoustic energy relation.

  1. The branch librarians' handbook

    CERN Document Server

    Rivers, Vickie

    2004-01-01

    ""Recommended""--Booklist; ""an excellent addition...highly recommended""--Public Libraries; ""clear...very sound advice...strongly recommend""--Catholic Library World; ""excellent resource...organized...well written""--Against the Grain; ""interesting...thoroughly practical...a very good book...well organized...clearly written""--ARBA. This handbook covers a wide variety of issues that the branch librarian must deal with every day. Chapters are devoted to mission statements (the Dallas Public Library and Dayton Metro Library mission statements are highlighted as examples), library systems,

  2. CASE REPORTS Thyroglossal duct cyst in adult Nigerians: a report ...

    African Journals Online (AJOL)

    MacBook

    Thyroglossal duct cyst (TGDC) is the most common paediatric midline neck lesion. It is rare ... modified Sistrunk's operation and histology confirmed the diagnosis of thyroglossal cyst. ... surgical procedure for the treatment of thyroglossal duct ...

  3. Liver and Bile Duct Cancer—Health Professional Version

    Science.gov (United States)

    Liver cancer includes two major types: hepatocellular carcinoma (HCC) and intrahepatic bile duct cancer, also known as cholangiocarcinoma. Find evidence-based information on liver and bile duct cancer treatment, causes and prevention, screening, research, genomics and statistics.

  4. New concept of the buildup factor in bent ducts

    International Nuclear Information System (INIS)

    Faik Ouahab, Z.; Jehouani, A.; Groetz, J.-E.

    2011-01-01

    A major problem confronting the radiation shielding designer is the accurate determination of neutron streaming through various penetrations in walls, ducts and mazes. The previous studies on neutron transmission were performed through empty ducts. The aim of this work is to evaluate the neutron transmission probability through a filled bent duct and the proposition of a new concept of the buildup factor for neutrons in multilegged ducts. An angular biaising technique is used in the Monte Carlo simulations to accelerate the calculation convergence. Results are first compared with those obtained by the MCNPX code. For an empty bent duct, the neutron transmission is only due to the neutron reflection on the duct wall. For a filled duct, the major contribution is due to the scattering on the atoms filling the duct.

  5. Solitary intrahepatic bile-duct cyst presenting with Jaundice

    International Nuclear Information System (INIS)

    Park, Jeong Mi; Chun, Ki Sung; Ha, Hyun Kwon; Shinn, Kyung Sub; Bahk, Yong Whee; Kim, Jun Gi

    1989-01-01

    Caroli's disease is an uncommon condition, and characterized by congenital segmental saccular dilatation of intrahepatic bile ducts. A case of Caroli's disease, manifested by only a large communicating cystic dilatation of left intrahepatic bile duct and causing extrinsic pressure over the extrahepatic bile duct, is presented. The patient was 43-year-old housewife, hospitalized because of abdominal distension and severe jaundice. To relieve jaundice and alleviate surgical intervention, percutaneous drainage of the bile-duct cyst preceded surgery

  6. Persistent Mullerian Duct Syndrome (PMDS With Large Intraabdominal Seminoma

    Directory of Open Access Journals (Sweden)

    Della Harigovind

    2017-07-01

    Full Text Available Persistent Mullerian Duct Syndrome, a form of male pseudohermaphroditism is characterized by the presence of the Mullerian duct derivatives in an otherwise phenotypically as well as genotypically normal male. We report a case of large intra abdominal seminoma in a male patient with cryptorchidism, along with persistence of Mullerian duct derivatives (uterus.

  7. Common Bile Duct Perforation Due to Tuberculosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2004-10-01

    Full Text Available A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

  8. Common Bile Duct Perforation Due to Tuberculosis: A Case Report

    OpenAIRE

    Razman Jarmin; Shaharin Shaharuddin

    2004-01-01

    A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.

  9. Iatrogenic injury of an aberrant right posterior sectoral bile duct

    African Journals Online (AJOL)

    (Figs 1 and 2). A week later, an endoscopic retrograde cholangiopancreatography. (ERCP) examination was performed. This showed no filling of the right posterior sectoral ducts but normal opacification of the other ducts. (Figs 3a and b). These findings led to the diagnosis of an aberrant right posterior sectoral bile duct that ...

  10. A case of fascioliasis in common bile duct

    Energy Technology Data Exchange (ETDEWEB)

    Ham, Soo Youn; Park, Cheol Min; Chung, Kyu Byung; Lee, Chang Hong; Park, Seung Chul; Choi, Sang Yong; Lim, Han Jong [Korea University College of Medicine, Seoul (Korea, Republic of)

    1989-10-15

    A case of Fascioliasis of common bile duct is confirmed by visualization of adult fluke. Fascioliasis caused by Fasciola hepatica, is common parasitic disease in cattle and sheep. Human is an accidental host. ERCP demonstrated irregular linear conglomerated filling defects in common bile duct. Through surgical intervention, we found adult flukes of F. hepatica and adenomatous hyperplasia of common bile duct.

  11. A case of fascioliasis in common bile duct

    International Nuclear Information System (INIS)

    Ham, Soo Youn; Park, Cheol Min; Chung, Kyu Byung; Lee, Chang Hong; Park, Seung Chul; Choi, Sang Yong; Lim, Han Jong

    1989-01-01

    A case of Fascioliasis of common bile duct is confirmed by visualization of adult fluke. Fascioliasis caused by Fasciola hepatica, is common parasitic disease in cattle and sheep. Human is an accidental host. ERCP demonstrated irregular linear conglomerated filling defects in common bile duct. Through surgical intervention, we found adult flukes of F. hepatica and adenomatous hyperplasia of common bile duct

  12. Internal radiotherapy for hilar bile duct cancer

    International Nuclear Information System (INIS)

    Ryu, Munemasa; Ogino, Takashi; Konishi, Hiroshi

    1999-01-01

    By December 1998, 24 patients with non-resected hilar bile duct cancer (mean age of 74) had received bile duct intracavitary irradiation and 13 patients with residual cancer after resection of hilar bile duct cancer had received postoperative intracavitary irradiation. After they were externally irradiated 30 Gy in total by 15 fractions (2 Gy/time, 5 times in a week), intracavitary irradiation using 192-Ir was given 5 times in total (2 times in a week) from 3 weeks after external irradiation under the condition which dose became 8 Gy in depth of 10 mm from radiation source. The cases of postoperative irradiation had 3 times in total. As for 20 patients of non-resected hilar bile duct cancer without metastasis, 50% survival time was 265 days and there was no 5 year survivor. Fifty percents survival time of 4 patients with metastasis was 113 days. The effect of local control was recognized in 20 patients (83.3%). In 13 patients of postoperative irradiation, 50% survival time was 554 days, and survival rate of 3 years was 28%. (K.H.)

  13. 46 CFR 116.610 - Ventilation ducts.

    Science.gov (United States)

    2010-10-01

    ... incidental to its installation, must be made of noncombustible material. (c) Combustibles and other foreign materials are not allowed within ventilation ducts. However, metal piping and electrical wiring installed in... the wiring does not interfere with the operation of fire dampers. Electrical wiring and piping may not...

  14. Calcium influx pathways in rat pancreatic ducts

    DEFF Research Database (Denmark)

    Hug, M J; Pahl, C; Novak, I

    1996-01-01

    A number of agonists increase intracellular Ca2+ activity, [Ca2+]i, in pancreatic ducts, but the influx/efflux pathways and intracellular Ca2+ stores in this epithelium are unknown. The aim of the present study was to characterise the Ca2+ influx pathways, especially their pH sensitivity, in nati...

  15. MR findings in thyroglossal duct cysts

    International Nuclear Information System (INIS)

    Blandino, A.; Salvi, L.; Chirico, G.; Scribano, E.; Longo, M.; Pandolfo, I.

    1990-01-01

    Two patients with thyroglossal duct cysts have been studied with CT and MR. The typical CT feature of these cystic upper-neck lesions are depicted in literature, conversely MR findings are not well known. The homogeneous high intensity on T1-weighted images, higher than simple cyst or fluid, is the most typical feature of the thyroglossal cyst. (author). 12 refs.; 5 figs

  16. [Bile duct lesions in laparoscopic cholecystectomy].

    Science.gov (United States)

    Siewert, J R; Ungeheuer, A; Feussner, H

    1994-09-01

    Laparoscopic cholecystectomy is both resulting in a slightly higher incidence of biliary lesions and a change of prevalence of the type of lesions. Damage to the biliary system occurs in 4 different types: The most severe case is the lesion with a structural defect of the hepatic or common bile duct with (IVa) or without (IVb) vascular injury. Tangential lesions without structural loss of the duct should be denominated as type III (IIIa with additional lesion to the vessels, type IIIb without). Type II comprehends late strictures without obvious intraoperative trauma to the duct. Type I includes immediate biliary fistulae of usually good prognosis. The increasing prevalence of structural defects of the bile ducts appears to be a peculiarity of laparoscopic cholecystectomy necessitating highly demanding operative repair. In the majority of cases, hepatico-jejunostomy or even intraparenchymatous anastomoses are required. Adaptation of well proven principles of open surgery is the best prevention of biliary lesions in laparoscopic cholecystectomy as well as the readiness to convert early to the open procedure.

  17. Depressurization test on hot gas duct

    International Nuclear Information System (INIS)

    Tanihira, Masanori; Kunitomi; Kazuhiko; Inagaki, Yoshiyuki; Miyamoto, Yoshiaki; Sato, Yutaka.

    1989-05-01

    To study the integrity of internal structures and the characteristics in a hot gas duct under the rapid depressurization accident, depressurization tests have been carried out using a test apparatus installed the hot gas duct with the same size and the same structures as that of the High Temperature Engineering Test Reactor (HTTR). The tests have been performed with three parameters: depressurization rate (0.14-3.08 MPa/s) determined by orifice diameter, area of the open space at the slide joint (11.9-2036 mm 2 ), and initial pressure (1.0-4.0 MPa) filled up in a pressure vessel, by using nitrogen gas and helium gas. The maximum pressure difference applied on the internal structures of the hot gas duct was 2.69 MPa on the liner tube and 0.45 MPa on the separating plate. After all tests were completed, the hot gas duct which was used in the tests was disassembled. Inspection revealed that there were no failure and no deformation on the internal structures such as separating plates, insulation layers, a liner tube and a pressure tube. (author)

  18. Whistler instability in a magnetospheric duct

    International Nuclear Information System (INIS)

    Talukdar, I.; Tripathi, V.K.; Jain, V.K.

    1989-01-01

    A whistler wave propagating through a preformed magnetospheric duct is susceptible to growth/amplification by an electron beam. The interaction is non-local and could be of Cerenkov or slow-cyclotron type. First-order perturbation theory is employed to obtain the growth rate for flat and Gaussian beam densities. (author)

  19. Tolerance of bile duct to intraoperative irradiation

    International Nuclear Information System (INIS)

    Sindelar, W.F.; Tepper, J.; Travis, E.L.

    1982-01-01

    In order to determine the effects of intraoperative radiation therapy of the bile duct and surrounding tissues, seven adult dogs were subjected to laparotomy and intraoperative irradiation with 11 MeV electrons. Two animals were treated at each dose level of 2000, 3000, and 4500 rads. A single dog which received a laparotomy and sham irradiation served as a control. The irradiation field consisted of a 5 cm diameter circle encompassing the extrahepatic bile duct, portal vein, hepatic artery, and lateral duodenal wall. The animals were followed clinically for mor than 18 months after treatment, and autopsies were performed on dogs that died to assess radiation-induced complications or tissue damage. All dogs developed fibrosis and mural thickening of the common duct, which appeared by 6 weeks following irradiation and which was dose-related, being mild at low doses and more severe at high doses. Hepatic changes were seen as early as 6 weeks after irradiation, consisting of periportal inflammation and fibrosis. The hepatic changes appeared earliest at the highest doses. Frank biliary cirrhosis eventually developed at all dose levels. Duodenal fibrosis appeared in the irradiation portal, being most severe at the highest doses and in some animals resulting in duodenal obstruction. No changes were observed in irradiated portions of portal vein and hepatic artery at any dose level. It was concluded that intraoperative radiation therapy delivered to the region of the common duct leads to ductal fibrosis, partial biliary obstruction with secondary hepatic changes, and duodenal fibrosis if bowel wall is included in the field. Clinical use of intraoperative radiation therapy to the bile duct in humans may require routine use of biliary and duodenal bypass to prevent obstructive complications

  20. Are Ducted Mini-Splits Worth It?

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, Jonathan M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Maguire, Jeffrey B [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Metzger, Cheryn E. [Pacific Northwest National Laboratory; Zhang, Jason [Pacific Northwest National Laboratory

    2018-02-01

    Ducted mini-split heat pumps are gaining popularity in some regions of the country due to their energy-efficient specifications and their ability to be hidden from sight. Although product and install costs are typically higher than the ductless mini-split heat pumps, this technology is well worth the premium for some homeowners who do not like to see an indoor unit in their living area. Due to the interest in this technology by local utilities and homeowners, the Bonneville Power Administration (BPA) has funded the Pacific Northwest National Laboratory (PNNL) and the National Renewable Energy Laboratory (NREL) to develop capabilities within the Building Energy Optimization (BEopt) tool to model ducted mini-split heat pumps. After the fundamental capabilities were added, energy-use results could be compared to other technologies that were already in BEopt, such as zonal electric resistance heat, central air source heat pumps, and ductless mini-split heat pumps. Each of these technologies was then compared using five prototype configurations in three different BPA heating zones to determine how the ducted mini-split technology would perform under different scenarios. The result of this project was a set of EnergyPlus models representing the various prototype configurations in each climate zone. Overall, the ducted mini-split heat pumps saved about 33-60% compared to zonal electric resistance heat (with window AC systems modeled in the summer). The results also showed that the ducted mini-split systems used about 4% more energy than the ductless mini-split systems, which saved about 37-64% compared to electric zonal heat (depending on the prototype and climate).

  1. CT findings of thyroglossal duct cyst

    International Nuclear Information System (INIS)

    Kim, Dong Oh; Kim, Hong Soo; So, Hyun Soon; Nam, Mee Young; Choi, Jae Ho; Rhee, Hak Song

    1995-01-01

    The purpose of this study was to evaluate the CT findings of thyroglossal duct cysts. Sixteen patients with pathologically proved thyroglossal duct cysts were included in the study. CT scans were assessed retrospectively for shape, size, location, density of the central portions, septations, rim enhancement, changes in the adjacent fascial planes and investment within the strap muscles in the infrahyoid cysts. Thirteen cases of thyroglossal duct cysts were seen as round or oval cystic masses, two cases of them were seen as irregular-shaped lobulated cystic masses, and one case was seen as ovoid soft tissue mass. The cysts were from 1.4 to 5.7 cm in diameter (mean, 2.6 cm). The cyst was infrahyoid in 15 cases and suprahyoid in one case. The cyst was located in midline in eight cases, off midline in four cases, and both midline and off midline in four cases. The density of the central portions ranged from 15 to 82HU (mean, 32HU). Septations were noted in four cases. Rim enhancement was seen in 14 cases (93%), and heterogeneously enhancing soft tissue mass was seen in one case. In four cases, abnormal fascial planes were observed. All but one of the infrahyoid cysts (14/15) were embedded within the strap muscles, and one case of them was located anteriorly to strap muscles. CT permits one to make the diagnosis a thyroglossal duct cyst with a high degree of accuracy, as it can differentiate thyroglossal duct cysts from the other anterior neck masses by their typical location, characteristic morphology, and investment within the strap muscles

  2. Duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma.

    Science.gov (United States)

    Wu, Wen-Guang; Gu, Jun; Dong, Ping; Lu, Jian-Hua; Li, Mao-Lan; Wu, Xiang-Song; Yang, Jia-Hua; Zhang, Lin; Ding, Qi-Chen; Weng, Hao; Ding, Qian; Liu, Ying-Bin

    2013-04-21

    At present, radical resection remains the only effective treatment for patients with hilar cholangiocarcinoma. The surgical approach for R0 resection of hilar cholangiocarcinoma is complex and diverse, but for the biliary reconstruction after resection, almost all surgeons use Roux-en-Y hepaticojejunostomy. A viable alternative to Roux-en-Y reconstruction after radical resection of hilar cholangiocarcinoma has not yet been proposed. We report a case of performing duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma. End-to-end anastomosis between the left hepatic duct and the distal common bile duct was used for the biliary reconstruction, and a single-layer continuous suture was performed along the bile duct using 5-0 prolene. The patient was discharged favorably without biliary fistula 2 wk later. Evidence for tumor recurrence was not found after an 18 mo follow-up. Performing bile duct end-to-end anastomosis in hilar cholangiocarcinoma can simplify the complex digestive tract reconstruction process.

  3. Developing flow in S-shaped ducts. 2: Circular cross-section duct

    Science.gov (United States)

    Taylor, A. M. K. P.; Whitelaw, J. H.; Yianneskis, M.

    1984-01-01

    Laser-Doppler velocimetry measured the laminar and turbulent streamwise flow in a S-duct. The wall pressure distribution and one component of cross-stream velocity were also obtained for the turbulent flow case. Boundary layers near the duct inlet were about 25 percent of the hydraulic diameter in the laminar flow and varied around the periphery of the pipe between 10 percent and 20 percent in turbulent flow. Pressure-driven secondary flows develop in the first half of the S-duct and are attenuated and reversed in the second half. For both Reynolds numbers there is a region near the outer wall of the second half of the duct where the sign of the radial vorticity results in an enforcement of the secondary flow which was established in the first half of the S-duct. The core flow migrates, for both Reynolds numbers, to the outside wall of the first half and lies towards the inside wall of the second half of the S-duct at the outlet. The thinner inlet boundary layers in the turbulent flow give rise to weaker secondary motion.

  4. Quiver Varieties and Branching

    Directory of Open Access Journals (Sweden)

    Hiraku Nakajima

    2009-01-01

    Full Text Available Braverman and Finkelberg recently proposed the geometric Satake correspondence for the affine Kac-Moody group Gaff [Braverman A., Finkelberg M., arXiv:0711.2083]. They conjecture that intersection cohomology sheaves on the Uhlenbeck compactification of the framed moduli space of Gcpt-instantons on $R^4/Z_r$ correspond to weight spaces of representations of the Langlands dual group $G_{aff}^{vee}$ at level $r$. When $G = SL(l$, the Uhlenbeck compactification is the quiver variety of type $sl(r_{aff}$, and their conjecture follows from the author's earlier result and I. Frenkel's level-rank duality. They further introduce a convolution diagram which conjecturally gives the tensor product multiplicity [Braverman A., Finkelberg M., Private communication, 2008]. In this paper, we develop the theory for the branching in quiver varieties and check this conjecture for $G = SL(l$.

  5. Integrating over Higgs branches

    International Nuclear Information System (INIS)

    Moore, G.; Shatashvili, S.

    2000-01-01

    We develop some useful techniques for integrating over Higgs branches in supersymmetric theories with 4 and 8 supercharges. In particular, we define a regularized volume for hyperkaehler quotients. We evaluate this volume for certain ALE and ALF spaces in terms of the hyperkaehler periods. We also reduce these volumes for a large class of hyperkaehler quotients to simpler integrals. These quotients include complex coadjoint orbits, instanton moduli spaces on R 4 and ALE manifolds, Hitchin spaces, and moduli spaces of (parabolic) Higgs bundles on Riemann surfaces. In the case of Hitchin spaces the evaluation of the volume reduces to a summation over solutions of Bethe ansatz equations for the non-linear Schroedinger system. We discuss some applications of our results. (orig.)

  6. Long-term follow-up after choledochojejunostomy for bile duct stones with complex clearance of the bile duct

    NARCIS (Netherlands)

    Gouma, D. J.; Konsten, J.; Soeters, P. B.; Von Meyenfeldt, M.; Obertop, H.

    1989-01-01

    In this retrospective study, the long-term follow-up of patients undergoing choledochojejunostomy (Roux-en-Y) for bile duct stones with complex clearance of the bile duct is evaluated. Bile duct exploration and subsequent choledochojejunostomy (Roux-en-Y) was performed in 43 patients (median age 67

  7. Parotid Duct Repair with Intubation Tube: Technical Note

    Science.gov (United States)

    Öztürk, Muhammed Beşir; Barutca, Seda Asrufoğlu; Keskin, Elif Seda; Atik, Bekir

    2017-01-01

    The parotid duct can be damaged in traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great importance because complications such as sialocele and salivary gland fistula may develop if the duct is not surgically repaired. We think the cuff of an intubation tube is an ideal material in parotid duct repair, because of its technical characteristics, easiness of availability, and low-cost. In this paper, we described the use of the cuff cannula of an intubation tube for the diagnosis and treatment of parotid duct laceration, as a low-cost and easy to access material readily available in every operating room. PMID:28713751

  8. The efficiency of bank branches

    OpenAIRE

    Omid Takbiri; Mohammad Mohammadi; Bahman Naderi

    2015-01-01

    Banking industry has significant contribution in development of economies of developing countries. Most banks execute their operations through different branches. Therefore it is important to measure the relative efficiencies of these branches. Data envelopment analysis (DEA) is one of the most useful tools in measuring banks’ performance. The present paper aims to extract ranking pattern of banks based on performance evaluation using DEA analysis. In the present research, 120 bank branches o...

  9. The Dynamics of Controlled Flow Separation within a Diverter Duct Diffuser

    Science.gov (United States)

    Peterson, C. J.; Vukasinovic, B.; Glezer, A.

    2016-11-01

    The evolution and receptivity to fluidic actuation of the flow separation within a rectangular, constant-width, diffuser that is branched off of a primary channel is investigated experimentally at speeds up to M = 0.4. The coupling between the diffuser's adverse pressure gradient and the internal separation that constricts nearly half of the flow passage through the duct is controlled using a spanwise array of fluidic actuators on the surface upstream of the diffuser's inlet plane. The dynamics of the separating surface vorticity layer in the absence and presence of actuation are investigated using high-speed particle image velocimetry combined with surface pressure measurements and total pressure distributions at the primary channel's exit plane. It is shown that the actuation significantly alters the incipient dynamics of the separating vorticity layer as the characteristic cross stream scales of the boundary layer upstream of separation and of the ensuing vorticity concentrations within the separated flow increase progressively with actuation level. It is argued that the dissipative (high frequency) actuation alters the balance between large- and small-scale motions near separation by intensifying the large-scale motions and limiting the small-scale dynamics. Controlling separation within the diffuser duct also has a profound effect on the global flow. In the presence of actuation, the mass flow rate in the primary duct increases 10% while the fraction of the diverted mass flow rate in the diffuser increases by more than 45% at 0.7% actuation mass fraction. Supported by the Boeing Company.

  10. Hepatic parenchymal atrophy induction for intractable segmental bile duct injury after liver resection.

    Science.gov (United States)

    Hwang, Shin; Park, Gil-Chun; Ha, Tae-Yong; Ko, Gi-Young; Gwon, Dong-Il; Choi, Young-Il; Song, Gi-Won; Lee, Sung-Gyu

    2012-05-01

    Liver resection can result in various types of bile duct injuries but their treatment is usually difficult and often leads to intractable clinical course. We present an unusual case of hepatic segment III duct (B3) injury, which occurred after left medial sectionectomy for large hepatocellular carcinoma and was incidentally detected 1 week later due to bile leak. Since the pattern of this B3 injury was not adequate for operative biliary reconstruction, atrophy induction of the involved hepatic parenchyma was attempted. This treatment consisted of embolization of the segment III portal branch to inhibit bile production, induction of heavy adhesion at the bile leak site and clamping of the percutaneous transhepatic biliary drainage (PTBD) tube to accelerate segment III atrophy. This entire procedure, from liver resection to PTBD tube removal took 4 months. This patient has shown no other complication or tumor recurrence for 4 years to date. These findings suggest that percutaneous segmental portal vein embolization, followed by intentional clamping of external biliary drainage, can effectively control intractable bile leak from segmental bile duct injury.

  11. A study on CT features of intrahepatic bile duct abscess

    International Nuclear Information System (INIS)

    Min Pengqiu; Li Peng; He Zhiyan; Chen Weixia; Liu Yan

    2001-01-01

    Objective: To evaluate CT features of intrahepatic bile duct abscess (IBDA) and its pathologic basis. Methods: The CT imaging data of 31 consecutive cases of intrahepatic bile duct abscess proved by surgery or clinical treatments from October 1989 to February 1999 were retrospectively studied. The causes included acute obstructive suppurative cholangitis and retrograde infection due to different etiologies. For all the cases, the CT manifestations of liver abscess, bile duct abnormalities, and their relationship were observed respectively. Results: Manifestations of liver abscess were revealed in all cases (31/31, 100%). The CT manifestations of bile duct abnormalities included signs of etiologies caused bile duct obstruction and other signs including cholangiectasis (29/31, 93.5%), the dilated bile ducts communicated with (5/31, 16.1%) or abut on (8/31, 25.8%) the abscesses, and gas collection in bile ducts (10/31, 32.2%). The signs showing the relationship between liver abscess and bile duct abnormalities were that the abscesses complied with the obstructive site and the dilated bile ducts (15/31, 48.4%), and the liver abscesses located in different (7/31, 22.6%) or same (4/31, 12.9%) liver lobes or segments with gas collection in the dilated bile ducts. Conclusion: The CT manifestations of IBDA included signs of liver abscess, abnormalities of bile ducts, and signs showing their relationship. CT scanning was helpful in making comprehensive and accurate diagnosis of IBDA

  12. Radiologic imaging of bile duct changes by clonorchiasis

    International Nuclear Information System (INIS)

    Kim, Myung Joon; Yoo, Hyung Sik; Lee, Jong Tae; Jung, Soon Hee

    1988-01-01

    The changes of the bile ducts were reviewed retrospectively in 38 patients of clonorchiasis by ultrasonography and/or CT. Diagnosis was made in 13 patients by cholecystectomy and exploration of the common bile duct, another 2 patients by segmentectomy and wedge resection of the liver, and 23 patients by stool examination. 14 of 36 cases done ultrasonography showed the parallel channel sign, and small nodular echoes around the dilated bile ducts. And 3 cases showed the echoes of worm of clonorchis sinensis in the common bile duct. 22 of 36 cases showed the parallel channel signs only. All cases (11) done CT showed diffuse dilatation of the peripheral bile ducts. 5 of 11 cases showed ring or tubular contrast enhancement around the dilated bile ducts. In 2 cases of liver resection, the bile ducts showed adenomatous hyperplasia and severe periductal fibrosis. Proliferation of blood vessels and infiltration of inflammatory cells were also seen. So we consider that the increased echoes of the bile duct wall, small nodular echoes around the bile ducts were attributed to the bile duct dilatation, severe adenomatous hyperplasia and periductal fibrosis. The ring or tubular contrast enhancement of the dilated bile ducts seems to be caused by the marked periductal inflammation resulting in capillary proliferation and the periductal fibrosis.

  13. Radiologic imaging of bile duct changes by clonorchiasis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Joon; Yoo, Hyung Sik; Lee, Jong Tae; Jung, Soon Hee [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    The changes of the bile ducts were reviewed retrospectively in 38 patients of clonorchiasis by ultrasonography and/or CT. Diagnosis was made in 13 patients by cholecystectomy and exploration of the common bile duct, another 2 patients by segmentectomy and wedge resection of the liver, and 23 patients by stool examination. 14 of 36 cases done ultrasonography showed the parallel channel sign, and small nodular echoes around the dilated bile ducts. And 3 cases showed the echoes of worm of clonorchis sinensis in the common bile duct. 22 of 36 cases showed the parallel channel signs only. All cases (11) done CT showed diffuse dilatation of the peripheral bile ducts. 5 of 11 cases showed ring or tubular contrast enhancement around the dilated bile ducts. In 2 cases of liver resection, the bile ducts showed adenomatous hyperplasia and severe periductal fibrosis. Proliferation of blood vessels and infiltration of inflammatory cells were also seen. So we consider that the increased echoes of the bile duct wall, small nodular echoes around the bile ducts were attributed to the bile duct dilatation, severe adenomatous hyperplasia and periductal fibrosis. The ring or tubular contrast enhancement of the dilated bile ducts seems to be caused by the marked periductal inflammation resulting in capillary proliferation and the periductal fibrosis.

  14. Methods and Technologies Branch (MTB)

    Science.gov (United States)

    The Methods and Technologies Branch focuses on methods to address epidemiologic data collection, study design and analysis, and to modify technological approaches to better understand cancer susceptibility.

  15. A Case of Adenomyomatous Hyperplasia of the Extrahepatic Bile Duct

    Directory of Open Access Journals (Sweden)

    Masakatsu Numata

    2011-08-01

    Full Text Available Adenomyomatous hyperplasia is rarely found in the extrahepatic bile duct. A 54-year-old man was referred to our center with a diagnosis of extrahepatic bile duct stenosis which had been detected by endoscopic retrograde choloangiopancreatography. Abdominal computed tomography revealed thickening of the wall of the middle extrahepatic bile duct, however no malignant cells were detected by cytology. Since bile duct carcinoma could not be ruled out, we performed resection of the extrahepatic duct accompanied by lymph node dissection. Histopathologically, the lesion was diagnosed as adenomyomatous hyperplasia of the extrahepatic bile duct. Present and previously reported cases showed the difficulty of making a diagnosis of adenomyomatous hyperplasia of the extrahepatic bile duct preoperatively or intraoperatively. Therefore, when adenomyomatous hyperplasia is suspected, a radical surgical procedure according to malignant disease may be necessary for definitive diagnosis.

  16. Dispersion properties of ducted whistlers, generated by lightning discharge

    Directory of Open Access Journals (Sweden)

    D. L. Pasmanik

    2005-06-01

    Full Text Available Whistler-mode wave propagation in magnetospheric ducts of enhanced cold plasma density is studied. The case of the arbitrary ratio of the duct radius to the whistler wavelength is considered, where the ray-tracing method is not applicable. The set of duct eigenmodes and their spatial structure are analysed and dependencies of eigenmode propagation properties on the duct characteristics are studied. Special attention is paid to the analysis of the group delay time of one-hop propagation of the whistler wave packet along the duct. We found that, in contrast to the case of a wide duct, the group delay time in a rather narrow duct decreases as the eigenmode number increases. The results obtained are suggested for an explanation of some types of multi-component whistler signals.

  17. Spectral measurements of gamma radiation streaming through ducts

    International Nuclear Information System (INIS)

    Meenakshisundaram, P.K.; Bhatnagar, V.M.; Raghunath, V.M.; Gopinath, D.V.

    1979-01-01

    The paper presents the spectral measurements of gamma radiation streaming through multi-legged rectangular concrete ducts for cesium-137 and cobald-60 sources. Effect of lead lining the inner surface of the duct on the streaming radiation spectrum and optimization of liner thickness for minimum streaming radiation dose have been studied. For three-legged ducts, a comparative analysis of lead lining the entire duct as against lining any one or both the corners of the duct is reported. It is seen that lead lining any one of the corners would reduce the streaming radiation dose by a factor of 5 to 12. Lining both the corners which is nearly as effective as lining the entire duct reduces the dose by a factor of 16 to 60 depending on the soruce energy and duct dimensions. (orig.)

  18. Effect of Resin Ducts and Sap Content on Infestation and Development of Immature Stages of Anastrepha obliqua and Anastrepha ludens (Diptera: Tephritidae) in Four Mango (Sapindales: Anacardiaceae) Cultivars.

    Science.gov (United States)

    Guillén, Larissa; Adaime, Ricardo; Birke, Andrea; Velázquez, Olinda; Angeles, Guillermo; Ortega, Fernando; Ruíz, Eliel; Aluja, Martín

    2017-04-01

    We determined the influence of resin ducts, sap content, and fruit physicochemical features of four mango cultivars (Criollo, Manila, Ataulfo, and Tommy Atkins) on their susceptibility to the attack of the two most pestiferous fruit fly species infesting mangoes in Mexico: Anastrepha ludens (Loew) and Anastrepha obliqua (Macquart). We performed three studies: 1) analysis of resin ducts in mango fruit exocarp to determine the density and area occupied by resin ducts in each mango cultivar, 2) assessment of mango physicochemical features including fruit sap content, and 3) a forced infestation trial under field conditions using enclosed fruit-bearing branches to expose mangoes to gravid A. ludens or A. obliqua females. Infestation rates, development time from egg to prepupae and pupae, pupal weight, and percent of adult emergence, were assessed. 'Ataulfo' and 'Tommy Atkins' cultivars exhibited the highest resin duct density and sap content, the lowest infestation rate, and had a negative effect on immature development and pupal weight. In sharp contrast, 'Manila' and 'Criollo' cultivars, with the lowest resin duct density and sap content, were highly susceptible to A. ludens and A. obliqua attack. We conclude that sap content and the number, size, and distribution of resin ducts as well as firmness in mango fruit exocarp are all involved in the resistance of mango to A. ludens and A. obliqua attack. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. SNM holdup assessment of Los Alamos exhaust ducts

    International Nuclear Information System (INIS)

    Marshall, R.S.

    1994-02-01

    Fissile material holdup in glovebox and fume hood exhaust ducting has been quantified for all Los Alamos duct systems. Gamma-based, nondestructive measurements were used to quantify holdup. The measurements were performed during three measurement campaigns. The first campaign, Phase I, provided foot-by-foot, semiquantitative measurement data on all ducting. These data were used to identify ducting that required more accurate (quantitative) measurement. Of the 280 duct systems receiving Phase I measurements, 262 indicated less than 50 g of fissile holdup and 19 indicated fissile holdup of 50 or more grams. Seven duct systems were measured in a second campaign, called Series 1, Phase II. Holdup estimates on these ducts ranged from 421 g of 235 U in a duct servicing a shut-down uranium-machining facility to 39 g of 239 Pu in a duct servicing an active plutonium-processing facility. Measurements performed in the second campaign proved excessively laborious, so a third campaign was initiated that used more efficient instrumentation at some sacrifice in measurement quality. Holdup estimates for the 12 duct systems measured during this third campaign ranged from 70 g of 235 U in a duct servicing analytical laboratories to 1 g of 235 U and 1 g of 239 Pu in a duct carrying exhaust air to a remote filter building. These quantitative holdup estimates support the conclusion made at the completion of the Phase I measurements that only ducts servicing shut-down uranium operations contain about 400 g of fissile holdup. No ventilation ducts at Los Alamos contain sufficient fissile material holdup to present a criticality safety concern

  20. Tau hadronic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    From 64492 selected \\tau-pair events, produced at the Z^0 resonance, the measurement of the tau decays into hadrons from a global analysis using 1991, 1992 and 1993 ALEPH data is presented. Special emphasis is given to the reconstruction of photons and \\pi^0's, and the removal of fake photons. A detailed study of the systematics entering the \\pi^0 reconstruction is also given. A complete and consistent set of tau hadronic branching ratios is presented for 18 exclusive modes. Most measurements are more precise than the present world average. The new level of precision reached allows a stringent test of \\tau-\\mu universality in hadronic decays, g_\\tau/g_\\mu \\ = \\ 1.0013 \\ \\pm \\ 0.0095, and the first measurement of the vector and axial-vector contributions to the non-strange hadronic \\tau decay width: R_{\\tau ,V} \\ = \\ 1.788 \\ \\pm \\ 0.025 and R_{\\tau ,A} \\ = \\ 1.694 \\ \\pm \\ 0.027. The ratio (R_{\\tau ,V} - R_{\\tau ,A}) / (R_{\\tau ,V} + R_{\\tau ,A}), equal to (2.7 \\pm 1.3) \\ \\%, is a measure of the importance of Q...

  1. Acoustic Power Transmission Through a Ducted Fan

    Science.gov (United States)

    Envia, Ed

    2016-01-01

    For high-speed ducted fans, when the rotor flowfield is shock-free, the main contribution to the inlet radiated acoustic power comes from the portion of the rotor stator interaction sound field that is transmitted upstream through the rotor. As such, inclusion of the acoustic transmission is an essential ingredient in the prediction of the fan inlet noise when the fan tip relative speed is subsonic. This paper describes a linearized Euler based approach to computing the acoustic transmission of fan tones through the rotor. The approach is embodied in a code called LINFLUX was applied to a candidate subsonic fan called the Advanced Ducted Propulsor (ADP). The results from this study suggest that it is possible to make such prediction with sufficient fidelity to provide an indication of the acoustic transmission trends with the fan tip speed.

  2. Impact fracture behavior of HT9 duct

    International Nuclear Information System (INIS)

    Huang, F.H.; Gelles, D.S.

    1994-07-01

    Ferritic alloys are known to undergo a ductile-brittle transition as the test temperature is decreased. This inherent problem has limited their applications to reactor component materials subjected to low neutron exposures. However, the excellent resistance to void swelling exhibited by these alloys has led to choosing the materials as candidate materials for fast and fusion reactor applications. Despite the ductile-brittle transition problem, results show that the materials exhibit superior resistance to fracture under very high neutron fluences at irradiation temperatures above 380 degrees C. Impact testing on FFTF duct sections of HT9 indicates that HT9 ducts have adequate fracture toughness at much higher temperatures for handling operations at room temperature and refueling operations

  3. Mullerian Ducts Anomalies: A Simple View

    International Nuclear Information System (INIS)

    Diaz Diaz, Nelson Enrique; Riano Montanez, Yeyson Fabian; Baron Criollo, Jose alexander

    2008-01-01

    Mullerian ducts anomalies are a major cause of infertility in women of reproductive age. They have multifactorial etiology. The following article reviews the classification of the American Fertility Society, the most widely accepted at present to describe this set of pathologies. Also a schematic review of the embryology is done and are shown cases of MRI, modality of choice by image to characterize the findings in the majority of presentation forms of these entities

  4. T-method duct design. Part 3

    International Nuclear Information System (INIS)

    Tsal, R.J.; Behls, H.F.; Mangel, R.

    1990-01-01

    This paper introduces a new method for simulating HVAC duct systems, called T-method. The desirability of simulation appears in many HVAC problems, such as determining system operating efficiency, system retrofitting, nuclear plant normal/emergency conditions, fire/smoke control systems, fans operating in parallel, pressure balancing after system modification, and noise generated by dampers. T-method is capable of simulating these problems. This paper includes problem definition, a theoretical approach, calculation procedures, and many examples

  5. Pressure drop in T's in concentric ducts

    International Nuclear Information System (INIS)

    Shock, R.A.W.

    1983-02-01

    A set of experiments has been carried out to measure the pressure drop characteristics of single-phase flow in dividing and joining right-angled T's in a concentric ducting system. These have been compared with measured pressure drops in a simple round tube system. In most tests with the concentric system the number of velocity heads lost is either similar to, or more than, the value for the round tubes. (author)

  6. Additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms of the pancreas with mural nodules

    International Nuclear Information System (INIS)

    Takanami, Kentaro; Hiraide, Tomomichi; Tsuda, Masashi; Nakamura, Yausuhiro; Kaneta, Tomohiro; Takase, Kei; Takahashi, Shoki; Fukuda, Hiroshi

    2011-01-01

    This study aimed at determining the additional value of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas with mural nodules. This retrospective review of medical records was approved by our institutional review board. The preoperative PET/CT images of 16 non-diabetic patients with surgically proven IPMN, where mural nodules of 3 mm or larger were shown by preoperative contrast-enhanced CT, were retrospectively evaluated. The 16 patients were divided into two groups: 7 patients with benign IPMN [adenoma (n=1) and borderline tumor (n=6)] and 9 patients with malignant IPMN [carcinoma in situ (CIS) (n=8) and invasive carcinoma (n=1)]. Nuclear medicine physician blinded to the pathologic assessment of malignancy of IPMN set a spherical volume of interest (VOI) over the mural nodules on PET/CT images and recorded the peak standardized uptake value (SUV max ) in the VOI, referring the contrast-enhanced CT images. Statistical differences in the size of mural nodule, the diameter of main pancreatic duct (MPD), and SUV max of the tumors between benign IPMNs and malignant IPMNs were compared using the Mann-Whitney U test. Statistical significance was set at p max of the malignant IPMNs with mural nodules of 3 mm or larger was higher than that of benign IPMNs (2.7±0.6 vs. 1.9±0.3, p<0.01). Meanwhile, there was no significant difference in mural nodule diameter and MPD diameter between the two groups. FDG PET/CT showed an excellent diagnostic accuracy for the differentiation between malignant and benign IPMNs with mural nodules: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in malignant IPMN with mural nodule of FDG PET/CT were 77.8, 100, 100, 77.8, and 87.5 for the cutoff value of 2.3; and 100, 57.1, 75.0, 100, and 81.3 for the cutoff value of 2

  7. Bile duct kinking after adult living donor liver transplantation: Case reports and literature review.

    Science.gov (United States)

    Wan, Ping; Xia, Qiang; Zhang, Jian Jun; Li, Qi Gen; Xu, Ning; Zhang, Ming; Chen, Xiao Song; Han, Long Zhi

    2015-10-01

    Regeneration of the partial allograft and the growth of children may cause kinking of the biliary tract after pediatric living donor liver transplantation (LDLT), but bile duct kinking after adult LDLT is rarely reported. We herein presented two patients who suffered from anastomotic strictures caused by severe bile duct kinking after LDLT. The first patient was a 57-year-old woman with hepatitis B virus (HBV)-related liver cirrhosis, who developed biliary stricture 5 months after receiving right-lobe LDLT. Subsequently, endoscopic and percutaneous treatments were attempted, but both failed to solve the problem. The second was a 44-year-old woman also having HBV-related liver cirrhosis. Biliary stricture occurred 14 months after LDLT. Likewise, the guide wire failed to pass through the stricture when endoscopic interventions were conducted. Afterwards, both of the two cases underwent reexploration, showing that compensatory hypertrophy of the allografts resulted in kinking and sharp angulation of the bile ducts, and the anastomotic sites were found to be severely stenotic. Finally, re-anastomosis by Roux-en-Y procedure was successfully performed, and long-term stenosis-free survival was achieved in both of them. Our experience suggests that bile duct kinking after LDLT may play a role in the high incidence of anastomotic strictures in adult LDLT recipients, which may also result in the treatment failure of the non-surgical techniques for anastomotic strictures. Re-anastomosis in the form of Roux-en-Y hepaticojejunostomy is an effective surgical option for the treatment of such a condition. © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  8. Hinkley Point A gas duct repairs

    International Nuclear Information System (INIS)

    Curtis, R.F.

    1996-01-01

    In 1990, routine visual inspection of the Hinckley Point A Reactor 1 pressure vessel gas outlet ducts showed failures in the welded stud bolts retaining the insulation edging strips. Since the ducts are accessible only from within the pressure vessel, a remote repair technique that could be deployed via the vessel stand pipe had to be found. A drawn arc stud welding and work package formerly used at the Oldbury Power Station was modified for the purpose. The only manipulators with sufficient reach and adequate carrying capacity to deploy the package were the Sizewell SNAKES manipulators. One of these was modified to fit the Hinckley reactor and repairs have been successfully carried out. Similar studs on the gas ducts in Reactor 2, are shielded from visual inspection by a Z-clip feature. A technique using pulsed thermography was developed. The studs were heated for a short time at their exposed ends using a prefocused lamp and the heat decay patterns monitored by an infrared camera enabling attached and detached studs to be distinguished. The inspection package was deployed using the SNAKES manipulator again. In both operations, I-Grip computer modelling was used in the design of the package envelope and the deployment routes. (UK)

  9. Dynamic response of cracked hexagonal subassembly ducts

    International Nuclear Information System (INIS)

    Glazik, J.L.; Petroski, H.J.

    1979-01-01

    The hexagonal subassembly ducts (hexcans) of current Liquid Metal Fast Breeder Reactor (LMFBR) designs are typically made of 20% coldworked Type 316 stainless steel. Prolonged exposure of this initially tough and ductile material to a fast neutron flux at high temperatures can result in severe embrittlement. Under these conditions, the unstable crack propagation of flaws, which may have been introduced during fabrication or transportation of the hexcans, is a problem of interest in LMFBR safety analysis. The abnormal overpressurization resulting from certain interactions within a subassembly, or the rupture of one or more fuel pins, may be sufficient to overload an otherwise subcritical crack in an embrittled hexcan. This paper examines the dynamic elastic response of flawed and unflawed fast reactor subassembly ducts. A plane-strain finite element analysis was performed for ducts containing internal corner cracks, as well as external midflat cracks. Two worst case loading situations were considered: rapid uniform internal pressurization and suddenly applied point loads at opposite midflats. The finite-element code CHILES, which can accomodate the stress singularities that occur at crack tips, was given dynamic capabilities through the inclusion of a consistent mass matrix and step-by-step time integration scheme. The SAP IV code was also employed for eigenvalue analysis and modal response. Although this code does not contain singular elements in its element library, dynamic stress intensity factors were calculated by a technique requiring only ordinary isoparametric quadrilaterals

  10. Effect of duct geometry on Wells turbine performance

    International Nuclear Information System (INIS)

    Shaaban, S.; Abdel Hafiz, A.

    2012-01-01

    Highlights: ► A Wells turbine duct design in the form of venturi duct is proposed and investigated. ► Optimum duct geometry is identified. ► Up to 14% increase of the turbine power can be achieved using the optimized duct geometry. ► Up to 9% improve of the turbine efficiency is attained by optimizing the turbine duct geometry. ► The optimized duct geometry results in tangible delay of the turbine stalling point. - Abstract: Wells turbines can represent important source of renewable energy for many countries. An essential disadvantage of Wells turbines is their low aerodynamic efficiency and consequently low power produced. In order to enhance the Wells turbine performance, the present research work proposes the use of a symmetrical duct in the form of a venturi tube with turbine rotor located at throat. The effects of duct area ratio and duct angle are investigated in order to optimize Wells turbine performance. The turbine performance is numerically investigated by solving the steady 3D incompressible Reynolds Averaged Navier–Stocks equation (RANS). A substantial improve of the turbine performance is achieved by optimizing the duct geometry. Increasing both the duct area ratio and duct angle increase the acceleration and deceleration upstream and downstream the rotor respectively. The accelerating flow with thinner boundary layer thickness upstream the rotor reduces the flow separation on the rotor suction side. The downstream diffuser reduces the interaction between tip leakage flow and blade suction side. Up to 14% increase in turbine power and 9% increase in turbine efficiency are achieved by optimizing the duct geometry. On other hand, a tangible delay of the turbine stall point is also detected.

  11. Compact Buried Ducts in a Hot-Humid Climate House

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, Dave [Home Innovation Research Labs, Upper Marlboro, MD (United States)

    2016-01-07

    "9A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely on encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences; 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs; 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.

  12. Imaging manifestation of hepatocellular carcinoma with bile duct tumor thrombi

    International Nuclear Information System (INIS)

    Liu Qingyu; Chen Jianyu; Liang Biling; Hu Tao

    2008-01-01

    Objective: To analyze the imaging features of hepatocellular carcinoma(HCC) with bile duct tumor thrombi. Methods: Thirteen patients with bile duct tumor thrombi proved pathologically underwent imaging examination. MR and CT were performed in 3 cases, and 2 cases had CT only and 8 cases had MRI only. Ultrasonography(US) was performed in all 13 patients. The accuracy of bile duct tumor thrombi detection was compared between US, CT and MRI with Fisher test. Results: Liver tumors and bile duct tumor thrombi were demonstrated in all patients on CT or MRI. Presence of intraluminal soft tissue mass was found in four of five cases on CT, and mild enhancement of the intraluminal mass in the arterial phase was noted, dilated bile duct distal to tumor thrombi was detected in all five patients. Eleven Tumor thrombi showed slight low signal intensity on T 1 WI, slight high signal intensity on T 2 WI, and mild to moderate contrast enhancement on the contrast-enhanced MR images. The MRCP findings of tumor thrombi were as follows: interruption, stricture of the bile ducts or irregular filling defect in the bile ducts with dilated intrahepatic ducts, bile duet was abruptly interrupted or showed a 'rat-tail' stricture (n=5); the common bile duct was filled with tumor thrombi, intrahepatic bile duct dilatation and missing common bile duct was noted on MRCP (n=2). Bile duct tumor thrombi were correctly diagnosed in 7 cases on US, and 12 cases on CT or MRI. Six cases were misdiagnosed or miss-diagnosed on US, and 4 cases were misdiagnosed on CT or MRI. There was no significant difference between US and CT/MRI in diagnosis of bile duct tumor thrombi (P=0.270). Conclusion: CT or MR imaging is useful for the diagnosis of HCC with biliary tumor thrombi and for evaluating the extension of thrombi. (authors)

  13. Unilateral Duplication Of Parotid Duct. A Rare Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Humberto Ferreira Arquez

    2017-11-01

    Full Text Available Background: The paired parotid glands are the largest of the major salivary glands and produces mainly serous secretions. The secretion of this gland reaches the oral cavity through single parotid duct (Stensen’s duct. The parotid duct begins at the anterior border of the gland, crosses the masseter muscle, and then pierces the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The purpose of this study is determine the morphologic features of the parotid duct and describe an anatomical variation until now unreported. Methods and Findings: A total of 17 cadavers were used for this study in the Morphology Laboratory at the University of Pamplona. In a cadaver were findings: The main parotid duct originated two conducts: Left superior parotid duct and Left inferior parotid duct, is observed the criss-cross of the ducts, and then perforated the buccinator muscle and entered the oral cavity at a double parotid papilla containing a double opening, separated from each other in 0,98 mm. In the remaining  33 parotid regions (97.06% the parotid duct is conformed to the classical descriptions given in anatomical textbooks. Conclusions: The parotid duct anatomy is important for duct endoscopy, lithotripsy, sialography and trans-ductal facial nerve stimulation in the early stage of facial palsy in some cases. The anatomical variations also has clinical importance for parotid gland surgery and facial cosmetic surgery. To keep in mind the parotid duct variation will reduce iatrogenic injury risks and improve diagnosis of parotid duct injury.

  14. MR pancreatography (MRP) for mucin-producing pancreatic tumors

    International Nuclear Information System (INIS)

    Usuki, Noriaki; Nishimoto, Masaoki; Shima, Tomoko; Hirokawa, Keiko; Tashiro, Takahiko; Saiwai, Shigeo; Miyamoto, Takeshi; Okabe, Sumihiro

    1997-01-01

    MR pancreatography was performed in 11 patients with mucin-producing pancreatic tumor (main duct type: four and branch duct type: seven) using HASTE with a body phased array coil on a 1.5-T unit. The results of MR pancreatography were compared with imaging of endoscopic retrograde pancreatography (ERP). In all cases, MR pancreatography demonstrated all dilated pancreatic ducts and cysts. ERP did not completely demonstrate dilated ducts and cysts because of mucinous materials. Conspicuity of an intraductal tumor was more excellent by ER pancreatography than MR pancreatography. Therefore MR pancreatography and ER pancreatography are complementary methods in diagnosis for mucin-producing pancreatic tumors. (author)

  15. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    Energy Technology Data Exchange (ETDEWEB)

    Courtney, Malachi; Ayyagari, Raj R. [Yale School of Medicine, Yale New Haven Hospital, New Haven, CT (United States); Division of Interventional Radiology, Department of Radiology, 789 Howard Avenue, P.O. Box 208042, New Haven, CT (United States)

    2015-06-15

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  16. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation

    International Nuclear Information System (INIS)

    Courtney, Malachi; Ayyagari, Raj R.

    2015-01-01

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. (orig.)

  17. Neutrophil-to-lymphocyte ratio and mural nodule height as predictive factors for malignant intraductal papillary mucinous neoplasms.

    Science.gov (United States)

    Watanabe, Yusuke; Niina, Yusuke; Nishihara, Kazuyoshi; Okayama, Takafumi; Tamiya, Sadafumi; Nakano, Toru

    2018-01-15

    Accurate preoperative prediction for malignant IPMN is still challenging. The aim of this study was to investigate the validity of neutrophil-to-lymphocyte ratio (NLR) and mural nodule height (MNH) for predicting malignant intraductal papillary mucinous neoplasm (IPMN). The medical records of 60 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. NLR tended to be higher in malignant IPMN (median: 2.23) than in benign IPMN (median: 2.04; p = .14). MNH was significantly greater in malignant IPMN (median: 16 mm) than in benign IPMN (median: 8 mm; p MNH were 3.60 and 11 mm, respectively. The sensitivity and specificity of NLR ≥3.60 for predicting malignant IPMN were 40% and 93%, and those of MNH ≥11 mm were 73% and 77%, respectively. Univariate analysis revealed that NLR ≥3.60 (p MNH ≥11 mm (p MNH ≥11 mm were not. NLR and MNH are suboptimal tests in predicting malignant IPMN; however, they can be useful to assist in clinical decision-making.

  18. Significance of aggressive surgery for an invasive carcinoma derived from an intraductal papillary mucinous neoplasm diagnosed preoperatively as borderline resectable.

    Science.gov (United States)

    Aimoto, Takayuki; Mizutani, Satoshi; Kawano, Youichi; Suzuki, Hideyuki; Uchida, Eiji

    2013-01-01

    We investigated the clinicopathological features of borderline resectable invasive carcinomas (BRICs) derived from intraductal papillary mucinous neoplasms (IPMNs) and examined the significance of the aggressive "surgery first" approach compared with the treatment of conventional borderline resectable pancreatic ductal adenocarcinomas (BRPDAs). We retrospectively studied 7 patients with BRICs derived from IPMNs and 14 patients with conventional BRPDAs. Several factors were reviewed: initial symptoms, preoperative imaging, serum level of CA19-9, perioperative factors, pathological findings, adjuvant chemotherapy, and outcome. All BRICs derived from IPMN were huge tumors (more than 3 cm in diameter) suspected to involve BRICs derived from IPMNs were larger than those of conventional BRPDAs (pBRICs derived from IPMN less frequently metastasized to lymph nodes (pBRICs derived from IPMNs (100%) than for conventional BRPDAs (19%, pBRICs derived from an intestinal or gastric IPMN are less aggressive than conventional BRPDAs and have a more favorable prognosis. In addition, aggressive "surgery first" approach may contribute to this better prognosis.

  19. Plasma protein profiling of patients with intraductal papillary mucinous neoplasm of the pancreas as potential precursor lesions of pancreatic cancer.

    Science.gov (United States)

    Ilies, Maria; Sappa, Praveen Kumar; Iuga, Cristina Adela; Loghin, Felicia; Gesell Salazar, Manuela; Weiss, Frank Ulrich; Beyer, Georg; Lerch, Markus M; Völker, Uwe; Mayerle, Julia; Hammer, Elke

    2018-02-01

    Efforts for the early diagnosis of the pancreatic ductal adenocarcinoma (PDAC) have recently been driven to one of the precursor lesions, namely intraductal papillary mucinous neoplasm of the pancreas (IPMN). Only a few studies have focused on IPMN molecular biology and its overall progression to cancer. Therefore, IPMN lacks comprehensive characterization which makes its clinical management controversial. In this study, we characterized plasma proteins in the presence of IPMNs in comparison to healthy controls, chronic pancreatitis, and PDAC by a proteomics approach using data-independent acquisition based mass spectrometry. We describe several protein sets that could aid IPMN diagnosis, but also differentiation of IPMN from healthy controls, as well as from benign and malignant diseases. Among all, high levels of carbonic anhydrases and hemoglobins were characteristic for the IPMN group. By employing ELISA based quantification we validated our results for human tissue inhibitor of metalloproteinase inhibitor 1 (TIMP-1). We consider IPMN management directed towards an early potential cancer development a crucial opportunity before PDAC initiation and thus its early detection and cure. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Eversion Bile Duct Anastomosis: A Safe Alternative for Bile Duct Size Discrepancy in Deceased Donor Liver Transplantation.

    Science.gov (United States)

    Leal-Leyte, Pilar; McKenna, Greg J; Ruiz, Richard M; Anthony, Tiffany L; Saracino, Giovanna; Giuliano, Testa; Klintmalm, Goran B; Kim, Peter Tw

    2018-04-10

    Introduction Bile duct size discrepancy in liver transplantation may increase the risk of biliary complications. The aim of this study was to evaluate the safety and outcomes of the eversion bile duct anastomosis technique in deceased donor liver transplantation (DDLT) with duct to duct anastomosis. Methods A total of 210 patients who received a DDLT with duct to duct anastomosis from 2012 to 2017 were divided into two groups: those who had eversion bile duct anastomosis (N=70) and standard bile duct anastomosis (N=140). Biliary complications rates were compared between the two groups. Results There was no difference in the cumulative incidence of biliary strictures (P=0.20) and leaks (P=0.17) between the two groups. The biliary complication rate in the eversion group was 14.3% and 11.4% in the standard anastomosis group. All the biliary complications in the eversion group were managed with endoscopic stenting. A severe size mismatch (≥3:1 ratio) was associated with a significantly higher incidence of biliary strictures (44.4%) compared to 2:1 ratio (8.2%), (P=0.002). Conclusion The use of the eversion technique is a safe alternative for bile duct discrepancy in deceased donor liver transplantation; however, severe bile duct size mismatch may be a risk factor for biliary strictures with such technique. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  1. Pressure analysis in ventilation ducts at bituminization facility

    International Nuclear Information System (INIS)

    Kikuchi, Naoki; Iimura, Masato; Takahashi, Yuki; Omori, Eiichi; Yamanouchi, Takamichi

    1997-09-01

    Pressure analysis in cell ventilation ducts at bituminization facility where the fire and explosion accident occured was carried out. This report also describes the results of bench mark calculations for computer code EVENT84 which was used for the accident analysis. The bench mark calculations were performed by comparing the analytical results by EVENT84 code with the experimental data of safety demonstration tests of ventilation system which were carried out by JAERI. We confirmed the applicability of EVENT84 code with the conservative results. The pressure analysis in cell ventilation ducts at bituminization facility were performed by comparing the analytical results of duct pressure by EVENT84 code with the yield stress of destroyed ducts by explosion, in order to estimate the scale of explosion. As a result, we could not explain the damage of ducts quantitatively, but we found the local pressure peaks analytically in downstream ducts where the serious damages were observed. (author)

  2. Clinicopathological features and prognosis of mucin-producing bile duct tumor and mucinous cystic tumor of the liver: a multi-institutional study by the Japan Biliary Association.

    Science.gov (United States)

    Kubota, Keiichi; Nakanuma, Yasuni; Kondo, Fukuo; Hachiya, Hiroyuki; Miyazaki, Masaru; Nagino, Masato; Yamamoto, Masakazu; Isayama, Hiroyuki; Tabata, Masami; Kinoshita, Hisafumi; Kamisawa, Terumi; Inui, Kazuo

    2014-03-01

    The aim of this study was to determine the clinicopathological features and surgical outcomes of mucinous cystic neoplasm of the liver (MCN) and mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB). We performed a multi-institutional, retrospective study of patients with MCN or M-IPNB pathologically defined by the presence or absence of an ovarian-like stroma. The M-IPNB and MCN were diagnosed in 119 and nine patients, respectively. MCN was observed in female patients, while M-IPNB produced symptoms of cholangitis. M-IPNBs were classed as low or intermediate grade in 53 cases, high grade in 23 and invasive carcinoma in 43. Fifty-one of the M-IPNBs were the pancreatobiliary type (PT), 33 were the intestinal type (IT), 23 were the oncocytic type (OT), and 12 were the gastric type (GT). The 1-, 5- and 10-year survival rates for the 105 patients with M-IPNB were 96%, 84% and 81%, respectively, while the 5-year survival rate for patients with MCN was 100%. OT and GT M-IPNB had better 10-year survival rates than PT and IT M-IPNB. Although MCN has different features from M-IPNB, both diseases have a good prognosis after resection. The cellular type of M-IPNB appears to predict outcome. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  3. HVAC; Heating, Ventilation, Air Conditioning - Aerosol Duct Sealant

    Science.gov (United States)

    2016-09-01

    material was applied. Annual energy and cost savings were predicted based on a typical weather year for each site. The installation of the duct...Balance reports; Visible dust streaks on duct work, ceilings near supply diffusers, or electrical boxes; Comfort complaints Specific Leakage...energy consumption , depending on the HVAC system type and the location of the ducts that were sealed. The cost effectiveness of the technology is

  4. Active noise control in a duct to cancel broadband noise

    Science.gov (United States)

    Chen, Kuan-Chun; Chang, Cheng-Yuan; Kuo, Sen M.

    2017-09-01

    The paper presents cancelling duct noises by using the active noise control (ANC) techniques. We use the single channel feed forward algorithm with feedback neutralization to realize ANC. Several kinds of ducts noises including tonal noises, sweep tonal signals, and white noise had investigated. Experimental results show that the proposed ANC system can cancel these noises in a PVC duct very well. The noise reduction of white noise can be up to 20 dB.

  5. Isolated Common Hepatic Artery Branch Thrombosis: Results and Risk Factors

    Directory of Open Access Journals (Sweden)

    Abdoulhossein Davoodabadi

    2016-10-01

    Full Text Available Isolated common hepatic artery branch thrombosis with severe gastric ischemia and duodenojejunal infarction is a rare condition; it usually presents with acute abdomen and may be associated with underlying thrombotic risk factors. We present a 35-year-old man admitted to our hospital with five days history of sudden abdominal pain and deteriorating epigastric pain. He was a driver and had no any past medical history. Explorative laparotomy showed: distal 2/3 gastric, duodenojejunal and papilla vater was sloughed. The stomach subtotal and sloughed duodenum and first 20 cm of jejunum were resected, continuity of the gastrointestinal was preserved with anastomosis of the proximal part of jejunum to gastric stump, pancreatic duct, and CBD repaired to the lateral side of jejunum on the guide of two 18 French feeding tube as an external drain. The patient had a good immediate postoperative recovery. Coagulation checkup after operation revealed isolated Hyperhomocysteinemia.

  6. Risk factors for central bile duct injury complicating partial liver resection

    NARCIS (Netherlands)

    Boonstra, E. A.; de Boer, M. T.; Sieders, E.; Peeters, P. M. J. G.; de Jong, K. P.; Slooff, M. J. H.; Porte, R. J.

    Background: Bile duct injury is a serious complication following liver resection. Few studies have differentiated between leakage from small peripheral bile ducts and central bile duct injury (CBDI), defined as an injury leading to leakage or stenosis of the common bile duct, common hepatic duct,

  7. Computed tomography of hepatocellular carcinoma. Dilatation of intrahepatic bile duct

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soomi; Nakamura, Hitonobu; Tanaka, Ken; Hori, Shinichi; Tokunaga, Kou [Osaka Univ. (Japan). Faculty of Medicine

    1983-10-01

    Based on a series of CT of the liver in 125 patients with hepatoma and 45 patients with metastatic hepatic tumors, the mode of dilatation of the intrahepatic bile duct was examined. In patients with hepatoma, partia dilatations of intrahepatic bile duct were more commonly seen than general dilatations. On the other hand, there was no case of partial dilatation of the intrahepatic bile duct in patients with metastatic hepatic tumors. It could be concluded that partial dilatation of the intrahepatic bile duct is an useful CT finding to make a diagnosis of hepatoma, particularly to differentiate hepatoma from metastatic hepatic tumor.

  8. ATP release, generation and hydrolysis in exocrine pancreatic duct cells

    DEFF Research Database (Denmark)

    Kowal, Justyna Magdalena; Yegutkin, G.G.; Novak, Ivana

    2015-01-01

    Extracellular adenosine triphosphate (ATP) regulates pancreatic duct function via P2Y and P2X receptors. It is well known that ATP is released from upstream pancreatic acinar cells. The ATP homeostasis in pancreatic ducts, which secrete bicarbonate-rich fluid, has not yet been examined. First, ou...... may be important in pancreas physiology and potentially in pancreas pathophysiology....... aim was to reveal whether pancreatic duct cells release ATP locally and whether they enzymatically modify extracellular nucleotides/sides. Second, we wished to explore which physiological and pathophysiological factors may be important in these processes. Using a human pancreatic duct cell line, Capan...

  9. Duct Remediation Program: Engineered access research and construction

    International Nuclear Information System (INIS)

    Beckman, T.D.; Davis, M.M.; Karas, T.M.

    1992-01-01

    The Rocky Flats Plant, Duct Remediation mission concentrated on removing Plutonium Oxide from the process ductwork in the primary Plutonium processing facility. When possible, remediation took place from existing process gloveboxes. Fifteen locations were identified, however, that required accessing duct runs where no process gloveboxes existed. The building's second floor utility areas had many locations where long, inaccessible duct runs were prevalent. Consequently, an extensive program for design, procurement and construction was initiated to contain and isolate ducts for penetration when existing glovebox sites were not present

  10. Occlusion of the cystic duct by electrocoagulation: A radiologic technique

    International Nuclear Information System (INIS)

    Becker, C.D.; Quenville, W.F.; Burhenne, H.J.

    1987-01-01

    Chemical dissolution and extracorporeal shock wave lithotripsy are promising new methods for the treatment of cholelithiasis without cholecystectomy. Nonsurgical defunctionalization of the gallbladder is now required to prevent recurrent stone formation. The authors consider cystic duct occlusion to be the first step. Ten domestic pigs underwent transcatheter electrocoagulation of the cystic duct via a cholecystostomy under fluoroscopic control. Stricture formation was followed by complete cystic duct occlusion in all ten cases. After a follow-up period ranging from 2 to 17 weeks (mean, 13 weeks), the animals were killed. Histologic studies demonstrated that complete obliteration of the cystic duct lumen was due to fibrous scar formation

  11. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  12. Effectiveness of duct sealing and duct insulation in multi-family buildings. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Karins, N.H.; Tuluca, A.; Modera, M.

    1997-07-01

    This research investigated the cost-effectiveness of sealing and insulating the accessible portions of duct systems exposed to unconditioned areas in multifamily housing. Airflow and temperature measurements were performed in 25 apartments served by 10 systems a 9 multi-family properties. The measurements were performed before and after each retrofit, and included apartment airflow (supply and return), duct system temperatures, system fan flow and duct leakage area. The costs for each retrofit were recorded. The data were analyzed and used to develop a prototypical multifamily house. This prototype was used in energy simulations (DOE-2.1E) and air infiltration simulations (COMIS 2.1). The simulations were performed for two climates: New York City and Albany. In each climate, one simulation was performed assuming the basement was tight, and another assuming the basement was leaky. Simulation results and average retrofit costs were used to calculate cost-effectiveness. The results of the analysis indicate that sealing leaks of the accessible ductwork is cost-effective under all conditions simulated (simple payback was between 3 and 4 years). Insulating the accessible ductwork, however, is only cost-effective for buildings with leaky basement, in both climates (simple paybacks were less than 5 years). The simple payback period for insulating the ducts in buildings with tight basements was greater than 10 years, the threshold of cost-effectiveness for this research. 13 refs., 5 figs., 27 tabs.

  13. Fluorescent Method for Observing Intravascular Bonghan Duct

    Directory of Open Access Journals (Sweden)

    Byung-Cheon Lee

    2005-12-01

    Full Text Available Observation of intra-vascular threadlike structures in the blood vessels of rats is reported with the images by differential interference contrast microscope, and fluorescence inverted microscope of the acridine-orange stained samples. The confocal microscope image and the hematoxylin-eosin staining revealed the distinctive pattern of nuclei distribution that clearly discerned the threadlike structure from fibrin, capillary, small venule, arteriole, or lymph vessel. Physiological function of the intra-vascular thread in connection with acupuncture is discussed. Especially, this threadlike duct can be a circulation path for herb-liquid flow, which may provide the scientific mechanism for therapeutic effect of herbal acupuncture.

  14. Levitated Duct Fan (LDF) Aircraft Auxiliary Generator

    Science.gov (United States)

    Eichenberg, Dennis J.; Emerson, Dawn C.; Gallo, Christopher A.; Thompson, William K.

    2011-01-01

    This generator concept includes a novel stator and rotor architecture made from composite material with blades attached to the outer rotating shell of a ducted fan drum rotor, a non-contact support system between the stator and rotor using magnetic fields to provide levitation, and an integrated electromagnetic generation system. The magnetic suspension between the rotor and the stator suspends and supports the rotor within the stator housing using permanent magnets attached to the outer circumference of the drum rotor and passive levitation coils in the stator shell. The magnets are arranged in a Halbach array configuration.

  15. JET neutral beam duct Optical Interlock

    Energy Technology Data Exchange (ETDEWEB)

    Ash, A.D.; Jones, T.T.C.; Surrey, E.; Ćirić, D.; Hall, S.I.; Young, D.; Afzal, M.; Hackett, L.; Day, I.E.; King, R.

    2015-10-15

    Highlights: • Optical Interlocks were installed on the JET NBI system as part of the EP2 upgrade. • The system protects the JET tokamak and NBI systems from thermal load damage. • Balmer-α beam emission is used to monitor the neutral beam-line pressure. • We demonstrate an improved trip delay of 2 ms compared to 50 ms before EP2. - Abstract: The JET Neutral Beam Injection (NBI) system is the most powerful neutral beam plasma heating system currently operating. Optical Interlocks were installed on the beam lines in 2011 for the JET Enhancement Project 2 (EP2), when the heating power was increased from 23 MW to 34 MW. JET NBI has two beam lines. Each has eight positive ion injectors operating in deuterium at 80 kV–125 kV (accelerator voltage) and up to 65 A (beam current). Heating power is delivered through two ducts where the central power density can be more than 100 MW/m{sup 2}. In order to deliver this safely, the beam line pressure should be below 2 × 10{sup −5} mbar otherwise the power load on the duct from the re-ionised fraction of the beam is excessive. The new Optical Interlock monitors the duct pressure by measuring the Balmer-α beam emission (656 nm). This is proportional to the instantaneous beam flux and the duct pressure. Light is collected from a diagnostic window and focused into 1-mm diameter fibres. The Doppler shifted signal is selected using an angle-tuned interference filter. The light is measured by a photo-multiplier module with a logarithmic amplifier. The interlock activation time of 2 ms is sufficient to protect the system from a fully re-ionised beam—a significant improvement on the previous interlock. The dynamic range is sufficient to see bremsstrahlung emission from JET plasma and not saturate during plasma disruptions. For high neutron flux operations the optical fibres within the biological shield can be annealed to 350 °C. A self-test is possible by illuminating the diagnostic window with a test lamp and measuring

  16. Spiral branches and star formation

    International Nuclear Information System (INIS)

    Zasov, A.V.

    1974-01-01

    Origin of spiral branches of galaxies and formation of stars in them are considered from the point of view of the theory of the gravitational gas condensation, one of comparatively young theories. Arguments are presented in favour of the stellar condensation theory. The concept of the star formation of gas is no longer a speculative hypothesis. This is a theory which assumes quantitative verification and explains qualitatively many facts observed. And still our knowledge on the nature of spiral branches is very poor. It still remains vague what processes give origin to spiral branches, why some galaxies have spirals and others have none. And shapes of spiral branches are diverse. Some cases are known when spiral branches spread outside boundaries of galaxies themselves. Such spirals arise exclusively in the region where there are two or some interacting galaxies. Only first steps have been made in the explanation of the galaxy spiral branches, and it is necessary to carry out new observations and new theoretical calculations

  17. Ultrasound imaging of the mouse pancreatic duct using lipid microbubbles

    Science.gov (United States)

    Banerjee, B.; McKeown, K. R.; Skovan, B.; Ogram, E.; Ingram, P.; Ignatenko, N.; Paine-Murrieta, G.; Witte, R.; Matsunaga, T. O.

    2012-03-01

    Research requiring the murine pancreatic duct to be imaged is often challenging due to the difficulty in selectively cannulating the pancreatic duct. We have successfully catheterized the pancreatic duct through the common bile duct in severe combined immune deficient (SCID) mice and imaged the pancreatic duct with gas filled lipid microbubbles that increase ultrasound imaging sensitivity due to exquisite scattering at the gas/liquid interface. A SCID mouse was euthanized by CO2, a midline abdominal incision made, the common bile duct cut at its midpoint, a 2 cm, 32 gauge tip catheter was inserted about 1 mm into the duct and tied with suture. The duodenum and pancreas were excised, removed in toto, embedded in agar and an infusion pump was used to instill normal saline or lipid-coated microbubbles (10 million / ml) into the duct. B-mode images before and after infusion of the duct with microbubbles imaged the entire pancreatic duct (~ 1 cm) with high contrast. The microbubbles were cavitated by high mechanical index (HMI) ultrasound for imaging to be repeated. Our technique of catheterization and using lipid microbubbles as a contrast agent may provide an effective, affordable technique of imaging the murine pancreatic duct; cavitation with HMI ultrasound would enable repeated imaging to be performed and clustering of targeted microbubbles to receptors on ductal cells would allow pathology to be localized accurately. This research was supported by the Experimental Mouse Shared Service of the AZ Cancer Center (Grant Number P30CA023074, NIH/NCI and the GI SPORE (NIH/NCI P50 CA95060).

  18. Global genomic analysis of intraductal papillary mucinous neoplasms of the pancreas reveals significant molecular differences compared to ductal adenocarcinoma.

    Science.gov (United States)

    Fritz, Stefan; Fernandez-del Castillo, Carlos; Mino-Kenudson, Mari; Crippa, Stefano; Deshpande, Vikram; Lauwers, Gregory Y; Warshaw, Andrew L; Thayer, Sarah P; Iafrate, A John

    2009-03-01

    To determine whether intraductal papillary mucinous neoplasms of the pancreas (IPMNs) have a different genetic background compared with ductal adenocarcinoma (PDAC). The biologic and clinical behavior of IPMNs and IPMN-associated adenocarcinomas is different from PDAC in having a less aggressive tumor growth and significantly improved survival. Up to date, the molecular mechanisms underlying the clinical behavior of IPMNs are incompletely understood. 128 cystic pancreatic lesions were prospectively identified during the course of 2 years. From the corresponding surgical specimens, 57 IPMNs were separated and subdivided by histologic criteria into those with low-grade dysplasia, moderate dysplasia, high-grade dysplasia, and invasive cancer. Twenty specimens were suitable for DNA isolation and subsequent performance of array CGH. While none of the IPMNs with low-grade dysplasia displayed detectable chromosomal aberrations, IPMNs with moderate and high-grade dysplasia showed frequent copy number alterations. Commonly lost regions were located on chromosome 5q, 6q, 10q, 11q, 13q, 18q, and 22q. The incidence of loss of chromosome 5q, 6q, and 11q was significantly higher in IPMNs with high-grade dysplasia or invasion compared with PDAC. Ten of 13 IPMNs with moderate dysplasia or malignancy had loss of part or all of chromosome 6q, with a minimal deleted region between linear positions 78.0 and 130.0. This study is the first to use array CGH to characterize IPMNs. Recurrent cytogenetic alterations were identified and were different than those described in PDAC. Array CGH may help distinguish between these 2 entities and give insight into the differences in their biology and prognosis.

  19. Common bile duct cancer with massive necrosis mimicking choledochal dilatation on CT

    International Nuclear Information System (INIS)

    Miyake, H.; Matsumoto, S.; Ueda, S.; Maeda, T.; Aikawa, H.; Mori, H.

    1991-01-01

    Carcinomas of the common bile duct are usually seen as dilatation of the bile duct proximal to a solid mass on CT. In the case reported here, the common bile duct cancer itself mimicked dilated common bile duct on CT because of massive necrosis. In a case of simulating dilated common bile duct on CT, and discrepancy between CT and ultrasonography or endoscopic retrograde cholangiopancreatography, a common bile duct cancer with massive necrosis should be included in the differential diagnosis. (orig.)

  20. Morphological study of pancreatic duct in red jungle fowl | Kadhim ...

    African Journals Online (AJOL)

    Neither goblet cells nor ductal glands were found in the pancreatic ducts. Secretion of both neutral and sulfated materials by the epithelial lining the pancreatic ducts, suggesting that they are acting not only to facilitate the transport of the pancreatic juice, but also as a protective barrier to protect the gland from autodigestion.

  1. Ursodeoxycholic acid treatment of vanishing bile duct syndromes

    NARCIS (Netherlands)

    Pusl, Thomas; Beuers, Ulrich

    2006-01-01

    Vanishing bile duct syndromes (VBDS) are characterized by progressive loss of small intrahepatic ducts caused by a variety of different diseases leading to chronic cholestasis, cirrhosis, and premature death from liver failure. The majority of adult patients with VBDS suffer from primary biliary

  2. Bile duct anastomotic stricture after pediatric living donor liver transplantation.

    Science.gov (United States)

    Chok, Kenneth S H; Chan, See Ching; Chan, Kwong Leung; Sharr, William W; Tam, Paul K H; Fan, Sheung Tat; Lo, Chung Mau

    2012-07-01

    Hepaticojejunostomy is a well-accepted method, whereas duct-to-duct anastomosis is gaining popularity for bile duct reconstruction in pediatric living donor liver transplantation (LDLT). Biliary complications, especially biliary anastomotic stricture (BAS), are not clearly defined. The aim of the present study is to determine the rate of BAS and its associated risk factors. The study included 78 pediatric patients (duct-to-duct anastomosis during LDLT. The median follow-up period for the BAS group and the non-BAS group was 57.8 and 79.5 months, respectively (P = .683). Ten of the patients with BAS required percutaneous transhepatic biliary drainage with or without dilatation for treating the stricture. Multivariable analysis showed that hepatic artery thrombosis and duct-to-duct anastomosis were 2 risk factors associated with BAS. In pediatric LDLT, hepaticojejunostomy is the preferred method for bile duct reconstruction, but more large-scale research needs to be done to reconfirm this result. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Liver and Bile Duct Cancer—Patient Version

    Science.gov (United States)

    Liver cancer includes hepatocellular carcinoma and bile duct cancer (cholangiocarcinoma). Risk factors for HCC include chronic infection with hepatitis B or C and cirrhosis of the liver. Start here to find information on liver and bile duct cancer treatment, causes and prevention, screening, research, and statistics.

  4. Cystic duct closure by sealing with bipolar electrocoagulation

    DEFF Research Database (Denmark)

    Schulze, S; Damgaard, B; Jørgensen, Lars Nannestad

    2010-01-01

    BACKGROUND: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure) for closure of the cystic duct. METHODS: The records from consecutive laparoscopic cholecystectomies performed i...

  5. Magnetic resonance imaging of Muellerian duct anomalies in children

    International Nuclear Information System (INIS)

    Li, Yi; Phelps, Andrew; Zapala, Matthew A.; MacKenzie, John D.; MacKenzie, Tippi C.; Courtier, Jesse

    2016-01-01

    Muellerian duct anomalies encompass a wide variety of disorders resulting from abnormalities in the embryological development of the Muellerian ducts. In the prepubertal pediatric population, Muellerian duct anomalies are often incidental findings on studies obtained for other reasons. The onset of menses can prompt more clinical symptoms. Proper characterization of Muellerian duct anomalies is important because these anomalies can affect the development of gynecological disorders as well as fertility. Muellerian duct anomalies also carry a high association with other congenital anomalies, particularly renal abnormalities. MRI is widely considered the best modality for assessing Muellerian duct anomalies; it provides multiplanar capability, clear anatomical detail and tissue characterization without ionizing radiation. MRI allows for careful description of Muellerian duct anomalies, often leading to classification into the most widely accepted classification system for Muellerian duct anomalies. This system, developed by the American Society of Reproductive Medicine, includes seven subtypes: uterine agenesis/hypoplasia, unicornuate, didelphys, bicornuate, septate, arcuate, and diethylstilbestrol (DES) drug-related uterus. In cases of complex anomalies that defy classification, MRI allows detailed depiction of all components of the anatomical abnormality, allowing for proper management and surgical planning. (orig.)

  6. Surgical management of Stenson's duct injury using epidural catheter

    African Journals Online (AJOL)

    2012-07-05

    Jul 5, 2012 ... Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of ... to diagnose and manage the parotid duct injuries using an “epidural catheter” which is often used for inducing spinal anesthesia. .... Water-soluble contrast media have a definite advantage.

  7. Chloride and potassium conductances of cultured human sweat ducts

    DEFF Research Database (Denmark)

    Novak, I; Pedersen, P S; Larsen, Erik Hviid

    1992-01-01

    The purpose of this study was to characterize the ion conductances, in particular those for Cl- and K+, of human sweat duct cells grown in primary culture. Sweat duct cells from healthy individuals were grown to confluence on a dialysis membrane, which was then mounted in a mini-Ussing chamber an...

  8. Seismic assessment of the Pickering pressure relief duct

    International Nuclear Information System (INIS)

    Ghobarah, A.

    1995-05-01

    The objectives of the study are to examine the structural response of the Pickering pressure relief duct when subjected to earthquake ground motion and to estimate the seismic withstand capacity of various components of the structural system on the basis of performance criteria consistent with the safety function of the duct. (author). 24 refs., 16 tabs., 31 figs

  9. Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

    Science.gov (United States)

    Atik-Ugan, Sezen; Saltik, Irfan Levent

    2018-04-01

    Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

  10. Positive predictive value of cholescintigraphy in common bile duct obstruction

    International Nuclear Information System (INIS)

    Lecklitner, M.L.; Austin, A.R.; Benedetto, A.R.; Growcock, G.W.

    1986-01-01

    Technetium-99m DISIDA imaging was employed in 400 patients to differentiate obstruction of the common bile duct from medical and other surgical causes of hyperbilirubinemia. Sequential anterior images demonstrated variable degrees of liver uptake, yet there was no evidence of intrabiliary or extrabiliary radioactivity for at least 4 hr after injection in 25 patients. Twenty-three patients were surgically documented to have complete obstruction of the common bile duct. One patient had hepatitis, and another had sickle cell crisis without bile duct obstruction. The remaining patients had either partial or no obstruction of the common bile duct. We conclude that the presence of liver uptake without evident biliary excretion by 4 hr on cholescintigraphy is highly sensitive and predictive of total obstruction of the common bile duct

  11. Cystic duct remnant mucocele in a liver transplant recipient

    Energy Technology Data Exchange (ETDEWEB)

    Ahlawat, Sushil K. [Georgetown University Hospital, Department of Medicine, Division of Gastroenterology, Washington, DC (United States); University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ (United States); Fishbien, Thomas M. [Georgetown University Hospital, Department of Medicine, Division of Gastroenterology, Washington, DC (United States); Haddad, Nadim G. [Georgetown University Hospital, Department of Surgery, Division of Transplant Surgery, Washington, DC (United States)

    2008-08-15

    Cystic duct remnant mucocele is an extremely rare complication of liver transplantation in children. Surgical correction is usually required for cystic duct remnant mucocele when it causes biliary obstruction. We describe a 14-month-old liver transplant recipient who presented with biliary obstruction 1 month after orthotopic liver transplantation with an end-to-end choledochocholedocal biliary anastomosis for hepatoblastoma. US, CT and cholangiography findings were consistent with mucocele of the allograft cystic duct remnant. Surgery was not needed in our patient because the mucocele and biliary obstruction had resolved on repeat imaging most likely due to guidewire manipulation during cholangiography, resulting in opening of the cystic duct remnant orifice and drainage into the common duct. (orig.)

  12. Cystic duct remnant mucocele in a liver transplant recipient

    International Nuclear Information System (INIS)

    Ahlawat, Sushil K.; Fishbien, Thomas M.; Haddad, Nadim G.

    2008-01-01

    Cystic duct remnant mucocele is an extremely rare complication of liver transplantation in children. Surgical correction is usually required for cystic duct remnant mucocele when it causes biliary obstruction. We describe a 14-month-old liver transplant recipient who presented with biliary obstruction 1 month after orthotopic liver transplantation with an end-to-end choledochocholedocal biliary anastomosis for hepatoblastoma. US, CT and cholangiography findings were consistent with mucocele of the allograft cystic duct remnant. Surgery was not needed in our patient because the mucocele and biliary obstruction had resolved on repeat imaging most likely due to guidewire manipulation during cholangiography, resulting in opening of the cystic duct remnant orifice and drainage into the common duct. (orig.)

  13. Scintigraphy of cysts of the common bile duct in children

    International Nuclear Information System (INIS)

    Mironov, S.P.; Akopyan, V.G.; Murieva, Z.D.; Tumanyan, G.T.; Mironova, E.S.

    1984-01-01

    Cyst of the common bile duct, the most frequent variant of cystic dilatation of the extrahepatic biliary tract, represents a serious diagnostic problem. 13 children with cysts of the common bile duct were studied by the method of dynamic scintigraphy with sup(99m)Tc-HIDA. The scintigraphic picture was characterized by the following signs: sacculated or spheroidal dilatation of the common bile duct, dilatation of the left or both lobular bile ducts, absence of the gall bladder visualization. Change of indicators of the hepatic function and the time of interstinal visualization reflects both the disorder of distal parts permeability and the degree of cyst drainage. An experience of radioisotropic cholegraphy application reveals, that the efficiency of preoperational diagnosis of cysts of the common bile duct increases as a result of the more accurate evaluation of the dynamic of improvement of absorptive-excretory hepatic function after different variants of operations

  14. Consistent approach to air-cleaning system duct design

    International Nuclear Information System (INIS)

    Miller, W.H.; Ornberg, S.C.; Rooney, K.L.

    1981-01-01

    Nuclear power plant air-cleaning system effectiveness is dependent on the capability of a duct system to safely convey contaminated gas to a filtration unit and subsequently to a point of discharge. This paper presents a logical and consistent design approach for selecting sheet metal ductwork construction to meet applicable criteria. The differences in design engineers' duct construction specifications are acknowledged. Typical duct construction details and suggestions for their effective use are presented. Improvements in duct design sections of ANSI/ASME N509-80 are highlighted. A detailed leakage analysis of a control room HVAC system is undertaken to illustrate the effects of conceptual design variations on duct construction requirements. Shortcomings of previously published analyses and interpretations of a current standard are included

  15. Space plasma branch at NRL

    Science.gov (United States)

    The Naval Research Laboratory (Washington, D.C.) formed the Space Plasma Branch within its Plasma Physics Division on July 1. Vithal Patel, former Program Director of Magnetospheric Physics, National Science Foundation, also joined NRL on the same date as Associate Superintendent of the Plasma Physics Division. Barret Ripin is head of the newly organized branch. The Space Plasma branch will do basic and applied space plasma research using a multidisciplinary approach. It consolidates traditional rocket and satellite space experiments, space plasma theory and computation, with laboratory space-related experiments. About 40 research scientists, postdoctoral fellows, engineers, and technicians are divided among its five sections. The Theory and Computation sections are led by Joseph Huba and Joel Fedder, the Space Experiments section is led by Paul Rodriguez, and the Pharos Laser Facility and Laser Experiments sections are headed by Charles Manka and Jacob Grun.

  16. Coulomb branches with complex singularities

    Science.gov (United States)

    Argyres, Philip C.; Martone, Mario

    2018-06-01

    We construct 4d superconformal field theories (SCFTs) whose Coulomb branches have singular complex structures. This implies, in particular, that their Coulomb branch coordinate rings are not freely generated. Our construction also gives examples of distinct SCFTs which have identical moduli space (Coulomb, Higgs, and mixed branch) geometries. These SCFTs thus provide an interesting arena in which to test the relationship between moduli space geometries and conformal field theory data. We construct these SCFTs by gauging certain discrete global symmetries of N = 4 superYang-Mills (sYM) theories. In the simplest cases, these discrete symmetries are outer automorphisms of the sYM gauge group, and so these theories have lagrangian descriptions as N = 4 sYM theories with disconnected gauge groups.

  17. A Plug-and-Play Duct System Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Beach, R. [IBACOS, Inc., Pittsburgh, PA (United States); Dickson, B. [IBACOS, Inc., Pittsburgh, PA (United States); Grisolia, A. [IBACOS, Inc., Pittsburgh, PA (United States); Poerschke, A. [IBACOS, Inc., Pittsburgh, PA (United States); Rapport, A. [IBACOS, Inc., Pittsburgh, PA (United States)

    2017-07-01

    This report describes an air distribution system composed of a series of uniformly-sized ducts that terminate in rooms throughout the home and return to a central manifold, similar in fashion to a “home-run” cross-linked polyethylene plumbing system. With a well-designed manifold, each duct receives an equal static pressure potential for airflow from the air handling unit, and the number of needed ducts for each room are simply attached to fittings located on the manifold; in this sense, the system is plug-and-play (PnP). As indicated, all ducts in the PnP system are identical in size and small enough to fit in the ceiling and wall cavities of a house (i.e., less than 3.5-in. outer diameter). These ducts are also more appropriately sized for the lower airflow requirements of modern, energy-efficient homes; therefore, the velocity of the air moving through the duct is between that of conventional duct systems (approximately 700 ft/min) and high-velocity systems (more than 1,500 ft/min) on the market today. The PnP duct system uses semi-rigid plastic pipes, which have a smooth inner wall and are straightforward to install correctly, resulting in a system that has minimal air leakage. However, plastic ducts are currently not accepted by code for use in residential buildings; therefore, the project team considered other duct materials for the system that are currently accepted by code, such as small-diameter, wirehelix, flexible ductwork.

  18. A Plug-and-Play Duct System Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Beach, Robert [IBACOS, Inc., Pittsburgh, PA (United States); Dickson, Bruce [IBACOS, Inc., Pittsburgh, PA (United States); Grisolia, Anthony [IBACOS, Inc., Pittsburgh, PA (United States); Poerschke, Andrew [IBACOS, Inc., Pittsburgh, PA (United States); Rapport, Ari [IBACOS, Inc., Pittsburgh, PA (United States)

    2017-07-10

    This report describes an air distribution system composed of a series of uniformly-sized ducts that terminate in rooms throughout the home and return to a central manifold, similar in fashion to a “home-run” cross-linked polyethylene plumbing system. With a well-designed manifold, each duct receives an equal static pressure potential for airflow from the air handling unit, and the number of needed ducts for each room are simply attached to fittings located on the manifold; in this sense, the system is plug-and-play (PnP). As indicated, all ducts in the PnP system are identical in size and small enough to fit in the ceiling and wall cavities of a house (i.e., less than 3.5-in. outer diameter). These ducts are also more appropriately sized for the lower airflow requirements of modern, energy-efficient homes; therefore, the velocity of the air moving through the duct is between that of conventional duct systems (approximately 700 ft/min) and high-velocity systems (more than 1,500 ft/min) on the market today. The PnP duct system uses semi-rigid plastic pipes, which have a smooth inner wall and are straightforward to install correctly, resulting in a system that has minimal air leakage. However, plastic ducts are currently not accepted by code for use in residential buildings; therefore, the project team considered other duct materials for the system that are currently accepted by code, such as small-diameter, wirehelix, flexible ductwork.

  19. Self-retaining small-looped catheter for narrow bile ducts in high common bile duct obstruction

    International Nuclear Information System (INIS)

    Guenther, R.W.; Daehnert, W.

    1985-01-01

    A new self-retaining catheter was devised for percutaneous drainage of small bile ducts. The device allows safe external drainage without the risk of catheter dislocation even in high bile duct obstruction. The catheter is also suitable for percutaneous nephrostomy in non-dilated pyelocaliceal system. (orig.)

  20. Branch prediction in the pentium family

    DEFF Research Database (Denmark)

    Fog, Agner

    1998-01-01

    How the branch prediction mechanism in the Pentium has been uncovered with all its quirks, and the incredibly more effective branch prediction in the later versions.......How the branch prediction mechanism in the Pentium has been uncovered with all its quirks, and the incredibly more effective branch prediction in the later versions....

  1. Breast intraductal papillomas without atypia in radiologic-pathologic concordant core-needle biopsies: Rate of upgrade to carcinoma at excision.

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana D; Brennan, Sandra B; Murray, Melissa P; Bowser, Zenica L; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth A; Brogi, Edi

    2016-09-15

    The surgical management of mammary intraductal papilloma without atypia (IDP) identified at core-needle biopsy (CNB) is controversial. This study assessed the rate of upgrade to carcinoma at surgical excision (EXC). This study identified women with a CNB diagnosis of intraductal papilloma without atypia or carcinoma at a cancer center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. The radiologic and clinicopathologic features of patients with a CNB diagnosis of IDP were correlated with an upgrade to carcinoma at EXC. The study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent EXC. The upgrade rate was 2.3% (4 of 171). The upgraded lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥ 8 mm away. Twenty-four women (25 IDPs) did not undergo EXC and had stable imaging on follow-up (median, 23.5 months). The upgrade rate at EXC for IDPs diagnosed at CNB with radiologic-pathologic concordance was 2.3%. These findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2819-2827. © 2016 American Cancer Society. © 2016 American Cancer Society.

  2. Benign bile duct stenosis: diagnosis and treatment

    International Nuclear Information System (INIS)

    Garcia-Medina, J.; Casal, M.; Vieito, X.

    1997-01-01

    The bening injuries of the biliary ducts are relatively little frequent. Exist two groups of injuries: to due to them to a series for responsible pathologies for itself of the such injuries training, and that basically are the sclerosant cholangitis, the chronic pancreatitis and the stenosis of the sfinter of Oddi, and related them to previous surgery. On both groups eitological, the interventional radiology occupies a place in the diagnosis as well as in the treatment, complementing or substituting to the surgery. Due to the greater frequency of the postchirurgical injuries, we have centered us basically in them. We make a review of the current state of the topic and a bibliographical tracking, emphasizing the most relevant projects. We show some clinical cases of our subject-specific experience. (Author) 42 refs

  3. Cash efficiency for bank branches.

    Science.gov (United States)

    Cabello, Julia García

    2013-01-01

    Bank liquidity management has become a major issue during the financial crisis as liquidity shortages have intensified and have put pressure on banks to diversity and improve their liquidity sources. While a significant strand of the literature concentrates on wholesale liquidity generation and on the alternative to deposit funding, the management of an inventory of cash holdings within the banks' branches is also a relevant issue as any significant improvement in cash management at the bank distribution channels may have a positive effect in reducing liquidity tensions. In this paper, we propose a simple programme of cash efficiency for the banks' branches, very easy to implement, which conform to a set of instructions to be imposed from the bank to their branches. This model proves to significantly reduce cash holdings at branches thereby providing efficiency improvements in liquidity management. The methodology we propose is based on the definition of some stochastic processes combined with renewal processes, which capture the random elements of the cash flow, before applying suitable optimization programmes to all the costs involved in cash movements. The classical issue of the Transaction Demand for the Cash and some aspects of Inventory Theory are also present. Mathematics Subject Classification (2000) C02, C60, E50.

  4. NCI: DCTD: Biometric Research Branch

    Science.gov (United States)

    The Biometric Research Branch (BRB) is the statistical and biomathematical component of the Division of Cancer Treatment, Diagnosis and Centers (DCTDC). Its members provide statistical leadership for the national and international research programs of the division in developmental therapeutics, developmental diagnostics, diagnostic imaging and clinical trials.

  5. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  6. Experiments and calculations on neutron streaming through bent ducts

    Energy Technology Data Exchange (ETDEWEB)

    Kloosterman, J.L.; Hoogenboom, J.E. (Delft Univ. of Technology (Netherlands). Interfaculty Reactor Inst.); Zsolnay, E.M.

    1993-07-01

    Neutron spectra in a cylindrical straight duct and in bent ducts with angles of 30deg, 60deg and 90deg have been measured by the multiple foil activation and thermoluminescence dosimetry methods. Two-dimensional discrete ordinates and three-dimensional Monte Carlo calculations are executed, and the results are compared with the measurements. The flow rate at the duct entrance calculated by the DOT3.5 code is underestimated by approximately 30 %, due to a conversion of the core and reflector geometry from XY to RZ geometry. The fast neutron flux in the ducts is underestimated by 20 % by the MORSE-SGC/S code due to a too coarse angular mesh of the source, which does not properly represent the actual angular distribution of the fast flux, which is highly peaked forwardly into the ducts. The thermal neutron flux was over-estimated by the Monte Carlo calculation. A method is proposed to calculate the angular distribution of the flow rate at the duct entrance and to calculate the source strength and the angular distribution of the flow rate at the entrance of the second leg of the duct. The results are compared with those of the transport calculations. Generally, the agreement is quite satisfactory. (author).

  7. Water condensation promotes fungal growth in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

    Pasanen, P.; Pasanen, A.-L. (University of Kupopio, Department of Environmental Sciences, Kuopio (Finland)); Jantunen, M. (National Public Health Institute, Kuopio (Finland))

    1993-01-01

    In a subarctic climate the diurnal variation in temperature may cause water condensation in ducts placed in the unheated spaces of a building. In this study, germination time and sporulation of a fungus, Penicillium verrucosum, were studied on dusty, galvanized steel sheet under different moisture conditions at room temperature. The effect of condensed water in a supply air duct on spore amplification was studied in an experimental ventilation set-up. In the field, air temperatures and the dew point temperature of air in the duct were monitored continuously for a week. P. verrucosum germinated on steel surfaces during five-hour incubation of the surface under humid conditions, when the surface has been moist for half an hour, germ tubes appeared within 17 hours. During 24-hour incubation under moist conditions, P. verrucosum produced hyphae and spores. In the experimental set-up the airborne spore counts increased when the air passed through a water-condensing section of the duct. Penicillium was the most abundant fungus sporulated on the moist duct surface. In the field, during humid weather, the surface temperature on the air stream surface decreased to the dew point temperature of the air in the duct. thus water condensation in air ducts may promote fungal growth. (au)

  8. Cystic Duct Closure by Sealing With Bipolar Electrocoagulation

    Science.gov (United States)

    Damgaard, B.; Jorgensen, L. N.; Larsen, S. S.; Kristiansen, V. B.

    2010-01-01

    Background: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure®) for closure of the cystic duct. Methods: The records from consecutive laparoscopic cholecystectomies performed in 2 hospitals with closure of the cystic duct with LigaSure after informed consent were recorded and complications and morbidity registered. The records were compared with those of patients undergoing laparoscopic cholecystectomy with closure of the cystic duct with clips during the same period. Results: During the study period, 218 laparoscopic cholecystectomies were performed; 102 of these were performed with the LigaSure. One patient was excluded due to violation of the protocol. We experienced no cases of cystic duct leakage, but in one patient, bile leakage from the gallbladder bed was observed probably due to a small aberrant duct. Conclusion: The LigaSure system was safe and effective for closure and division of the cystic duct in laparoscopic cholecystectomy. PMID:20412641

  9. The correlation between the dilated extent of bile duct and gallbladder and low bile duct obstructive jaundice diseases

    International Nuclear Information System (INIS)

    Wang Zhongqiu; Lu Guangming; Li Jieshou; Li Weiqin

    2005-01-01

    Objective: To evaluate the diagnostic value about the dilated extent of bile duct and gallbladder in low biliary obstructive diseases. Methods: CT and ERCP findings of 105 patients with low biliary obstructive disease were retrospectively analyzed. The dilated extent of intrahepatic and extra- hepatic bile duct and gallbladder were classified into seven types: Type I: severe dilatation of intrahepatic and extrahepatic bile duct and gallbladder; Type II: severe dilatation of extrahepatic bile duct and gallbladder and slight dilated intrahapetic bile duct; Type III: severe dilatation of intrahepatic and extrahepatic bile duct without or slight dilatation of gallbladder; Type IV: severe extrahepatic bile duct dilatation without or slight dilatation of intrahepatic bile duct and gallbladder; Type V: severe intrahepatic bile duct dilatation without or with slight dilatation of extrahepatic bile duct and gallbladder; Type VI: severe gallbladder dilatation without or with slight intrahepatic and extra- hepatic bile duct dilatation; Type VII: without or with slight dilatation of intrahepatic and extrahepatic bile duct and gallbladder. The biliary system dilated extent of low biliary obstructive disease on CT and ERCP were compared with results of clinical, operation, and pathology. Results: Thirty-three cases of tumor and 72 cases of non-tumor were proved by clinical and operation in 105 patients with low biliary obstructive disease. In 33 tumor patients, 16 patients were identified as Type I, 10 patients Type II, 4 patients Type III, 1 patient Type IV, 2 patients Type VII. In 72 non-tumor patients, 4 patients were identified as Type I, 4 patients Type II, 9 patients Type III, 33 patients Type IV, 2 patients Type V, 11 patients Type VI, 19 patients Type VII. A large difference between I, II type and III-VII type biliary dilatation existed in tumor and non-tumor group (χ 2 =47.33, P<0.01). Conclusion:Low obstructive biliary diseases are closely correlated with the dilated

  10. Module for the organization of a branch of the universal branch driver in the CAMAC standard

    International Nuclear Information System (INIS)

    Nguen Fuk; Smirnov, V.A.; Khmelevski, E.

    1976-01-01

    A module is elaborated for the organization of a branch of the universal branch driver in the CAMAC standard for the conjugation of a control crate trunk with a branch trunk. A block diagram of the module is described; its principal specifications are given. The universal branch driver system may accomodate up to 10 branch organization modules with one control source module

  11. Effects of explosion-generated shock waves in ducts

    International Nuclear Information System (INIS)

    Busby, M.R.; Kahn, J.E.; Belk, J.P.

    1976-01-01

    An explosion in a space causes an increase in temperature and pressure. To quantify the challenge that will be presented to essential components in a ventilation system, it is necessary to analyze the dynamics of a shock wave generated by an explosion, with attention directed to the propagation of such a wave in a duct. Using the equations of unsteady flow and shock tube theory, a theoretical model has been formulated to provide flow properties behind moving shock waves that have interacted with various changes in duct geometry. Empirical equations have been derived to calculate air pressure, temperature, Mach number, and velocity in a duct following an explosion

  12. Preoperative intraluminal irradiation of the extrahepatic bile duct tumor

    International Nuclear Information System (INIS)

    Kamada, Tadashi; Tsujii, Hirohiko; Arimoto, Takuro; Irie, Goro.

    1991-01-01

    From 1984 through 1986, six patients with extrahepatic bile duct tumor were treated preoperatively with intraluminal irradiation of the bile duct. There were no unresectable cases and pathological examination of the surgical specimens showed moderate to remarkable tumor regression in all cases. Postoperative biliary tract hemorrhage occurred in 2 of 3 patients who received 60 Gy at a point 7.5 mm from the center of the source. With accurate preoperative diagnosis of the tumor extent and careful setting of the target area of intraluminal irradiation, improved local tumor control of extrahepatic bile duct tumor can be expected with this method. (author)

  13. BACTERIOLOGICAL INVESTIGATION ON Fasciola hepatica AND CATTLE BILIARY DUCTS

    Directory of Open Access Journals (Sweden)

    A. Panebianco

    2009-03-01

    Full Text Available The aim of this work was to investigate the occurrence of bacteria in Fasciola hepatica and into cattle biliary ducts containing the parasite. A total of 24 liver and 58 F. hepatica samples were analysed. In all biliary ducts and in 62,06% of parasite Enterobacteriaceae were isolated. The bacterial specie more frequently isolated from parasite were Citrobacter freundii (34%, Proteus mirabilis (18%, Providencia rettgeri (12%, Staphylococcus spp. (18%, Enterobacter spp. (12%. There doesn’t appear to be a correlation between bacterial specie from parasite and ducts. The Authors conclude with some related inspective consideration.

  14. A remote joint system for large vacuum ducts

    International Nuclear Information System (INIS)

    Hagmann, D.B.; Coughlan, J.B.

    1983-01-01

    A large remote vacuum duct joining system has been developed for fusion machines that uses several two-jaw screwdriven clamps. The preferred location for clamp installation is inside the vacuum duct where access space is available for the actuating device. It also decreases space needed for handling operations exterior to the duct. The clamp system is unique in that it is low cost, applies force directly over the seal, permits leak testing to the seal annulus, is highly reliable, can be remotely replaced, and is usable on a variety of other applications

  15. Mechanism of primitive duct formation in the pancreas and submandibular glands: a role for SDF-1

    Directory of Open Access Journals (Sweden)

    Courtoy Pierre J

    2009-12-01

    Full Text Available Abstract Background The exocrine pancreas is composed of a branched network of ducts connected to acini. They are lined by a monolayered epithelium that derives from the endoderm and is surrounded by mesoderm-derived mesenchyme. The morphogenic mechanisms by which the ductal network is established as well as the signaling pathways involved in this process are poorly understood. Results By morphological analyzis of wild-type and mutant mouse embryos and using cultured embryonic explants we investigated how epithelial morphogenesis takes place and is regulated by chemokine signaling. Pancreas ontogenesis displayed a sequence of two opposite epithelial transitions. During the first transition, the monolayered and polarized endodermal cells give rise to tissue buds composed of a mass of non polarized epithelial cells. During the second transition the buds reorganize into branched and polarized epithelial monolayers that further differentiate into tubulo-acinar glands. We found that the second epithelial transition is controlled by the chemokine Stromal cell-Derived Factor (SDF-1. The latter is expressed by the mesenchyme, whereas its receptor CXCR4 is expressed by the epithelium. Reorganization of cultured pancreatic buds into monolayered epithelia was blocked in the presence of AMD3100, a SDF-1 antagonist. Analyzis of sdf1 and cxcr4 knockout embryos at the stage of the second epithelial transition revealed transient defective morphogenesis of the ventral and dorsal pancreas. Reorganization of a globular mass of epithelial cells in polarized monolayers is also observed during submandibular glands development. We found that SDF-1 and CXCR4 are expressed in this organ and that AMD3100 treatment of submandibular gland explants blocks its branching morphogenesis. Conclusion In conclusion, our data show that the primitive pancreatic ductal network, which is lined by a monolayered and polarized epithelium, forms by remodeling of a globular mass of non

  16. Kidney branching morphogenesis under the control of a ligand–receptor-based Turing mechanism

    International Nuclear Information System (INIS)

    Menshykau, Denis; Iber, Dagmar

    2013-01-01

    The main signalling proteins that control early kidney branching have been defined. Yet the underlying mechanism is still elusive. We have previously shown that a Schnakenberg-type Turing mechanism can recapitulate the branching and protein expression patterns in wild-type and mutant lungs, but it is unclear whether this mechanism would extend to other branched organs that are regulated by other proteins. Here, we show that the glial cell line-derived neurotrophic factor–RET regulatory interaction gives rise to a Schnakenberg-type Turing model that reproduces the observed budding of the ureteric bud from the Wolffian duct, its invasion into the mesenchyme and the observed branching pattern. The model also recapitulates all relevant protein expression patterns in wild-type and mutant mice. The lung and kidney models are both based on a particular receptor–ligand interaction and require (1) cooperative binding of ligand and receptor, (2) a lower diffusion coefficient for the receptor than for the ligand and (3) an increase in the receptor concentration in response to receptor–ligand binding (by enhanced transcription, more recycling or similar). These conditions are met also by other receptor–ligand systems. We propose that ligand–receptor-based Turing patterns represent a general mechanism to control branching morphogenesis and other developmental processes. (paper)

  17. Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Bile duct cancer (also called cholangiocarcinoma) can occur in the bile ducts in the liver (intrahepatic) or outside the liver (perihilar or distal extrahepatic). Learn about the types of bile duct cancer, risk factors, clinical features, staging, and treatment for bile duct cancer in this expert-reviewed summary.

  18. Bile Duct Cancer (Cholangiocarcinoma) Symptoms, Tests, Prognosis, and Stages (PDQ®)—Patient Version

    Science.gov (United States)

    Bile duct cancer, or cholangiocarcinoma, is rare. Bile ducts are tubes that carry bile between the liver, gallbladder, and small intestine. Bile duct cancer can occur in the intrahepatic, perihilar (Klatskin tumor), or distal extrahepatic area. Learn about tests to diagnose and the stages of bile duct cancer.

  19. ß-adrenergic regulation of ion transport in pancreatic ducts: Patch-clamp study of isolated rat pancreatic ducts

    DEFF Research Database (Denmark)

    Novak, I

    1998-01-01

    BACKGROUND & AIMS: In the intact pancreas, bicarbonate secretion is thought to be controlled by a number of regulators, including adrenergic agonists. The aim of this study was to investigate the effects of adrenergic agonists on pancreatic ducts, which are the site of bicarbonate secretion....... METHODS: Small intralobular ducts were isolated from rat pancreas and studied in vitro by the whole-cell patch clamp technique. Cell membrane voltages and currents were indicators of cellular ion transport. In some ducts, intracellular Ca2+ activity was measured by fluorescence optical methods. RESULTS...

  20. BDC 500 branch driver controller

    CERN Document Server

    Dijksman, A

    1981-01-01

    This processor has been designed for very fast data acquisition and date pre-processing. The dataway and branch highway speeds have been optimized for approximately 1.5 mu sec. The internal processor cycle is approximately 0.8 mu sec. The standard version contains the following functions (slots): crate controller type A1; branch highway driver including terminator; serial I/O port (TTY, VDU); 24 bit ALU and 24 bit program counter; 16 bit memory address counter and 4 word stack; 4k bit memory for program and/or data; battery backup for the memory; CNAFD and crate LAM display; request/grant logic for time- sharing operation of several BDCs. The free slots can be equipped with e.g. extra RAM, computer interfaces, hardware multiplier/dividers, etc. (0 refs).

  1. Status of the development of hot gas ducts for HTRs

    International Nuclear Information System (INIS)

    Stehle, H.; Klas, E.

    1984-01-01

    In the PNP nuclear process heat system the heat generated in the helium cooled core is transferred to the steam reformer and to the successive steam generator or to the intermediate heat exchanger by the primary helium via suitable hot gas ducts. The heat is carried over to the steam gasifier by the intermediate heat exchanger and a secondary helium loop. In both the primary and the secondary loop, the hot gas ducts are internally insulated by a ceramic fibre insulation to protect the support tube and the pressure housing from the high helium temperatures. A graphite hot gas liner will be used for the coaxial primary duct with an annular gap between support tube and pressure shell for the cold gas counterflow. A metallic hot gas liner will be installed in the secondary duct

  2. Improvement in the management of bile duct injuries?

    NARCIS (Netherlands)

    Keulemans, Y. C.; Bergman, J. J.; de Wit, L. T.; Rauws, E. A.; Huibregtse, K.; Tytgat, G. N.; Gouma, D. J.

    1998-01-01

    BACKGROUND: Previous studies have suggested that improvements in diagnostic workup and treatment of bile duct injuries (BDI) sustained during laparoscopic cholecystectomy can be expected as experience increases with the laparoscopic procedure. Many published articles reported that early diagnosis,

  3. Design requirement on KALIMER control rod assembly duct

    International Nuclear Information System (INIS)

    Hwang, W.; Kang, H. Y.; Nam, C.; Kim, J. O.; Kim, Y. J.

    1998-03-01

    This document establishes the design guidelines which are needs for designing the control rod assembly duct of the KALIMER as design requirements. it describes control rod assembly duct of the KALIMER and its requirements that includes functional requirements, performance requirements, interfacing systems, design limits and strength requirements, seismic requirements, structural requirements, environmental requirements, reliability and safety requirements, standard and codes, QA programs, and other requirements. The control rod system consists of three parts, which are drive mechanism, drive-line, and absorber bundle. This report deals with the absorber bundle and its outer duct only because the others are beyond the scope of fuel system design. The guidelines for design requirements intend to be used for an improved design of the control rod assembly duct of the KALIMER. (author). 19 refs

  4. Design requirement on KALIMER control rod assembly duct

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, W.; Kang, H. Y.; Nam, C.; Kim, J. O.; Kim, Y. J

    1998-03-01

    This document establishes the design guidelines which are needs for designing the control rod assembly duct of the KALIMER as design requirements. it describes control rod assembly duct of the KALIMER and its requirements that includes functional requirements, performance requirements, interfacing systems, design limits and strength requirements, seismic requirements, structural requirements, environmental requirements, reliability and safety requirements, standard and codes, QA programs, and other requirements. The control rod system consists of three parts, which are drive mechanism, drive-line, and absorber bundle. This report deals with the absorber bundle and its outer duct only because the others are beyond the scope of fuel system design. The guidelines for design requirements intend to be used for an improved design of the control rod assembly duct of the KALIMER. (author). 19 refs.

  5. Spontaneous common bile duct perforation—A rare clinical entity

    Directory of Open Access Journals (Sweden)

    Melissa Amberger

    Full Text Available Introduction: Spontaneous common bile duct perforation is an uncommon clinical entity in both adults and children. Few case reports have been published since the first clinical description in 1882. Our work has been reported in line with SCARE criteria. Presentation of case: Herein, we describe the case of a 28 year-old female who suffered spontaneous common bile duct perforation while admitted for choledocholithiasis. Discussion: The perforation occurred while in-hospital, and extensive imaging and laboratory tests characterized the disease in detail. To our knowledge, this is the first report of spontaneous common bile duct perforation witnessed from pre-perforation through definitive management. Conclusion: Physicians and Surgeons should seek out this uncommon diagnosis in the patient with suspected Choledocholithiasis who suddenly become peritoneal on physical exam so that definitive care can be expedited. Keywords: Common bile duct, Biliary peritonitis, Choledocholithiasis

  6. Heuristic approach to the passive optical network with fibre duct ...

    African Journals Online (AJOL)

    Integer programming, network flow optimisation, passive optical network, ... This paper uses concepts from network flow optimisation to incorporate fibre duct shar ... [4] studied the survivable constrained ConFL problem and solved a number of.

  7. Body-force-driven multiplicity and stability of combined free and forced convection in rotating curved ducts: Coriolis force

    Science.gov (United States)

    Yang, T.; Wang, L.

    A numerical study is made on the fully developed bifurcation structure and stability of forced convection in a rotating curved duct of square cross-section. Solution structure is determined as variation of a parameter that indicates the effect of rotation (Coriolis-force-driven multiplicity). Three solutions for the flows in a stationary curved duct obtained in the work of Yang and Wang [1] are used as initial solutions of continuation calculations to unfold the solution branches. Twenty-one solution branches are found comparing with five obtained by Selmi and Nandakumar [2]. Dynamic responses of the multiple solutions to finite random disturbances are examined by the direct transient computation. Results show that characteristics of physically realizable fully developed flows changes significantly with variation of effect of rotation. Fourteen sub-ranges are identified according to characteristics of physically realizable solutions. As rotation effect changes, possible physically realizable fully-developed flows can be stable steady 2-cell state, stable multi-cell state, temporal periodic oscillation between symmetric/asymmetric 2-cell/4-cell flows, temporal oscillation with intermittency, temporal chaotic oscillation and temporal oscillation with pseudo intermittency. Among these possible physically realizable fully developed flows, stable multi-cell state and stable steady 2-cell state exist as dual stable. And oscillation with pseudo intermittency is a new phenomenon. In addition to the temporal oscillation with intermittency, sudden shift from stationary stable solution to temporal chaotic oscillation is identified to be another way of onset of chaos.

  8. Branching geodesics in normed spaces

    International Nuclear Information System (INIS)

    Ivanov, A O; Tuzhilin, A A

    2002-01-01

    We study branching extremals of length functionals on normed spaces. This is a natural generalization of the Steiner problem in normed spaces. We obtain criteria for a network to be extremal under deformations that preserve the topology of networks as well as under deformations with splitting. We discuss the connection between locally shortest networks and extremal networks. In the important particular case of the Manhattan plane, we get a criterion for a locally shortest network to be extremal

  9. Cash efficiency for bank branches

    OpenAIRE

    Cabello, Julia Garc?a

    2013-01-01

    Bank liquidity management has become a major issue during the financial crisis as liquidity shortages have intensified and have put pressure on banks to diversity and improve their liquidity sources. While a significant strand of the literature concentrates on wholesale liquidity generation and on the alternative to deposit funding, the management of an inventory of cash holdings within the banks? branches is also a relevant issue as any significant improvement in cash management at the bank ...

  10. Solid State Photovoltaic Research Branch

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    This report summarizes the progress of the Solid State Photovoltaic Research Branch of the Solar Energy Research Institute (SERI) from October 1, 1988, through September 30,l 1989. Six technical sections of the report cover these main areas of SERIs in-house research: Semiconductor Crystal Growth, Amorphous Silicon Research, Polycrystalline Thin Films, III-V High-Efficiency Photovoltaic Cells, Solid-State Theory, and Laser Raman and Luminescence Spectroscopy. Sections have been indexed separately for inclusion on the data base.

  11. Branching processes and neutral evolution

    CERN Document Server

    Taïb, Ziad

    1992-01-01

    The Galton-Watson branching process has its roots in the problem of extinction of family names which was given a precise formulation by F. Galton as problem 4001 in the Educational Times (17, 1873). In 1875, an attempt to solve this problem was made by H. W. Watson but as it turned out, his conclusion was incorrect. Half a century later, R. A. Fisher made use of the Galton-Watson process to determine the extinction probability of the progeny of a mutant gene. However, it was J. B. S. Haldane who finally gave the first sketch of the correct conclusion. J. B. S. Haldane also predicted that mathematical genetics might some day develop into a "respectable branch of applied mathematics" (quoted in M. Kimura & T. Ohta, Theoretical Aspects of Population Genetics. Princeton, 1971). Since the time of Fisher and Haldane, the two fields of branching processes and mathematical genetics have attained a high degree of sophistication but in different directions. This monograph is a first attempt to apply the current sta...

  12. Bile Duct Obstruction Secondary to Chronic Pancreatitis in Seven Dogs

    OpenAIRE

    Cribb, Alastair E.; Burgener, David C.; Reimann, Keith A.

    1988-01-01

    Seven icteric dogs were determined to have bile duct obstruction secondary to chronic pancreatitis. All dogs had histories of intermittent vomiting and diarrhea. Alkaline phosphatase and alanine aminotransferase activities and total bilirubin concentrations were markedly elevated. Diagnosis was based on exploratory laparotomy and histological examination. Each dog had a 3 to 10 cm mass in the body of the pancreas and obstruction of the common bile duct. Three dogs treated with pancreatectomy,...

  13. Studying the sampling representativeness in the NPP ventilation ducts

    International Nuclear Information System (INIS)

    Sosnovskij, R.I.; Fedchenko, T.K.; Minin, S.A.

    2000-01-01

    Measurements of the gas and aerosol voluminous activity in the NPP ventilation ducts are an important source of information on the radiation contaminants ingress into the environmental medium. These measurements include sampling, samples transport and proper measurements. The work is devoted to calculation of metrological characteristics of the sampling systems for the NPP gas-aerosol releases by different parameters of these systems and ventilation ducts. The results obtained are intended for application by designing such systems and their metrological certification [ru

  14. Endoscopic stenting in bile duct cancer increases liver volume.

    Science.gov (United States)

    Lee, Chang Hun; Kim, Seong Hun; Kim, In Hee; Kim, Sang Wook; Lee, Soo Teik; Kim, Dae Ghon; Yang, Jae Do; Yu, Hee Chul; Cho, Baik Hwan; Lee, Seung Ok

    2014-09-01

    Objective evaluation tools for assessing the effectiveness of stenting in palliative treatment of malignant biliary obstruction are not satisfactory. Effects of biliary stenting on liver volume change have never been studied. We aimed to use volumetry to analyze liver volume changes after endoscopic stenting in bile duct cancer according to the location and number of stents. Retrospective review. University hospital. Patients with a diagnosis of hilar or distal bile duct cancer and who underwent biliary metal stenting. ERCP with self-expandable metal stent placement. Liver volume change after biliary stenting and its comparison according to the location (hilar vs distal common bile duct) and number (hilar bilateral vs hilar unilateral). There were 60 patients; 31 were treated for hilar bile duct cancer (13 for bilateral stent and 18 for unilateral stent) and 29 for distal bile duct cancer. Overall mean follow-up duration was 11.7 ± 4.9 weeks. Liver volume increased 17.4 ± 24.1%. The rate of liver growth was rapid during the early period from 4 to 8 weeks. Stenting in hilar bile duct cancer tended to increase liver volume more than distal biliary stents (22.5% vs 11.9%, P = .091). In hilar bile duct cancer, unilateral and bilateral stents showed similar liver volume increases (20.1% and 25.8%, respectively; P = .512). Single center, retrospective. Biliary stenting markedly increased liver volume in both hilar and distal bile duct cancer. Our data suggest that liver volume assessment could be a useful tool for evaluating stent efficacy. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  15. Surgical versus endoscopic treatment of bile duct stones

    DEFF Research Database (Denmark)

    Martin, D J; Vernon, D R; Toouli, J

    2006-01-01

    10% to 18% of patients undergoing cholecystectomy for gallstones have common bile duct (CBD) stones. Treatment options for these stones include pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) or open or laparoscopic surgery.......10% to 18% of patients undergoing cholecystectomy for gallstones have common bile duct (CBD) stones. Treatment options for these stones include pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) or open or laparoscopic surgery....

  16. Compact Buried Ducts in a Hot-Humid Climate House

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, D. [Home Innovation Research Labs, Upper Marlboro, MD (United States)

    2016-01-01

    A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval.

  17. BETTER DUCT SYSTEMS FOR HOME HEATING AND COOLING.

    Energy Technology Data Exchange (ETDEWEB)

    ANDREWS,J.

    2001-01-01

    This is a series of six guides intended to provide a working knowledge of residential heating and cooling duct systems, an understanding of the major issues concerning efficiency, comfort, health, and safety, and practical tips on installation and repair of duct systems. These guides are intended for use by contractors, system designers, advanced technicians, and other HVAC professionals. The first two guides are also intended to be accessible to the general reader.

  18. Generation of branching ureteric bud tissues from human pluripotent stem cells.

    Science.gov (United States)

    Mae, Shin-Ichi; Ryosaka, Makoto; Toyoda, Taro; Matsuse, Kyoko; Oshima, Yoichi; Tsujimoto, Hiraku; Okumura, Shiori; Shibasaki, Aya; Osafune, Kenji

    2018-01-01

    Recent progress in kidney regeneration research is noteworthy. However, the selective and robust differentiation of the ureteric bud (UB), an embryonic renal progenitor, from human pluripotent stem cells (hPSCs) remains to be established. The present study aimed to establish a robust induction method for branching UB tissue from hPSCs towards the creation of renal disease models. Here, we found that anterior intermediate mesoderm (IM) differentiates from anterior primitive streak, which allowed us to successfully develop an efficient two-dimensional differentiation method of hPSCs into Wolffian duct (WD) cells. We also established a simplified procedure to generate three-dimensional WD epithelial structures that can form branching UB tissues. This system may contribute to hPSC-based regenerative therapies and disease models for intractable disorders arising in the kidney and lower urinary tract. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Alloy development for cladding and duct applications

    International Nuclear Information System (INIS)

    Straalsund, J.L.; Johnson, G.D.

    1981-01-01

    Three general classes of materials under development for cladding and ducts are listed. Solid solution strengthened, or austenitic, alloys are Type 316 stainless steel and D9. Precipitation hardened (also austenitic) alloys consist of D21, D66 and D68. These alloys are similar to such commercial alloys as M-813, Inconel 706, Inconel 718 and Nimonic PE-16. The third general class of alloys is composed of ferritic alloys, with current emphasis being placed on HT-9, a tempered martensitic alloy, and D67, a delta-ferritic steel. The program is comprised of three parallel paths. The current reference, or first generation alloy, is 20% cold worked Type 316 stainless steel. Second generation alloys for near-term applications include D9 and HT-9. Third generation materials consist of the precipitation strengthened steels and ferritic alloys, and are being considered for implementation at a later time than the first and second generation alloys. The development of second and third generation materials was initiated in 1974 with the selection of 35 alloys. This program has proceeded to today where there are six advanced alloys being evaluated. These alloys are the developmental alloys D9, D21, D57, D66 and D68, together with the commerical alloy, HT-9. The status of development of these alloys is summarized

  20. WAVE PROPAGATION in the HOT DUCT of VHTR

    Energy Technology Data Exchange (ETDEWEB)

    Richard Schultz; Jim C. P. Liou

    2013-07-01

    In VHTR, helium from the reactor vessel is conveyed to a power conversion unit through a hot duct. In a hypothesized Depressurized Conduction Cooldown event where a rupture of the hot duct occurs, pressure waves will be initiated and reverberate in the hot duct. A numerical model is developed to quantify the transients and the helium mass flux through the rupture for such events. The flow path of the helium forms a closed loop but only the hot duct is modeled in this study. The lower plum of the reactor vessel and the steam generator are treated as specified pressure and/or temperature boundary to the hot duct. The model is based on the conservation principles of mass, momentum and energy, and on the equations of state for helium. The numerical solution is based on the method of characteristics with specified time intervals with a predictor and corrector algorithm. The rupture sub-model gives reasonable results. Transients induced by ruptures with break area equaling 20%, 10%, and 5% of the duct cross-sectional area are described.

  1. A non-local computational boundary condition for duct acoustics

    Science.gov (United States)

    Zorumski, William E.; Watson, Willie R.; Hodge, Steve L.

    1994-01-01

    A non-local boundary condition is formulated for acoustic waves in ducts without flow. The ducts are two dimensional with constant area, but with variable impedance wall lining. Extension of the formulation to three dimensional and variable area ducts is straightforward in principle, but requires significantly more computation. The boundary condition simulates a nonreflecting wave field in an infinite duct. It is implemented by a constant matrix operator which is applied at the boundary of the computational domain. An efficient computational solution scheme is developed which allows calculations for high frequencies and long duct lengths. This computational solution utilizes the boundary condition to limit the computational space while preserving the radiation boundary condition. The boundary condition is tested for several sources. It is demonstrated that the boundary condition can be applied close to the sound sources, rendering the computational domain small. Computational solutions with the new non-local boundary condition are shown to be consistent with the known solutions for nonreflecting wavefields in an infinite uniform duct.

  2. Conservative Treatment for Cystic Duct Stenosis in a Child

    Directory of Open Access Journals (Sweden)

    Marco Gasparetto

    2013-01-01

    Full Text Available Introduction. Few cases of common bile duct stenosis have been reported in the literature, and observations of strictures in the cystic duct are even more rare. Surgical cholecystectomy is the treatment needed in most cases of gallbladder hydrops. This paper describes the diagnosis and successful medical treatment of a rare pediatric case of cystic duct stenosis and gallbladder hydrops. Case Report. A formerly healthy one-year-old girl was admitted with colicky abdominal pain. Blood tests were normal, except for an increase in transaminases. Abdominal ultrasound excluded intestinal intussusception and identified a distended gallbladder with biliary sludge. MR cholangiography revealed a dilated gallbladder containing bile sediment and no detectable cystic duct, while the rest of the intra- and extrahepatic biliary tree and hepatic parenchyma were normal. This evidence was consistent with gallbladder hydrops associated with cystic duct stenosis. The baby was treated with i.v. hydration, corticosteroids, antibiotics, and ursodeoxycholic acid. Her general condition rapidly improved, with no further episodes of abdominal pain and normalization of liver enzymes. This allowed to avoid cholecystectomy, and the child is well 1.5 years after diagnosis. Conclusions. Although cholecystectomy is usually necessary in case of gallbladder hydrops, our experience suggests that surgical procedures can be avoided when the distension is caused by a cystic duct stenosis.

  3. Parotid duct laceration repair in two horses : case report

    Directory of Open Access Journals (Sweden)

    A. Olivier

    1998-07-01

    Full Text Available Repair of parotid duct lacerations in 2 horses is described using intraluminal silastic tubing as a stent. The duct was lacerated traumatically at the facial vessel notch (incisura vasorum facialium in the 1st horse, and iatrogenically after removal of an intraluminal sialolith after development of infection within the duct in the 2nd horse. In both cases, a silastic tube was passed retrograde into the duct via the salivary papilla, past the wound until the end lay rostroventral to the parotid salivary gland. The severed salivary ducts and the wounds were sutured. The external portion of the silastic tube was sutured to the skin and the tube left in place. Recovery in the 1st case was uneventful. In the 2nd case a salivary duct/cutaneous fistula formed at a wound distant from the sutured wound, which healed spontaneously. This technique differs from a similar described technique in that the stent tube exits the oral cavity and is attached to the outer skin surface.

  4. Thermal performance test of the hot gas ducts of HENDEL

    International Nuclear Information System (INIS)

    Hishida, M.; Kunitomi, K.; Ioka, I.; Umenishi, K.; Tanaka, T.; Shimomura, H.; Sanokawa, K.

    1984-01-01

    A hot gas duct provided with internal thermal insulation is to be used for high-temperature gas-cooled reactors (HTGR). This type of hot gas duct has not been used so far in industrial facilities, and only a couple of tests on such a large-scale model of a hot gas duct have been conducted. The present report deals with the results of the thermal performance of the single tube type hot gas ducts which are installed as parts of a helium engineering demonstration loop (HENDEL). Uniform temperature and heat flux distribution at the surface of the duct were observed, the experimental correlations being obtained for the effective thermal conductivity of the internal thermal insulation layer. The measured temperature distribution of the pressure tube was in good agreement with the calculation by a TRUMP heat transfer computer code. The temperature distribution of the inner tube of the co-axial hot gas duct was evaluated and no hot spot was detected. These results would be very valuable for the design and development of HTGR. (orig.)

  5. Isolation and characterization of portal branch ligation-stimulated Hmga2-positive bipotent hepatic progenitor cells

    International Nuclear Information System (INIS)

    Sakai, Hiroshi; Tagawa, Yoh-ichi; Tamai, Miho; Motoyama, Hiroaki; Ogawa, Shinichiro; Soeda, Junpei; Nakata, Takenari; Miyagawa, Shinichi

    2010-01-01

    Research highlights: → Hepatic progenitor cells were isolated from the portal branch-ligated liver of mice. → Portal branch ligation-stimulated hepatic progenitor cells (PBLHCs) express Hmga2. → PBLHCs have bidirectional differentiation capability in vitro. -- Abstract: Hepatic stem/progenitor cells are one of several cell sources that show promise for restoration of liver mass and function. Although hepatic progenitor cells (HPCs), including oval cells, are induced by administration of certain hepatotoxins in experimental animals, such a strategy would be inappropriate in a clinical setting. Here, we investigated the possibility of isolating HPCs in a portal branch-ligated liver model without administration of any chemical agents. A non-parenchymal cell fraction was prepared from the portal branch-ligated or non-ligated lobe, and seeded onto plates coated with laminin. Most of the cells died, but a small number were able to proliferate. These proliferating cells were cloned as portal branch ligation-stimulated hepatic cells (PBLHCs) by the limiting dilution method. The PBLHCs expressed cytokeratin19, albumin, and Hmga2. The PBLHCs exhibited metabolic functions such as detoxification of ammonium ions and synthesis of urea on Matrigel-coated plates in the presence of oncostatin M. In Matrigel mixed with type I collagen, the PBLHCs became rearranged into cystic and tubular structures. Immunohistochemical staining demonstrated the presence of Hmga2-positive cells around the interlobular bile ducts in the portal branch-ligated liver lobes. In conclusion, successful isolation of bipotent hepatic progenitor cell clones, PBLHCs, from the portal branch-ligated liver lobes of mice provides the possibility of future clinical application of portal vein ligation to induce hepatic progenitor cells.

  6. Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Beal, D. [BA-PIRC, Cocoa, FL (United States); McIlvaine, J. [BA-PIRC, Cocoa, FL (United States); Fonorow, K. [BA-PIRC, Cocoa, FL (United States); Martin, E. [BA-PIRC, Cocoa, FL (United States)

    2011-11-01

    This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces.

  7. Metabolomic Assessment of Acute Cholestatic Injuries Induced by Thioacetamide and by Bile Duct Ligation, and the Protective Effects of Huang-Lian-Jie-Du-Decoction

    Directory of Open Access Journals (Sweden)

    Dan-Dan Wei

    2018-05-01

    Full Text Available Huang-Lian-Jie-Du-Decoction, a traditional Chinese formula, has been reported to protect liver from various injuries. Two cholestasis models of rats induced by thioacetamide and by bile duct ligation were established and treated with Huang-Lian-Jie-Du-Decoction. Nuclear Magnetic Resonance-based urinary metabolic profiles were analyzed by orthogonal partial least squares discriminant analysis and univariate analysis to excavate differential metabolites associated with the injuries of the two models and the treatment effects of Huang-Lian-Jie-Du-Decoction. The two cholestatic models shared common metabolic features of excessive fatty acid oxidation, insufficient glutathione regeneration and disturbed gut flora, with specific characteristics of inhibited urea cycle and DNA damage in thioacetamide-intoxicated model, and perturbed Kreb's cycle and inhibited branched chain amino acid oxidation in bile duct ligation model. With good treatment effects, Huang-Lian-Jie-Du-Decoction could regain the balance of the disturbed metabolic status common in the two cholestasis injuries, e.g., unbalanced redox system and disturbed gut flora; and perturbed urea cycle in thioacetamide-intoxicated model and energy crisis (disturbed Kreb's cycle and oxidation of branched chain amino acid in bile duct ligation model, respectively.

  8. Dynamic Crack Branching - A Photoelastic Evaluation,

    Science.gov (United States)

    1982-05-01

    0.41 mPai and a 0.18 MPa, and predicted a theoretical kinking angle of 84°whichagreed well with experimentally measured angle. After crack kinking...Consistent crack branching’at KIb = 2.04 MPaI -i- and r = 1.3 mm verified this crack branching criterion. The crack branching angle predicted by--.’ DD

  9. Ret and Etv4 Promote Directed Movements of Progenitor Cells during Renal Branching Morphogenesis.

    Directory of Open Access Journals (Sweden)

    Paul Riccio

    2016-02-01

    Full Text Available Branching morphogenesis of the epithelial ureteric bud forms the renal collecting duct system and is critical for normal nephron number, while low nephron number is implicated in hypertension and renal disease. Ureteric bud growth and branching requires GDNF signaling from the surrounding mesenchyme to cells at the ureteric bud tips, via the Ret receptor tyrosine kinase and coreceptor Gfrα1; Ret signaling up-regulates transcription factors Etv4 and Etv5, which are also critical for branching. Despite extensive knowledge of the genetic control of these events, it is not understood, at the cellular level, how renal branching morphogenesis is achieved or how Ret signaling influences epithelial cell behaviors to promote this process. Analysis of chimeric embryos previously suggested a role for Ret signaling in promoting cell rearrangements in the nephric duct, but this method was unsuited to study individual cell behaviors during ureteric bud branching. Here, we use Mosaic Analysis with Double Markers (MADM, combined with organ culture and time-lapse imaging, to trace the movements and divisions of individual ureteric bud tip cells. We first examine wild-type clones and then Ret or Etv4 mutant/wild-type clones in which the mutant and wild-type sister cells are differentially and heritably marked by green and red fluorescent proteins. We find that, in normal kidneys, most individual tip cells behave as self-renewing progenitors, some of whose progeny remain at the tips while others populate the growing UB trunks. In Ret or Etv4 MADM clones, the wild-type cells generated at a UB tip are much more likely to remain at, or move to, the new tips during branching and elongation, while their Ret-/- or Etv4-/- sister cells tend to lag behind and contribute only to the trunks. By tracking successive mitoses in a cell lineage, we find that Ret signaling has little effect on proliferation, in contrast to its effects on cell movement. Our results show that Ret

  10. An incidence study on thyroglossal duct cysts in adults

    International Nuclear Information System (INIS)

    Kurt, A.; Ortug, C.; Aydar, Y.; Ortug, G.

    2007-01-01

    To investigate the incidence of the asymptomatic thyroglossal duct anomalies and to review the literature and make comments on the significance of this condition. A total of 80 cadavers were dissected in the present study. This study was carried out during 2005, where the cadavers were randomly included from the criminal laboratories of the Ministry of Justice, Republic of Turkey in Istanbul. None of the cadavers had laryngeal and cervical injuries resulting from a trauma or the cause of their death. The examined cadavers included 59 men and 21 females, and their ages were ranged from 35-80 years old. The larynges were removed and fixed in 10% formalin and then dissected. The sections were examined using surgical SMZ 10 Nikon stereomicroscope. We evaluated the presence, localization and diameter of the cysts with regard to age and sex of the cadavers. We observed a total of 12 different localization of thyroglossal ducts and cysts among the 80 dissected cadavers. Ten of these ducts cysts were found in males with an age range of 35-68 years and 2 female cadavers aged 45-65 years. In 6 cases, the thyroglossal ducts and cysts were located in the left of the midline of the neck, while 3 cases were from the right of the midline, and the remaining was located on the midline of the neck. In all cases, thryoglossal ducts and cysts were complete and restricted to the infrahyoid region: all of them had connection with the hyoid bone, but not with the perichondrium of the cartilage. In addition, the thyroglossal ducts have connection with the left lobe of the thyroid glands in 3 cases, one case in the right lobe, and 2 cases with the isthmus of the thyroid gland. Finally in 5 cases thyroglossal ducts were complete and had well developed cysts. Thyroglossal duct remnants are one of the most often seen congenital asymptomatic masses of the neck region (7%). The presence of these duct remnants may lead to abnormal phonation and epithelial carcinomas. Therefore, correlation of

  11. Molecular characterization of apocrine salivary duct carcinoma.

    Science.gov (United States)

    Chiosea, Simion I; Williams, Lindsay; Griffith, Christopher C; Thompson, Lester D R; Weinreb, Ilan; Bauman, Julie E; Luvison, Alyssa; Roy, Somak; Seethala, Raja R; Nikiforova, Marina N

    2015-06-01

    Contemporary classification and treatment of salivary duct carcinoma (SDC) require its thorough molecular characterization. Thirty apocrine SDCs were analyzed by the Ion Ampliseq Cancer HotSpot panel v2 for mutations in 50 cancer-related genes. Mutational findings were corroborated by immunohistochemistry (eg, TP53, BRAF, β-catenin, estrogen, and androgen receptors) or Sanger sequencing/SNaPshot polymerase chain reaction. ERBB2 (HER2), PTEN, FGFR1, CDKN2A/P16, CMET, EGFR, MDM2, and PIK3CA copy number changes were studied by fluorescence in situ hybridization. TP53 mutations (15/27, 56%), PTEN loss (11/29, 38%, including 2 cases with PTEN mutation), PIK3CA hotspot mutations (10/30, 33%), HRAS hotspot mutations (10/29; 34%), and ERBB2 amplification (9/29, 31%, including 1 case with mutation) represented the 5 most common abnormalities. There was no correlation between genetic changes and clinicopathologic parameters. There was substantial overlap between genetic changes: 8 of 9 cases with ERBB2 amplification also harbored a PIK3CA, HRAS, and TP53 mutation and/or PTEN loss. Six of 10 cases with PIK3CA mutation also had an HRAS mutation. These findings provide a molecular rationale for dual targeting of mitogen-activated protein kinase and phosphoinositide 3-kinase pathways in SDC. FGFR1 amplification (3/29, 10%) represents a new potential target. On the basis of studies of breast carcinomas, the efficacy of anti-ERBB2 therapy will likely be decreased in SDC with ERBB2 amplification co-occurring with PIK3CA mutation or PTEN loss. Therefore, isolated ERBB2 testing is insufficient for theranostic stratification of apocrine SDC. On the basis of the prevalence and type of genetic changes, apocrine SDC appears to resemble one subtype of breast carcinoma-"luminal androgen receptor positive/molecular apocrine."

  12. Parametric study of electromagnetic waves propagating in absorbing curved S ducts

    Science.gov (United States)

    Baumeister, Kenneth J.

    1989-01-01

    A finite-element Galerkin formulation has been developed to study attenuation of transverse magnetic (TM) waves propagating in two-dimensional S-curved ducts with absorbing walls. In the frequency range where the duct diameter and electromagnetic wave length are nearly equal, the effect of duct length, curvature (duct offset), and absorber wall thickness was examined. For a given offset in the curved duct, the length of the S-duct was found to significantly affect both the absorptive and reflective characteristics of the duct. For a straight and a curved duct with perfect electric conductor terminations, power attenuation contours were examined to determine electromagnetic wall properties associated with maximum input signal absorption. Offset of the S-duct was found to significantly affect the value of the wall permittivity associated with the optimal attenuation of the incident electromagnetic wave.

  13. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy

    International Nuclear Information System (INIS)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-01-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct

  14. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy.

    Science.gov (United States)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-04-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.

  15. Optimum design of the injection duct system of a stenter machine

    Energy Technology Data Exchange (ETDEWEB)

    Juraeva, Makhsuda; Song, Dong Joo [Yeungnam University, Geyongsan (Korea, Republic of); Ryu, Kyung Jin [Ajou Motor College, Boryeong (Korea, Republic of)

    2017-05-15

    Stenter machines are used for drying fabrics in the textile industry and have a heater, injection duct system, and fans inside a chamber. The injection duct system has ducts and air-injecting holes. Plane-type injection duct systems were investigated to obtain uniform airflow at the air-injecting holes. The flow field of the injection duct systems was computed using ANSYS CFX with different heights of the duct end and different shapes for the air-injecting holes. There was a high mass flow rate at the air-injecting holes and high airflow circulation inside both plane-type and mountain-type ducts at the ends. The height of the duct end was varied between 40 mm and 160 mm. The injection duct systems were analyzed with four different shapes of air-injecting holes. The circular and elliptical holes had lower standard deviations of the mass flow rate than other shapes. Relatively uniform mass flow rates were obtained in the plane-type and mountain-type duct systems when the height of the duct end was 40 mm and the shape of the air-injecting holes was circular or elliptical. The developed injection duct systems were improved by obtaining a uniform mass flow rate at the air-injecting holes. A stenter prototype was fabricated with the developed injection duct system to confirm the numerical results. The developed injection duct system had better performance than the original system.

  16. Branched-Chain Amino Acids.

    Science.gov (United States)

    Yamamoto, Keisuke; Tsuchisaka, Atsunari; Yukawa, Hideaki

    Branched-chain amino acids (BCAAs), viz., L-isoleucine, L-leucine, and L-valine, are essential amino acids that cannot be synthesized in higher organisms and are important nutrition for humans as well as livestock. They are also valued as synthetic intermediates for pharmaceuticals. Therefore, the demand for BCAAs in the feed and pharmaceutical industries is increasing continuously. Traditional industrial fermentative production of BCAAs was performed using microorganisms isolated by random mutagenesis. A collection of these classical strains was also scientifically useful to clarify the details of the BCAA biosynthetic pathways, which are tightly regulated by feedback inhibition and transcriptional attenuation. Based on this understanding of the metabolism of BCAAs, it is now possible for us to pursue strains with higher BCAA productivity using rational design and advanced molecular biology techniques. Additionally, systems biology approaches using augmented omics information help us to optimize carbon flux toward BCAA production. Here, we describe the biosynthetic pathways of BCAAs and their regulation and then overview the microorganisms developed for BCAA production. Other chemicals, including isobutanol, i.e., a second-generation biofuel, can be synthesized by branching the BCAA biosynthetic pathways, which are also outlined.

  17. Abnormalities of intrahepatic bile ducts in extrahepatic biliary atresia.

    Science.gov (United States)

    Raweily, E A; Gibson, A A; Burt, A D

    1990-12-01

    The infantile cholangiopathies are a group of conditions associated with neonatal jaundice, which include extrahepatic biliary atresia, paucity of intra-hepatic bile ducts and disorders associated with persistence of fetal biliary structures, the so-called ductal plate malformations. Although previously regarded as distinct entities, it has recently been suggested that they may represent parts of a disease spectrum in which the principal process is one of bile duct destruction, the morphological manifestations in individual cases being influenced by the stage of intra-uterine development at which such injury occurs and by the site within the biliary system at which there is maximum damage. To further examine this concept, we have studied liver biopsy specimens from 37 neonates with extrahepatic biliary atresia, with particular reference to abnormalities of the intrahepatic bile ducts. Paucity of intrahepatic ducts, defined as a bile duct: portal tract ratio of less than 0.9, was identified in six cases (16.2%). In eight cases (21.6%) we found concentric tubular ductal structures similar to those observed in ductal plate malformations. In one case, both abnormalities could be demonstrated. Our findings support the concept that there is overlap between the various types of infantile cholangiopathy.

  18. Extracorporeal shock-wave lithotripsy of bile duct stones

    International Nuclear Information System (INIS)

    Lee, Jong Tae; Kim, Myung Joon; Yoo, Hyung Sik; Suh, Jung Ho; Lee, Moo Sang; Jo, Jang Hwan; Kim, Byung Ro

    1989-01-01

    During the past one and half year, we performed ESWL therapy in 13 patients with common bile duct and intrahepatic duct stones, applying Lithostar-R (Siemens co. West Germany) and analyzed their results. In 13 patients, 9 residual common bile duct stones and 7 intrahepatic duct stones were selected postoperatively. The size of stones were ranged from 0.7 cm to 3.5 cm in diameter. 2 stones were multiple and the remained 14 were single in number. The visualization of stones were done with fluoroscopy after the injection of contrast media via cholangiographic T-tube or ERCP. ESWL were applied continuously until stone disintegration was visible, or upto maximum number of 3500 discharge of shock wave. If not disintegrated upto 3500, patients were underwent second or third lithotripsy session with interval of one week. Our results showed that among 9 common bile duct stones, 4 were completely disintegrated and passed out spontaneously, but 3 partially fragmented and removed by the additional procedure. 2 were failed. Among 7 intrahepatic stones, 3 completely and 2 partially were succeeded. One stone partially fragmented were retained without removal and other one were failed. Skin petechia in all patients were revealed on the entry port of shock wave, but no serous complication was not occurred

  19. High-Performance Ducts in Hot-Dry Climates

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschele, Marc [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Chitwood, Rick [National Renewable Energy Laboratory (NREL), Golden, CO (United States); German, Alea [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Weitzel, Elizabeth [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-07-30

    Duct thermal losses and air leakage have long been recognized as prime culprits in the degradation of heating, ventilating, and air-conditioning (HVAC) system efficiency. Both the U.S. Department of Energy’s Zero Energy Ready Home program and California’s proposed 2016 Title 24 Residential Energy Efficiency Standards require that ducts be installed within conditioned space or that other measures be taken to provide similar improvements in delivery effectiveness (DE). Pacific Gas & Electric Company commissioned a study to evaluate ducts in conditioned space and high-performance attics (HPAs) in support of the proposed codes and standards enhancements included in California’s 2016 Title 24 Residential Energy Efficiency Standards. The goal was to work with a select group of builders to design and install high-performance duct (HPD) systems, such as ducts in conditioned space (DCS), in one or more of their homes and to obtain test data to verify the improvement in DE compared to standard practice. Davis Energy Group (DEG) helped select the builders and led a team that provided information about HPD strategies to them. DEG also observed the construction process, completed testing, and collected cost data.

  20. Extracorporeal shock-wave lithotripsy of bile duct stones

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kim, Myung Joon; Yoo, Hyung Sik; Suh, Jung Ho; Lee, Moo Sang; Jo, Jang Hwan; Kim, Byung Ro [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    During the past one and half year, we performed ESWL therapy in 13 patients with common bile duct and intrahepatic duct stones, applying Lithostar-R (Siemens co. West Germany) and analyzed their results. In 13 patients, 9 residual common bile duct stones and 7 intrahepatic duct stones were selected postoperatively. The size of stones were ranged from 0.7 cm to 3.5 cm in diameter. 2 stones were multiple and the remained 14 were single in number. The visualization of stones were done with fluoroscopy after the injection of contrast media via cholangiographic T-tube or ERCP. ESWL were applied continuously until stone disintegration was visible, or upto maximum number of 3500 discharge of shock wave. If not disintegrated upto 3500, patients were underwent second or third lithotripsy session with interval of one week. Our results showed that among 9 common bile duct stones, 4 were completely disintegrated and passed out spontaneously, but 3 partially fragmented and removed by the additional procedure. 2 were failed. Among 7 intrahepatic stones, 3 completely and 2 partially were succeeded. One stone partially fragmented were retained without removal and other one were failed. Skin petechia in all patients were revealed on the entry port of shock wave, but no serous complication was not occurred.

  1. Primary Follicular Lymphoma of the Common Bile Duct Mimicking Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Khaled Youssef Elbanna

    2014-01-01

    Full Text Available Primary non-Hodgkin′s lymphoma of the common bile duct is extremely rare. We present a case with history of inflammatory bowel disease and clinical manifestations of obstructive jaundice. Abdominal magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRCP was done and demonstrated tight stricture at the middle part of common bile duct, and radiological findings were supportive of extra-hepatic cholangiocarcinoma. Whipple′s procedure was performed and the case was histopathologically proven to be non-Hodgkin′s lymphoma of follicular subtype involving the common bile duct. Lymphoma of the hepatobiliary system is usually present as secondary manifestation of systemic malignant lymphoma. However, primary malignant lymphomas arising from the hepatobiliary tree are extremely rare. The radiological appearance of common bile duct lymphoma is very similar to cholangiocarcinoma, making preoperative diagnosis very difficult, as in our present case. We also compare the imaging findings of our case to those seen in reported cases of follicular lymphoma of the common bile duct.

  2. Radiation therapy in extrahepatic bile duct carcinoma

    International Nuclear Information System (INIS)

    Mahe, Marc; Romestaing, Pascale; Talon, Bernard; Ardiet, J.M.; Salerno, Nathalie; Sentenac, Irenee; Gerard, J.P.

    1991-01-01

    Fifty-one patients with carcinoma of the extrahepatic bile ducts (EHBD) received radiation therapy between Jan 1980-Dec 1988. The location of the tumors was: proximal third, 20 patients; middle third, 23; distal third, 3; diffuse, 5 patients. Thirty-six patients underwent surgery with complete gross resection in 14 (10/14 with positive margins), incomplete gross resection in 12 and only biopsy in 10. Fifteen patients had only biliary drainage without laparotomy after cytologic diagnosis of malignancy in 11/15. Radiation therapy was done with curative intent after complete or incomplete resection (n=26) and it was palliative in patients who had no resection or only biliary drainage (n=25). Twenty-five patients received external radiation-therapy (ERT) alone to the tumor and lymph nodes (mean dose 45 Gy/2Gy per fraction for cure, 35 Gy/10 fractions for palliation), 8 patients had only iridium-192 ( 192 Ir) implant (50-60 Gy at a 1 cm radius for cure, 30 Gy for palliation), 17 patients had both ERT + 192 Ir(ERT 42.5 Gy + 192 Ir 10-15 Gy for cure; ERT 20 Gy/5 fractions + 192 Ir 20-30 Gy for palliation) and one intra-operative irradiation + ERT. The overall survival rate for the entire group was 55, 28.5 and 15 percent at 12, 24, 36 months and median survival 12 months. Median survival was 22 months in patients treated with curative intent and only 10 months after palliative treatment (p0.03). Among patients who had curative treatment, median survival was 27.5 months after complete gross resection and 13 months after incomplete gross resection (p0.045). After complete gross resection 5/14 patients were alive without evolutive disease at 11, 19, 20, 23 and 41 months, 2 were alive with metastases at 25 and 27 months and 7/14 died of cancer from 7 to 59 months. The rate of complications was low: 3 cholangitis responsive to antibiotics, 1 hemobilia and 2 gastric ulcers. These results are encouraging especially for patients with complete gross resection but they must be

  3. Cardi-O-Fix duct occluder versus Amplatzer duct occluder for closure of patent ductus arteriosus.

    Science.gov (United States)

    Celebi, Ahmet; Demir, Ibrahim Halil; Saritaş, Türkay; Dedeoğlu, Reyhan; Yucel, Ilker Kemal; Demir, Fadli; Erdem, Abdullah

    2013-11-15

    We sought to investigate the safety, efficacy, and follow-up results of percutaneous patent ductus arteriosus (PDA) closure using the novel Cardi-O-Fix duct occluder (CDO), a device similar to but less expensive than the Amplatzer duct occluder (ADO). We also aimed to compare these two devices in terms of results. Between March 2005 and May 2012, 167 patients diagnosed with moderate-to-large PDA underwent transcatheter closure. ADO was used in 56 (33.5%) patients with a mean age of 8.1 ± 11.9 years (3.6 months-56 years), whereas CDO was used in 111 (66.5%) patients with a mean age of 12.6 ± 14.6 years (4.8 months-63 years). The narrowest PDA diameter, the used device diameter, procedure time, fluoroscopy time, and residual shunt rates were similar between the two groups. Procedural success rate was 100% in both groups. Although the residual shunt rate was higher in the CDO group immediately after the procedure, the difference was not statistically significant (12.6 vs. 8.9%; P = 0.3). There was no statistically significant difference between groups at discharge and during follow-up. No deaths occurred in any of the groups, and there were no differences in complication rates during the short- and mid-term follow-up periods (CDO 7/111 vs. ADO 5/56; P = 0.5 π). The CDO can be used for PDA closure because of its safety, effectiveness, and simplicity in use. It is available in bigger sizes and can be used in patients with large defects. According to our short- and mid-term findings, the results it yields are similar to those of the ADO; thus, it may be the preferred choice owing to its low cost and large size variability. Copyright © 2013 Wiley Periodicals, Inc.

  4. ACPSEM (NZ Branch) annual meeting

    International Nuclear Information System (INIS)

    McEwan, A.C.

    1999-01-01

    The 1998 annual meeting of the New Zealand Branch of the Australasian College of Physical Scientists and Engineers in Medicine was held at the Christchurch School of Medicine over 26-27 November 1998, and attracted a record number of around 45 registrations. The meeting serves a number of purposes but one of the primary ones is to bring together scientists in medicine from around the country to compare notes on practices and advances, particularly in radiotherapy and diagnostic radiology physics. Following the meeting format established over recent years, separate workshops were devoted to radiotherapy physics and developments in the regional centres represented, and to practical issues relating to medical physics in diagnostic radiology. The workshops were held in parallel with presentations of scientific papers covering a wide range of topics, but with about half relating to engineering applications in medicine. (author)

  5. Branching process models of cancer

    CERN Document Server

    Durrett, Richard

    2015-01-01

    This volume develops results on continuous time branching processes and applies them to study rate of tumor growth, extending classic work on the Luria-Delbruck distribution. As a consequence, the authors calculate the probability that mutations that confer resistance to treatment are present at detection and quantify the extent of tumor heterogeneity. As applications, the authors evaluate ovarian cancer screening strategies and give rigorous proofs for results of Heano and Michor concerning tumor metastasis. These notes should be accessible to students who are familiar with Poisson processes and continuous time. Richard Durrett is mathematics professor at Duke University, USA. He is the author of 8 books, over 200 journal articles, and has supervised more than 40 Ph.D. students. Most of his current research concerns the applications of probability to biology: ecology, genetics, and most recently cancer.

  6. Prolapse of inverted ileal loops through a patent vitellointestinal duct

    Science.gov (United States)

    Pathak, Ashish; Agarwal, Nitin; Singh, Poonam; Dhaneria, Mamta

    2015-01-01

    We report a case of a prolapsed patent vitellointestinal duct (PVID) in a 2-month-old girl child who presented with sudden increase in size of a polypoidal lesion into a large, ‘Y’-shaped reddish, prolapsing lesion, discharging gaseous and faecal matter at her umbilicus. The lesion was diagnosed as a prolapse of inverted ileal loops through the PVID. The child had no associated congenital anomalies. A transumbilical exploration was performed, followed by wedge resection and anastomosis. The child tolerated the procedure well and the postoperative course was uneventful. If the omphalomesenteric duct fails to obliterate a range of congenital defects related to the umbilicus, it can become clinically apparent. Meckel's diverticulum is the commonest of these defects but is most often asymptomatic. PVID is the most common symptomatic anomaly of the patent omphalomesenteric duct and requires prompt surgical correction to avoid complications. PMID:26494719

  7. Squamous Cell Carcinoma of the Hilar Bile Duct

    Directory of Open Access Journals (Sweden)

    Ippei Yamana

    2011-08-01

    Full Text Available We herein report a rare case of squamous cell carcinoma of the hilar bile duct. A 66-year-old Japanese male patient was admitted to our hospital because of appetite loss and jaundice. Abdominal computed tomography revealed an enhanced mass measuring 10 × 30 mm in the hilar bile duct region. After undergoing biliary drainage, the patient underwent extended right hepatic lobectomy with regional lymph nodes dissection. The tumor had invaded the right portal vein. Therefore, we also performed resection and reconstruction of the portal vein. Histopathologically, the carcinoma cells exhibited a solid structure with differentiation to squamous cell carcinoma with keratinization and intercellular bridges. Immunohistochemical staining of the tumor cells revealed positive cytokeratin staining and negative CAM 5.2 staining. Based on these findings, a definitive diagnosis of well-differentiated squamous cell carcinoma of the hilar bile duct was made.

  8. Intracellular pH in rat pancreatic ducts

    DEFF Research Database (Denmark)

    Novak, I; Hug, M; Greger, R

    1997-01-01

    In order to study the mechanism of H+ and HCO3- transport in a HCO3- secreting epithelium, pancreatic ducts, we have measured the intracellular pH (pHi) in this tissue using the pH sensitive probe BCECF. We found that exposures of ducts to solutions containing acetate/acetic acid or NH4+/NH3...... buffers (20 mmol/l) led to pHi changes in accordance with entry of lipid-soluble forms of the buffers, followed by back-regulation of pHi by duct cells. In another type of experiment, changes in extracellular pH of solutions containing HEPES or HCO3-/CO2 buffers led to significant changes in pHi that did....... Under some conditions, these exchangers can be invoked to regulate cell pH....

  9. Diagnosis of functional nasolacrimal duct obstruction using dacryoscintigraphy

    International Nuclear Information System (INIS)

    Lim, Hyun Wook; Sohn, Hyung Sun; Kim, Euy Neyng; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo

    2000-01-01

    To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: 37 ∼76,8 males, 10 females) that were patent on syringing. Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (27%). Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy

  10. Bile Duct Obstruction Secondary to Chronic Pancreatitis in Seven Dogs

    Science.gov (United States)

    Cribb, Alastair E.; Burgener, David C.; Reimann, Keith A.

    1988-01-01

    Seven icteric dogs were determined to have bile duct obstruction secondary to chronic pancreatitis. All dogs had histories of intermittent vomiting and diarrhea. Alkaline phosphatase and alanine aminotransferase activities and total bilirubin concentrations were markedly elevated. Diagnosis was based on exploratory laparotomy and histological examination. Each dog had a 3 to 10 cm mass in the body of the pancreas and obstruction of the common bile duct. Three dogs treated with pancreatectomy, gastrojejunostomy, and cholecystojejunostomy died within five weeks. Three dogs treated with conservative surgical procedures were alive at 8, 16, and 26 months postoperatively. One dog was euthanized because of suspected neoplasia. Hepatic enzyme activity and bilirubin levels decreased markedly in the surviving dogs. Histological examination of the pancreatic masses indicated chronic pancreatitis. Hepatic biopsies revealed evidence of cholestasis. Chronic pancreatitis should be included in the differential diagnoses of icterus, bile duct obstruction, and masses in the pancreas. PMID:17423102

  11. [Qilin Pills for obstructive azoospermia after ejaculatory duct reconstruction].

    Science.gov (United States)

    Zhang, Lei; Gao, Ping; Ren, Fei-Qiang; Chang, De-Gui; Yu, Xu-Jun; Zhang, Pei-Hai

    2016-09-01

    To observe the clinical effect of Qilin Pills in the treatment of severe oligozoospermia after microsurgical ejaculatory duct reconstruction for obstructive azoospermia. We retrospectively analyzed 75 cases of obstructive azoospermia treated by ejaculatory duct reconstruction followed by administration of Qilin Pills. The patients were divided into a Qilin group (n=42) and a control group (n=33) postoperatively, treated with Qilin Pills and placebo, respectively. After 3 months of medication, we compared the sperm quality between the two groups of patients. After 3 months' treatment, all the patients experienced remarkable improvement in sperm quality (P0.05). The total effectiveness rate was higher in the Qilin group than in the controls (88.1% vs 72.7%), but with no significant difference between the two groups (P>0.05). Qilin Pills are fairly effective in improving the quantity of sperm in obstructive azoospermia patients after ejaculatory duct reconstruction.

  12. Thermal behavior of the duct applied functionally graded material

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jung Sun; Yoon, Dong Young; Im, Jong Bin [Hankuk Aviation Univ., Goyang (Korea, Republic of)

    2004-07-01

    In Unmanned Aerial Vehicles (UAV), the high temperature results from friction among the air, combustion of fuel in engine and combustion gas of a nozzle. The high temperature may cause serious damages in UAV structure. The Functionally Graded Material(FGM) is chosen as a material of the engine duct structure. Thermal stress analysis of FGM is performed in this paper. FGM is composed of two constituent materials that are mixed up according to the specific volume fraction distribution in order to withstand high temperature. Therefore, hoop stress, axial stress and shear stress of duct with 2 layers, 4 layers and 8 layers FGM are compared and analyzed respectively. In addition, the creep behavior of FGM used in duct structure of an engine is analyzed for better understanding of FGM characteristics.

  13. Design of a Mobile Robot for Air Ducts Exploration

    Directory of Open Access Journals (Sweden)

    Moses A. Koledoye

    2017-10-01

    Full Text Available This work presents the solutions adopted for the design and the implementation of an autonomous wheeled robot developed for the exploration and mapping of air ventilation ducts. The hardware is based on commercial off-the-shelf devices, including sensors, motors, processing devices and interfaces. The mechanical chassis was designed from scratch to meet a trade-off between small size and available volume to host the components. The software stack is based on the Robot Operating System (ROS. Special attention was dedicated to the design of the mobility strategy, which must take into account some constraints and issues that are specific to the considered application, such as the relatively small size of ducts, the need to detect and avoid possible holes on the floor of the duct and other unusual obstacles and the unavailability of external reference frameworks for localization. The main contribution of this paper lies in the design, implementation and experimentation of the overall system.

  14. Thyroid cancer in lingual thyroid and thyroglossal duct cyst.

    Science.gov (United States)

    Sturniolo, Giacomo; Vermiglio, Francesco; Moleti, Mariacarla

    2017-01-01

    Ectopy is the most common embryogenetic defect of the thyroid gland, representing between 48 and 61% of all thyroid dysgeneses. Persistence of thyroid tissue in the context of a thyroglossal duct remnant and lingual thyroid tissue are the most common defects. Although most cases of ectopic thyroid are asymptomatic, any disease affecting the thyroid may potentially involve the ectopic tissue, including malignancies. The prevalence of differentiated thyroid carcinoma in lingual thyroid and thyroglossal duct cyst is around 1% of patients affected with the above thyroid ectopies. We here review the current literature concerning primary thyroid carcinomas originating from thyroid tissue on thyroglossal duct cysts and lingual thyroid. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Ductus arteriosus stenting: A promising percutaneous palliation in patients with duct-dependent pulmonary circulation.

    Science.gov (United States)

    Raval, Abhishek; Thakkar, Bhavesh; Madan, Tarun; Oswal, Nilesh; Garg, Rajiv; Umalkar, Rhshikesh; Shah, Komal; Maheriya, Bhumika

    2016-11-01

    We aimed to study the feasibility and outcomes of ductal stenting in patients with duct-dependent pulmonary blood flow (PBF). Duct-dependent hypoxic patients with confluent pulmonary artery (PA) branches were enrolled for ductal stenting and followed regularly. Sixty patients, with a median age of 12 (1-1095) days and weight of 2.8 (2.2-8.9) kg, were enrolled. Median right PA (RPA) and left PA (LPA) Z-scores were -1.23 (-10.54 to 2.81) and -0.96 (-8.03 to 3.0), respectively. Mean narrowest ductal diameter was 1.73±0.57 mm and length was 12.78±3.32 mm. Sixty-four stents with mean diameter of 4.21±0.32 mm and length of 14.34±3.44 mm were deployed in 59 patients. The procedure was unsuccessful in one. Post-stenting mean oxygen saturation (SO 2 ) increased significantly from baseline of 68.88±7.47% to 90.43±6.04% (pedema in one patient and acute stent occlusion in another. At a median follow-up of eight (2-14) months, mean SO 2 (80.04±7.54%) was significantly higher than baseline (p<0.0001). Median RPA and LPA Z-scores, 0.56 (-2.89 to 3.29) and -0.02 (-2.81 to 3.86), respectively, were significantly higher than baseline. Six patients required re-interventions (shunt in three and angioplasty in three). Six patients died, three due to sepsis and another three with worsened cyanosis due to impaired PBF, probably due to ductal occlusion. Ductal stenting is an effective palliation in patients with duct-dependent PBF. It maintains adequate SO 2 and promotes balanced PA growth at mid-term follow-up. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Vegetation survey of PEN Branch wetlands

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    A survey was conducted of vegetation along Pen Branch Creek at Savannah River Site (SRS) in support of K-Reactor restart. Plants were identified to species by overstory, understory, shrub, and groundcover strata. Abundance was also characterized and richness and diversity calculated. Based on woody species basal area, the Pen Branch delta was the most impacted, followed by the sections between the reactor and the delta. Species richness for shrub and groundcover strata were also lowest in the delta. No endangered plant species were found. Three upland pine areas were also sampled. In support of K Reactor restart, this report summarizes a study of the wetland vegetation along Pen Branch. Reactor effluent enters Indian Grove Branch and then flows into Pen Branch and the Pen Branch Delta.

  17. Adenomas of the common bile duct in familial adenomatous polyposis

    Science.gov (United States)

    Yan, Mao-Lin; Pan, Jun-Yong; Bai, Yan-Nan; Lai, Zhi-De; Chen, Zhong; Wang, Yao-Dong

    2015-01-01

    Familial adenomatous polyposis (FAP) or Gardner’s syndrome is often accompanied by adenomas of the stomach and duodenum. We experienced a case of adenomas of the common bile duct in a 40-year-old woman with FAP presenting with acute cholangitis. Only 8 cases of adenomas or adenocarcinoma of the common bile duct have been reported in the literature in patients with FAP or Gardner’s syndrome. Those patients presented with acute cholangitis or pancreatitis. Local excision or Whipple procedure may be the reasonable surgical option. PMID:25780319

  18. Advanced Strategy Guideline: Air Distribution Basics and Duct Design

    Energy Technology Data Exchange (ETDEWEB)

    Burdick, A.

    2011-12-01

    This report discusses considerations for designing an air distribution system for an energy efficient house that requires less air volume to condition the space. Considering the HVAC system early in the design process will allow adequate space for equipment and ductwork and can result in cost savings. Principles discussed that will maximize occupant comfort include delivery of the proper amount of conditioned air for appropriate temperature mixing and uniformity without drafts, minimization of system noise, the impacts of pressure loss, efficient return air duct design, and supply air outlet placement, as well as duct layout, materials, and sizing.

  19. Parametric investigation of fracture of EBR-II ducts

    International Nuclear Information System (INIS)

    Chopra, P.S.; Moustakakis, B.

    1977-01-01

    Results of preliminary static and dynamic finite element fracture mechanics analyses that were conducted to analytically simulate the dynamic fracture behavior of EBR-II ducts are presented. The loads considered are those that may arise because of rapid release of fission gases from a failed fuel element inside a duct, obtained from some previous tests and a recent analytical model. In spite of the motivation for the present work, the analytical procedures described may have a wider general application in the fail-safe design of structures

  20. Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid

    Directory of Open Access Journals (Sweden)

    Gustavo Cancela e Penna

    2017-01-01

    Full Text Available Thyroglossal duct cyst (TDC is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.

  1. Analysis of materials in ducts by Compton scattering

    International Nuclear Information System (INIS)

    Gouveia, M.A.G.; Lopes, R.T.; Jesus, E.F.O. de; Camerini, C.S.

    2000-01-01

    This work presents the use of the Compton Scattering Technique as essay, for materials characterization in petroleum ducts. The essay have been accomplished in laboratory ambit, so that the presented results should be analyzed so that the system can come to be used in the field. The inspection was performed using Compton Scattering techniques, with two detectors aligned, in an angle of 90 degrees with a source of Cs-137 with energy of 662 keV. The results demonstrated the good capacity of the system to detect materials deposited in petroleum ducts during petroleum transportation. (author)

  2. Field electron emission from branched nanotubes film

    International Nuclear Information System (INIS)

    Zeng Baoqing; Tian Shikai; Yang Zhonghai

    2005-01-01

    We describe the preparation and analyses of films composed of branched carbon nanotubes (CNTs). The CNTs were grown on a Ni catalyst film using chemical vapor deposition from a gas containing acetylene. From scanning electron microscope (SEM) and transmission electron microscope (TEM) analyses, the branched structure of the CNTs was determined; the field emission characteristics in a vacuum chamber indicated a lower turn on field for branched CNTs than normal CNTs

  3. Current perspectives on shoot branching regulation

    Directory of Open Access Journals (Sweden)

    Cunquan YUAN,Lin XI,Yaping KOU,Yu ZHAO,Liangjun ZHAO

    2015-03-01

    Full Text Available Shoot branching is regulated by the complex interactions among hormones, development, and environmental factors. Recent studies into the regulatory mecha-nisms of shoot branching have focused on strigolactones, which is a new area of investigation in shoot branching regulation. Elucidation of the function of the D53 gene has allowed exploration of detailed mechanisms of action of strigolactones in regulating shoot branching. In addition, the recent discovery that sucrose is key for axillary bud release has challenged the established auxin theory, in which auxin is the principal agent in the control of apical dominance. These developments increase our understan-ding of branching control and indicate that regulation of shoot branching involves a complex network. Here, we first summarize advances in the systematic regulatory network of plant shoot branching based on current information. Then we describe recent developments in the synthesis and signal transduction of strigolactones. Based on these considerations, we further summarize the plant shoot branching regulatory network, including long distance systemic signals and local gene activity mediated by strigolactones following perception of external envi-ronmental signals, such as shading, in order to provide a comprehensive overview of plant shoot branching.

  4. [Branches of the National Institute of Hygiene].

    Science.gov (United States)

    Gromulska, Marta

    2008-01-01

    National Epidemiological Institute (National Institute of Hygiene, from 7th September 1923) was established in 1918 in Warsaw and acted at national level. Its actions in the field of diseases combat were supported by bacteriological stations and vaccine production in voivodeship cities, which were taken charge of by the state, and names "National Epidemiological Institutes". According to the ministers resolution from 6th July 1921,Epidemiological Institutes were merged to National Central Epidemiological Institutes (PZH), the epidemiological institutes outside Warsaw were named branches, which were to be located in every voivodeship city, according to the initial organizational resolutions. There were country branches of NCEI in: Cracow, Lwów, Lódź, Toruń, Lublin, and Wilno in the period 1919-1923. New branches in Poznań (1925), Gdynia(1934), Katowice (Voivodeship Institute of Hygiene (1936), Luck (1937), Stanisławów (1937), Kielce(1938), and Brześć/Bug (Municipal Station acting as branch of National Central Epidemiological Institute. Branches were subordinated to NCEI-PZH) in Warsaw where action plans and unified research and diagnostic method were established and annual meeting of the country branches managers took place. All branches cooperated with hospitals, national health services, district general practitioners and administration structure in control of infectious diseases. In 1938, the post of branch inspector was established, the first of whom was Feliks Przesmycki PhD. Branches cooperated also with University of Cracow, University of Lwów and University of Wilno. In 1935, National Institutes of Food Research was incorporated in PZH, Water Department was established, and these areas of activity began to develop in the branches accordingly. In 1938 there were 13 branches of PZH, and each had three divisions: bacteriological, food research and water research. Three branches in Cracow, Kielce and Lublin worked during World War II under German

  5. Positioning of supporting-cable ducts in a prestressed concrete bridge

    International Nuclear Information System (INIS)

    Roetzer, H.

    1981-01-01

    Before inserting the supporting cables positioning of cable ducts in prestressed concrete bridges can be performed with the aid of radiation sources hauled through the ducts and localized by means of radiation monitors

  6. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis

    NARCIS (Netherlands)

    Cahen, Djuna L.; Gouma, Dirk J.; Nio, Yung; Rauws, Erik A. J.; Boermeester, Marja A.; Busch, Olivier R.; Stoker, Jaap; Lameris, Johan S.; Dijkgraaf, Marcel G. W.; Huibregtse, Kees; Bruno, Marco J.

    2007-01-01

    BACKGROUND: For patients with chronic pancreatitis and a dilated pancreatic duct, ductal decompression is recommended. We conducted a randomized trial to compare endoscopic and surgical drainage of the pancreatic duct. METHODS: All symptomatic patients with chronic pancreatitis and a distal

  7. ASSESSMENT OF FUNGAL (PENICILLIUM CHRYSOGENUM) GROWTH ON THREE HVAC DUCT MATERIALS

    Science.gov (United States)

    The article discusses laboratory experiments to evaluate the susceptibility of three ventilation duct materials (fibrous glass ductboard, galvanized steel, and insulated flexible duct) to fungal (P. chrysogenum) growth. [NOTE: Many building investigators have documented fungal bi...

  8. Endoscopic Management of Perforation of Right Hepatic Duct Following Non-Surgical Abdominal Trauma

    OpenAIRE

    Sharma, B. C.; Maini, A.; Saraswat, V. A.

    1997-01-01

    Isolated bile duct injuries after blunt abdominal trauma are rare. Surgery is the usual mode of treatment. We report a patient with a right hepatic duct injury following blunt abdominal trauma who was managed successfully by endoscopic papillotomy.

  9. Congenital double bile duct presenting as recurrent cholangitis in a child

    Directory of Open Access Journals (Sweden)

    K.D. Chakravarty

    2015-12-01

    Full Text Available Double common bile duct (DCBD is a rare congenital anomaly. Most of these bile duct anomalies are associated with bile duct stones, anomalous pancreaticobiliary junction (APBJ, pancreatitis and bile duct or gastric cancers. Early detection and treatment is important to avoid long term complications. Surgical resection of the anomalous bile duct and reconstruction of the biliary enteric anastomosis is the treatment of choice. We report a rare case of DCBD anomaly in a girl, who presented with recurrent cholangitis. She had type Va DCBD anomaly. She underwent successful resection of the bile duct and reconstruction of the biliary enteric anastomosis. Preoperative imaging and diagnosis of the congenital biliary anomaly is very important to avoid intraoperative bile duct injury. Review of the literature shows very few cases of type Va DCBD, presenting with either bile duct stones or APBJ.

  10. A QUANTITATIVE METHOD FOR ANALYSING 3-D BRANCHING IN EMBRYONIC KIDNEYS: DEVELOPMENT OF A TECHNIQUE AND PRELIMINARY DATA

    Directory of Open Access Journals (Sweden)

    Gabriel Fricout

    2011-05-01

    Full Text Available The normal human adult kidney contains between 300,000 and 1 million nephrons (the functional units of the kidney. Nephrons develop at the tips of the branching ureteric duct, and therefore ureteric duct branching morphogenesis is critical for normal kidney development. Current methods for analysing ureteric branching are mostly qualitative and those quantitative methods that do exist do not account for the 3- dimensional (3D shape of the ureteric "tree". We have developed a method for measuring the total length of the ureteric tree in 3D. This method is described and preliminary data are presented. The algorithm allows for performing a semi-automatic segmentation of a set of grey level confocal images and an automatic skeletonisation of the resulting binary object. Measurements of length are automatically obtained, and numbers of branch points are manually counted. The final representation can be reconstructed by means of 3D volume rendering software, providing a fully rotating 3D perspective of the skeletonised tree, making it possible to identify and accurately measure branch lengths. Preliminary data shows the total length estimates obtained with the technique to be highly reproducible. Repeat estimates of total tree length vary by just 1-2%. We will now use this technique to further define the growth of the ureteric tree in vitro, under both normal culture conditions, and in the presence of various levels of specific molecules suspected of regulating ureteric growth. The data obtained will provide fundamental information on the development of renal architecture, as well as the regulation of nephron number.

  11. Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

    Energy Technology Data Exchange (ETDEWEB)

    Beal, D.; McIlvaine , J.; Fonorow, K.; Martin, E.

    2011-11-01

    This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. This document illustrates guidelines for the efficient installation of interior duct systems in new housing. Interior ducts result from bringing the duct work inside a home's thermal and air barrier. Architects, designers, builders, and new home buyers should thoroughly investigate any opportunity for energy savings that is as easy to implement during construction, such as the opportunity to construct interior duct work. In addition to enhanced energy efficiency, interior ductwork results in other important advantages, such as improved indoor air quality, increased system durability and increased homeowner comfort. While the advantages of well-designed and constructed interior duct systems are recognized, the implementation of this approach has not gained a significant market acceptance. This guideline describes a variety of methods to create interior ducts including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. As communication of the intent of an interior duct system, and collaboration on its construction are paramount to success, this guideline details the critical design, planning, construction, inspection, and verification steps that must be taken. Involved in this process are individuals from the design team; sales/marketing team; and mechanical, insulation, plumbing, electrical, framing, drywall and solar contractors.

  12. Practical use of CFD for air conditioning duct and defroster designing; Kucho duct defroster no CFD sekkei katsuyo

    Energy Technology Data Exchange (ETDEWEB)

    Okumura, K [Daihatsu Motor Co. Ltd., Osaka (Japan)

    1997-10-01

    The automobile industry have made effort to shorten the development period. Recently CFD (Computational Fluid Dynamics) on initial design stage becomes use for improvement of development efficiency. Although the practical guidepost (computed examples) for air conditioning duct and defroster are a little reported. This report presents how to optimize and standardize the calculational methods, calculational grid, boundary conditions for air conditioning duct and defroster nozzle in the practical use. Also we tried the discontinuous interface grid and the solution adaptive method. 2 refs., 17 figs.

  13. A simple method to calculate the neutron flow through full ducts

    International Nuclear Information System (INIS)

    Faik Ouahab, Z.; Jehouani, A.; Ghassoun, J.; Senhou, N.; Groetz, J.E.

    2010-01-01

    Summary of a study of assessment of the probability for neutrons to be guided in a full duct with a square cross section and doubly bent. Two software have been developed, based on the Monte Carlo simulation, to compute the neutron transmission probability at the end of the duct. Results are in good agreement with that obtained with the MCNP-5 code. The neutron flow and probability at the duct end have been determined for different materials and different duct dimensions

  14. Chitin in the Silk Gland Ducts of the Spider Nephila edulis and the Silkworm Bombyx mori

    Science.gov (United States)

    Davies, Gwilym J. G.; Knight, David P.; Vollrath, Fritz

    2013-01-01

    Here we report the detection and localisation of chitin in the cuticle of the spinning ducts of both the spider Nephila edulis and the silkworm Bombyx mori. Our observations demonstrate that the duct walls of both animals contain chitin notwithstanding totally independent evolutionary pathways of the systems. We conclude that chitin may well be an essential component for the construction of spinning ducts; we further conclude that in both species chitin may indicate the evolutionary origin of the spinning ducts. PMID:24015298

  15. Ducting Conditions for Electromagnetic Wave Propagation in Tropical Disturbances from GPS Dropsonde Data

    Science.gov (United States)

    2013-12-01

    depression, tropical storm , hurricane, extratropical cyclone, subtropical depression, subtropical storm , a low of no category, tropical wave, disturbance or...surface-based ducts, and elevated ducts. We further separate the duct occurrence based on the location relative to their respective storms . Based...on the number of soundings in different types of tropical disturbances, we chose to further analyze duct conditions in hurricanes and tropical storms

  16. Resin duct characteristics in the wood of fire-scarred North American conifers

    Science.gov (United States)

    Estelle Arbellay; Markus Stoffel; Elaine K. Sutherland; Kevin T. Smith; Donald A. Falk

    2013-01-01

    Traumatic resin ducts form in xylem and phloem tissue of conifers in response to abiotic wounding, fungal invasion, and insect attack. Little is known about resin duct characteristics in the wood of fire-scarred trees. The aim of this study is to quantify changes in traits of both axial and radial resin ducts, along with those of associated epithelial cells and...

  17. Effects of partial portal vein arterialization on the hilar bile duct in a rat model.

    Science.gov (United States)

    Guo, Shao-Hua; Li, Chong-Hui; Chen, Yong-Liang; Song, Jian-Ning; Zhang, Ai-Qun; Zhou, Cheng

    2011-10-01

    Liver revascularization is frequently required during the enlarged radical operation for hilar cholangiocarcinoma involving the hepatic artery. Researchers have carried out a number of experiments applying partial portal vein arterialization (PVA) in clinical practice. In this study we aimed to establish a theoretical basis for clinical application of partial PVA and to investigate the effects of partial PVA on rat hilar bile duct and hepatic functions. Thirty rats were randomly and equally assigned into 3 groups: control (group A), hepatic artery ligation+bile duct recanalization (group B), and partial PVA+bile duct recanalization (group C). Proliferation and apoptosis of rat hilar bile duct epithelial cells, arteriolar counts of the peribiliary plexus (PBP) of the bile duct wall, changes in serum biochemistry, and pathologic changes in the bile duct were assessed 1 month after operation. The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C (Philar bile duct epithelial cells were detected in any of the groups. The PBP arteriolar counts of the hilar bile duct wall were similar in groups A and C (P>0.05), but the count was lower in group B than in group A (Philar bile duct walls were observed only in group B. Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.

  18. Erlotinib in Treating Patients With Unresectable Liver, Bile Duct, or Gallbladder Cancer

    Science.gov (United States)

    2013-06-03

    Adult Primary Cholangiocellular Carcinoma; Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Cholangiocarcinoma of the Extrahepatic Bile Duct; Cholangiocarcinoma of the Gallbladder; Localized Unresectable Adult Primary Liver Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

  19. Branched-Chain Amino Acids

    Directory of Open Access Journals (Sweden)

    Matteo Ghiringhelli

    2015-07-01

    Full Text Available Our study is focused on evaluation and use of the most effective and correct nutrients. In particular, our attention is directed to the role of certain amino acids in cachectic patients. During parenteral nutrition in humans, physician already associates in the PN-bags different formulations including amino acids, lipids and glucose solutions or essential amino acids solution alone or exclusively branched-chain amino acids (BCAA. Studies investigated the effects of dietary BCAA ingestion on different diseases and conditions such as obesity and metabolic disorders, liver disease, muscle atrophy, cancer, impaired immunity or injuries (surgery, trauma, burns, and sepsis. BCAAs have been shown to affect gene expression, protein metabolism, apoptosis and regeneration of hepatocytes, and insulin resistance. They have also been shown to inhibit the proliferation of liver cancer cells in vitro, and are essential for lymphocyte proliferation and dendritic cell maturation. Oral or parenteral administration of these three amino acids will allow us to evaluate the real efficacy of these compounds during a therapy to treat malnutrition in subjects unable to feed themselves.

  20. AVM branch vibration test equipment

    International Nuclear Information System (INIS)

    Anne, J.P.

    1995-01-01

    An inventory of the test equipment of the AVM Branch ''Acoustic and Vibratory Mechanics Analysis Methods'' group has been undertaken. The purpose of this inventory is to enable better acquaintance with the technical characteristics of the equipment, providing an accurate definition of their functionalities, ad to inform potential users of the possibilities and equipment available in this field. The report first summarizes the various experimental surveys conduced. Then, using the AVM equipment database to draw up an exhaustive list of available equipment, it provides a full-scope picture of the vibration measurement systems (sensors, conditioners and exciters) and data processing resources commonly used on industrial sites and in laboratories. A definition is also given of a mobile test unit, called 'shelter', and a test bench used for the testing and performance rating of the experimental analysis methods developed by the group. The report concludes with a description of two fixed installations: - the calibration bench ensuring the requisite quality level for the vibration measurement systems ; - the training bench, whereby know-how acquired in the field in the field of measurement and experimental analysis processes is made available to others. (author). 27 refs., 15 figs., 2 appends

  1. Spontaneous bile duct perforation in an infant, managed with simple ...

    African Journals Online (AJOL)

    Spontaneous bile duct perforation is a very rare but important cause of surgical jaundice in pediatric patients and one of the most common causes of surgical jaundice during infancy after biliary atresia. Preoperative diagnosis may not be possible in most of the cases. The exact cause of the perforation remains unclear.

  2. Design requirement on KALIMER blanket fuel assembly duct

    International Nuclear Information System (INIS)

    Hwang, Woan; Kang, H. Y.; Nam, C.; Kim, J. O.

    1998-03-01

    This document describes design requirements which are needed for designing the blanket fuel assembly duct of the KALIMER as design guidance. The blanket fuel assembly duct of the KALIMER consists of fuel rods, mounting rail, nosepiece, duct with pad, handling socket with pad. Blanket fuel rod consists of top end plug, bottom end plug with solid ferritic-martensitic steel rod and key way blanket fuel slug, cladding, and wire wrap. In the assembly, the rods are in a triangular pitch array, and the rod bundle is attached to the nosepiece with mounting rails. The bottom end of the assembly duct is formed by a long nosepiece which provides the lower restraint function and the paths for coolant inlet. This report contains functional requirements, performance and operational requirements, interfacing systems requirements, core restraint and interface requirements, design limits and strength requirements, system configuration and essential feature requirements, seismic requirements, structural requirements, environmental requirements, reliability and safety requirements, standard and codes, QA programs, and other requirements. (author). 20 refs., 4 figs

  3. Two phase flow combustion modelling of a ducted rocket

    NARCIS (Netherlands)

    Stowe, R.A.; Dubois, C.; Harris, P.G.; Mayer, A.E.H.J.; Champlain, A. de; Ringuette, S.

    2001-01-01

    Under a co-operative program, the Defence Research Establishment Valcartier and Université Laval in Canada and the TNO Prins Maurits Laboratory in the Netherlands have studied the use of a ducted rocket for missile propulsion. Hot-flow direct-connect combustion experiments using both simulated and

  4. Reconstruction of major bile duct injuries after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Holte, Kathrine; Bardram, Linda; Wettergren, André

    2010-01-01

    Bile duct injury (BDI) after cholecystectomy remains a serious complication with major implications for patient outcome. For most major BDIs, the recommended method of repair is a hepaticojejunostomy (HJ). We conducted a retrospective review aiming to examine the perioperative and the long...

  5. Optimizing the Treatment of Acute Duct-Destructive Pancreatitis

    Science.gov (United States)

    Zhakiev, Bazylbek S.; Karsakbayev, Uteugali G.; Kelimberdiev, Mersaid S.; ?uhamedgalieva, Bodagoz M.; K?nonenko, Aleksander F.

    2016-01-01

    The search for new methods for treating duct-destructive pancreatitis is a relevant problem. Endogenous intoxication and oxidative stress that accompany acute pancreatitis often progress even after surgery, which forces one to search for additional possibilities of preventing these severe consequences. This research studied the effect of small…

  6. Laparoscopic managment of common bile duct stones: our initial experience.

    Science.gov (United States)

    Aroori, S; Bell, J C

    2002-05-01

    The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence.

  7. Cladding and Duct Materials for Advanced Nuclear Recycle Reactors

    International Nuclear Information System (INIS)

    Allen, Todd R.; Busby, J. T.; Klueh, R. L.; Maloy, Stuart A.; Toloczko, Mychailo B.

    2008-01-01

    This is a review article that provides an overview of the reactor core structural materials and clad and duct needs for the GNEP advanced burner reactor design. A short history of previous research on structural materials for irradiation environments is provided. There is also a section describing some advanced materials that may be candidate materials for various reactor core structures

  8. Flow in curved ducts of varying cross-section

    Science.gov (United States)

    Sotiropoulos, F.; Patel, V. C.

    1992-07-01

    Two numerical methods for solving the incompressible Navier-Stokes equations are compared with each other by applying them to calculate laminar and turbulent flows through curved ducts of regular cross-section. Detailed comparisons, between the computed solutions and experimental data, are carried out in order to validate the two methods and to identify their relative merits and disadvantages. Based on the conclusions of this comparative study a numerical method is developed for simulating viscous flows through curved ducts of varying cross-sections. The proposed method is capable of simulating the near-wall turbulence using fine computational meshes across the sublayer in conjunction with a two-layer k-epsilon model. Numerical solutions are obtained for: (1) a straight transition duct geometry, and (2) a hydroturbine draft-tube configuration at model scale Reynolds number for various inlet swirl intensities. The report also provides a detailed literature survey that summarizes all the experimental and computational work in the area of duct flows.

  9. Discontinuous finite element treatment of duct problems in transport calculations

    International Nuclear Information System (INIS)

    Mirza, A. M.; Qamar, S.

    1998-01-01

    A discontinuous finite element approach is presented to solve the even-parity Boltzmann transport equation for duct problems. Presence of ducts in a system results in the streaming of particles and hence requires the employment of higher order angular approximations to model the angular flux. Conventional schemes based on the use of continuous trial functions require the same order of angular approximations to be used everywhere in the system, resulting in wastage of computational resources. Numerical investigations for the test problems presented in this paper indicate that the discontinuous finite elements eliminate the above problems and leads to computationally efficient and economical methods. They are also found to be more suitable for treating the sharp changes in the angular flux at duct-observer interfaces. The new approach provides a single-pass alternate to extrapolation and interactive schemes which need multiple passes of the solution strategy to acquire convergence. The method has been tested with the help of two case studies, namely straight and dog-leg duct problems. All results have been verified against those obtained from Monte Carlo simulations and K/sup +/ continuous finite element method. (author)

  10. Thyroglossal Duct Papillary Thyroid Carcinoma and Synchronous Lingual Thyroid Atypia

    Directory of Open Access Journals (Sweden)

    Timothy Yoo

    2016-01-01

    Full Text Available Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.

  11. Percutaneous management of bile duct injury after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Islim, F.; Ors, S.; Salik, A.; Guven, K.; Yanar, F.; Alis, H.

    2012-01-01

    Full text: Introduction: The risk of bile duct injury after laparoscopic cholecystectomy is higher than open cholecystectomy. Objective: To discuss the importance of minimally invasive treatment options in the management of bile duct injuries after laparoscopic cholecystectomy and to present our approach in the management. Materials and methods: Management of 25 patients with symptomatic bile duct injury after laparoscopic cholecystectomy was retrospectively evaluated. Percutaneous collection drainage, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and percutaneous biliary drainage were performed for the management of the patients. Results: Mean age of the patients (15 women, 10 men) was 55. Either ultrasonography or computed tomography guided percutaneous drainage was performed in 13 patients. 9 of them completely recovered only with percutaneous drainage. In 4 of them ERCP was performed because of high drainage volume. In 9 of the patients with jaundice and high bilirubin levels ERCP was performed as the first option. And 3 patients were reoperated because of acute abdomen signs. ERCP, MRCP and PTC revealed type A in 7, type E2 in 3, type E3 in 3 and type E4 in 1 of the patients according to Strasberg classification. Conclusion: Presenting symptoms of the patients with symptomatic bile duct injury are useful in the determination of the treatment option.

  12. Percutaneous transhepatic cholelithotripsy for difficult common bile duct stones

    DEFF Research Database (Denmark)

    Stage, J G; Moesgaard, F; Grønvall, S

    1998-01-01

    or ureteroscope in ten patients and by stone removal by basket in the remaining four patients. The procedure was carried out using local anesthesia in the last 11 patients. Except for two patients with transient cholangitis, no complications occurred. CONCLUSIONS: Difficult bile duct and intrahepatic stones can...

  13. Experimental study on the particles deposition in the sampling duct

    Energy Technology Data Exchange (ETDEWEB)

    Vendel, J.; Charuau, J. [Institut de Protection et de Surete Nucleaire, Yvette (France)

    1995-02-01

    A high standard of protection against the harmful effects of radioactive aerosol dissemination requires a measurement, as representative as possible, of their concentration. This measurement depends on the techniques used for aerosol sampling and transfer to the detector, as well as on the location of the latter with respect to the potential sources. The aeraulic design of the apparatus is also an important factor. Once collected the aerosol particles often have to travel through a variably shaped duct to the measurement apparatus. This transport is responsible for losses due to the particles deposition on the walls, leading to a distortion on the concentration measurements and a change in the particle size distribution. To estimate and minimize measurement errors it is important to determine the optimal transport conditions when designing a duct; its diameter and material, the radius of curvature of the bends and the flow conditions must be defined in particular. This paper presents an experimental study in order to determine, for each deposition mechanism, the retained fraction, or the deposition velocity for different flow regimes. This study has pointed out that it exists a favourable flow regime for the particle transport through the sampling ducts (2 500 < Re < 5 000). It has been established, for any particle diameters, equations to predict the aerosol penetration in smooth-walled cylindrical metal ducts.

  14. Sonographic and radiologic diagnosis of a pancreatic duct stone

    International Nuclear Information System (INIS)

    Habscheid, W.; Kulke, H.; Heidbreder, E.

    1986-01-01

    A case is reported in which asymptomatic chronic pancreatitis of initially unknown etiology was detected as result of a routine follow-up examination of a patient with membraneproliferative glomerulonephritis. Ultrasound and endoscopic cholangio-pancreatography detected a stone in the major pancreatic duct. The stone was of such size and irregular form that endoscopic extraction was impossible. (orig.) [de

  15. Sonographic and radiologic diagnosis of a pancreatic duct stone

    Energy Technology Data Exchange (ETDEWEB)

    Habscheid, W.; Kulke, H.; Heidbreder, E.

    1986-09-01

    A case is reported in which asymptomatic chronic pancreatitis of initially unknown etiology was detected as result of a routine follow-up examination of a patient with membraneproliferative glomerulonephritis. Ultrasound and endoscopic cholangio-pancreatography detected a stone in the major pancreatic duct. The stone was of such size and irregular form that endoscopic extraction was impossible.

  16. Pattern and outcome of surgical management of nasolachrymal duct ...

    African Journals Online (AJOL)

    The commonest complication noted was stent extrusion before 6 weeks in 17.6% of cases. Conclusion: NLDO was mostly of congenital origin and was characterized by delayed presentation. Patients have good outcome with external DCR. Keywords: Children, dacryocystorhinostomy, naso lachrymal duct, obstruction.

  17. Molecular basis of potassium channels in pancreatic duct epithelial cells

    DEFF Research Database (Denmark)

    Hayashi, M.; Novak, Ivana

    2013-01-01

    Potassium channels regulate excitability, epithelial ion transport, proliferation, and apoptosis. In pancreatic ducts, K channels hyperpolarize the membrane potential and provide the driving force for anion secretion. This review focuses on the molecular candidates of functional K channels...... and pancreatic pathologies, including pancreatitis, cystic fibrosis, and cancer, in which the dysregulation or altered expression of K channels may be of importance....

  18. T-tube vs Primary Common Bile Duct Closure

    Directory of Open Access Journals (Sweden)

    M R Joshi

    2010-09-01

    Full Text Available INTRODUCTION: Closure of the common bile duct over T-tube after exploration is a widely practiced traditional method. However, its use may give rise to many complications. We do primary closure of common bile duct after exploration. Aim of the study is to see the efficacy and safety of the primary closure. METHODS: Study was carried out to compare the results of both the techniques from 2006 to 2009 in the cases proven to have common bile duct stone with or without the features of obstructive jaundice. Post operative hospital stay and morbidities related to both the groups were recorded and analyzed. RESULTS: There were total 71 cases included in the study. Thirty one in T-tube group and 40 in primary closure group. T-tube was removed in most of the cases after three weeks where as average time of drain removal in primary closure group is 5.79 +/-1.79 days. Incidence of retained stone was equal in each group. Major complication in T-tube group is biliary peritonitis in four patients at the time of T-tube removal whereas none of the patient from primary closure group suffered from such major complication. CONCLUSIONS: Primary closure after the common bile duct exploration is safe and it helps to avoid the morbidities related to T-tube. Keywords: Choledocholithiasis, Primary closure, retained stone, T-tube, Ureterorenoscope.

  19. Surgical management of Stenson's duct injury using epidural catheter

    African Journals Online (AJOL)

    2012-07-05

    Jul 5, 2012 ... Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of ... Mansarovar Dental College Hospital and Research Centre,. Kolar Road ... A 42-year-old male patient presented to maxillofacial .... catheter, catgut suture, and pediatric intravascular cannula.

  20. Echinococcal Cyst of the Pancreas with Cystopancreatic Duct Fistula ...

    African Journals Online (AJOL)

    Echinococcal Cyst of the Pancreas with Cystopancreatic. Duct Fistula Successfully Treated by Partial Cystectomy and. Cystogastrostomy. Ahmed Elaffand, Adarsh Vijay1, Samah Mohamed, Hassan Hani Al-Battah1, Ayda Youssef, Ahmed Farahat. INTRODUCTION. Hydatid disease (HD) is a rare endemic disease in.

  1. A pilot study of bendamustine in advanced bile duct cancer.

    Science.gov (United States)

    Schoppmeyer, Konrad; Kreth, Florian; Wiedmann, Marcus; Mössner, Joachim; Preiss, Rainer; Caca, Karel

    2007-07-01

    We performed a pilot study to evaluate the safety and tolerability of bendamustine in patients with advanced hilar bile duct cancer and impaired liver function. Six patients with histologically proven, unresectable adenocarcinoma of the hilar bile duct were treated with bendamustine 140 mg/m intravenously on day 1 of the first cycle and with bendamustine 100 mg/m on days 1 and 2 of the second to fourth cycle. Treatment cycles were repeated every 21 days. Primary endpoint was the safety and tolerability of the treatment; secondary endpoints were response rate, time to progression and overall survival. Transient lymphopenia grade 3 occurred in all six patients. No other grade 3 or 4 toxicities were present. The most common nonhematologic toxicity was mouth dryness grade 2 in six patients. Three patients had stable disease. No partial or complete responses were observed. Median time to progression was 3.3 months; median overall survival was 6 months. Our study demonstrates that bendamustine can be safely administered in patients with hilar bile duct cancer and impaired liver function. A potential role of bendamustine in combination therapies for bile duct cancer will be a subject of further trials.

  2. Heat transfer in an asymmetrically heated duct, 2

    International Nuclear Information System (INIS)

    Satoh, Isao; Kurosaki, Yasuo

    1986-01-01

    The objective of this article is to study theoretically and experimentally the effects of nonuniform heating on turbulent heat transfer characteristics for flow in a horizontal rectangular duct ; a vertical side wall was uniformly heated, and the other wall were insulated. In our theoretical approach, the zero-equation model for turbulent eddy viscosity was employed. The effects of mesh size of finite difference on the calculation results were examined, and some refined compensation for wall temperatures and wall shear stresses by no use of fine mesh were proposed to reduce the calculation time. The heat transfer coefficients in thermally developing region for a nonuniformly heated duct obtained from numerical solutions are larger than the one for uniformly heated case. The buoyancy effects on heat transfer were evaluated. However, it was seen that the secondary flow due to buoyancy force was hardly expected to enhance heat transfer in a turbulent duct flow. Experiments were performed to measure the velocity and temperature profiles in a turbulent duct flow with a nonuniform heated wall. The experimental results were in good agreement with the theoretical ones. (author)

  3. Clinical and cholangiographic evaluation of bile duct carcinoma

    International Nuclear Information System (INIS)

    Park, Yeon Won; Kim, So Seon; Kim, Ho Joon; Joh, Young Duk; Chun, Byung Hee

    1986-01-01

    40 cases of bile duct carcinoma gathered over a 6-year period at Kosin Medical College were reviewed and their clinical and cholangiographic findings were as follows: 1. There were 29 males and 11 females (the ratio of men to women, 2.6:1) ranging from 37 to 74 years of age. The majority (70% of cases) were in 4th and 5th decades. 2. Clinical symptoms and signs: jaundice in 95%, RUQ or epigastric pain in 75%, pruritus in 52.5%, dark urine in 35%, weight loss in 32.5%, fever and chills in 22.5%, clay colored stool in 12.5%, and palpable mass in 12.5%. 3. Lab. findings: elevated serum total bilirubin (above 20.0mg% in 45%, 10.0-19.9mg% in 22.5%, 5.0-9.9mg% in 20%, 1.3-4.9mg% in 5%), elevated alkaline phosphatase in 95%. Clonorchiasis were noted in 17.5%. 4. Histologic findings were adenocarcinoma in most cases. 5. The location of bile duct carcinoma were common hepatic duct in 35%, common bile duct in 32.5%, porta hepatic in 12.5%, junction with cystic duct in 10% and diffuse form in 10%. 6. In 33 cases, PTC or post-operative cholangiographic examination were done. And the most frequent findings were dilatation of the proximal bile duct and abrupt narrowing or complete obstruction of distal lumen. In 27 cases (82%), complete obstruction of bile duct were noted. Attempts were made to analyze the type of obstruction: Constricted type in 39%, Nipple type in 18%, round or flat type (smooth or slightly irregular) in 15%, and serrated type in 9%. Incomplete obstruction were noted in 6 cases (18%). Among them, abrupt narrowing of lumen was noted in 9% and diffuse narrowing in 9%. 7. ERCP was done in 7 cases. Findings were: constricted type in 42.6%, constricted and slightly irregular type in 14.3%, downward convexity in 14.3%, diffuse irregular narrowing in 14.3% and intraluminal filing defect in 14.3%.

  4. Causes and Prevention of Laparoscopic Bile Duct Injuries

    Science.gov (United States)

    Way, Lawrence W.; Stewart, Lygia; Gantert, Walter; Liu, Kingsway; Lee, Crystine M.; Whang, Karen; Hunter, John G.

    2003-01-01

    Objective To apply human performance concepts in an attempt to understand the causes of and prevent laparoscopic bile duct injury. Summary Background Data Powerful conceptual advances have been made in understanding the nature and limits of human performance. Applying these findings in high-risk activities, such as commercial aviation, has allowed the work environment to be restructured to substantially reduce human error. Methods The authors analyzed 252 laparoscopic bile duct injuries according to the principles of the cognitive science of visual perception, judgment, and human error. The injury distribution was class I, 7%; class II, 22%; class III, 61%; and class IV, 10%. The data included operative radiographs, clinical records, and 22 videotapes of original operations. Results The primary cause of error in 97% of cases was a visual perceptual illusion. Faults in technical skill were present in only 3% of injuries. Knowledge and judgment errors were contributory but not primary. Sixty-four injuries (25%) were recognized at the index operation; the surgeon identified the problem early enough to limit the injury in only 15 (6%). In class III injuries the common duct, erroneously believed to be the cystic duct, was deliberately cut. This stemmed from an illusion of object form due to a specific uncommon configuration of the structures and the heuristic nature (unconscious assumptions) of human visual perception. The videotapes showed the persuasiveness of the illusion, and many operative reports described the operation as routine. Class II injuries resulted from a dissection too close to the common hepatic duct. Fundamentally an illusion, it was contributed to in some instances by working too deep in the triangle of Calot. Conclusions These data show that errors leading to laparoscopic bile duct injuries stem principally from misperception, not errors of skill, knowledge, or judgment. The misperception was so compelling that in most cases the surgeon did not

  5. Geometrical scaling, furry branching and minijets

    International Nuclear Information System (INIS)

    Hwa, R.C.

    1988-01-01

    Scaling properties and their violations in hadronic collisions are discussed in the framework of the geometrical branching model. Geometrical scaling supplemented by Furry branching characterizes the soft component, while the production of jets specifies the hard component. Many features of multiparticle production processes are well described by this model. 21 refs

  6. Branching out Has So Much to Offer

    Science.gov (United States)

    Murray, Joe

    2012-01-01

    In 1989 there were thirty ATM branches nationally. In January 2012 there were just twelve ATM branches with another three "proposed". How can that happen? How did it happen? Maybe the most pertinent question is: Why did it happen? There is no single answer to the last question, but perhaps it was something to do with the changes that…

  7. Conformal branching rules and modular invariants

    International Nuclear Information System (INIS)

    Walton, M.A.

    1989-01-01

    Using the outer automorphisms of the affine algebra SU(n), we show how the branching rules for the conformal subalgebra SU(pq) contains SU(p) x SU(q) may be simply calculated. We demonstrate that new modular invariant combinations of SU(n) characters are obtainable from the branching rules. (orig.)

  8. Aeroacoustics of pipe systems with closed branches

    NARCIS (Netherlands)

    Tonon, D.; Hirschberg, A.; Golliard, J.; Ziada, S.

    2011-01-01

    Flow induced pulsations in resonant pipe networks with closed branches are considered in this review paper. These pulsations, observed in many technical applications, have been identified as self-sustained aeroacoustic oscillations driven by the instability of the flow along the closed branches. The

  9. Branching miter joints : principles and artwork

    NARCIS (Netherlands)

    Verhoeff, T.; Verhoeff, K.; Hart, G.W.; Sarhangi, R.

    2010-01-01

    A miter joint connects two beams, typically of the same cross section, at an angle such that the longitudinal beam edges continue across the joint. When more than two beams meet in one point, like in a tree, we call this a branching joint. In a branching miter joint, the beams’ longitudinal edges

  10. Branching bisimulation congruence for probabilistic systems

    NARCIS (Netherlands)

    Trcka, N.; Georgievska, S.; Aldini, A.; Baier, C.

    2008-01-01

    The notion of branching bisimulation for the alternating model of probabilistic systems is not a congruence with respect to parallel composition. In this paper we first define another branching bisimulation in the more general model allowing consecutive probabilistic transitions, and we prove that

  11. Prebiotic branched galacto-oligosaccharides (gos)

    NARCIS (Netherlands)

    Lammerts van Bueren-Brandt, Alica; Dijkhuizen, Lubbert

    2018-01-01

    The invention relates to galacto-oligosaccharide (GOS) compositions and the use thereof. Provided is the use of a GOS composition comprising branched and linear GOS species having a degree of polymerization (DP) of 3, wherein the branched DP3 GOS species are present in excess of linear DP3 GOS

  12. Differentiation of benign and malignant hilar bile duct stenosis.

    Science.gov (United States)

    Liu, Xiaolei; Yang, Zhiying; Tan, Haidong; Shao, Chen; Liu, Liguo; Si, Shuang; Xu, Li; Sun, Yongliang

    2016-06-15

    Failure to differentiate benign and malignant hilar bile duct stenosis may lead to inappropriate treatment. We retrospectively analyzed the methods for differentiation. A total of 53 patients with hilar bile duct stenosis were included, comprising 41 malignant cases (hilar cholangiocarcinoma) and 12 benign cases (six primary sclerosing cholangitis and six IgG4-associated sclerosing cholangitis). Data of clinical histories, laboratory tests, imaging studies, and liver pathologies were collected, and comparison was made between benign and malignant groups. Compared with malignant group, patients in the benign group were more likely to have multiorgan involvement of clinical histories (P < 0.001). There was no difference on bilirubin, liver enzyme, and serum tumor marker between the two groups, whereas serum IgG4 levels were higher in the benign group (P = 0.003). Patients in the benign group were more likely to have pancreatic changes (P < 0.001) and multiple-segmental bile duct stenosis (P < 0.001) on imaging. Compared with the malignant group, patients in the benign group were more likely to show severe periportal inflammation in noninvolved liver (P < 0.001), fibrosis around intrahepatic bile duct (P < 0.001), and more IgG4-positive plasma cells (P < 0.001) on liver pathology. Benign lesion should be considered for patients with history of multiorgan involvement, pancreas changes, or multiple-segmental bile duct stenosis on imaging. Liver biopsy could be helpful for differential diagnosis before surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. [Common bile duct stones: the surgical treatment is always valid].

    Science.gov (United States)

    Nardi, F; Gavelli, A; Dapri, G; Huguet, C

    2004-02-01

    The treatment of common bile duct stones has changed with the new therapeutic techniques, that have replaced the conventional therapy, represented by surgery. Anyway, they could cause some problems, that must be regarded. Therefore, we wish to confirm the importance of the conventional surgery in the management of patients with common bile duct stones. A total of 147 patients were operated for common bile duct stones (73 in emergency and 74 in election). The intraoperative cholangiography was carried out in 141 patients and a choledocoscopy in 130 patients. A drain of Kehr was positioned in 120 patients, a bilio-digestive anastomosis in 26 cases and in 1 case there was a direct suture of the common bile duct without drain. All patients were treated with a short-term antibioticotherapy, protracted to 5 days in the emergency cases. In the patients with the drain of Kehr there was a control cholangiography after 7 days from operation and it was removed after 25 days. The analysis of the results was done dividing the patients according to the age: old and >75 years old. Nobody died during the operation. Complications were 17.4% in the patients >75 years old and 2,6% in the patients old. There were 2 death, in the postoperative period, for the group >75 years old. Cases operated in emergency were 68.1% of "old" patients and 37.2% of "young" patients. The postoperative period was 14.9+/-9.2 days for the "old" group and 10.9+/-5.2 days for the "young" group. The treatment of common bile duct stones is still a surgical treatment, particularly for "old" patients.

  14. Identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    PENG Lei

    2015-10-01

    Full Text Available ObjectiveTo investigate the identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy (LC, and to reduce the occurrence of bile duct injury. MethodsThis study included 60 patients who received LC in the People′s Hospital of Caidian District in Wuhan and had structural variation of extrahepatic bile duct found during the operation from January 2012 to January 2014. The clinical data were retrospectively analyzed, and the intraoperative and postoperative conditions were summarized. ResultsDuring operation, cystic duct variation was found in 32 cases, abnormal position of the point where the cystic duct joins the extrahepatic bile duct in 20 cases, the cystic duct and the common hepatic duct having the common wall before joining the common bile duct in 2 cases, aberrant bile duct in the gallbladder bed in 2 cases, and accessory hepatic duct in 4 cases. Fifty-one patients (85% successfully underwent LC; 9 patients (15% were converted to open surgery. All patients finished surgery successfully. There were 2 cases of postoperative complications; one patient developed residual stones in the bile duct, and bile leakage occurred in the other patient at one week after LC, who recovered after reoperation. All patients were cured and discharged, without severe complications such as intraperitoneal hemorrhage, infection, and intestinal injury. ConclusionIdentifying the structural variation of extrahepatic bile duct, dissecting the Calot′s triangle meticulously, and determining the type of variation of extrahepatic bile duct play important roles in LC and significantly reduce the incidence of bile duct injury.

  15. Flow characteristics of developing laminar steady flows in a straight duct connected to a square curved duct

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyun Chull [Chosun Univ., Gwangju (Korea, Republic of)

    2005-05-01

    In the present study, the characteristics of developing steady laminar flows of a straight duct connected to a 180 .deg. curved duct were examined in the entrance region through experimental measurement. Flow characteristics such as shear stress distributions, pressure distributions and friction coefficient experimentally in a square cross-sectional straight duct by using the PIV system. For the PIV measurement by particles produced from mosquito coils particles. The experimental data were obtained at 9 points dividing the test sections by 400 mm. Experimental results can be summarized as follows. Critical Reynolds number, Re{sub cr} which indicates transition from laminar steady flow to transition steady flow was 2,150. Shear stress per unit length on the wall was stronger than that in the fully developed flow region. This was attributed to the fact that shear stress and pressure loss in the curvature of a duct were increased. Pressure distributions were gradually decreased irrespective of Reynolds number in the whole test section. This trends were in a good agreement with the reference results. Pipe friction coefficient in the steady state flow region was calculate from method of least squares. The co-relationship between fiction coefficient and Reynolds number was established as follow; {lambda}=56/Re.

  16. Transcatheter occlusion of perimembranous ventricular septal defects with Amplatzer duct occluder

    International Nuclear Information System (INIS)

    Ren Sengen; Kang Kang; Wu Danning; Shi Hong; Wu Jingzhang; Yang Mei; Han Feizhou; Zhou Fei; Zhu Zhijun

    2003-01-01

    Objective: To study the feasibility of congenital perimembranous ventricular septal defect (VSD) occlusion by Amplatzer duct occluder (ADO) and to establish guidelines for its safe and effective application. Methods: From May 2001 to December 2002, percutaneous transcatheter occlusion of congenital perimembranous VSD was performed in 41 patients, in which 18 patients had an associated aneurysm of the membranous septum. There were 20 male and 21 female subjects, with age ranging from 6 to 38 years (median 14.9) and weights of 18 to 62 kg (median 41.5). The diameter of VSD ranged from 4 to 12.8 mm (median 6.0), and the distance of VSD to the aortic valve were 4.5 to 12 mm (median 6.6). The ratio of pulmonary to systemic blood flow (Qp/Qs) was 1.4 to 2.6 (median 1.7) and the pulmonary systolic pressure was 19 to 34 mmHg (median 25). Results: All the patients underwent successfully complete occlusion of VSD with ADO, and the size of ADO ranged from 6/4 to 16/14 mm. After the procedure, left ventricular angiography and transthoracic echocardiography showing the ADOs were precisely placed inside the VSDs with no residual shunt and also no abnormalities revealed by auscultation. Chest X-ray showed the relief of congestion of the lungs. Electrocardiogram demonstrated complete left bundle branch block in one case and incomplete right bundle branch block in other 12 cases, all disappeared within 1 to 2 weeks. Over a period of 2 to 21 months follow-up, all the devices maintained in good position and the patients' condition turned much better. No patient developed aortic or tricuspid regurgitation and other complications. Conclusions: ADO is a safe, effective and convenient occlusion device which could be practically applied for the congenital perimembranous VSDs

  17. Smoking increased the risk of prostate cancer with grade group ≥ 4 and intraductal carcinoma in a prospective biopsy cohort.

    Science.gov (United States)

    Tang, Bo; Han, Cheng-Tao; Gan, Hua-Lei; Zhang, Gui-Ming; Zhang, Cui-Zhu; Yang, Wei-Yi; Shen, Ying; Zhu, Yao; Ye, Ding-Wei

    2017-06-01

    To investigate the association between smoking and different prostate cancer (PCa) pathological subtypes incidence in Chinese men. We prospectively included 1795 patients who underwent prostate biopsies in one tertiary center between March 2013 and April 2016. Clinical data and biopsy outcomes were collected. Logistic regression was used to evaluate the association between cigarette smoking and PCa incidence. A total of 737 men, 480 men and 58 men were diagnosed with PCa, high-grade PCa (HGPCa, grade group ≥ 4 as accepted by the 2014 ISUP) and intraductal carcinoma of the prostate (IDC-P), respectively. Current smokers had a significantly higher risk of HGPCa than never smokers (OR = 1.89, 95%CI: 1.44-2.48). No such association was observed for low-grade disease and cigarette smoking (OR = 0.84, 95%CI: 0.61-1.16). In a sub-analysis, men who had smoked longer than 30 years had a higher risk of HGPCa, compared with men who had smoked fewer than 30 years (OR = 1.50, 95%CI: 1.09-2.06). Current smokers were more likely to develop IDC-P than never smokers (OR = 2.29, 95%CI: 1.14-4.59). Among men in this Chinese biopsy cohort, current smoking was associated with highly malignant PCa incidence, such as HGPCa and IDC-P. The duration of smoking may be associated with HGPCa. © 2017 Wiley Periodicals, Inc.

  18. Can we better predict the biologic behavior of incidental IPMN? A comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Tulla, Kiara A; Maker, Ajay V

    2018-03-01

    Predicting the biologic behavior of intraductal papillary mucinous neoplasm (IPMN) remains challenging. Current guidelines utilize patient symptoms and imaging characteristics to determine appropriate surgical candidates. However, the majority of resected cysts remain low-risk lesions, many of which may be feasible to have under surveillance. We herein characterize the most promising and up-to-date molecular diagnostics in order to identify optimal components of a molecular signature to distinguish levels of IPMN dysplasia. A comprehensive systematic review of pertinent literature, including our own experience, was conducted based on the PRISMA guidelines. Molecular diagnostics in IPMN patient tissue, duodenal secretions, cyst fluid, saliva, and serum were evaluated and organized into the following categories: oncogenes, tumor suppressor genes, glycoproteins, markers of the immune response, proteomics, DNA/RNA mutations, and next-generation sequencing/microRNA. Specific targets in each of these categories, and in aggregate, were identified by their ability to both characterize a cyst as an IPMN and determine the level of cyst dysplasia. Combining molecular signatures with clinical and imaging features in this era of next-generation sequencing and advanced computational analysis will enable enhanced sensitivity and specificity of current models to predict the biologic behavior of IPMN.

  19. Molecular alterations in lesions of anogenital mammary-like glands and their mammary counterparts including hidradenoma papilliferum, intraductal papilloma, fibroadenoma and phyllodes tumor.

    Science.gov (United States)

    Konstantinova, Anastasia M; Vanecek, Tomas; Martinek, Petr; Kyrpychova, Liubov; Spagnolo, Dominic V; Stewart, Colin J R; Portelli, Francesca; Michal, Michal; Kazakov, Dmitry V

    2017-06-01

    Lesions affecting anogenital mammary-like glands (AGMLG) are histopathologically very similar to those seen in the breast but whether this morphological similarity is also reflected at the genetic level is unknown. To compare the underlying molecular mechanisms in lesions of AGMLG and their mammary counterparts, we analyzed the mutational profile of 16 anogenital neoplasms including 5 hidradenomas papilliferum (HP), 1 lesion with features of HP and fibroadenoma (FA), 7 FA, 3 phyllodes tumors (PhT)) and 18 analogous breast lesions (6 intraductal papillomas (IDP), 9 FA, and 3 PhT) by high-coverage next generation sequencing (NGS) using a panel comprising 50 cancer-related genes. Additionally, all cases were analyzed for the presence of a mutation in the MED12 gene. All detected mutations with allele frequencies over 20% were independently validated by Sanger sequencing (concordance: 100%). Mutations in PIK3CA, AKT1, MET, ABL1 and TP53 genes were found in lesions of AGMLG and also their mammary counterparts. The PI3K-AKT cascade plays a role in tumors arising at both sites. It appears that some histopathologically similar anogenital and breast lesions develop along similar molecular pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Mucocele of the cystic duct remnant after orthotopic liver transplant: a problem revisited.

    Science.gov (United States)

    Chatterjee, Suvadip; Das, Debasish; Hudson, Mark; Bassendine, Margaret Fiona; Scott, John; Oppong, Kofi Ernest; Sen, Gourab; French, Jeremy J

    2011-06-01

    Mucocele of the cystic duct remnant is an uncommon hepatobiliary complication of a liver transplant. Current practice usually involves either excising the cystic duct, or incorporating the distal end of the transected cystic duct into the suture line of the biliary anastomosis to ensure drainage. We report a patient who developed cystic duct remnant mucocele after the latter approach was adopted. We believe that this is likely related to delayed anastomotic stricturing, which prevented draining from the remnant cystic duct. We also discuss the incidence, pathology, investigations, and treatment of this condition.

  1. Bowing-reactivity trends in EBR-II assuming zero-swelling ducts

    International Nuclear Information System (INIS)

    Meneghetti, D.

    1994-01-01

    Predicted trends of duct-bowing reactivities for the Experimental Breeder Reactor II (EBR-II) are correlated with predicted row-wise duct deflections assuming use of idealized zero-void-swelling subassembly ducts. These assume no irradiation induced swellings of ducts but include estimates of the effects of irradiation-creep relaxation of thermally induced bowing stresses. The results illustrate the manners in which at-power creeps may affect subsequent duct deflections at zero power and thereby the trends of the bowing component of a subsequent power reactivity decrement

  2. On Computations of Duct Acoustics with Near Cut-Off Frequency

    Science.gov (United States)

    Dong, Thomas Z.; Povinelli, Louis A.

    1997-01-01

    The cut-off is a unique feature associated with duct acoustics due to the presence of duct walls. A study of this cut-off effect on the computations of duct acoustics is performed in the present work. The results show that the computation of duct acoustic modes near cut-off requires higher numerical resolutions than others to avoid being numerically cut off. Duct acoustic problems in Category 2 are solved by the DRP finite difference scheme with the selective artificial damping method and results are presented and compared to reference solutions.

  3. Carcinosarcoma of the Extrahepatic Bile Duct Presenting with Stone-like Radiological Findings.

    Science.gov (United States)

    Kumei, Shinsuke; Onishi, Yutaka; Ogura, Takeshi; Kusumoto, Chosei; Matsuno, Yasuko; Nishigami, Takashi; Maeda, Mitsuo; Harada, Masaru

    2015-01-01

    A 73-year-old woman was referred to our hospital due to epigastralgia and jaundice. The radiological findings showed a stone-like tumor in the extrahepatic bile duct. The patient was initially thought to have adenocarcinoma of the bile duct based on the findings of a pathological examination of the bile duct biopsy specimen and underwent pancreaticoduodenectomy; the final diagnosis of the lesion was so-called carcinosarcoma of the extrahepatic bile duct. She died of liver metastasis six months after the surgery. This case suggests that surgical resection is not adequate for achieving a radical cure, and the optimal treatment for extrahepatic bile duct carcinosarcoma should be established immediately.

  4. [Croatian Medical Association--Branch Zagreb].

    Science.gov (United States)

    Kaić, Zvonimir; Sain, Snjezana; Gulić, Mirjana; Mahovlić, Vjekoslav; Krznarić, Zeljko

    2014-01-01

    The available literature shows us that "Druztvo ljeciteljah u Zagrebus (the Society of Healers in Zagreb) was founded as far back as the year 1845 by a total of thirteen members. This data allows us to follow the role of doctors and health workers in Zagreb through their everyday profession, research, organizational and social work as well as management through a period of over one hundred to seventy years. The Branch Zagreb was active before the official establishment of subsidiaries of CMA which is evident from the minutes of the regular annual assembly of the Croatian Medical Association on 21 March 1948. Until the end of 1956, there was no clear division of labor, functions and competencies between the Branch and the Main Board. Their actions were instead consolidated and the Branch operated within and under the name of Croatian Medical Association. In that year the Branch became independent. The Branch Zagreb is the largest and one of the most active branches of the Croatian Medical Association. At the moment, the Branch brings together 3621 members, regular members--doctors of medicine (2497), doctors of dental medicine (384), retired physicians (710), and associate members (30 specialists with higher education who are not doctors). The Branch is especially accomplished in its activities in the area of professional development of its members and therefore organizes a series of scientific conferences in the framework of continuous education of physicians, allowing its members to acquire necessary points for the extension of their operating license. The choir "Zagrebacki lijecnici pjevaci" (Zagreb Physicians' Choir) of the Croatian Medical Music Society of the CMA and its activities are inseparable from the Branch Zagreb. The Branch is firmly linked to the parent body, the CMA, and thus has a visible impact on the strategy and the activities of the Association as a whole. Most professional societies of the CMA have their headquarters in Zagreb and this is

  5. Pancreaticobiliary duct changes of periampullary carcinomas: Quantitative analysis at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Dong Sheng, E-mail: victoryhope@163.com [Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041 (China); Department of Radiology, No.4 West China Teaching Hospital of Sichuan University, Chengdu 610041 (China); Chen, Wei Xia, E-mail: wxchen25@126.com [Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041 (China); Wang, Xiao Dong, E-mail: tyfs03yz@163.com [Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041 (China); Acharya, Riwaz, E-mail: riwaz007@hotmail.com [Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041 (China); Jiang, Xing Hua, E-mail: 13881865517@163.com [Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041 (China)

    2012-09-15

    Purpose: To quantitatively analyse the pancreaticobiliary duct changes of periampullary carcinomas with volumetric interpolated breath-hold examination (VIBE) and true fast imaging with steady-state precession (true FISP) sequence, and investigate the value of these findings in differentiation and preoperative evaluation. Materials and methods: Magnetic resonance (MR) images of 71 cases of periampullary carcinomas (34 cases of pancreatic head carcinoma, 16 cases of intrapancreatic bile duct carcinoma and 21 cases of ampullary carcinoma) confirmed histopathologically were analysed. The maximum diameter of the common bile duct (CBD) and main pancreatic duct (MPD), dilated pancreaticobiliary duct angle and the distance from the end of the proximal dilated pancreaticobiliary duct to the major papilla were measured. Analysis of variance and the Chi-squared test were performed. Results: These findings showed significant differences among the three subtypes: the distance from the end of proximal dilated pancreaticobiliary duct to the major papilla and pancreaticobiliary duct angle. The distance and the pancreaticobiliary duct angle were least for ampullary carcinoma among the three subtypes. The percentage of dilated CBD was 94.1%, 93.8%, and 100% for pancreatic head carcinoma, intrapancreatic bile duct carcinoma and ampullary carcinoma, respectively. And that for the dilated MPD was 58.8%, 43.8%, and 42.9%, respectively. Conclusion: Quantitative analysis of the pancreaticobiliary ductal system can provide accurate and objective assessment of the pancreaticobiliary duct changes. Although benefit in differential diagnosis is limited, these findings are valuable in preoperative evaluation for both radical resection and palliative surgery.

  6. Change of hepatic volume after selective bile duct ligation: an experimental study in the rabbit

    International Nuclear Information System (INIS)

    Lee, Hye Won; Yoon, Yup; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won; Oh, Joo Hyeong; Rim, Hyeong Teck; Kim, Youn Wha; Lee, Seok Hwan

    1998-01-01

    To evaluate the role of bile duct obstuction in the development of atrophy of the liver, using an animal model. Seven rabbits were divided into two groups: group 1(n=3D5), in which there was selective bile duct ligation, and group 2(n=3D2), which underwent a sham operation. Each group was evaluated using CT for changes in hepatic volume after selective bile duct ligation or a sham operation. In group I, the diameter of dilated bile duct was measured 2, 4, 8, 12 and 16 weeks after bile duct ligation, while gross and histologic change were evaluated in all cases. In group 1, bile duct dilatation was seen on CT two weeks after selective bile duct ligation, and did not change significantly during follow-up. In four of five cases, CT revealed no evidence of significant atrophy of the involved segment. Pathologic specimens, however, revealed dilatation of the bile duct, periductal fibrosis, infiltration of chronic inflammatory cells, and periportal fibrosis. One of five cases showed segmental liver atrophy after selective bile duct ligation. In addion to the above pathologic findings, there was obstruction of the portal vein by foreign body reaction. In group 2, no evidence of dilated bile duct or liver atrophy was revealed by CT or pathologic specimen after a sham operation. During long-term follow-up of 16 weeks, obstruction of the bile duct did not play a major role in the development of lobar atrophy in the rabbit.=20

  7. The experimental study of radiation injury on bile duct and liver tissue

    International Nuclear Information System (INIS)

    Cao Guiwen; Wang Bin; Sun Yequan; Shao Xueye; Ning Houfa; Sui Shouguang; Wang Xiuchun; Bai Xuming

    2007-01-01

    Objective: To investigate the safety, acceptance and the effective extent of 192 Ir-internal irradiation, providing theoretical guidelines for HC. Methods: Sixteen male healthy hybrid dogs enrolled in the experiment were divided into 4 groups of 4 each. The brachytherapy applicator was introduced from gall bladder into the convergence of cystic duct with common hepatic duct during the operation and a small chip of 1 cm 3 liver tissue was cut off and taken for control later on. The animals in group A-D were irradiated by 192 Ir-internal irradiation with 30 Gy, 40 Gy, 50 Gy arid 60 Gy at the correlative dose points respectively. Animals were put to death after 10 days subsequently, with sampling specimens obtained from radiation cystic duct and the in between liver tissue with the distant cystic duct. The radiation injury of the cystic duct and liver tissue near bile ducts were observed and studied by light microscope and transmission election microscope. Results: By the limit of the safest endurance dose(50 Gy) of Bile duct, unreversed injury of the nuclei of liver cells occurred at 0 to 15 mm from bile duct revealed by transmission electron microscope and light microscope. The whole biliary duct wall would be undergone necrosis with irradiation dose over 60 Gy. Conclusions: Normal bile duct possesses good endurance to 192 Ir-internal irradiation. Within the safest endurance limit of 50 Gy the effective irradiation field could reach 15 mm from the involved bile duct. (authors)

  8. Heat Pump Water Heater Ducting Strategies with Encapsulated Attics in Climate Zones 2 and 4

    Energy Technology Data Exchange (ETDEWEB)

    Sweet, M. L. [Southface Energy Inst., Upper Marlboro, MD (United States); Francisco, A.; Roberts, S. G.

    2016-05-01

    The focus of this study is on the performance of HPWHs with several different duct configurations and their effects on whole building heating, cooling, and moisture loads. A.O. Smith 60 gallon Voltex (PHPT-60) heat pump water heaters (HPWHs) were included at two project sites and ducted to or located within spray foamed encapsulated attics. The effect of ducting a HPWH's air stream does not diminish its efficiency if the ducting does not reduce intake air temperature, which expands HPWH application to confined areas. Exhaust ducts should be insulated to avoid condensation on the exterior, however this imposes a risk of condensation occurring in the duct's interior near the HPWH due to large variation of temperatures between the compressor and the duct and the presence of bulk moisture around the condenser. The HPWH's air conditioning impact on HVAC equipment loads is minimal when the intake and exhaust air streams are connected to a sealed attic and not the living space. A HPWH is not suitable as a replacement dehumidifier in sealed attics as peak moisture loads were observed to only be reduced if the heat pump operated during the morning. It appears that the intake air temperature and humidity was the most dominant variable affecting HPWH performance. Different ducting strategies such as exhaust duct only, intake duct only, and exhaust and intake ducting did not have any effect on HPWH performance.

  9. An evaluation of damping ratios for HVAC duct systems using vibration test data

    International Nuclear Information System (INIS)

    Gunyasu, K.; Horimizu, Y.; Kawakami, A.; Iokibe, H.; Yamazaki, T.

    1988-01-01

    The function of Heating Ventilating Air Conditioning (HVAC) systems must be maintained including HVAC duct systems to keep the operation of safety-related equipment in nuclear power plants during earthquake excitations. Therefore, it is important to carry out seismic design for HVAC duct systems. In the previous aseismic design for HVAC duct systems, the 0.5% damping ratio has been used in Japan. In recent years, vibration tests, held on actual duct systems in nuclear power plants and mockup duct systems were performed in order to investigate damping ratios for HVAC duct systems. Based on the results, it was confirmed that the damping ratio for HVAC duct systems, evaluated from these tests, were much greater than the 0.5% damping ratio used in the previous aseismic design of Japan. The new damping ratio in aseismic design was proposed to be 2.5%. The present paper describes the results of the above mentioned investigation

  10. Characterization of the secondary flow in hexagonal ducts

    Science.gov (United States)

    Marin, O.; Vinuesa, R.; Obabko, A. V.; Schlatter, P.

    2016-12-01

    In this work we report the results of DNSs and LESs of the turbulent flow through hexagonal ducts at friction Reynolds numbers based on centerplane wall shear and duct half-height Reτ,c ≃ 180, 360, and 550. The evolution of the Fanning friction factor f with Re is in very good agreement with experimental measurements. A significant disagreement between the DNS and previous RANS simulations was found in the prediction of the in-plane velocity, and is explained through the inability of the RANS model to properly reproduce the secondary flow present in the hexagon. The kinetic energy of the secondary flow integrated over the cross-sectional area yz decreases with Re in the hexagon, whereas it remains constant with Re in square ducts at comparable Reynolds numbers. Close connection between the values of Reynolds stress u w ¯ on the horizontal wall close to the corner and the interaction of bursting events between the horizontal and inclined walls is found. This interaction leads to the formation of the secondary flow, and is less frequent in the hexagon as Re increases due to the 120∘ aperture of its vertex, whereas in the square duct the 90∘ corner leads to the same level of interaction with increasing Re. Analysis of turbulence statistics at the centerplane and the azimuthal variance of the mean flow and the fluctuations shows a close connection between hexagonal ducts and pipe flows, since the hexagon exhibits near-axisymmetric conditions up to a distance of around 0.15DH measured from its center. Spanwise distributions of wall-shear stress show that in square ducts the 90∘ corner sets the location of a high-speed streak at a distance zv+≃50 from it, whereas in hexagons the 120∘ aperture leads to a shorter distance of zv+≃38 . At these locations the root mean square of the wall-shear stresses exhibits an inflection point, which further shows the connections between the near-wall structures and the large-scale motions in the outer flow.

  11. CPI-613 in Treating Patients With Advanced or Metastatic Bile Duct Cancer That Cannot Be Removed By Surgery

    Science.gov (United States)

    2018-05-22

    Adult Primary Cholangiocellular Carcinoma; Advanced Adult Primary Liver Cancer; Cholangiocarcinoma of the Extrahepatic Bile Duct; Cholangiocarcinoma of the Gallbladder; Localized Unresectable Adult Primary Liver Cancer; Metastatic Extrahepatic Bile Duct Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Unresectable Extrahepatic Bile Duct Cancer

  12. Gamma-ray streaming in bent ducts and voids

    International Nuclear Information System (INIS)

    Bourdet, L.; Nimal, J.C.; Vergnaud, T.

    1983-05-01

    We have developed an analytical method to calculate gamma-ray streaming through straight ducts and a numerical method to study the gamma propagation in bends or in annular clearances. The whole set allows a rigorous treatment of gamma streaming through bent ducts. In the same time a Monte Carlo method allows to study any form of geometry, by using sophisticated biasing techniques. All these developments are made with a simplified albedo. An easy to use code is also proposed to calculate very general albedos and a code to calculate the dose rate due to reflection in a room. Gamma dose rate albedos are determined for all elements and the energy range which concerns fission reactors

  13. Fire protection of nuclear power plant cable ducts

    International Nuclear Information System (INIS)

    Kandrac, J.; Lukac, L.

    1987-01-01

    Fire protection of cable ducts in the Bohunice and Dukovany V-2 nuclear power plants is of a fourtier type. The first level consists in preventive measures incorporated in the power plant design and layout. The second level consists in early detection and a quick repressive action provided by an electric fire alarm system and a stationary spray system, respectively. Fire partitions and glands represent the third level while special spray, paint and lining materials represent the fourth level of the protection. Briefly discussed are the results of an analysis of the stationary spray system and the effects reducing the efficiency of a fire-fighting action using this system. The analysis showed the need of putting off cable duct fires using mobile facilities in case the stationary spray system cannot cope any longer. (Z.M.). 3 figs., 2 refs

  14. Characterization of turbulent coherent structures in square duct flow

    Science.gov (United States)

    Atzori, Marco; Vinuesa, Ricardo; Lozano-Durán, Adrián; Schlatter, Philipp

    2018-04-01

    This work is aimed at a first characterization of coherent structures in turbulent square duct flows. Coherent structures are defined as connected components in the domain identified as places where a quantity of interest (such as Reynolds stress or vorticity) is larger than a prescribed non-uniform threshold. Firstly, we qualitatively discuss how a percolation analysis can be used to assess the effectiveness of the threshold function, and how it can be affected by statistical uncertainty. Secondly, various physical quantities that are expected to play an important role in the dynamics of the secondary flow of Prandtl’s second kind are studied. Furthermore, a characterization of intense Reynolds-stress events in square duct flow, together with a comparison of their shape for analogous events in channel flow at the same Reynolds number, is presented.

  15. Flow Through a Rectangular-to-Semiannular Diffusing Transition Duct

    Science.gov (United States)

    Foster, Jeff; Wendt, Bruce J.; Reichert, Bruce A.; Okiishi, Theodore H.

    1997-01-01

    Rectangular-to-semiannular diffusing transition ducts are critical inlet components on supersonic airplanes having bifucated engine inlets. This paper documents measured details of the flow through a rectangular-to-semiannular transition duct having an expansion area ratio of 1.53. Three-dimensional velocity vectors and total pressures at the exit plane of the diffuser are presented. Surface oil-flow visualization and surface static pressure data are shown. The tests were conducted with an inlet Mach number of 0.786 and a Reynolds number based on the inlet centerline velocity and exit diameter of 3.2 x 10(exp 6). The measured data are compared with previously published computational results. The ability of vortex generators to reduce circumferential total pressure distortion is demonstrated.

  16. Approximate models for neutral particle transport calculations in ducts

    International Nuclear Information System (INIS)

    Ono, Shizuca

    2000-01-01

    The problem of neutral particle transport in evacuated ducts of arbitrary, but axially uniform, cross-sectional geometry and isotropic reflection at the wall is studied. The model makes use of basis functions to represent the transverse and azimuthal dependences of the particle angular flux in the duct. For the approximation in terms of two basis functions, an improvement in the method is implemented by decomposing the problem into uncollided and collided components. A new quadrature set, more suitable to the problem, is developed and generated by one of the techniques of the constructive theory of orthogonal polynomials. The approximation in terms of three basis functions is developed and implemented to improve the precision of the results. For both models of two and three basis functions, the energy dependence of the problem is introduced through the multigroup formalism. The results of sample problems are compared to literature results and to results of the Monte Carlo code, MCNP. (author)

  17. [Lithiasis of the common bile duct and its treatment].

    Science.gov (United States)

    Boutelier, P

    1995-11-18

    Controversy concerning the most appropriate treatment for a patient with a stone in the main duct almost always leads to an overused conclusion in medical-surgical meeting--laparoscopic and classical surgery are complementary procedures--yet in everyday practice, the gastroenterologist will almost always order a retrograde cholangiogram to confirm the diagnosis and, once the obstacle identified, complete the procedure with an endoscopic sphincterotomy even though many surgeons emphasize its danger. At present few operators are equally experienced in the three major therapeutic options, endoscopy, conventional surgery and laparoscopic surgery, and consequently everybody has a tendency to favour his most proficient technique. Whatever technique is chosen, the aim is to completely remove all gall stones from the main bile duct with a minimum amount of risk and at the most reasonable cost. Careful attention to these three factors should help in weighting the advantages and disadvantages of the different means of management.

  18. Intestinal obstruction caused by omphalomesenteric duct remnant: usefulness of laparoscopy.

    Science.gov (United States)

    Bueno Lledó, J; Serralta Serra, A; Planeéis Roig, M; Dobón Giménez, F; Ibáñez Palacín, F; Rodero Rodero, R

    2003-10-01

    The anomalies related to omphalomesenteric duct remnant constitute an uncommon cause of intestinal obstruction, of which Meckel"s diverticulum and its variants represent the most important clinical presentation. In most cases they are asymptomatic and usually affect young patients. When symptomatic, they usually present episodes of gastrointestinal bleeding or acute abdomen syndromes caused by strangulation of intestinal loops as a result of fibrous intraabdominal remnants or inflammation produced by the diverticulum. In most cases, the unexpected presence of these alterations makes intraoperative diagnosis necessary. Treatment is surgical and consists in exeresis of the diverticulum or the fibrous band causing the clinical picture. We report two cases of persistence of the vitelline duct resolved by laparoscopic approach.

  19. In vivo multiphoton imaging of bile duct ligation

    Science.gov (United States)

    Liu, Yuan; Li, Feng-Chieh; Chen, Hsiao-Chin; Chang, Po-shou; Yang, Shu-Mei; Lee, Hsuan-Shu; Dong, Chen-Yuan

    2008-02-01

    Bile is the exocrine secretion of liver and synthesized by hepatocytes. It is drained into duodenum for the function of digestion or drained into gallbladder for of storage. Bile duct obstruction is a blockage in the tubes that carry bile to the gallbladder and small intestine. However, Bile duct ligation results in the changes of bile acids in serum, liver, urine, and feces1, 2. In this work, we demonstrate a novel technique to image this pathological condition by using a newly developed in vivo imaging system, which includes multiphoton microscopy and intravital hepatic imaging chamber. The images we acquired demonstrate the uptake, processing of 6-CFDA in hepatocytes and excretion of CF in the bile canaliculi. In addition to imaging, we can also measure kinetics of the green fluorescence intensity.

  20. Bilateral endoscopic endonasal marsupialization of nasopalatine duct cyst

    Directory of Open Access Journals (Sweden)

    Yohei Honkura

    2015-02-01

    Full Text Available Nasopalatine duct cysts are the most common non-odontogenic cysts in the maxilla, and are conventionally treated through a sublabial or palatine approach. Recently, the endoscopic approach has been used, but experience is extremely limited. We treated a 29-year-old male with nasopalatine duct cyst by endoscopic marsupialization, but paresthesia of the incisor region occurred after surgery. This paresthesia gradually remitted within 6 months. The nasopalatine nerve, which innervates the upper incisor region, enters two lateral canals separately at the nasal floor and exits the central main canal at the palate. Damage to the bilateral nasopalatine nerves might lead to paresthesia, so we recommend careful examination for nerve fibers during endoscopic surgery, especially if fenestration is performed on both sides.