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Sample records for bypass operations facts

  1. Evaluation of bypass lane safety, operations, and design in Kansas.

    Science.gov (United States)

    2015-08-01

    The construction of bypass lanes at rural intersections has typically been considered a low-cost highway safety : improvement by the transportation community. However, this needs to be quantitatively evaluated so that decisions can be made : on wheth...

  2. Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice

    DEFF Research Database (Denmark)

    Andersen, J R; Sørensen, S M; Kruse, A

    1989-01-01

    cholangiography 50 patients were randomised to the two treatment alternatives. All 25 patients randomised to endoprosthesis were treated by this procedure, whereas only 19 of 25 patients randomised to bypass surgery underwent operative biliary-digestive anastomosis. Life table analysis revealed no difference...... in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass....

  3. Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice

    DEFF Research Database (Denmark)

    Andersen, J R; Sørensen, S M; Kruse, A

    1989-01-01

    In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic cholangi......In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic...... cholangiography 50 patients were randomised to the two treatment alternatives. All 25 patients randomised to endoprosthesis were treated by this procedure, whereas only 19 of 25 patients randomised to bypass surgery underwent operative biliary-digestive anastomosis. Life table analysis revealed no difference...... in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass....

  4. The value of pre-operative ultrasound mapping of the greater saphenous vein prior to 'closed' in situ bypass operations

    NARCIS (Netherlands)

    L.C. van Dijk (Lukas); C.H. Wittens; H. Pieterman; H. van Urk (Hero)

    1996-01-01

    textabstractObjective: The aim of this study was to test pre-operative ultrasound mapping for the detection of duplications and narrow vein segments of the greater saphenous vein (GSV) used as bypass for occlusive arterial disease surgery. Patients and methods: In 44 patients pre-operative

  5. Improved red blood cell survival after cardiac operations with administration of urea during cardiopulmonary bypass

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, D.; Bake, B.; William-Olsson, G.

    1985-01-01

    The plasma hemoglobin and red blood cell survival (half-life of /sup 51/Cr) was studied in 48 patients undergoing single valve replacement or coronary artery bypass graft. Urea or placebo was administered during cardiopulmonary bypass in a prospective, randomized, double-blind manner to test the potential effect on mechanical hemolysis. The mean plasma hemoglobin level at the end of extracorporeal circulation was significantly lower in the urea-treated groups (coronary artery bypass 342 mg/L; valve replacement 364 mg/L) than in the control groups (coronary artery bypass 635 mg/L, valve replacement 518 mg/L. The half-life of /sup 51/Cr was significantly longer in the urea-treated patients (coronary artery bypass 18 days; valve replacement 16 days) than in the control groups (coronary artery bypass 12.4 days; valve replacement 12.7 days) but still below the normal reference value (29 +/- 4 days). The plasma hemoglobin returned to near normal values (50 mg/L) the day after operation (day 1) and remained low with no differences between control and urea-treated groups. The total blood hemoglobin was followed for 2 weeks after operation and showed significantly less anemia in the urea-treated group. The lowest mean blood hemoglobin level was noted between days 5 and 9-114 (coronary artery bypass) and 107 (valve replacement) gm/L in the urea-treated patients compared to 92.3 gm/L in the control subjects. The reduction in the severity of the anemia led to less transfusion in the urea-treated patients (approximately 0.5 unit/patient) than in the control subjects (approximately 1 unit/patient) between days 3 and 14.

  6. Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice.

    Science.gov (United States)

    Andersen, J R; Sørensen, S M; Kruse, A; Rokkjaer, M; Matzen, P

    1989-01-01

    In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic cholangiography 50 patients were randomised to the two treatment alternatives. All 25 patients randomised to endoprosthesis were treated by this procedure, whereas only 19 of 25 patients randomised to bypass surgery underwent operative biliary-digestive anastomosis. Life table analysis revealed no difference in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass. PMID:2475392

  7. Bypass chromatography--design and analysis of an improved strategy for operating batch chromatography processes.

    Science.gov (United States)

    Siitonen, Jani; Sainio, Tuomo; Rajendran, Arvind

    2012-03-23

    The possibility to improve the performance of batch chromatographic separations by using so-called bypass method is analyzed for the first time. In bypass chromatography, only a part of the feed is introduced into the column and purified to purity larger than the desired value. The resulting fractions are then blended with fresh feed to match the given purity constraints. A general approach is presented for designing bypass batch chromatography. Analytical design equations, based on equilibrium theory of chromatography, are presented for the case of binary systems with linear or competitive Langmuir adsorption isotherms under ideal conditions. The approach allows direct calculation of optimal loading and amount of bypass so that arbitrary purity requirements are satisfied without waste streams. It is shown that the bypass strategy enhances productivity of batch chromatography without an increase in the eluent consumption. In the case of a Langmuir isotherm, maximum productivity and minimum eluent consumption are always obtained when the less retained component is collected from the column at 100% purity. In contrast, the optimal purity of the second fraction from the column is typically less than 100% and depends on the purity constraint of the more retained component. In the case of linear isotherms, operation with touching bands is preferred. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Early postoperative cognitive dysfunction and blood pressure during coronary artery bypass graft operation.

    Science.gov (United States)

    Gottesman, Rebecca F; Hillis, Argye E; Grega, Maura A; Borowicz, Louis M; Selnes, Ola A; Baumgartner, William A; McKhann, Guy M

    2007-08-01

    To determine the relationship between change in blood pressure during coronary artery bypass graft operations and early cognitive dysfunction. Cohort study. Quaternary care facility. Patients Fifteen patients undergoing coronary artery bypass graft operations who were at high risk for postoperative stroke. Preoperative and intraoperative mean arterial pressures (MAPs) were measured in all patients. Intervention A subset of patients underwent preoperative and postoperative magnetic resonance imaging. Main Outcome Measure Change in cognitive performance, using the Mini-Mental State Examination and other simple cognitive tests. A drop in MAP (preoperatively to intraoperatively) predicted a decrease in Mini-Mental State Examination score. When change in MAP was dichotomized (after excluding an outlier), subjects with a small decrease improved on the Mini-Mental State Examination by 1 point, whereas those with a large drop in MAP worsened by 1.4 points (P = .04). A drop in MAP from a preoperative baseline may put patients at risk for early cognitive dysfunction after a coronary artery bypass graft operation.

  9. Magnesium sulphate and amiodarone prophylaxis for prevention of postoperative arrhythmia in coronary by-pass operations

    Directory of Open Access Journals (Sweden)

    Huysal Kagan

    2009-02-01

    Full Text Available Abstract Background The aim of this study was to investigate the use of prophylactic magnesium sulphate and amiodarone in treating arrhythmias that may occur following coronary bypass grafting operations. Methods The study population consisted of 192 consecutive patients who were undergoing coronary artery bypass grafting (CABG. Sixty-four patients were given 3 g of magnesium sulphate (MgSO4 [20 ml = 24.32 mEq/L Mg+2] in 100 cc of isotonic 0.9% solution over 2 hours intravenously at the following times: 12 hours prior to the operation, immediately following the operation, and on postoperative days 1, 2, and 3 (Group 1. Another group of 64 patients was given a preoperative infusion of amiodarone (1200 mg on first post-operative day (Group 2. After the operation amiodarone was administered orally at a dose of 600 mg/day. Sixty-four patients in group 3 (control group had 100 cc. isotonic 0.9% as placebo, during the same time periods. Results In the postoperative period, the magnesium values were significantly higher in Group 1 than in Group 2 for all measurements. The use of amiodarone for total arrhythmia was significantly more effective than prophylactic treatment with magnesium sulphate (p = 0.015. There was no difference between the two drugs in preventing supraventricular arrhythmia, although amiodarone significantly delayed the revealing time of atrial fibrillation (p = 0.026. Ventricular arrhythmia, in the form of ventricular extra systole, was more common in the magnesium prophylaxis group. The two groups showed no significant differences in other operative or postoperative measurements. No side effects of the drugs were observed. Conclusion Prophylactic use of magnesium sulphate and amiodarone are both effective at preventing arrhythmia that may occur following coronary by-pass operations. Magnesium sulphate should be used in prophylactic treatment since it may decrease arrhythmia at low doses. If arrhythmia should occur despite this

  10. Readmission To Intensive Care Unit After Coronary Bypass Operations in the Short Term.

    Science.gov (United States)

    Gümüş, Funda; Polat, Adil; Yektaş, Abdülkadir; Erentuğ, Vedat; Alagöl, Ayşin

    2014-08-01

    Intensive care unit (ICU) readmissions after coronary bypass (CABG) operations occur in a significant number of patients, and the prognosis is poor. We analyzed the risk factors for ICU readmissions after CABG operations. We retrospectively analyzed the prospectively collected data of 679 coronary bypass patients operated in a single institution in order to evaluate the risk factors for readmittance to the ICU with logistic regression analysis. The outcome results of patients readmitted to the ICU (Group R) and others (Group N) were compared. Thirty-six (5.3%) patients were readmitted to the ICU. Postoperative in-hospital mortality and pulmonary and neurologic morbidity occurred in 43 (6.3%), 135 (19.9%), and 46 (6.8%) patients, respectively. The comparison of groups showed that mortality and morbidity were significantly higher in Group R compared to Group N (mortality 16.7% vs. 5.9, p=0.029; pulmonary morbidity 66.7% vs. 17.3%, p=0.0001; neurologic morbidity 38.9% vs. 5.0%, p=0.0001). Features associated with readmission included presence of left ventricular dysfunction preoperatively[odds ratio (OR)=4.1; 95% confidence interval (CI)=1.4-12.5; p=0.013], advanced NYHA Class (OR=5.3; 95% CI=1.3-21.7; p=0.022), pulmonary complications (OR=7.3; 95% CI=2.1-25.5; p=0.002), and neurologic complications (OR=4.6; 95% CI=1.3-16.7; p=0.021). Patients readmitted to the ICU postoperatively have higher rates of mortality and pulmonary and neurologic morbidity after coronary bypass operations. Left ventricular dysfunction, advanced NYHA class, and postoperative pulmonary and neurologic complications are significant risk factors for readmission to the ICU.

  11. Fact Sheet: Control Techniques Guidelines (CTG) for Shipbuilding and Ship Repair Facilities Operation (Surface Coating)

    Science.gov (United States)

    This page contains an August 1996 fact sheet with information regarding the CTG and Alternative Control Techniques (ACT) for Surface Coating at Shipbuilding and Ship Repair Facilities Operations. This document provides a summary of this guidance

  12. Numerical study of a VM type multi-bypass pulse tube cryocooler operating at 4K

    Science.gov (United States)

    Pan, Changzhao; Zhang, Tong; Wang, Jue; Chen, Liubiao; Cui, Chen; Wang, Junjie; Zhou, Yuan

    2017-12-01

    VM cryocooler is one kind of Stirling type cryocooler working at low frequency. At present, we have obtained the liquid helium temperature by using a two-stage VM/pulse tube hybrid cryocooler. As a new kind of 4K cryocooler, there are many aspects need to be studied and optimized in detail. In order to reducing the vibration and improving the stability of this cryocooler, a pulse tube cryocooler was designed to get rid of the displacer in the first stage. This paper presents a detail numerical investigation on this pulse tube cryocooler by using the SAGE software. The low temperature phase shifters were adopted in this cryocooler, which were low temperature gas reservoir, low temperature double-inlet and multi-bypass. After optimizing, the structure parameters and the best diameters of orifice, multi-bypass and double-inlet were obtained. With the pressure ratio of about 1.6 and operating frequency 2Hz, this cryocooler could supply above 40mW cooling power at 4.2K, and the total input power needs no more than 60W at 77K. Based on the highest efficiency of 77K high capacity cryocooler, the overall efficiency of this VM type pulse tube cryocooler is above 0.5% relative Carnot efficient.

  13. Efficacy of post-operative clopidogrel treatment in patients revascularized with coronary artery bypass grafting after myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Abildstrøm, Steen Z; Hansen, Peter R

    2011-01-01

    OBJECTIVES: The objective of this study was to examine the clinical efficacy of clopidogrel treatment on death and recurrent myocardial infarction (MI) among MI patients revascularized by coronary artery bypass graft surgery (CABG). BACKGROUND: The benefit from post-operative clopidogrel in CABG...

  14. It's Indisputable: Five Facts About Planning and Operating Modern Power Systems

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, Aaron; Helman, Udi; Holttinen, Hannele; Summers, Kate; Bakke, Jordan; Brinkman, Gregory; Lopez, Anthony

    2017-11-01

    An indisputable fact cannot be rebutted. It is supported by theory and experience. Over the past 25 years, wind and solar generation has undergone dramatic growth, resulting in a variety of experiences that model the integration of wind and solar into the planning and operation of modern electric power systems. In this article, we bring together examples from Europe, North America, and Australia to identify five indisputable facts about planning and operating modern power systems. Taken together, we hope these experiences can help build consensus among the engineering and public policy communities about the current state of wind and solar integration and also facilitate conversations about evolving future challenges.

  15. Preoperative statin is associated with decreased operative mortality in high risk coronary artery bypass patients

    Directory of Open Access Journals (Sweden)

    Maher Thomas D

    2010-02-01

    Full Text Available Abstract Background Statins are widely prescribed to patients with atherosclerosis. A retrospective database analysis was used to examine the role of preoperative statin use in hospital mortality, for patients undergoing isolated coronary artery bypass grafting (CABG. Methods The study population comprised 2377 patients who had isolated CABG at Allegheny General Hospital between 2000 and 2004. Mean age of the patients was 65 ± 11 years (range 27 to 92 years. 1594 (67% were male, 5% had previous open heart procedures, and 4% had emergency surgery. 1004 patients (42% were being treated with a statin at the time of admission. Univariate, bivariate (Chi2, Fisher's Exact and Student's t-tests and multivariate (stepwise linear regression analyses were used to evaluate the association of statin use with mortality following CABG. Results Annual prevalence of preoperative statin use was similar over the study period and averaged 40%. Preoperative clinical risk assessment demonstrated a 2% risk of mortality in both the statin and non-statin groups. Operative mortality was 2.4% for all patients, 1.7% for statin users and 2.8% for non-statin users (p Conclusions Between 2000 and 2004 less than 50% of patients at this institution were receiving statins before admission for isolated CABG. A retrospective analysis of this cohort provides evidence that preoperative statin use is associated with lower operative mortality in high-risk patients.

  16. Effect of prior cardiac operations on survival after coronary artery bypass grafting.

    Science.gov (United States)

    Likosky, Donald S; Surgenor, Stephen D; Kramer, Robert S; Russo, Louis; Leavitt, Bruce J; Sorensen, Meredith J; Helm, Robert E; Sardella, Gerald L; Dipierro, Francis V; Baribeau, Yvon R; Malenka, David J; Mackenzie, Todd A; Brown, Jeremiah R; Ross, Cathy S

    2011-10-01

    We examined a recent regional experience to determine the effect of a prior cardiac operation on short-term and midterm outcomes after coronary artery bypass grafting (CABG). We identified 20,703 patients who underwent nonemergent CABG at 8 centers in northern New England from 2000 to 2008, of whom 818 (3.8%) had undergone prior cardiac operations. Prior CABG using a minimal or full sternotomy was considered a prior sternotomy. Survival data out to 4 years were obtained from a link with the Social Security Administration Death Index. Hazard ratios were estimated using a Cox proportional hazards regression model, and adjusted survival curves were estimated using inverse probability weighting. In a separate analysis, 1,182 patients were matched 1:1 by a patient's propensity for having undergone prior CABG. Patients with prior sternotomies had a greater burden of comorbid diseases and increased acuity and had a greater likelihood of returning to the operating room for bleeding and low cardiac output failure. Prior sternotomy was associated with an increased risk of death out to 4 years for patients undergoing CABG, with an unmatched hazard ratio of 1.34 (95% confidence interval, 1.10 to 1.64) and a matched hazard ratio of 1.36 (95% confidence interval, 1.01 to 1.81). Analyses of our recent regional experience with nonemergent CABG showed that a prior cardiac operation was associated with a nearly twofold increased hazard of death at up to 4 years of follow-up. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Design and operation of FACT - the first G-APD Cherenkov telescope

    Science.gov (United States)

    Anderhub, H.; Backes, M.; Biland, A.; Boccone, V.; Braun, I.; Bretz, T.; Buß, J.; Cadoux, F.; Commichau, V.; Djambazov, L.; Dorner, D.; Einecke, S.; Eisenacher, D.; Gendotti, A.; Grimm, O.; von Gunten, H.; Haller, C.; Hildebrand, D.; Horisberger, U.; Huber, B.; Kim, K.-S.; Knoetig, M. L.; Köhne, J.-H.; Krähenbühl, T.; Krumm, B.; Lee, M.; Lorenz, E.; Lustermann, W.; Lyard, E.; Mannheim, K.; Meharga, M.; Meier, K.; Montaruli, T.; Neise, D.; Nessi-Tedaldi, F.; Overkemping, A.-K.; Paravac, A.; Pauss, F.; Renker, D.; Rhode, W.; Ribordy, M.; Röser, U.; Stucki, J.-P.; Schneider, J.; Steinbring, T.; Temme, F.; Thaele, J.; Tobler, S.; Viertel, G.; Vogler, P.; Walter, R.; Warda, K.; Weitzel, Q.; Zänglein, M.

    2013-06-01

    The First G-APD Cherenkov Telescope (FACT) is designed to detect cosmic gamma-rays with energies from several hundred GeV up to about 10 TeV using the Imaging Atmospheric Cherenkov Technique. In contrast to former or existing telescopes, the camera of the FACT telescope is comprised of solid-state Geiger-mode Avalanche Photodiodes (G-APD) instead of photomultiplier tubes for photo detection. It is the first full-scale device of its kind employing this new technology. The telescope is operated at the Observatorio del Roque de los Muchachos (La Palma, Canary Islands, Spain) since fall 2011. This paper describes in detail the design, construction and operation of the system, including hardware and software aspects. Technical experiences gained after one year of operation are discussed and conclusions with regard to future projects are drawn.

  18. Evaluation of bypass lane safety, operations, and design in Kansas : [technical summary].

    Science.gov (United States)

    2015-08-01

    The construction of bypass lanes at rural intersections has typically been considered : a low-cost highway safety improvement by the transportation community. : However, this needs to be quantitatively evaluated so that decisions can be made : on whe...

  19. Surgical problems and complex procedures: issues for operative time in robotic totally endoscopic coronary artery bypass grafting.

    Science.gov (United States)

    Wiedemann, Dominik; Bonaros, Nikolaos; Schachner, Thomas; Weidinger, Felix; Lehr, Eric J; Vesely, Mark; Bonatti, Johannes

    2012-03-01

    Robotically assisted totally endoscopic coronary artery bypass grafting (TECAB) is a viable option for closed chest coronary surgery, but it requires learning curves and longer operative times. This study evaluated the effect of extended operation times on the outcome of patients undergoing TECAB. From 2001 to 2009, 325 patients underwent TECAB with the da Vinci telemanipulation system. Correlations between operative times and preoperative, intraoperative, and early postoperative parameters were investigated. Receiver operating characteristic analysis was used to define the threshold of the procedure duration above which intensive care unit stay and ventilation time were prolonged. Demographic data, intraoperative and postoperative parameters, and survival data were compared. Patients with prolonged operative times more often underwent multivessel revascularization (P 445 minutes and >478 minutes to predict prolonged (>48 hours) intensive care unit stay and mechanical ventilation, respectively. Patients with procedures >478 minutes had longer hospital stays and higher perioperative morbidity and mortality. Kaplan-Meier analysis revealed decreased survival among patients with operative times >478 minutes. Multivessel revascularization and conversions lead to prolonged operative times in totally endoscopic coronary artery bypass grafting. Longer operative times significantly influence early postoperative and midterm outcomes. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  20. Increased post-operative cardiopulmonary fitness in gastric bypass patients is explained by weight loss

    DEFF Research Database (Denmark)

    Lund, M. T.; Hansen, M.; Wimmelmann, C. L.

    2016-01-01

    Roux-en-Y gastric bypass (RYGB) leads to a major weight loss in obese patients. However, given that most patients remain obese after the weight loss, regular exercise should be part of a healthier lifestyle. The primary aim of this study was to investigate the cardiopulmonary fitness in obese pat...

  1. LOW-DOSE APROTININ IN INTERNAL MAMMARY ARTERY BYPASS OPERATIONS CONTRIBUTES TO IMPORTANT BLOOD SAVING

    NARCIS (Netherlands)

    SCHONBERGER, JPAM; EVERTS, PAM; ERCAN, H; BREDEE, JJ; BAVINCK, JH; BERREKLOUW, E; WILDEVUUR, CRM

    1992-01-01

    The effect on postoperative blood loss and blood use of blood-saving treatment with or without 280 mg of low-dose aprotinin (2 million kallikrein inactivator units) was studied in 200 consecutive patients undergoing either unilateral or bilateral internal mammary artery bypass grafting.

  2. The effect of mannitol on renal function following cardio-pulmonary bypass in patients with normal pre-operative creatinine.

    Science.gov (United States)

    Yallop, K G; Sheppard, S V; Smith, D C

    2008-06-01

    Mannitol is often added to the cardiopulmonary bypass pump prime to reduce the incidence of renal dysfunction, but studies so far have been inconclusive. Urinary excretion of microalbumin and retinol binding protein are more sensitive than routine biochemical tests of renal function after cardiac surgery. We performed a double-blind, randomised, controlled trial in cardiac surgical patients with pre-operative plasma creatinine Hartmann's solution. Blood and urine samples were taken on the day before surgery and daily for 5 days postoperatively for measurement of plasma urea and creatinine, urinary creatinine, retinol binding protein and microalbumin. We found no differences between the mannitol and control patients for any measured variable, and conclude that mannitol has little impact on renal function in patients with normal pre-operative plasma creatinine concentrations.

  3. Extracranial-intracranial bypass surgery at high magnification using a new high-resolution operating microscope: technical note.

    Science.gov (United States)

    Matsumura, Nobuhisa; Shibata, Takashi; Umemura, Kimiko; Nagao, Seiya; Horie, Yukio

    2009-12-01

    We report a precise technique for EC-IC bypass surgery using a stereoscopic high-resolution microscope at magnifications of 40x and 50x. A stereoscopic operating microscope (Mitaka MM50 Surgical Microscope; Mitaka Kohoki Co, Tokyo, Japan) was used in STA-MCA anastomosis. This microscope has 2 optical systems, a standard zooming system, a newly developed high-magnification system, and 4 fixed working distances of 200, 250, 300 and 350 mm, with highest magnifications of 50.4x at 200 mm and 40.3x at 250 mm. High resolution is achieved by a new lens design in the optical system, which makes the image of the object very clear at high magnification. The magnification can be changed depending on the circumstances in a given procedure. The STA-MCA anastomoses were performed using this microscope. Very small vessels were observable, and arterial anastomosis could be performed precisely at high magnification. All anastomoses were patent on postoperative angiograms. Use of the new microscope allows visualization and manipulation of small vessels at high magnification and high resolution and may be very useful in EC-IC bypass surgery. Copyright 2009 Elsevier Inc. All rights reserved.

  4. Analysis of operations and cyber security policies for a system of cooperating Flexible Alternating Current Transmission System (FACTS) devices.

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, Laurence R.; Tejani, Bankim; Margulies, Jonathan; Hills, Jason L.; Richardson, Bryan T.; Baca, Micheal J.; Weiland, Laura

    2005-12-01

    Flexible Alternating Current Transmission Systems (FACTS) devices are installed on electric power transmission lines to stabilize and regulate power flow. Power lines protected by FACTS devices can increase power flow and better respond to contingencies. The University of Missouri Rolla (UMR) is currently working on a multi-year project to examine the potential use of multiple FACTS devices distributed over a large power system region in a cooperative arrangement in which the FACTS devices work together to optimize and stabilize the regional power system. The report describes operational and security challenges that need to be addressed to employ FACTS devices in this way and recommends references, processes, technologies, and policies to address these challenges.

  5. Fact Sheets: Final Air Toxics Rules for Ethylene Oxide Emissions from Commercial Sterilization and Fumigation Operations

    Science.gov (United States)

    This page contains November 1994 and November 1999 fact sheets with information regarding the Final Ethylene Oxide Emissions Standards for Sterilization Facilities. These documents contain answers to common questions for this NESHAP

  6. Rural Bypass for Elective Surgeries.

    Science.gov (United States)

    Weigel, Paula A M; Ullrich, Fred; Finegan, Chance N; Ward, Marcia M

    2017-04-01

    Rural bypass of Critical Access Hospitals (CAHs) for elective inpatient and outpatient surgical procedures has not been studied. Residents choosing to have their elective surgeries elsewhere, when the local CAH provides those surgical services, erode their rural hospital's financial base. The purpose of this research is to describe the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among CAHs that offer elective surgical services, and factors predictive of bypass. A sample of elective surgery discharges was created from the 2011 Healthcare Cost and Utilization Project State Inpatient Databases and State Ambulatory Surgery Databases for Colorado, North Carolina, Vermont, and Wisconsin. Frequencies of procedures bypassed and CAH volume distribution were performed. Logistic regression was used to model factors associated with rural bypass for elective surgical care. The rural bypass rate for elective surgical procedures is 48.4%. Procedures bypassed most are operations on the musculoskeletal system, eye, and digestive system. Annual volume distribution for elective surgical procedures among CAHs varied widely. Patients who are younger, medically complex, at higher surgical risk, and have private insurance are at higher odds of bypass. Patients are also more likely to bypass low-volume hospitals. Rural hospitals should consider developing surgical services that are performed electively and on an outpatient basis that are attractive to a broader rural population. CAHs that already offer elective surgical procedures and yet who are still bypassed must examine the mutable factors that drive bypass behavior. © 2015 National Rural Health Association.

  7. Impact of the use of FACTS to increase robustness of operation in grids with large scale wind generation

    Energy Technology Data Exchange (ETDEWEB)

    Franco Marques, P.J. [School of Technology and Management, Polytechnic Institute of Leiria (Portugal); Pecas Lopes, J.A. [INESC Porto, Institute for Systems and Computer Engineering of Porto (Portugal)

    2006-07-01

    Increased penetration of wind power should not jeopardize power system robustness of operation. One of the critical issues is related with the possibility of the loss of large shares of wind power following a system disturbance. The propagation of voltage reduction that results from a short circuit may provoke the disconnection of the wind generators, especially those that do not present ride through default capabilities. The use of FACTS connected to the grid, nearby the large wind parks, may attenuate such a situation. In this work the effectiveness of such technical approach is addressed and discussed. Results obtained demonstrate that the use of FACTS increases grid robustness of operation by avoided the disconnection of part of the wind generation. (orig.)

  8. Development, feasibility, validity, and reliability of a scale for objective assessment of operative performance in laparoscopic gastric bypass surgery.

    Science.gov (United States)

    Zevin, Boris; Bonrath, Esther M; Aggarwal, Rajesh; Dedy, Nicolas J; Ahmed, Najma; Grantcharov, Teodor P

    2013-05-01

    There is no objective scale for assessment of operative skill in laparoscopic gastric bypass (LGBP). The objective of this study was to develop and demonstrate feasibility of use, validity, and reliability of a Bariatric Objective Structured Assessment of Technical Skill (BOSATS) scale. The BOSATS scale was developed using a hierarchical task analysis (HTA), a Delphi questionnaire, and a panel of international experts in bariatric surgery. The feasibility of use, reliability, and validity of the developed scale were demonstrated by reviewing 52 prospectively collected video recordings of LGBP performed by novice and experienced surgeons. A total of 214 discrete steps were identified in HTA. A total of 12 and 17 panel members completed the first and second round of the Delphi questionnaire, respectively. Consensus among the panel was achieved after the second round (Cronbach's alpha = 0.85). The BOSATS scale demonstrated high inter-rater (intraclass correlation coefficient [ICC] = 0.954; p circular stapled GJ, and hand-sewn GJ. Moderate to high correlations between BOSATS scale and Objective Structured Assessment of Technical Skills Global Rating Scale (OSATS GRS) were seen for JJ (rho = 0.59; p = 0.001), gastric pouch (rho = 0.48; p = 0.0004), linear stapled GJ (rho = 0.70; p = 0.0001), and hand-sewn GJ (rho = 0.96; p < 0.0001). The BOSATS scale is a feasible to use, reliable, and valid instrument for objective assessment of operative performance in LGBP. Implementation of this scale is expected to facilitate deliberate practice and provide a means for future certification in bariatric surgery. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality.

    Science.gov (United States)

    Ono, Masahiro; Brady, Kenneth; Easley, R Blaine; Brown, Charles; Kraut, Michael; Gottesman, Rebecca F; Hogue, Charles W

    2014-01-01

    Optimizing blood pressure using near-infrared spectroscopy monitoring has been suggested to ensure organ perfusion during cardiac surgery. Near-infrared spectroscopy is a reliable surrogate for cerebral blood flow in clinical cerebral autoregulation monitoring and might provide an earlier warning of malperfusion than indicators of cerebral ischemia. We hypothesized that blood pressure below the limits of cerebral autoregulation during cardiopulmonary bypass would be associated with major morbidity and operative mortality after cardiac surgery. Autoregulation was monitored during cardiopulmonary bypass in 450 patients undergoing coronary artery bypass grafting and/or valve surgery. A continuous, moving Pearson's correlation coefficient was calculated between the arterial pressure and low-frequency near-infrared spectroscopy signals and displayed continuously during surgery using a laptop computer. The area under the curve of the product of the duration and magnitude of blood pressure below the limits of autoregulation was compared between patients with and without major morbidity (eg, stroke, renal failure, mechanical lung ventilation >48 hours, inotrope use >24 hours, or intra-aortic balloon pump insertion) or operative mortality. Of the 450 patients, 83 experienced major morbidity or operative mortality. The area under the curve of the product of the duration and magnitude of blood pressure below the limits of autoregulation was independently associated with major morbidity or operative mortality after cardiac surgery (odds ratio, 1.36; 95% confidence interval, 1.08-1.71; P = .008). Blood pressure management during cardiopulmonary bypass using physiologic endpoints such as cerebral autoregulation monitoring might provide a method of optimizing organ perfusion and improving patient outcomes from cardiac surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. Current peripheral bypass surgery: various clinical studies

    NARCIS (Netherlands)

    Slaa, Alexander te

    2011-01-01

    Substantial post-operative edema occurs in the majority of patients who undergo peripheral bypass surgery due to severe peripheral arterial disease (PAD). The pathophysiological mechanisms that underlay edema formation following peripheral bypass surgery include hyperemia, an increased capillary

  11. Organ Facts: Kidney / Pancreas

    Science.gov (United States)

    ... Your Child Adjust Camps Resources LIVING DONATION Facts Types Being a Living Donor About the Operation Financing Living Donation Home / Before The Transplant / Organ Facts / Kidney/Pancreas Organ Facts Heart Lung Heart/ ...

  12. A NEW APPROACH TO SOLVING GENERAL ANAESTHESIA INDIVIDUALIZATION PROBLEM DURING SURGICAL OPERATIONS WITH CARDIOPULMONARY BYPASS

    Directory of Open Access Journals (Sweden)

    V. M. Magilevets

    2009-01-01

    Full Text Available The computerized system to control depth of anesthesia during surgical operation was developed in our research center. The depth of anesthesia is regulated by controlled intravenous infusion of propofol. The varied propofol rate is controlled by the closed-loop propofol system (CLPS with mean arterial pressure (MAP controller. MAP is used in the CLPS as input parameter and indicator of anesthesia depth. CLPS consists PC, invasive blood pressure (BP sensor and Graseby 3400 infusion pump. The C language computer program sets the propofol infusion rate based on empirical algorithm including proportional component to maintain the measured MAP more closely to the target MAP (85% of patient standard MAP. The propofol concentrations are calculated by Runge–Kutta’s method PK/PD model differential equations solving with Marsh’s microconstants and Kazama’s BIS effect site microconstant and age depended BP effect site microconstants every 30 s. The designed CLPS was effective and useful for anesthesia maintenance during open-heart surgery, especially for early extubation. 

  13. Operative risk and preoperative hematocrit in bypass graft surgery: Role of gender and blood transfusion.

    Science.gov (United States)

    Ad, Niv; Holmes, Sari D; Massimiano, Paul S; Spiegelstein, Dan; Shuman, Deborah J; Pritchard, Graciela; Halpin, Linda

    2015-01-01

    The association between lower preoperative hematocrit (Hct) and risk for morbidity/mortality after cardiac surgery is well established. We examined whether the impact of low preoperative Hct on outcome is modified by blood transfusion and operative risk in women and men undergoing nonemergent CABG surgery. Patients having nonemergent, first-time, isolated CABG were included (N=2757). Logistic regressions assessed effect of hematocrit on major perioperative morbidity/mortality separately by males (n=2232) and females (n=525). Mean age was 63.2±10.1years, preoperative hematocrit was 38.9±4.8%, and STS risk score was 1.3±1.8%. Blood transfusion was more likely in female patients (26% vs. 12%, Ptransfusion in males and females, whereas older age (OR=1.03, P=0.017) also predicted transfusion in females. Major morbidity was also more likely in female patients (12% vs. 7%, Pblood transfusion was the only predictive factor for major morbidity in females (OR=4.56, Pblood transfusion (OR=9.22, Pblood transfusion and major morbidities after nonemergent CABG. Traditional factors that have been found to predict outcomes, such as hematocrit and STS risk, were related only to major morbidity in male patients. However, blood transfusion negatively impacted major outcome after nonemergent CABG surgery across all STS risk levels in both genders. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  15. Gastric bypass surgery

    Science.gov (United States)

    ... Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass Patient Instructions Bathroom safety - adults Gastric bypass surgery - discharge Laparoscopic gastric banding - discharge ...

  16. Reducing Bat Fatalities From Interactions with Operating Wind Turbines (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    Lawson, M.

    2013-11-01

    One of the biggest advantages of wind energy is that, overall, it has fewer negative impacts on the environment than fossil fuel-generated energy. Most professionals in the wind industry would like to reduce the impact of energy generation on plants, animals, and their habitats. This is why the industry is highly motivated to find out why migrating bats have unexpectedly high fatality rates near operating wind farms. New research has provided quantitative data that indicates barotrauma is not a major cause of bat deaths around operating turbines.

  17. The value of various clinical and imaging procedures for post-operative control of extra-anatomical by-passes. Wertigkeit unterschiedlicher klinischer und bildgebender Verfahren fuer die postoperative Verlaufskontrolle extraanatomischer Bypasses

    Energy Technology Data Exchange (ETDEWEB)

    Metz, V.; Dock, W.; Grabenwoeger, F.; Eibenberger, K.; Fenzl, G.; End, A. (Vienna Univ. (Austria). 2. Chirurgische Klinik)

    1991-02-01

    In order to judge the patency of extra-anatomical by-passes in the lower extremities, 24 patients with 29 by-passes were examined clinically (palpation of the by-pass pulse, Fontaine staging, Doppler index) and by imaging methods (i-v DSA, Duplex sonography, colour-coded Doppler sonography). The value of these methods was compared. Sonography was found to be the ideal method for follow-up. Palpation was unreliable, particularly for femoro-femoral by-passes. The Doppler index and the Fontaine method provided no information about the actual state of the by-pass. Angiography is indicated only if further vascular reconstruction is planned. (orig.).

  18. Drug Facts

    Medline Plus

    Full Text Available ... Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) Facts Marijuana (Weed, Pot) Facts MDMA (Ecstasy, Molly) Facts Meth (Crank, Ice) Facts Pain Medicine (Oxy, Vike) Facts Spice (K2) Facts Tobacco and Nicotine Facts Other Drugs of Abuse What is Addiction? What are some signs and symptoms ...

  19. Drug Facts

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    Full Text Available ... Facts Bath Salts Facts Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) Facts Marijuana (Weed, Pot) Facts MDMA ( ... Videos Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/ ...

  20. Heart bypass surgery - discharge

    Science.gov (United States)

    Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery ...

  1. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... Health Topics / Coronary Artery Bypass Grafting Coronary Artery Bypass Grafting What Is Coronary artery bypass grafting (CABG) ... multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of the ...

  2. Performance characteristics of part-load operations of a solid oxide fuel cell/gas turbine hybrid system using air-bypass valves

    Science.gov (United States)

    Yang, Jin Sik; Sohn, Jeong L.; Ro, Sung Tack

    In spite of the high-performance characteristics of a solid oxide fuel cell/gas turbine (SOFC/GT) hybrid system, it is difficult to maintain high-level performance under real application conditions, which generally require part-load operations. The efficiency loss of the SOFC/GT hybrid system under such conditions is closely related to that of the gas turbine. The power generated by the gas turbine in a hybrid system is much less than that generated by the SOFC, but its contribution to the efficiency of the system is important, especially under part-load conditions. Over the entire operating load profile of a hybrid system, the efficiency of the hybrid system can be maximized by increasing the contribution of power coming from the high efficiency component, namely the fuel cell. In this study, part-load control strategies using air-bypass valves are proposed, and their impact on the performance of an SOFC/GT hybrid system is discussed. It is found that air-bypass modes with control of the fuel supply help to overcome the limits of the part-load operation characteristics in air/fuel control modes, such as variable rotational speed control and variable inlet guide vane control.

  3. Drug Facts

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    Full Text Available ... Search form Search Menu Home Drugs That People Abuse Alcohol Facts Bath Salts Facts Cocaine (Coke, Crack) ... Facts Tobacco and Nicotine Facts Other Drugs of Abuse What is Addiction? What are some signs and ...

  4. Drug Facts

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    Full Text Available ... Ecstasy, Molly) Facts Meth (Crank, Ice) Facts Pain Medicine (Oxy, Vike) Facts Spice (K2) Facts Tobacco and ... Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine Other Drugs You can ...

  5. Drug Facts

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    Full Text Available ... Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) Facts Marijuana (Weed, Pot) Facts MDMA (Ecstasy, Molly) Facts Meth ( ... Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine ...

  6. Drug Facts

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    Full Text Available ... MDMA (Ecstasy, Molly) Facts Meth (Crank, Ice) Facts Pain Medicine (Oxy, Vike) Facts Spice (K2) Facts Tobacco ... Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine Other Drugs You ...

  7. Drug Facts

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    Full Text Available ... That People Abuse Alcohol Facts Bath Salts Facts Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) Facts Marijuana ( ... Watch Videos Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) ...

  8. Drug Facts

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    Full Text Available ... Marijuana (Weed, Pot) Facts MDMA (Ecstasy, Molly) Facts Meth (Crank, Ice) Facts Pain Medicine (Oxy, Vike) Facts ... Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine Other Drugs ...

  9. Drug Facts

    Medline Plus

    Full Text Available ... Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) Facts Marijuana (Weed, Pot) Facts MDMA (Ecstasy, Molly) Facts Meth (Crank, ... Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine ...

  10. Strategy over operation: neural activation in subtraction and multiplication during fact retrieval and procedural strategy use in children.

    Science.gov (United States)

    Polspoel, Brecht; Peters, Lien; Vandermosten, Maaike; De Smedt, Bert

    2017-09-01

    Arithmetic development is characterized by strategy shifts between procedural strategy use and fact retrieval. This study is the first to explicitly investigate children's neural activation associated with the use of these different strategies. Participants were 26 typically developing 4th graders (9- to 10-year-olds), who, in a behavioral session, were asked to verbally report on a trial-by-trial basis how they had solved 100 subtraction and multiplication items. These items were subsequently presented during functional magnetic resonance imaging. An event-related design allowed us to analyze the brain responses during retrieval and procedural trials, based on the children's verbal reports. During procedural strategy use, and more specifically for the decomposition of operands strategy, activation increases were observed in the inferior and superior parietal lobes (intraparietal sulci), inferior to superior frontal gyri, bilateral areas in the occipital lobe, and insular cortex. For retrieval, in comparison to procedural strategy use, we observed increased activity in the bilateral angular and supramarginal gyri, left middle to inferior temporal gyrus, right superior temporal gyrus, and superior medial frontal gyrus. No neural differences were found between the two operations under study. These results are the first in children to provide direct evidence for alternate neural activation when different arithmetic strategies are used and further unravel that previously found effects of operation on brain activity reflect differences in arithmetic strategy use. Hum Brain Mapp 38:4657-4670, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Drug Facts

    Medline Plus

    Full Text Available ... Home Drugs That People Abuse Alcohol Facts Bath Salts Facts Cocaine (Coke, Crack) Facts Heroin (Smack, Junk) ... treatment. Watch Videos Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain Medicines Spice ( ...

  12. Drug Facts

    Medline Plus

    Full Text Available ... form Search Menu Home Drugs That People Abuse Alcohol Facts Bath Salts Facts Cocaine (Coke, Crack) Facts ... addiction, and treatment. Watch Videos Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain ...

  13. The effect of pre-operative aspirin on bleeding, transfusion, myocardial infarction, and mortality in coronary artery bypass surgery: a systematic review of randomized and observational studies.

    Science.gov (United States)

    Sun, Jack C J; Whitlock, Richard; Cheng, Ji; Eikelboom, John W; Thabane, Lehana; Crowther, Mark A; Teoh, Kevin H T

    2008-04-01

    To obtain estimates of the efficacy and safety of pre-operative aspirin in patients undergoing coronary artery bypass grafting (CABG). Eligible studies included randomized controlled trials (RCTs) and observational studies of patients undergoing CABG, comparing pre-operative aspirin with no aspirin/placebo, and reporting at least one of our primary outcomes. In eight RCTs (n = 805), pre-operative aspirin increased post-operative bleeding [Mean difference (MD), 104.9 mL; 95% confidence interval (CI), 19.2-190.6; P = 0.016] and reoperation [odds ratio (OR), 2.52; 95% CI, 1.18-5.38; P = 0.017), but not transfusion requirements (MD, 0.62 units; 95% CI, -0.06-1.30; P = 0.072). Subgroup analysis suggested that bleeding was increased with aspirin doses > or =325 mg/day, but not with lower doses. In 14 observational studies (n = 4485), pre-operative aspirin increased post-operative bleeding (MD, 113.6 mL; 95% CI, 45.2-182.0; P = 0.001) and transfusion requirements (MD, 0.34; 95% CI, 0.12-0.56 units; P = 0.002), but not reoperation (OR, 1.12; 95% CI, 0.69-1.83; P = 0.647). Neither analysis detected a significant effect on myocardial infarction or death. Pre-operative aspirin increases post-operative bleeding, but this may be avoided by the use of aspirin doses aspirin in the setting of contemporary cardiac surgical practice.

  14. Incidence and aetiology of a raised hemidiaphragm after cardiopulmonary bypass.

    Science.gov (United States)

    Large, S R; Heywood, L J; Flower, C D; Cory-Pearce, R; Wallwork, J; English, T A

    1985-01-01

    A raised hemidiaphragm has been reported as an uncommon complication of cardiopulmonary bypass, possibly resulting from cold injury to the phrenic nerve. At Papworth Hospital myocardial protection during cardiac arrest relies in part on irrigation of the pericardial cavity with large volumes of Hartmann's solution at 4 degrees C. Retrospective review of the chest radiographs of 100 consecutive patients undergoing cardiopulmonary bypass showed that 31 had a raised left hemidiaphragm soon after operation. The only significant correlation was with aortic cross clamp time (p less than 0.03). A prospective study of 36 consecutive patients undergoing cardiopulmonary bypass was then undertaken with diaphragmatic screening and chest radiography. Preoperative screening gave normal results in all patients. In the early postoperative period 16 (44%) had left diaphragmatic weakness or paralysis, two (5.5%) right sided weakness, and two (5.5%) bilateral weakness. Repeat screening of these patients showed resolution in all but four cases (80%) at six months and in all but two (90%) at one year. The greater number of left sided lesions than of right (8:1) is probably due to the fact that the cold jet of irrigating fluid is directed towards the left phrenic nerve. These findings have implications with regard to the optimum temperature of the irrigant fluid for myocardial protection during cardiopulmonary bypass. PMID:4024004

  15. Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery

    NARCIS (Netherlands)

    Valkenet, K.; Trappenburg, J. C A; Hulzebos, E. H.; van Meeteren, N. L U; Backx, F. J G

    Objectives: Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of

  16. Drug Facts

    Medline Plus

    Full Text Available ... to main content Easy-to-Read Drug Facts Search form Search Menu Home Drugs That People Abuse Alcohol Facts ... Past Drug Use Prevention Phone Numbers and Websites Search Share Government Shutdown Because of a lapse in ...

  17. Dumping symptoms is triggered by fat as well as carbohydrates in patients operated with Roux-en-Y gastric bypass.

    Science.gov (United States)

    Laurenius, Anna; Werling, Malin; le Roux, Carel W; Fändriks, Lars; Olbers, Torsten

    2017-07-01

    Dumping syndrome after Roux-en-Y gastric bypass (RYGB) is traditionally associated with the consumption of refined carbohydrates, but the role of dietary fat is unclear. This study compares symptoms after consumption of a carbohydrate-rich or fat-rich beverage to determine perceived symptoms, glycemic control, and pulse rate. University hospital. We assessed perceived symptoms (Sigstad's Dumping Index) and glycemic control (P-glucose and S-insulin) as well as autonomic nervous system activity (reflected by arterial pulse rate) after a standardized liquid meal test (440 kcal/300 mL carbohydrates [CARB] or fat [FAT]) in a randomized crossover blinded setting. Blood samples were drawn before and 1, 15, 30, and 60 minutes after finishing each meal and the area under the curve (AUC) was calculated. Twelve patients 42±10 months after undergoing RYGB were studied. AUC differed between drinks for glucose (P = .003) and insulin (P = .005). Pulse rate increased more after CARB than after FAT (P = .01). AUC for perceived symptoms in the Sigstad's Dumping Index were similar after meals (P = .79), yet the pattern of type of symptoms differed. In patients with RYGB, a meal with predominant fat content resulted in as much perceived dumping symptoms as a carbohydrate-profiled meal. As expected, an increase in glucose and insulin levels were found only after carbohydrate intake and the pulse rise was more pronounced for carbohydrates than fat. Dietary counseling in patients undergoing RYGB should address dietary fat as well as traditional information about carbohydrates to avoid dumping symptoms. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  18. A novel technique to prevent intra-operative pneumothorax in awake coronary artery bypass grafting: biomaterial neo-pleura.

    Science.gov (United States)

    Kato, Yosuke; Matsumoto, Isao; Tomita, Shigeyuki; Watanabe, Go

    2009-01-01

    Pneumothorax caused by damaged pleura represents the biggest obstacle in awake coronary artery bypass grafting. In order to safely perform this surgery, a new technique was developed to close the damaged pleura. A rub-and-spray method was employed using polyglycolic acid nonwoven fabric and fibrin glue. At first, some fibrinogen solution was rubbed on the edge of the pleural defect and then the PGA fabric was placed and the fibrinogen and thrombin solutions were sprayed. Using a thorax model, the burst pressure caused by positive pressure and the influence of negative pressure, moisture, time, continuous respiratory movement and pleural defect size were examined. In an animal experiment using pigs, the duration spent on repair was measured and any air leakage from the pleura was also identified. In the thorax model, the burst pressure was 355.9+/-55.8 mmHg with positive pressure and no significant difference in negative pressure, moisture, time and respiratory moment was identified. However, there was a significant difference in the defect size. In the animal model, repair was easily achieved regardless of the defect size or location and air leakage was not seen after repair. The average duration of repair was 21.0s. The present method achieved a strong closure with sufficient durability. Since the fabric is soft and flexible and suturing is not required, moving and fragile pleura can be easily repaired regardless of the defect location and size. Once established, the present method may be used in other forms of awake thoracic surgery or reconstruction of the thorax.

  19. Drug Facts

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    Full Text Available ... Search form Search Menu Home Drugs That People Abuse Alcohol Facts Bath Salts Facts Cocaine (Coke, Crack) Facts ... text to you. This website talks about drug abuse, addiction, and treatment. Watch Videos Information About Drugs Alcohol Bath Salts Cocaine Heroin Marijuana MDMA Meth Pain ...

  20. Drug Facts

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    Full Text Available ... Oxy, Vike) Facts Spice (K2) Facts Tobacco and Nicotine Facts Other Drugs of Abuse What is Addiction? ... Marijuana MDMA Meth Pain Medicines Spice (K2) Tobacco/Nicotine Other Drugs You can call 1-800-662- ...

  1. Reoperation risk following the first operation for internal herniation in patients with laparoscopic Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Danshøj Kristensen, S; Jess, P; Floyd, A K

    2016-01-01

    of this study was to investigate a possible increased risk of subsequent operations after an initial IH or IIH event. METHODS: This long-term follow-up study of patients who had surgery for an initial IH or IIH event in 2006-2011, based on the Danish National Patient Registry (NPR), was performed to 2013...... event, and three (0·8 per cent) a fourth event requiring surgery. CONCLUSION: Patients who have surgery for IH or IIH have a substantial risk of needing further operations....... operation. Twenty-seven (26·5 (18·9 to 35·8) per cent) of these 102 patients had a third operation, and five (19 (8 to 37) per cent) of the 27 had a fourth operation. Of the 383 patients diagnosed with an initial IH or IIH event, 72 (18·8 per cent) had a second IH/IIH event, 14 (3·7 per cent) had a third...

  2. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 43...... bypass operations....

  3. Application of Detailed Phase Comparison Protection Models for the Analysis of its Operation in Networks with Facts Devices

    Directory of Open Access Journals (Sweden)

    Ruban Nikolay Yu.

    2015-01-01

    Full Text Available The problem of relay protection misoperations in networks with FACTS devices is considered in the paper. It is offered a solution to this problem for a phase comparison protection of transmission power line through the use of its detailed model for the analysis of the functioning for a case of various normal, emergency and post-emergency modes of electric power systems. The research results of this approach are given in the paper.

  4. Nutritional Deficiencies in Gastric Bypass Patients; Incidence, Time of Occurrence and Implications for Post-operative Surveillance

    NARCIS (Netherlands)

    van der Beek, Eva S J; Monpellier, Valerie M.; Eland, Ingo; Tromp, Ellen; van Ramshorst, Bert

    2015-01-01

    Background: Post-operative nutritional deficiencies are a common complication following bariatric surgery. The incidence and time of occurrence are not clear, and the efficacy of supplementation remains questionable. Clear guidelines for nutritional follow-up and counselling are needed.Methods:

  5. Drug Facts

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    Full Text Available ... to main content Easy-to-Read Drug Facts Search form Search Menu Home Drugs That People Abuse Alcohol Facts ... Past Drug Use Prevention Phone Numbers and Websites Search Share Listen English Español Information about this page ...

  6. Choroidal changes after cardiopulmonary bypass.

    Science.gov (United States)

    Pekel, G; Alur, I; Alihanoglu, Y I; Yagci, R; Emrecan, B

    2014-11-01

    Choroid, which is the vascular tissue responsible for blood supply to the outer parts of the retina, might be affected by hemodynamic events. We aimed to reveal choroidal thickness and ocular pulse amplitude changes after cardiopulmonary bypass in which gross hemodynamic alterations occur. Forty-two eyes of 42 patients who underwent heart surgery with cardiopulmonary bypass were examined in this prospective, cross-sectional case series. The spectral domain optical coherence tomography (Spectralis, Heidelberg, Germany) was used to analyze sub-foveal choroidal thickness. The ocular pulse amplitude, the surrogate of gross choroidal blood flow, was measured with the Pascal dynamic contour tonometer (Pascal DCT, Swiss Microtechnology AG, Port, Switzerland).. The intraocular pressure was also measured with this tonometer. The examinations were performed pre-operatively and post-operatively at the first week and first month. The mean age of the patients was 58.8 ± 12.4 years. The mean sub-foveal choroidal thickness and ocular pulse amplitude values did not change statistically significantly after the operations at the follow-up visits (p>0.05). Also, there were no important correlations between cardiopulmonary bypass time and mean sub-foveal choroidal thickness and ocular pulse amplitude changes at the post-operative first week (p>0.05). The intraocular pressure values were decreased markedly at the control visits (pcardiopulmonary bypass. © The Author(s) 2014.

  7. Ferret facts

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This update functions to inform cooperators on the latest, most recent facts on the 1994 Montana Black-footed Ferret Reintroduction. This is a weekly update,...

  8. Liver Facts

    Science.gov (United States)

    ... Page Transplant Living > Organ facts and surgeries > Liver Liver The liver is one of the largest and ... lobes. Detail of the liver How does your liver work? The liver has many functions that are ...

  9. Drug Facts

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    Full Text Available ... Nicotine Facts Other Drugs of Abuse What is Addiction? What are some signs and symptoms of someone ... use problem? How Does Drug Use Become an Addiction? What Makes Someone More Likely to Get Addicted ...

  10. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... don't help, you may need coronary artery bypass surgery. The surgery creates a new path for ... narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more ...

  11. Heart bypass surgery - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100190.htm Heart bypass surgery - series—Normal anatomy To use the sharing ... Editorial team. Related MedlinePlus Health Topics Coronary Artery Bypass Surgery A.D.A.M., Inc. is accredited ...

  12. Coronary Artery Bypass

    Science.gov (United States)

    ... to 3 days in the Intensive Care Unit (ICU). Life After Bypass After bypass surgery, your doctor will recommend that you join a cardiac rehabilitation program. These programs help you make lifestyle changes ...

  13. [Use of a biological graft for subclavian-femoral bypassing in patients at operational-anaesthesiological risk].

    Science.gov (United States)

    Sukovatykh, B S; Belikov, L N; Rodionov, O A; Rodionov, A O

    2015-01-01

    Analysed herein are the results of an experimental study performed on 30 rabbits and a clinical study of treating a total of 60 patients presenting with critical ischaemia of lower limbs on the background of bilateral atherosclerotic lesions of the aortoiliac segment and running high operational-anaesthesiological risk. The animals were subdivided into three groups: an intact group consisting of 6 animals and two study groups comprising 12 rabbits each. In the first study group onto the wall of the abdominal aorta we implanted a synthetic polytetrafluoroethylene prosthesis, the second study group animals received biological graft "Kemangioprotez" from bovine internal thoracic arteries. The biological prosthesis on day three after implantation onto the arterial wall induced 3.2 times and on day seven 1.2 times more pronounced inflammatory reaction than the polytetrafluoroethylene prosthesis. 30 days after implantation of the synthetic graft the degree of repair connective-tissue processes in the arterial wall was 1.8-fold and 70 days after was 3.3-fold more pronounced than after implantation of the biological prosthesis at the same terms. In the connective-tissue capsule around the synthetic prosthesis predominated cellular elements while around the biological prosthesis - fibrous structures predominated. The patients were subdivided into 2 groups consisting of 30 patients each. In Group One patients the shunt used was a synthetic polytetrafluoroethylene prosthesis, in Group Two being a biological graft from bovine internal thoracic arteries. All patients suffered from severe concomitant diseases in the decompensation stage and a multi-level lesion of lower-limb arteries. Revascularization of the ischaemized extremity was carried out through the system of the deep femoral artery system. The use of a biological prosthesis made it possible in the immediate postoperative period to decrease the frequency of early postoperative complications by 13.3%, that of late graft

  14. Snack, Facts

    Science.gov (United States)

    Smith, Suzanne M.

    2005-01-01

    The American diet has undergone substantial changes, a fact that has negatively impacted the dental health of children. Primary prevention is the ideal method to address the current increased incidence of tooth decay. Educating kids, and their parents, about the qualities of snacks as well as the role of frequency of snacking could help to reduce…

  15. Reptile Facts.

    Science.gov (United States)

    Steinheimer, Margaret

    1993-01-01

    Describes an award-winning bulletin board for introducing a unit on reptiles. This interactive bulletin board contains fun facts and counters common misconceptions about reptiles. Twelve true-false statements are hidden behind pull-up flaps. Four pictures ask students to identify the difference between often-confused animals. (PR)

  16. [The influence of cardiopulmonary bypass operation on the biodistribution of 99mTc-HMPAO-labelled granulocytes - Evaluation in pigs by planar scintigraphy and section-analyses].

    Science.gov (United States)

    Happel, C; Margraf, S; Diener, J; Kranert, W T; Francischetti, I; Bitu-Moreno, J; Ackermann, H; Middendorp, M; Theisen, A; Moritz, A; Scholz, M; Grünwald, F

    2012-01-01

    of the study was to evaluate the influence of an extra corporal perfusion (cardiopulmonary bypass operation - cpb) on activation and biodistribution of (99m)Tc labelled granulocytes in pigs with and without inhibition of the granulocytes by a leukocyte inhibition module (LIM). The cpb is often related to an activation of granulocytes resulting in an inflammatory answer. The biological mechanisms are unsolved yet. First trials of our group showed that LIM may inhibit the activation of neutrophils and therefore antagonize a cpb-caused impairment of cardiac function. This study is the continuation of these experiments with a higher number of animals and the focus on scintigraphic imaging. ANIMALS, MATERIAL, METHODS: 39 German landrace pigs were subdivided into three groups: group A (control) median sternotomy without cpb, group B with cpb, group C with LIM in addition to cpb. After labelling with (99m)Tc-HMPAO autologues granulocytes were reinjected. Subsequently to cpb, the animals underwent scintigraphic imaging. Quantification was performed with ROI evaluation and with tissue samples (section analysis) examined in a well counter. A high uptake of (99m)Tc-HMPAO was found in the liver. The count rates in brain, heart, lung, spleen and kidneys were far below. The amount of 99mTc-activity in the organ related to the half life corrected administered activity [%] was for the tissue samples (group A/B/C): brain 0.01/0.02/0.03; lung 12.1/8.3/11.5; heart 0.35/0.54/0.42; kidney 1.24/0.87/1.02; spleen 4.0/4.0/4.5, liver 16.8/20.9/19.6. The count rates determined by ROI-evaluation of the scintigraphic images related to the total count rate in the image [%] were (group A/B/C): brain 1.1/0.9/1.0; lung 15.6/10.4/12.2; heart 4.0/3.5/3.4; kidney 4.0/2.9/3.2; spleen 7.6/7.7/9.5, liver 23.1/36.7/31.4. A significant difference in the tracer uptake between the groups could neither be detected by scintigraphic imaging nor evaluation of tissue samples. Scintigraphic imaging as well as

  17. Gut hormones and gastric bypass

    DEFF Research Database (Denmark)

    Holst, Jens J.

    2016-01-01

    Gut hormone secretion in response to nutrient ingestion appears to depend on membrane proteins expressed by the enteroendocrine cells. These include transporters (glucose and amino acid transporters), and, in this case, hormone secretion depends on metabolic and electrophysiological events elicited...... that determines hormone responses. It follows that operations that change intestinal exposure to and absorption of nutrients, such as gastric bypass operations, also change hormone secretion. This results in exaggerated increases in the secretion of particularly the distal small intestinal hormones, GLP-1, GLP-2......, oxyntomodulin, neurotensin and peptide YY (PYY). However, some proximal hormones also show changes probably reflecting that the distribution of these hormones is not restricted to the bypassed segments of the gut. Thus, cholecystokinin responses are increased, whereas gastric inhibitory polypeptide responses...

  18. Evaluation of retrospectively ECG-gated 4-row multidetector CT in patients planned for minimal invasive coronary artery bypass grafting; Die EKG-getriggerte 4-Zeilen-Spiral-CT des Herzens in der praeoperativen Bildgebung vor minimalinvasiver koronarer Bypass-Operation

    Energy Technology Data Exchange (ETDEWEB)

    Begemann, P.G.C.; Ittrich, H.; Koops, A.; Adam, G.; Weber, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Radiologisches Zentrum, Universitaetsklinikum, Hamburg (Germany); Arnold, M.; Detter, C.; Boehm, D.H.; Reichenspurner, H. [Universitaetsklinikum Hamburg-Eppendorf, Herzzentrum, Herz und Gefaesschirurgie, Hamburg (Germany)

    2005-08-01

    Purpose: Minimal invasive direct coronary artery bypass grafting (MIDCAB) or off-pump coronary artery bypass grafting (OPCAB) on the beating heart with full or mini-sternotomy are becoming more common in coronary bypass surgery of the left anterior descending (LAD). In the decision, which surgical approach (MIDCAB, OPCAB or conventional surgery with cardiopulmonary bypass) will be best used, knowledge of the anatomical field is of major importance. The aim of the study was to evaluate retrospective ECG-gated 4-row multidetector CT (MDCT) in patients planned for MIDCAB as additional imaging to coronary angiography. Material and methods: The study included 25 consecutive patients. MSCT was performed as unenhanced (collimation 4 x 2.5 mm) and contrast-enhanced examination (140-170 ml, 300 mg Iodine/ml, collimation 4 x 1 mm). The evaluation included presence of LAD calcifications, distance of LAD and left internal mammarian artery (LIMA), coursek of LAD and LIMA, the presence or absence of bridging through myocardium or epicardial fat and the presence of pleural fibrosis. The MDCT results were correlated with intra-operative findings. Results: All MDCTs could be assessed with reference to the demands. In 20/25 operations, MDCT had direct influence as to the selection of the surgical approach (11 MIDCAB, 7 OPCAB with mini-sternotomy and 5 with full sternotomy, 2 conventional surgeries). The distance of LAD and LIMA varied from 0.9 to 4.5 cm in MDCT. As to calcifications, 3/25 correlated patients had calcifications and 10 patients had no calcifications in the middle LAD. Seven patients had intraoperative fibrosis of the vessel wall without calcification of the middle LAD, which could not be detected with MDCT. Another 5 patients had single calcified plaques in the middle LAD, 4 of these had a fibrosis of the vessel and 1 had a normal vessel at surgery. In these cases, the anastomosis was done between the calcified plaques. No myocardial bridging was detected by MDCT and

  19. Bypass materials in vascular surgery

    Directory of Open Access Journals (Sweden)

    Willich, Stephan N.

    2006-03-01

    Full Text Available Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle, surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives: The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information

  20. BPA Facts

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-03-01

    The Bonneville Power Administration is a federal nonprofit power marketing administration based in the Pacific Northwest . Although BPA is part of the U .S . Department of Energy, it is self-funding and covers its costs by selling its products and services . BPA markets wholesale electrical power from 31 federal hydro projects in the Columbia River Basin, one nonfederal nuclear plant and several small nonfederal power plants . The dams are operated by the U .S . Army Corps of Engineers and the Bureau of Reclamation . About 30 percent of the electric power used in the Northwest comes from BPA . BPA’s resources — primarily hydroelectric — make its power nearly carbon free . BPA also operates and maintains about three- fourths of the high-voltage transmission in its service territory . BPA’s service territory includes Idaho, Oregon, Washington, western Montana and small parts of eastern Montana, California, Nevada, Utah and Wyoming . BPA promotes energy efficiency, renewable resources and new technologies that improve its ability to deliver on its mission . BPA also funds regional efforts to protect and enhance fish and wildlife populations affected by hydropower development in the Columbia River Basin . BPA is committed to public service and seeks to make its decisions in a manner that provides opportunities for input from stakeholders . In its vision statement, BPA dedicates itself to providing high system reliability, low rates consistent with sound business principles, environmental stewardship and accountability

  1. Asendan Desendan Aortic Bypass: Atan Kalpte Mediyan Sternotomi Yoluyla Onarim

    Directory of Open Access Journals (Sweden)

    Muhammet Akyuz

    2013-10-01

    Full Text Available We report the case of a 9-month-old patient presenting for redo aortic arch surgery because of recoarctation. In present case, ascending-to-descending aortic bypass via median sternotomy was performed without cardiopulmonary bypass with good result. In spite of the fact that the different surgical and intervention treatment options of aortic coarctation are quite satisfactory, a certain group of patients need reoperation because of recoarctation. The recoarctation repair of the aorta with the extra-anatomic aortic bypass is considered a low-risk procedure with high success rate.

  2. Blood Facts and Statistics

    Science.gov (United States)

    ... Blood > Blood Facts and Statistics Blood Facts and Statistics Facts about blood needs Facts about the blood ... to Top Learn About Blood Blood Facts and Statistics Blood Components Whole Blood and Red Blood Cells ...

  3. Sen perforation af tyndtarm efter laparoskopisk gastrisk bypass

    DEFF Research Database (Denmark)

    Spanager, Lene; Sigild, Ulf Henrik; Neuenschwander, Anders Ulrich

    2010-01-01

    We present two cases in which the patients were admitted to a local hospital with acute abdominal pain four or five months after having undergone laparoscopic gastric bypass. In both cases, operation revealed a perforation of the small bowel close to the distal anastomosis. In the first case...... bypass but as our two cases illustrate they are important to keep in mind....

  4. Predicting the need for blood during cardiopulmonary bypass

    African Journals Online (AJOL)

    Adele

    infections.1 Furthermore, autologous blood transfusions relieve pres- sure on scarce banked-blood ... delivery that occurs on initiation of cardiopulmonary bypass (CPB). In spite of patient cooling during CPB that ... considered prudent to have blood ready in the operating room at the time of going onto bypass in order to ...

  5. Arterial bypass leg - slideshow

    Science.gov (United States)

    ... presentations/100155.htm Arterial bypass leg - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  6. Thrombin During Cardiopulmonary Bypass

    National Research Council Canada - National Science Library

    Edmunds, L. Henry; Colman, Robert W

    2006-01-01

    Cardiopulmonary bypass (CPB) ignites a massive defense reaction that stimulates all blood cells and five plasma protein systems to produce a myriad of vasoactive and cytotoxic substances, cell-signaling molecules...

  7. Cardiopulmonary bypass in pregnancy

    National Research Council Canada - National Science Library

    Kapoor, MukulChandra

    2014-01-01

      Cardiac surgery carried out on cardiopulmonary bypass (CPB) in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women...

  8. Cardiopulmonary bypass and hemostasis

    NARCIS (Netherlands)

    Eijsman, Leon

    1992-01-01

    In chapter 1, we recalled that intracardiac defects can only be corrected when cardiopulmonary circulation is maintained by extracorporeal criculation and ventilation. To prevent clot formation in this artificial circuit, the socalled cardiopulmonary bypass (CPB), we completely depend on the

  9. Gastric bypass surgery - discharge

    Science.gov (United States)

    ... heart disease Gastric bypass surgery Laparoscopic gastric banding Obesity Obstructive sleep apnea - adults Type 2 diabetes Patient Instructions Getting out of bed after surgery Weight-loss surgery - after - what to ask your doctor Weight- ...

  10. Bypassing damaged nervous tissue

    CERN Document Server

    Shneider, M N

    2016-01-01

    We show the principal ability of bypassing damaged demyelinated portions of nervous tissue, thereby restoring its normal function for the passage of action potentials. We carry out a theoretical analysis on the basis of the synchronization mechanism of action potential propagation along a bundle of neurons, proposed recently in [1]. And we discuss the feasibility of implement a bypass to restore damaged nervous tissue and creating an artificial neuron network.

  11. Coronary Artery Bypass in Octogenarians

    Directory of Open Access Journals (Sweden)

    Chen-Yen Chien

    2012-09-01

    Full Text Available Prevalence of coronary artery disease (CAD has increased with the expansion of life span among the elderly population in the world. Hence, the issue of the coronary artery bypass in octogenarians has attracted more attention. Recent literature about the topic revealed nearly the same excellent results as those in the younger population under the newly developed operative techniques and improving concept in perioperative management and postoperative care. In this article, we review the current status of the procedure that was thought to be dangerous in the earlier era, including its risk factors, result, and benefit.

  12. Revision to malabsorptive Roux-en-Y gastric bypass (MRNYGBP) provides long-term (10 years) durable weight loss in patients with failed anatomically intact gastric restrictive operations: long-term effectiveness of a malabsorptive Roux-en-Y gastric bypass in salvaging patients with poor weight loss or complications following gastroplasty and adjustable gastric bands.

    Science.gov (United States)

    Srikanth, Myur Srinivasan; Oh, Ki Hyun; Fox, Samuel Ross

    2011-07-01

    Twenty percent of gastric restrictive operations require revision. Conversion to Proximal Roux-en-Y gastric bypass (PRNYGBP) is associated with weight regain. Forty-one percent of these fail to achieve a body mass index (BMI) gastric restrictive operation (S1) at least a year out from revision (S2) to a MRNYGBP: small lesser curve 22 ± 10 (11-55) cm(3) pouch, long biliopancreatic limb, 150 cm alimentary limb, 141 ± 24 (102-190) cm common channel. Staple-line disruptions were excluded. Thirty-eight (37 F, 1 M) patients aged 46 ± 8 (17-56) years underwent conversion to a MRYGBP 8 ± 5 (2-23) years after: gastroplasty 25, adjustable gastric band 13 for weight regain (79%), gastroesophageal reflux disease (GERD; 29%), and band problems (24%). S1 provided only 24 ± 25% excess weight loss (EWL; 5.9 ± 6.3 BMI drop) and caused GERD in 32% of patients (p = 0.0124). There were no deaths or leaks. BMI dropped from 41.4 ± 7.8 to 27.3 ± 5.6 (down 20.5 ± 8.3 from S1), 80.1 ± 23.3% EWL (n = 32) at year 1 (p gastric restrictive operations. Non-compliant patients are at a higher risk for malnutrition, anemia, and osteoporosis.

  13. Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction: Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.

    Science.gov (United States)

    Wrobel, Krzysztof; Stevens, Susanna R; Jones, Robert H; Selzman, Craig H; Lamy, Andre; Beaver, Thomas M; Djokovic, Ljubomir T; Wang, Nan; Velazquez, Eric J; Sopko, George; Kron, Irving L; DiMaio, J Michael; Michler, Robert E; Lee, Kerry L; Yii, Michael; Leng, Chua Yeow; Zembala, Marian; Rouleau, Jean L; Daly, Richard C; Al-Khalidi, Hussein R

    2015-08-25

    Patients with severe left ventricular dysfunction, ischemic heart failure, and coronary artery disease suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk, which makes decision making regarding whether to proceed to surgery difficult in such patients. To better inform such decision making, we analyzed the Surgical Treatment for Ischemic Heart Failure (STICH) CABG population for detailed information on perioperative risk and outcomes. In both STICH trials (hypotheses), 2136 patients with a left ventricular ejection fraction of ≤35% and coronary artery disease were allocated to medical therapy, CABG plus medical therapy, or CABG with surgical ventricular reconstruction. Relationships of baseline characteristics and operative conduct with morbidity and mortality at 30 days were evaluated. There were a total of 1460 patients randomized to and receiving surgery, and 346 (≈25%) of these high-risk patients developed a severe complication within 30 days. Worsening renal insufficiency, cardiac arrest with cardiopulmonary resuscitation, and ventricular arrhythmias were the most frequent complications and those most commonly associated with death. Mortality at 30 days was 5.1% and was generally preceded by a serious complication (65 of 74 deaths). Left ventricular size, renal dysfunction, advanced age, and atrial fibrillation/flutter were significant preoperative predictors of mortality within 30 days. Cardiopulmonary bypass time was the only independent surgical variable predictive of 30-day mortality. CABG can be performed with relatively low 30-day mortality in patients with left ventricular dysfunction. Serious postoperative complications occurred in nearly 1 in 4 patients and were associated with mortality. URL: http

  14. Arterial Filter Bypass Loop: What Occurs in this Area during Cardiopulmonary Bypass and Are There Potential Patient Implications

    Science.gov (United States)

    Hawkins, Justin L.; Myers, Gerard J.; Légaré, Jean-Francois; Swyer, Wilfred

    2010-01-01

    Abstract: The arterial filter is an integral part of bypass circuitry. When introduced, manufacturers suggested a bypass loop for retrograde priming and de-airing, and for uninterrupted blood flow in case of malfunction. Practice has shown antegrade priming and de-airing is possible. This questions the necessity of the loop and presents the question—what occurs in the loop during bypass? After obtaining Human Research Ethics Board approval, eight consecutive patients (n = 8) were chosen for this study. Exclusive exclusion criterion was receiving any transfusions during cardiopulmonary bypass, as this could possibly influence results. The choice of patient numbers was based simply on proof of concept. Investigation involved isolation and collection of loop contents after cardiopulmonary bypass was completed. Testing included complete blood count, prothrombin time, international normalized ratio, partial thromboplastin time, activated clotting time, plasma free hemoglobin, slide photography with analysis for platelet clumping, and debris detection. One perfusionist collected samples, providing uniform collection and isolation technique. Regular blood samples were collected from the bypass circuitry, and from patients’ pre-operative blood work. Analysis of data revealed that platelet counts in the bypass loops were statistically lower than control. Evidence of platelet clumping was present in 3 of 8 bypass loop samples, representing 37.5% of the study population. There was no clumping detected in any of the controls. In patients where platelet clumping was present, a positive correlation was noted between mean bypass time and size of platelet clumps. Prothrombin time and international normalized ratio results were immeasurable. Hemoglobin levels were higher in the loop samples. There was no evidence of debris or fibrin monomer present in any of the samples analyzed. The study results indicate that during “normal” cardiopulmonary bypass with an arterial filter

  15. A compliance monitoring program for use and operation of the Grasslands Bypass for drainage conveyance in the western San Joaquin Valley

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, N.W.T.

    1995-11-01

    The Bureau of Reclamation (Reclamation) signed a Finding of No Significant Impact (FONSI) No. 92-02-MP dated October 18, 1991 and a Supplement to the FONSI No. 92-03-MP dated April 15, 1991, for use of a 19 mile segment of the San Luis Drain, renamed the Grasslands Bypass, to convey agricultural drainage waters to the San Joaquin River. An Environmental Assessment was prepared and published in support of the FONSI. On September 7, 1995 a Supplemental Environmental Assessment was prepared to update the original document to account for changes to the original project. These changes included a change to the point of entry to the Drain and an increase in the length of the Drain utilized by the Project from 19 to 28 miles. Environmental commitments and a schedule of fees for non-compliance with monthly and annual selenium load targets were also agreed upon for the current Project. Environmental documents preceding the FONSI outlined a monitoring program that obtained general and informal concurrence by technical staff of the participating agencies. A revised version of the proposed monitoring program was distributed by Reclamation for review and comment by the agencies in July 1992. A final monitoring plan document was issued in June 1993 and was subsequently approved by the Oversight Committee. This document includes substantial revisions to the existing June 1993 monitoring plan to reflect the compliance requirements of the current Project.

  16. Subjective and objective physical activity patterns after Roux-en Y gastric bypass surgery compared with non-operated obese and non-obese control women.

    Science.gov (United States)

    Wilms, Britta; Ernst, Barbara; Thurnheer, Martin; Schultes, Bernd

    2016-01-01

    Previous studies on physical activity after bariatric surgery provided inconsistent results. The aim of our study was to comprehensively assess physical activity by subjective (questionnaires) and objective (accelerometry) measures in women who had undergone Roux-en Y gastric bypass (RYGB) surgery and to compare results with those of women displaying grade II or higher obesity and of non-obese control women. Our cross-sectional case-control study included 12 women in each group (RYGB, obese, non-obese). Wrist accelerometry was performed over 5 days. Two questionnaires were used to assess women's self-reported leisure- and work-time and sport-related physical activity. Accelerometry indicated a lower physical activity in RYGB women than in non-obese women in particular during the weekend (p=0.010), while there was no difference between RYGB and obese women (p=0.57). Questionnaires revealed that RYGB women self-report a greater leisure- and work-time physical activity than obese women and also greater work-related physical activity than non-obese women (all p≤0.032). In contrast, sport-related activities were reduced in RYGB as compared with non-obese women (p=0.011), while there was no difference between RYGB and obese women (p=0.51). Comparison of the obese and non-obese group revealed less leisure-time and sport-related activities in the obese women (both p≤0.002). Despite the preliminary character of our rather small study, data suggest a differential physical activity pattern in women who have previously undergone RYGB surgery that is characterized by rare sport activities, an increased subjective work-related physical activity and objectively reduced physical activity during the weekend as compared with non-obese control women. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  17. Coronary bypass grafting without use of cardiopulmonary bypass for dextrocardia.

    Science.gov (United States)

    Mujanovic, Emir; Bergsland, Jacob; Tursic, Ademir; Stanimirovic-Mujanovic, Sanja; Kabil, Emir

    2011-01-01

    Dextrocardia is a condition in which the heart is pointed toward the right side of the chest instead of normally pointing to the left. The rate of atherosclerotic heart disease in subjects with this condition is similar to that of the general population. We present a patient with situs inversus totalis with dextrocardia who underwent coronary artery bypass grafting without use of cardiopulmonary bypass (OPCAB). A 74-year-old man who was known to have dextrocardia with situs inversus was admitted to the hospital because of angina. Coronary angiography was performed and showed ostial occlusion of the left anterior descendng artery (LAD) unsuitable for percutaneous coronary interventions but collatereralised from the right coronary artery. Patient underwent OPCAB under general anestesia. Right internal mammary artery was anastomosed to LAD on the beating heart with the surgeon standing on the right side of the patient. The patient's post-operative course was uneventful, and he was discharged on the 6th postoperative day in good condition. Performing OPCAB surgery is not technically more demanding, and present no unusual challenge on patients with dextrocardia.

  18. The Best Bypass Surgery Trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Jensen, Birte Østergaard; Gluud, Christian

    2007-01-01

    Recent trials suggest that off-pump coronary artery bypass grafting (OPCAB) reduces the risk of mortality and morbidity compared with conventional coronary artery bypass grafting (CCAB) using cardiopulmonary bypass. Patients with a moderate- to high-risk of complications after CCAB may have...

  19. Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training.

    Science.gov (United States)

    Stegen, Sanne; Derave, Wim; Calders, Patrick; Van Laethem, Christophe; Pattyn, Piet

    2011-01-01

    There is a growing consensus that bariatric surgery is currently the most efficacious and long-term treatment for clinically severe obesity. However, it remains to be determined whether poor physical fitness, an important characteristic of these patients, improves as well. The purpose of this pilot study is to investigate the effect of gastric bypass surgery on physical fitness and to determine if an exercise program in the first 4 months is beneficial. Fifteen morbidly obese patients (BMI 43.0 kg/m(2)) were tested before and 4 months after gastric bypass surgery. Eight of them followed a combined endurance and strength training program. Before and after 4 months the operation, anthropometrical characteristics were measured, and an extensive assessment of physical fitness (strength, aerobic, and functional capacity) was performed. Large-scale weight loss through gastric bypass surgery results in a decrease in dynamic and static muscle strength and no improvement of aerobic capacity. In contrast, an intensive exercise program could prevent the decrease and even induced an increase in strength of most muscle groups. Together with an improvement in aerobic capacity, functional capacity increased significantly. Both groups evolved equally with regard to body composition (decrease in fat mass and fat-free mass). An exercise training program in the first 4 months after bariatric surgery is effective and should be promoted, considering the fact that physical fitness does not improve by weight loss only.

  20. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI...

  1. Artery Bypass Grafting

    African Journals Online (AJOL)

    Unknown

    nary artery disease (CAD) was coronary artery bypass graft (CAB G) using a segment of saphenous vein interposed between the ascend- ing aorta and the coronary artery distal to the obstructing lesion. This was performed by David Sabiston of Duke University in 1962. With the use of the recently developed technique of ...

  2. Evaluation of Early Complications of Coronary Artery Bypass Grafting Surgery (CABGS in the First Month After Operation in Imam Khomeini Hospital of Ardabil During 2013-2014

    Directory of Open Access Journals (Sweden)

    Adalat Hosseinian

    2014-04-01

    Full Text Available Background & Objectives : Nowadays, coronary artery disease is the most common cause of death in developed countries and in the whole world. According to the WHO reports, it will be the main cause of death in 2020. Myocardial infarction is the most common diagnosis among hospitalized patients in industrialized countries. This disease causes more mortality and morbidity than others. Coronary artery bypass grafting surgery (CABGS is one of the common treatments for ischemic heart disease but it may have some complications. In this study we wanted to evaluate the incidence of CABGS complications in Imam Khomeini Hospital of Ardabil in the first month after CABG.   Methods: This study was a cross sectional analytic descriptive type and performed on all of the patients underwent CABGS in Imam Khomeini Hospital during 2011-2012. All of the data from patients (like demographic, past medical history, physical exam findings, paraclinical findings and CABGS complications were inserted in special forms after gathering, and analyzed by SPSS v.16.   Results: In this study, 211 patients were studied. About 145 (68.72% of them were male and 66 (31.28% were female. Seventy patient (33.17% were more than 70 years old. About 33.22% of patients had a history of cigarette smoking and 9.95% were opioid abused. The 34.12% of patients had hypertension (HTN history, 40.28% diabetes mellitus (DM, 17.06% history of hyperlipidemia and 63.98% had a history of the previous MI. Chest pain was the most common complication among the patients (93.36%. According to our study the prevalence rate of post CABGS complications were: bleeding after surgery 13.27%, postoperative myocardial infection 8.05%, neurological disorders 12.32%, renal complications 2.36%, respiratory symptoms 11.37% and 34.59% for cardiovascular complications. Also the total mortality was 5 (2.36% persons. The data analysis showed that there was a significant relationship between sex with survival status

  3. Zika Virus Fact Sheet

    Science.gov (United States)

    ... Fact files Questions & answers Features Multimedia Contacts Zika virus Fact sheet Updated 6 September 2016 Key facts ... last for 2-7 days. Complications of Zika virus disease Based on a systematic review of the ...

  4. Oral Cancer Facts

    Science.gov (United States)

    ... Events Get involved Dental Research Resources Contact Sitemap Oral Cancer Facts Home » Oral Cancer Facts Oral Cancer Facts ... needed on the Check Your Mouth website. How oral cancer develops We know that all cancers (neoplastic transformations) ...

  5. Zika Virus Fact Sheet

    Science.gov (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Zika virus Fact sheet Updated 6 September 2016 Key facts ... and last for 2-7 days. Complications of Zika virus disease Based on a systematic review of the ...

  6. Cholera Fact Sheet

    Science.gov (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Cholera Fact sheet Updated December 2017 Key facts Cholera ... behaviour and to the control of cholera. Oral cholera vaccines Currently there are three WHO pre-qualified ...

  7. Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: a case report.

    Science.gov (United States)

    Haenen, Filip Wn; Gys, Ben; Moreels, Tom; Michielsen, Maartje; Gys, Tobie; Lafullarde, Thierry

    2017-10-24

    Laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the preferred surgical procedure to treat morbid obesity. It has proven its effects on excess weight loss and its positive effect on comorbidities. One of the main issues, however, is the post-operative evaluation of the bypassed gastric remnant. In literature, cancer of the excluded stomach after RYGB is rare. We describe the case of a 52-year-old woman with gastric linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass, diagnosed by means of laparoscopy and Single-Balloon enteroscopy, and it is clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term post-operative follow-up, and the importance of single-balloon enteroscopy for visualization of the bypassed stomach remnant, when other investigations remain without results. This case report is only the second report of a linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass.

  8. Description and theory of operation of the computer by-pass system for the NASA F-8 digital fly-by-wire control system

    Science.gov (United States)

    1978-01-01

    A triplex digital flight control system was installed in a NASA F-8C airplane to provide fail operate, full authority control. The triplex digital computers and interface circuitry process the pilot commands and aircraft motion feedback parameters according to the selected control laws, and they output the surface commands as an analog signal to the servoelectronics for position control of the aircraft's power actuators. The system and theory of operation of the computer by pass and servoelectronics are described and an automated ground test for each axis is included.

  9. Coronary arteries bypass grafting stenosis

    Directory of Open Access Journals (Sweden)

    Mahmoud Ebrahimi

    2014-12-01

    Full Text Available Coronary artery disease (CAD is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980’s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-ĸB are described.

  10. Robotically-Assisted Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Thierry A. Folliguet

    2010-01-01

    Full Text Available Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery. Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of the mammary conduit followed by minimal invasive direct coronary artery bypass (MIDCAB, and twenty-three patients had a totally endoscopic coronary artery bypass (TECAB grafting. Nine patients (16% were converted to open techniques. The mean total operating time for TECAB was 372±104 minutes and for MIDCAB was 220±69 minutes. Followup was complete for all patients up to one year. There was one hospital death following MIDCAB and two deaths at follow up. Forty-eight patients had an angiogram or CT scan revealing occlusion or anastomotic stenoses (>50% in 6 patients. Overall permeability was 92%. Conclusions. Robotic surgery can be performed with promising results.

  11. Bypass: A Memoir

    OpenAIRE

    Amato, Joseph A.

    2000-01-01

    This inquiry into matters of heart, conducted under the shadows of pending surgery, awakens themes of boyhood, education, and marriage and prompt questions about loyalty to a deceased father, connections with immigrant grandparents, loss and rediscovery of faith, and solitude versus community. A medical narrative, the book also chronicles a span of contemporary American life. Throughout Amato's account, the consistent reminder of his upcoming bypass invites readers to reflect on their own liv...

  12. Effects of a pre-operative home-based inspiratory muscle training programme on perceived health-related quality of life in patients undergoing coronary artery bypass graft surgery.

    Science.gov (United States)

    Valkenet, K; Trappenburg, J C A; Hulzebos, E H; van Meeteren, N L U; Backx, F J G

    2017-09-01

    Pre-operative inspiratory muscle training has been shown to decrease the incidence of postoperative pneumonia and length of hospital stay in patients undergoing coronary artery bypass graft surgery (CABG). This study investigated if this decrease acted as a mediator on the time course of quality of life. Complementary analyses of a published randomised controlled trial. The initial trial included patients awaiting CABG surgery at a Dutch university hospital. The secondary analyses used data from the initial trial for patients who had completed at least one quality-of-life questionnaire. Participants were allocated at random to the intervention group or the usual care group. The intervention group followed a home-based pre-operative inspiratory muscle training programme. Quality of life was measured at five time points. Between-group differences in quality-of-life scores were analysed using mixed linear modelling. The secondary analyses used data for 235 patients. In line with the initial trial, pneumonia and length of hospital stay were decreased significantly in the intervention group. The time courses for all patients showed significant improvements in quality of life after surgery compared with baseline. No significant differences in quality of life were observed over time between the two groups. Despite decreased incidence of pneumonia and length of hospital stay in the intervention group, this study did not find any improvements in quality of life due to the pre-operative home-based inspiratory muscle training programme. Clinical trial registration number ISRCTN17691887. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  13. Relationship of femorodistal bypass patency to clinical outcome. Iloprost Bypass International Study Group

    DEFF Research Database (Denmark)

    Watson, H R; Schroeder, T V; Simms, M H

    1999-01-01

    To investigate the relationship between bypass patency, limb survival and clinical symptoms after femorodistal bypass procedures.......To investigate the relationship between bypass patency, limb survival and clinical symptoms after femorodistal bypass procedures....

  14. Robotically assisted totally endoscopic coronary artery bypass surgery

    OpenAIRE

    Canale, Leonardo Secchin; Mick, Stephanie; Mihaljevic, Tomislav; Nair, Ravi; Bonatti, Johannes

    2013-01-01

    Robotically assisted totally endoscopic coronary artery bypass surgery has emerged as a feasible and efficient alternative to conventional full sternotomy coronary artery bypass graft surgery in selected patients. This minimally invasive approach using the daVinci robotic system allows fine intrathoracic maneuvers and excellent view of the coronary arteries. Both on-pump and off-pump operations can be performed to treat single and multivessel disease. Hybrid approaches have the potential of o...

  15. Comparison of two technics of cardiopulmonary bypass (conventional and mini CPB) in the trans-and postoperative periods of cardiac surgery.

    Science.gov (United States)

    Pereira, Sergio Nunes; Zumba, Izabelle Balta; Batista, Micheline Sulzbacher; Pieve, Daniela da; Santos, Elisandra dos; Stuermer, Ralf; Oliveira, Gerson Pereira de; Senger, Roberta

    2015-01-01

    This study aimed to compare the effects of two different perfusion techniques: conventional cardiopulmonary bypass and miniature cardiopulmonary bypass in patients undergoing cardiac surgery at the University Hospital of Santa Maria--RS. We perform a retrospective, cross-sectional study, based on data collected from the patients operated between 2010 and 2013. We analyzed the records of 242 patients divided into two groups: Group I: 149 patients undergoing cardiopulmonary bypass and Group II - 93 patients undergoing the miniature cardiopulmonary bypass. The clinical profile of patients in the preoperative period was similar in the cardiopulmonary bypass and miniature cardiopulmonary bypass groups without significant differences, except in age, which was greater in the miniature cardiopulmonary bypass group. The perioperative data were significant of blood collected for autotransfusion, which were higher in the group with miniature cardiopulmonary bypass than the cardiopulmonary bypass and in transfusion of packed red blood cells, which was higher in cardiopulmonary bypass than in miniature cardiopulmonary bypass. In the immediate, first and second postoperative period the values of hematocrit and hemoglobin were higher and significant in miniature cardiopulmonary bypass than in the cardiopulmonary bypass, although the bleeding in the first and second postoperative days was higher and significant in miniature cardiopulmonary bypass than in the cardiopulmonary bypass. The present results suggest that the miniature cardiopulmonary bypass was beneficial in reducing the red blood cell transfusion during surgery and showed slight but significant increase in hematocrit and hemoglobin in the postoperative period.

  16. Your diet after gastric bypass surgery

    Science.gov (United States)

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... completely. Some of these are pasta, rice, bread, raw vegetables, and meats. Adding a low-fat sauce, ...

  17. The impact of avoiding cardiopulmonary by-pass during coronary artery bypass surgery in elderly patients: the Danish On-pump Off-pump Randomisation Study (DOORS)

    DEFF Research Database (Denmark)

    Houlind, Kim; Juel Kjeldsen, Bo; Madsen, Susanne Nørgaard

    2009-01-01

    BACKGROUND: Coronary Artery Bypass Graft operation for ischemic heart disease provides improved quality of life and, in some patients, prolonged survival. Concern has, however, been raised about complications that may be related to the use of cardiopulmonary by-pass (CPB) and aortic cross...

  18. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  19. Oil Bypass Filter Technology Performance Evaluation - January 2003 Quarterly Report

    Energy Technology Data Exchange (ETDEWEB)

    Laurence R. Zirker; James E. Francfort

    2003-01-01

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  20. Oil Bypass Filter Technology Performance Evaluation - First Quarterly Report

    Energy Technology Data Exchange (ETDEWEB)

    Zirker, L.R.; Francfort, J.E.

    2003-01-31

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  1. Homosexuality: Facts for Teens

    Science.gov (United States)

    ... About Virginity Home Family Health Kids and Teens Homosexuality: Facts for Teens Homosexuality: Facts for Teens Share Print What is sexuality? ... no wrong type of orientation.You may be homosexual if you are attracted to people of the ...

  2. Facts About Usher Syndrome

    Science.gov (United States)

    ... Usher Syndrome > Facts About Usher Syndrome Facts About Usher Syndrome This information was developed by the National Eye ... is the best person to answer specific questions. Usher Syndrome Defined What is Usher syndrome? Usher syndrome is ...

  3. Marijuana: Facts for Teens

    Science.gov (United States)

    ... Publications » Marijuana: Facts for Teens » Letter to Teens Marijuana: Facts for Teens Email Facebook Twitter Letter to ... they once were. Did you know that teen marijuana use has dropped dramatically since the late 1990s? ...

  4. Cocaine (Coke, Crack) Facts

    Science.gov (United States)

    ... That People Abuse » Cocaine (Coke, Crack) Facts Cocaine (Coke, Crack) Facts Listen Cocaine is a white ... Version Download "My life was built around getting cocaine and getting high." ©istock.com/ Marjot Stacey is ...

  5. Chlamydia - CDC Fact Sheet

    Science.gov (United States)

    ... Archive STDs Home Page Bacterial Vaginosis (BV) Chlamydia Gonorrhea Genital Herpes Hepatitis HIV/AIDS & STDs Human Papillomavirus ( ... sheet Pelvic Inflammatory Disease (PID) – CDC fact sheet Gonorrhea – CDC fact sheet STDs Home Page Bacterial Vaginosis ( ...

  6. Meningitis Myths and Facts

    Science.gov (United States)

    ... May 2014) 14 Adult Vaccine-Preventable Diseases Infographic Meningitis Myths and Facts Myth: Meningococcal disease is easy ... infected person, such as shaking hands. Fact: Meningococcal meningitis is spread through air droplets and direct contact ...

  7. Facts about Type 2

    Medline Plus

    Full Text Available ... Text Size: A A A Listen En Español Facts About Type 2 Type 2 diabetes is the ... 2, In this section Diabetes Basics Type 2 Facts About Type 2 Recently Diagnosed Treatment and Care ...

  8. Facts about Presbyopia

    Science.gov (United States)

    ... Information > Refractive Errors > Facts About Presbyopia Facts About Presbyopia This information was developed by the National Eye ... is the best person to answer specific questions. Presbyopia Defined What is presbyopia? Presbyopia is a common ...

  9. Steam by-pass reciprocating rod pump

    Energy Technology Data Exchange (ETDEWEB)

    Waterhouse, B. [Weatherford, Edmonton, AB (Canada)

    2008-07-01

    This article presented the design details of Weatherford's steam by-pass reciprocating rod rod pump which was designed to work under specific well conditions and individual applications, including Imperial Oil's Cold Lake bitumen recovery project located 230 km northeast of Edmonton, Alberta. Imperial Oil uses a cyclic steam stimulation (CSS) process to enhance bitumen recovery from the Clearwater oil sand reservoir. A typical wellbore reach can be up to 700 m and 80 degrees deviation at a target depth of 455 m TVD. These long well bore reaches along with high bottomhole angles and high produced fluid viscosities complicate the design of the artificial lift, which is essentially a modified conventional API pump. The hold-down section is a friction ring design incorporating stainless steel friction rings to provide positive holding force. The steam by-pass coupling is a reduced-diameter tube fitting between the API pump and the friction ring hold-down section. Three stages of the Imperial Cold Lake operation were described, namely the steam injection stage, soak phase stage and production stage. Typically, the steam by-pass pump is suspended in the tubing for the entire cycle. This presentation reviewed the operating steps of the pump, whose average run time in the field is about 15 months, depending on the potential for scaling or sand influx. tab., figs.

  10. Heart bypass surgery - minimally invasive - discharge

    Science.gov (United States)

    Minimally invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole heart surgery - discharge; Coronary artery disease - MIDCAB discharge; CAD - ...

  11. Spiritual Bypass: A Preliminary Investigation

    Science.gov (United States)

    Cashwell, Craig S.; Glosoff, Harriet L.; Hammond, Cheree

    2010-01-01

    The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to…

  12. Variations in dietary intake after bypass surgery for obesity. Possible relation to development of fatty liver after jejunoileal bypass

    Energy Technology Data Exchange (ETDEWEB)

    Rogus, J.; Blumenthal, S.A.

    1981-01-01

    Consumption of nutrients and food energy was compared, with concomitant chemical and radiologic measurements of hepatic fat content, preoperatively and postoperatively in 25 patients who underwent gastric or jejunoileal bypass for obesity. Patients in the two operative groups ingested similar quantities of food before surgery. After surgery, caloric intake from all sources decreased in both groups but to a significantly greater extent in the gastric bypass patients. During the first six months postoperatively, the 13 gastric bypass patients showed no changes in hepatic fat content, whereas substantial increases in liver fat uniformly occurred in the 12 patients who had jejunoileal bypasses. It is suggested that dietary carbohydrate may have contributed to the accretion of liver fat in these 12 patients.

  13. Angina pectoris, one to 10 years after aortocoronary bypass surgery

    NARCIS (Netherlands)

    K. Laird-Meeter; H.J. ten Katen (Harald); R.W. Brower (Ronald); M.J.B.M. van den Brand (Marcel); P.W.J.C. Serruys (Patrick); M.M.P. Haalebos (Max); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1983-01-01

    textabstractThe incidence of angina pectoris (AP) after bypass surgery was assessed in 1041 patients operated on consecutively between 1971 and 1980. Of the 977 survivors, 920 (94%) participated in the study with a followup time varying from 1 to 10 years (mean 3.5 years). Post-operative angina

  14. Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass.

    Science.gov (United States)

    Droeser, Raoul A; Ottosson, Johan; Muth, Andreas; Hultin, Hella; Lindwall-Åhlander, Karin; Bergenfelz, Anders; Almquist, Martin

    2017-03-01

    Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass. The risk of treatment with intravenous calcium during hospital stay, and with oral calcium and vitamin D at 6 weeks and 6 months postoperatively was calculated by using multiple logistic regression in the overall cohort and in a 1:1 nested case-control analysis. We identified 6115 patients treated with total thyroidectomy. Out of these, 25 (0.4 %) had undergone previous gastric bypass surgery. In logistic regression, previous gastric bypass was not associated with treatment with i.v. calcium (OR 2.05, 95 % CI 0.48-8.74), or calcium and/or vitamin D at 6 weeks (1.14 (0.39-3.35), 1.31 (0.39-4.42)) or 6 months after total thyroidectomy (1.71 (0.40-7.32), 2.28 (0.53-9.75)). In the nested case-control analysis, rates of treatment for hypocalcemia were similar in patients with and without previous gastric bypass. Previous gastric bypass surgery was infrequent in patients undergoing total thyroidectomy and was not associated with an increased risk of postoperative hypocalcemia.

  15. Role of ascorbic acid in reduction of the incidence of the atrial fibrillation in patients under B-blocker and undergoing coronary artery bypass graft operation in early post-operative period

    Directory of Open Access Journals (Sweden)

    Moataz E. Rezk, MD

    2017-09-01

    Conclusions: The incidence of post CABG AF, intensive care unit stay, need for inotropic support and ventilator stay were decreased by patients intake of vitamin C in combination with β -blockers pre-operatively.

  16. Aerodynamic/acoustic performance of YJ101/double bypass VCE with coannular plug nozzle

    Science.gov (United States)

    Vdoviak, J. W.; Knott, P. R.; Ebacker, J. J.

    1981-01-01

    Results of a forward Variable Area Bypass Injector test and a Coannular Nozzle test performed on a YJ101 Double Bypass Variable Cycle Engine are reported. These components are intended for use on a Variable Cycle Engine. The forward Variable Area Bypass Injector test demonstrated the mode shifting capability between single and double bypass operation with less than predicted aerodynamic losses in the bypass duct. The acoustic nozzle test demonstrated that coannular noise suppression was between 4 and 6 PNdB in the aft quadrant. The YJ101 VCE equipped with the forward VABI and the coannular exhaust nozzle performed as predicted with exhaust system aerodynamic losses lower than predicted both in single and double bypass modes. Extensive acoustic data were collected including far field, near field, sound separation/ internal probe measurements as Laser Velocimeter traverses.

  17. Electric power supply 3. Dynamics, control and stabililty, quality of supply, grid planning, operational planning and control, control and information technology, FACTS, high-speed transmission. 3. rev. ed.; Elektrische Energieversorgung 3. Dynamik, Regelung und Stabilitaet, Versorgungsqualitaet, Netzplanung, Betriebsplanung und -fuehrung, Leit- und Informationstechnik, FACTS, HGUe

    Energy Technology Data Exchange (ETDEWEB)

    Westermann, Dirk [Technische Univ. Ilmenau (Germany). Inst. fuer elektrische Energie- und Steuerungstechnik; Crastan, Valentin

    2012-07-01

    In view of the large quantity of information, Vol. 2 was divided up into two volumes in the third edition. All three volumes combine theory with practical applicability and present exercises, examples and simulations. The authors have long experience in electric power supply and also teaching experience as university professors. Volume 3, which is published for the first time in the third edition, discusses the following subjects: Control and stability of the power transmission grid, grid planning, operational planning and control, grid control technology, flexible AC transmission systems (FACTS), and high-speed DC transmission systems. [German] Der zweite Band dieses umfassenden Lehr- und Nachschlagewerkes fuer Studenten und Ingenieure in der elektrischen Energietechnik wurde wegen der vielen Erweiterungen in zwei Teile aufgespalten, die fortan als Band 2 und 3 erscheinen. Die drei Baende der ''elektrischen Energieversorgung'' zeichnen sich durch die Synthese von theoretischer Fundierung und unmittelbarem Praxisbezug aus und unterstuetzen das Verstaendnis und den Lernerfolg mit Uebungsaufgaben, Modellbeispielen und Simulationen. Die Autoren schoepfen inhaltlich aus ihrer langjaehrigen Erfahrung auf dem Gebiet der Energieversorgung sowie didaktisch aus ihrer Lehrtaetigkeit als Professoren. Der erstmalig vorliegende dritte Band behandelt die Themen Regelung und Stabilitaet des Energieversorgungnetzes, Netzplanung, Betriebsplanung und -fuehrung, Netzleittechnik sowie Leistungselektronische Netzsteuerung (FACTS) und Hochpannungsgleichstromuebertragung. (orig.)

  18. Off-pump coronary artery bypass grafting in patients with mirror-imaging dextrocardia.

    Science.gov (United States)

    Yuan, Xin; Sun, Hansong; Wang, Xianqiang

    2015-08-01

    Dextrocardia requires alterations in techniques during coronary artery bypass graft (CABG) surgery. We report two cases undergoing off-pump coronary artery bypass graft (OPCAB) surgery and discuss techniques for the operative management of these patients. © 2015 Wiley Periodicals, Inc.

  19. Weight-bearing recommendations after operative fracture treatment-fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole.

    Science.gov (United States)

    Braun, Benedikt J; Veith, Nils T; Rollmann, Mika; Orth, Marcel; Fritz, Tobias; Herath, Steven C; Holstein, Jörg H; Pohlemann, Tim

    2017-08-01

    Rehabilitation after lower-extremity fractures is based on the physicians' recommendation for non-, partial-, or full weight-bearing. Clinical studies rely on this assumption, but continuous compliance or objective loading rates are unknown. The purpose of this study was to determine the compliance to weight-bearing recommendations by introducing a novel, pedobarography system continuously registering postoperative ground forces into ankle, tibial shaft and proximal femur fracture aftercare and test its feasibility for this purpose. In this prospective, observational study, a continuously measuring pedobarography insole was placed in the patients shoe during the immediate post-operative aftercare after ankle, tibial shaft and intertrochanteric femur fractures. Weight-bearing was ordered as per the institutional standard and controlled by physical therapy. The insole was retrieved after a maximum of six weeks (28 days [range 5-42 days]). Non-compliance was defined as a failure to maintain, or reach the ordered weight-bearing within 30%. Overall 30 patients were included in the study. Fourteen (47%) of the patients were compliant to the weight-bearing recommendations. Within two weeks after surgery patients deviated from the recommendation by over 50%. Sex, age and weight did not influence the performance (p > 0.05). Ankle fracture patients (partial weight-bearing) showed a significantly increased deviation from the recommendation (p = 0.01). Our study results show that, despite physical therapy training, weight-bearing compliance to recommended limits was low. Adherence to the partial weight-bearing task was further decreased over time. Uncontrolled weight-bearing recommendations should thus be viewed with caution and carefully considered as fiction. The presented insole is feasible to determine weight bearing continuously, could immediately help define real-time patient behaviour and establish realistic, individual weight-bearing recommendations.

  20. Robotically assisted totally endoscopic coronary artery bypass surgery

    Science.gov (United States)

    Canale, Leonardo Secchin; Mick, Stephanie; Mihaljevic, Tomislav; Nair, Ravi

    2013-01-01

    Robotically assisted totally endoscopic coronary artery bypass surgery has emerged as a feasible and efficient alternative to conventional full sternotomy coronary artery bypass graft surgery in selected patients. This minimally invasive approach using the daVinci robotic system allows fine intrathoracic maneuvers and excellent view of the coronary arteries. Both on-pump and off-pump operations can be performed to treat single and multivessel disease. Hybrid approaches have the potential of offering complete revascularization with the “best of both worlds” from surgery (internal mammary artery anastomosis in less invasive fashion) and percutaneous coronary intervention (least invasive approach). In this article we review the indications, techniques, short and long term results, as well as current developments in totally endoscopic robotic coronary artery bypass operations. PMID:24251021

  1. Reconnaissance Report Yolo Bypass, California

    National Research Council Canada - National Science Library

    1992-01-01

    The purpose of this study was to investigate flooding and related water resources problems associated with the Yolo Bypass and determine the Federal interest in proceeding into feasibility phase studies...

  2. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass surgery - minimally invasive - discharge Heart disease - risk factors Heart pacemaker - discharge ...

  3. High Blood Pressure Facts

    Science.gov (United States)

    ... Stroke Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN High Blood Pressure Facts Recommend on Facebook Tweet Share Compartir On ... the facts about high blood pressure [PDF-255K] . High Blood Pressure in the United States About 75 million American ...

  4. Assessing Basic Fact Fluency

    Science.gov (United States)

    Kling, Gina; Bay-Williams, Jennifer M.

    2014-01-01

    In this article, the authors share a variety of ways to formatively assess basic fact fluency. The define fluency, raise some issues related to timed testing, and then share a collection of classroom-tested ideas for authentic fact fluency assessment. This article encourages teachers to try a variety of alternative assessments from this sampling,…

  5. Type 1 Diabetes Facts

    Science.gov (United States)

    ... Contact Us Donate Events More Type 1 Diabetes Facts Type 1 diabetes (T1D) is an autoimmune disease ... of T1D The Complexity of Diagnosing T1D T1D Facts Insulin Types and Usage T1D Treatments Sign up ...

  6. Meth (Crank, Ice) Facts

    Science.gov (United States)

    ... That People Abuse » Meth (Crank, Ice) Facts Meth (Crank, Ice) Facts Listen Methamphetamine—meth for short—is a white, bitter powder. Sometimes ... clear or white shiny rock (called a crystal). Meth powder can be eaten or snorted up the ...

  7. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download the Infographic: English Spanish Share the facts: Quick Facts Prevalence Mortality Caregivers Costs Special Report Alzheimer's in each state Quick Facts ...

  8. Avian Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    NWCC Wildlife Work Group

    2004-12-01

    OAK-B135 After conducting four national research meetings, producing a document guiding research: Metrics and Methods for Determining or Monitoring Potential Impacts on Birds at Existing and Proposed Wind Energy Sites, 1999, and another paper, Avian Collisions with Wind Turbines: A Summary of Existing Studies and Comparisons to Other Sources of Avian Collision Mortality in the United States, 2001, the subcommittee recognized a need to summarize in a short fact sheet what is known about avian-wind interaction and what questions remain. This fact sheet attempts to summarize in lay terms the result of extensive discussion about avian-wind interaction on land. This fact sheet does not address research conducted on offshore development. This fact sheet is not intended as a conclusion on the subject; rather, it is a summary as of Fall/Winter 2002.

  9. Facts about Type 2

    Medline Plus

    Full Text Available ... In Honor Become a Member En Español Type 1 Type 2 About Us Online Community Meal Planning ... Basics Home Symptoms Diagnosis America's Diabetes Challenge Type 1 Type 2 Facts About Type 2 Enroll in ...

  10. Sepsis Fact Sheet

    Science.gov (United States)

    ... Education About NIGMS NIGMS Home > Science Education > Sepsis Sepsis Tagline (Optional) Middle/Main Content Area PDF Version ( ... KB) En español Other Fact Sheets What is sepsis? Sepsis is a serious medical condition. It is ...

  11. Blood Facts and Statistics

    Science.gov (United States)

    ... Donor Community Learn About Blood Blood Facts and Statistics Blood Types Blood Components What Happens to Donated Blood Blood and Diversity History of Blood Transfusion Iron and Blood Donation Hosting ...

  12. Facts about Hypospadias

    Science.gov (United States)

    ... label> Information For… Media Policy Makers Facts about Hypospadias Language: English (US) Español (Spanish) Recommend on Facebook ... at the tip of the penis. What is Hypospadias? Hypospadias is a birth defect in boys in ...

  13. Trauma Fact Sheet

    Science.gov (United States)

    ... NIGMS NIGMS Home > Science Education > Physical Trauma Physical Trauma Tagline (Optional) Middle/Main Content Area PDF Version (572 KB) Other Fact Sheets What is physical trauma? Physical trauma is a serious injury to the ...

  14. Burns Fact Sheet

    Science.gov (United States)

    ... of most of these problems is the body’s explosive inflammatory response. A normal inflammatory response protects the ... your website or other digital platform? This fact sheet and others are available for syndication through the ...

  15. Facts about Type 2

    Medline Plus

    Full Text Available ... Know Your Risk Alert Day Diabetes Basics Home Symptoms Diagnosis America's Diabetes Challenge Type 1 Type 2 Facts ... Online Community Site Menu Are You at Risk? Diagnosis Lower Your Risk Risk Test Alert Day Prediabetes ...

  16. CMS Fast Facts

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS has developed a new quick reference statistical summary on annual CMS program and financial data. CMS Fast Facts includes summary information on total program...

  17. Facts about Benzene

    Science.gov (United States)

    ... phosphorus List by Category Chemical-Specific Fact Sheets Toxicology FAQs Case Definitions Toxic Syndrome Descriptions Toxicological Profiles ... types of lubricants, rubbers, dyes, detergents, drugs, and pesticides. How you could be exposed to benzene Outdoor ...

  18. Childhood Obesity Facts

    Science.gov (United States)

    ... Breastfeeding Micronutrient Malnutrition State and Local Programs Childhood Obesity Facts Recommend on Facebook Tweet Share Compartir On ... Children (WIC) Program, 2000–2014 Prevalence of Childhood Obesity in the United States, 2011-2014 Childhood obesity ...

  19. Silicosis: Learn the Facts!

    Science.gov (United States)

    Silicosis: Learn the Facts! Do you work in construction or do abrasive blasting? Do you know someone ... document. 3 Safety Information For more information on silicosis and how it can affect you and your ...

  20. Facts about Type 2

    Medline Plus

    Full Text Available ... Type 2 About Us Online Community Meal Planning Sign In Search: Search More Sites Search ≡ Are You ... Your Risk Alert Day Diabetes Basics Home Symptoms Diagnosis America's Diabetes Challenge Type 1 Type 2 Facts ...

  1. Facts about Pulmonary Atresia

    Science.gov (United States)

    ... Websites Information For… Media Policy Makers Facts about Pulmonary Atresia Recommend on Facebook Tweet Share Compartir Click ... pick up oxygen for the body. What is Pulmonary Atresia? Pulmonary atresia is a birth defect of ...

  2. Facts about Type 2

    Medline Plus

    Full Text Available ... Forecast® magazine: lp-type-2, In this section Diabetes Basics Type 2 Facts About Type 2 Recently Diagnosed Treatment and Care Blood Glucose Control Complications Medication Doctors, ...

  3. Cholesterol Facts and Statistics

    Science.gov (United States)

    ... Blood Pressure Salt Million Hearts® WISEWOMAN Program High Cholesterol Facts Recommend on Facebook Tweet Share Compartir Find ... about high cholesterol in the United States. High Cholesterol in the United States In 2011–2012, 78 ...

  4. Facts about Physical Activity

    Science.gov (United States)

    ... Micronutrient Malnutrition State and Local Programs Facts about Physical Activity Recommend on Facebook Tweet Share Compartir Some Americans ... Activity Guideline for aerobic activity than older adults. Physical activity and socioeconomic status Adults with more education are ...

  5. SEER Cancer Stat Facts

    Science.gov (United States)

    Cancer Statistical Fact Sheets are summaries of common cancer types developed to provide an overview of frequently-requested cancer statistics including incidence, mortality, survival, stage, prevalence, and lifetime risk.

  6. Organ Facts: Pancreas

    Science.gov (United States)

    ... Page Transplant Living > Organ facts and surgeries > Pancreas Pancreas Beneath your ribs, you’ll find the pancreas, ... shape. Location of the pancreas How does the pancreas work? The pancreas controls your sugar levels and ...

  7. Predicting the need for blood during cardiopulmonary bypass ...

    African Journals Online (AJOL)

    Methods: An equation for prediction of HctCPB (Hctpred), based on weight and pre-operative haemoglobin concentration was used to forecast which patients would develop HctCPB < 20%. ... Key Words: Haematocrit, Blood transfusion, Autologous, Cardiopulmonary bypass, ROC curve, Predictive value of tests. Southern ...

  8. Biodiesel Basics (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-06-01

    This fact sheet provides a brief introduction to biodiesel, including a discussion of biodiesel blends, which blends are best for which vehicles, where to buy biodiesel, how biodiesel compares to diesel fuel in terms of performance, how biodiesel performs in cold weather, whether biodiesel use will plug vehicle filters, how long-term biodiesel use may affect engines, biodiesel fuel standards, and whether biodiesel burns cleaner than diesel fuel. The fact sheet also dismisses the use of vegetable oil as a motor fuel.

  9. [Suicide, a social fact].

    Science.gov (United States)

    Baudelot, Christian

    2017-04-01

    Treating suicide as a social fact means disregarding its individual and dramatic dimensions. Sociologists do not reason on the basis of specific cases but by studying the variations, in space and time, of suicide rates. Their contribution relates essentially to a renewed perspective on society: suicide is in fact a very accurate indicator of the intensity and quality of the bonds which unite or isolate individuals in a society. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Results of revisional operation following vertical banded gastroplasty performed due to morbid obesity--comparison between restoration of vertical banded gastroplasty and conversion of gastric bypass up to three years.

    Science.gov (United States)

    Wylezol, M; Pardela, M

    2005-12-01

    The aim of this study was to analyse incidence and efficacy of revisional surgery for failed vertical banded gastroplasty among 458 patients who underwent primary surgery between 1993 and 2003. Staple line disruption was diagnosed in 29 patients and was an indication for restoration of gastroplasty in 10 cases and a conversion to Roux-en-Y gastric bypass in 19 patients. In two cases of outlet stenosis the band was exchanged to enlarge the collar. In two cases of psychological intolerance of restriction the band was removed because of refusion by patients the conversion to Roux-en-Y gastric bypass. A substantial weight reduction without statistical differences between restoration and conversion group was recognized. In two patients (20%) after restoration and three patients (15.8%) after conversion we observed weight regain (p=0.57). In cases with removed band weight regained up to its value recorded before surgery. In patients with exchanged band weight was under control. No serious complications were observed. We could conclude that patients with weight regain after vertical banded gastroplasty should be offered conversion to Roux-en-Y gastric bypass. When malabsorption is refused, restoration of vertical banded gastroplasty could be also performed. Both of procedures are technically difficult but safe.

  11. USSOCOM Fact Book: Special Operations Forces

    Science.gov (United States)

    2010-01-01

    Coronado, Calif. • SEAL Teams 1/3/5/7 — Coronado, Calif. • NSWU 1 — Guam • NSWU 3 — ASU Bahrain  Naval Special Warfare Group 2 – Little Creek, Va...a multitude of weapons and is fitted with a modular armor kit. Depending on the mission, armor can be added or removed to either increase speed and

  12. Atrial Fibrillation, Neurocognitive Decline and Gene Expression After Cardiopulmonary Bypass.

    Science.gov (United States)

    Dalal, Rahul S; Sabe, Ashraf A; Elmadhun, Nassrene Y; Ramlawi, Basel; Sellke, Frank W

    2015-01-01

    Atrial fibrillation and neurocognitive decline are common complications after cardiopulmonary bypass. By utilizing genomic microarrays we investigate whether gene expression is associated with postoperative atrial fibrillation and neurocognitive decline. Twenty one cardiac surgery patients were prospectively matched and underwent neurocognitive assessments pre-operatively and four days postoperatively. The whole blood collected in the pre-cardiopulmonary bypass, 6 hours after-cardiopulmonary bypass, and on the 4th postoperative day was hybridized to Affymetrix Gene Chip U133 Plus 2.0 Microarrays. Gene expression in patients who developed postoperative atrial fibrillation and neurocognitive decline (n=6; POAF+NCD) was compared with gene expression in patients with postoperative atrial fibrillation and normal cognitive function (n=5; POAF+NORM) and patients with sinus rhythm and normal cognitive function (n=10; SR+NORM). Regulated genes were identified using JMP Genomics 4.0 with a false discovery rate of 0.05 and fold change of >1.5 or cardiopulmonary bypass, and 34 named genes four days postoperatively (Pcardiopulmonary bypass may have differential genomic responses compared to normal patients and patients with only postoperative atrial fibrillation, suggesting common pathophysiology for these conditions. Further exploration of these genes may provide insight into the etiology and improvements of these morbid outcomes.

  13. Neuroprotective Strategies during Cardiac Surgery with Cardiopulmonary Bypass

    Science.gov (United States)

    Salameh, Aida; Dhein, Stefan; Dähnert, Ingo; Klein, Norbert

    2016-01-01

    Aortocoronary bypass or valve surgery usually require cardiac arrest using cardioplegic solutions. Although, in principle, in a number of cases beating heart surgery (so-called off-pump technique) is possible, aortic or valve surgery or correction of congenital heart diseases mostly require cardiopulmonary arrest. During this condition, the heart-lung machine also named cardiopulmonary bypass (CPB) has to take over the circulation. It is noteworthy that the invention of a machine bypassing the heart and lungs enabled complex cardiac operations, but possible negative effects of the CPB on other organs, especially the brain, cannot be neglected. Thus, neuroprotection during CPB is still a matter of great interest. In this review, we will describe the impact of CPB on the brain and focus on pharmacological and non-pharmacological strategies to protect the brain. PMID:27879647

  14. Shoulder arthroplasty following gastric bypass, do complications follow?

    Science.gov (United States)

    Schoch, Bradley S; Aibinder, William R; Werthel, Jean-David; Sperling, John W; Sanchez-Sotelo, Joaquin; Cofield, Robert H

    2018-02-01

    Previous reports have shown an increased risk of complications after arthroplasty in the obese population. It remains unclear if gastric bypass surgery prior to shoulder arthroplasty modifies the complication and failure rate. The purpose of this study is to assess the complication and re-operation rates following shoulder arthroplasty in this population. Between 2002 and 2012, 39 shoulders with prior gastric bypass underwent shoulder arthroplasty (3 HA, 16 TSA, 20 RSA). The mean time from the gastric bypass to arthroplasty was 13 years (range, 0.7-32). Shoulders were followed for a minimum of two years (mean, 3.8 years) or until re-operation. Outcome measures included pain, range of motion, satisfaction, modified Neer ratings, and ASES scores. Complications occurred in seven shoulders (18%), with five requiring re-operation. There was no common failure mechanism. Re-operations occurred for aseptic glenoid loosening, periprosthetic fracture, and unexplained pain. Those shoulders with complications were similar to those without in regard to age, sex, and BMI. Complications were more common following anatomic arthroplasty compared to reverse arthroplasty (5 vs 1, p = 0.06); however, complications were not improved compared to historical controls with morbid obesity. Overall, pain improved significantly from 4.8 pre-operatively to 2.3 postoperatively (p bypass surgery prior to shoulder arthroplasty leads to clinical improvement in both pain and range of motion. Prior gastric bypass surgery does not result in a lower surgical complication rate compared to previously published reports in the morbidly obese population. Level 4, case series.

  15. Secondary and College LD Bypass Strategies.

    Science.gov (United States)

    Mosby, Robert J.

    1981-01-01

    The author describes the Developmental By-Pass (DBP) Instructional technology for teaching secondary and college learning disabled (LD) students by allowing students to bypass ordering and organizational deficits. (SB)

  16. In situ bypass og diabetes

    DEFF Research Database (Denmark)

    Jensen, Leif Panduro; Schroeder, T V; Lorentzen, J E

    1993-01-01

    From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p...... decreased survival rate was found in diabetics (p bypass technique very useful in the treatment of critical ischaemia of the lower limb in diabetic patients. The overall results in diabetic patients, whether insulin-dependent or not, were equal to those in non...

  17. Feasibility and safety of minimized cardiopulmonary bypass in major aortic surgery.

    Science.gov (United States)

    Momin, Aziz U; Sharabiani, Mansour T A; Kidher, Emadin; Najefi, Ali; Mulholland, John W; Reeves, Barnaby C; Angelini, Gianni D; Anderson, Jon R

    2013-10-01

    Conventional cardiopulmonary bypass causes haemodilution and is a trigger of systemic inflammatory reactions, coagulopathy and organ failure. Miniaturized cardiopulmonary bypass has been proposed as a way to reduce these deleterious effects of conventional cardiopulmonary bypass and to promote a more physiological state. The use of miniaturized cardiopulmonary bypass has been reported in low-risk patients undergoing valve and coronary artery bypass graft (CABG) surgery. However, little is known about its application in major aortic surgery. From February 2007 to September 2010, 49 patients underwent major aortic surgery using the Hammersmith miniaturized cardiopulmonary bypass (ECCO, Sorin). Data were extracted from medical records to characterize preoperative comorbidities (EuroSCORE), perioperative complications and the use of blood products. The same data were collected and described for 328 consecutive patients having similar surgery with conventional cardiopulmonary bypass at the Bristol Heart Institute, our twinned centre, during the same period. The miniaturized cardiopulmonary bypass group had a median EuroSCORE of 8 [inter-quartile range (IQR): 5-11], 13% had preoperative renal dysfunction and 20% of operations were classified as emergency or salvage. Thirty-day mortalities were 6.4; and 69, 67 and 74% had ≥ 1 unit of red cells, fresh frozen plasma (FFP) and platelets transfused, respectively. Eight percent of patients experienced a renal complication, and 8% a neurological complication. The conventional cardiopulmonary bypass group was similar, with a EuroSCORE of 8 (IQR: 6-10); 30-day mortalities were 9.4; and 68, 62 and 74% had ≥ 1 unit of red cells, FFP and platelets transfused, respectively. The proportions experiencing renal and neurological complications were 14 and 5%. Our experience suggests that miniaturized cardiopulmonary bypass is safe and feasible for use in major aortic cardiac surgery. A randomized trial is needed to evaluate

  18. Undiagnosed phaeochromocytoma following infrainguinal bypass surgery

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1998-01-01

    We present a rare case of undiagnosed phaeochromocytoma following infrainguinal bypass surgery. The patient, a 59-year-old lady, had a one year history of hypertension following a first femoro-tibial bypass and presented as a cardiorespiratory emergency in the admission room following her...... contralateral femoro-tibial bypass. The patient recovered after some days in intensive care despite a delayed diagnosis....

  19. Facts about Type 2

    Medline Plus

    Full Text Available ... Membership Please Join Us in the Fight for a Cure Your tax-deductible gift today can fund ... A A Listen En Español Facts About Type 2 Type 2 diabetes is the most common form ...

  20. Facts & Impacts, 2003.

    Science.gov (United States)

    Columbia Basin Coll., Pasco, WA.

    This fact book for Columbia Basin College (CBC), Washington, opens with a message from CBC's president and a mission statement. CBC serves over 13,000 students and offers associate degrees in arts and science, as well as applied science. The document also offers information regarding staff and faculty profiles for 2002, degrees awarded, top 5 hot…

  1. Ethanol Basics (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  2. NASA Facts, The Countdown.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC.

    This pamphlet describes the preparations for launching a giant Atlas, Gemini (Titan 11), or Saturn launch vehicle. The material is intended for use in elementary general science. The pamphlet is one of the NASA Facts Science Series (each of which consists of four pages) and is designed to fit in the standard size three-ring notebook. Review…

  3. NASA Facts, Weightlessness.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC.

    Weightlessness and how it can be artificially produced is described in this pamphlet written for junior high school students. The pamphlet is one of the NASA Facts Science Series (each of which consists of four pages) and is designed to fit in the standard size three-ring notebook. Review questions, suggested activities, and references are…

  4. Facts about Type 2

    Medline Plus

    Full Text Available ... Alert Day Diabetes Basics Home Symptoms Diagnosis America's Diabetes Challenge Type 1 Type 2 Facts About Type 2 Enroll in ... Where Do I Begin With Type2? Living With Type 1 Diabetes Enroll in the Living WIth Type 2 Diabetes ...

  5. NASA Facts, Solar Cells.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC.

    The design and function of solar cells as a source of electrical power for unmanned space vehicles is described in this pamphlet written for high school physical science students. The pamphlet is one of the NASA Facts Science Series (each of which consists of four pages) and is designed to fit in the standard size three-ring notebook. Review…

  6. Diet myths and facts

    Science.gov (United States)

    ... yourself to healthy snacks such as low-fat yogurt or baby carrots. MYTH? You cannot be overweight and healthy. FACT: There are some people who are overweight with healthy blood pressure, cholesterol, and blood sugar levels. For most people, excess ...

  7. Respirator Fact Sheet

    Science.gov (United States)

    ... wear the escape hood and get the expected protection? Respirator Fact Sheet [PDF - 706 KB] Follow NIOSH Facebook Flickr Pinterest Twitter ... PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Microsoft PowerPoint file Microsoft Word ... last updated: June 6, 2014 Content source: National Institute for Occupational Safety and Health Education ...

  8. Facts about Vitamin K

    Science.gov (United States)

    Facts about Vitamin K 1 R. Elaine Turner and Wendy J. Dahl 2 FCS8666 Figure 1. Vitamin K is mostly found in vegetables, especially green ... ColognePhotos/iStock/Thinkstock, © ColognePhotos Why do we need vitamin K? Vitamin K is one of the fat- ...

  9. Facts about Vitamin C

    Science.gov (United States)

    Facts about Vitamin C 1 Linda B. Bobroff and Isabel Valentín-Oquendo 2 FCS8702 Why do we need vitamin C? Vitamin C, also known as ascorbic acid, has a ... keep body tissues and the immune system healthy. Vitamin C also helps the body absorb iron from ...

  10. Facts about Type 2

    Medline Plus

    Full Text Available ... Patient Education Materials — Taking Care of Type 2 Diabetes This two-page introduction to type 2 diabetes is in ... Forecast® magazine: lp-type-2, In this section Diabetes Basics Type 2 Facts About Type 2 Recently Diagnosed Treatment and ...

  11. Nuclear fact book

    Energy Technology Data Exchange (ETDEWEB)

    Hill, O. F.; Platt, A. M.; Robinson, J. V. [comps

    1983-05-01

    This reference provides significant highlights and summary facts in the following areas: general energy; nuclear energy; nuclear fuel cycle; uranium supply and enrichment; nuclear reactors; spent fuel and advanced repacking concepts; reprocessing; high-level waste; gaseous waste; transuranic waste; low-level waste; remedial action; transportation; disposal; radiation information; environment; legislation; socio-political aspects; conversion factors; and a glossary. (GHT)

  12. Gun Sales. Firearm Facts.

    Science.gov (United States)

    Duker, Laurie, Ed.

    Minimal federal regulations on firearm sales have facilitated the proliferation of guns, gun owners, and gun dealers in the United States. This fact sheet offers data on the growing number of firearm dealers, the relative ease of obtaining and keeping a license to sell guns from the Federal Bureau of Alcohol, Tobacco, and Firearms, the lack of…

  13. Mastering the Multiplication Facts

    Science.gov (United States)

    D'Ettorre, Jenna

    2009-01-01

    The purpose of this paper is to share the results of a six-week research project (after baseline data was collected) that focused on three different strategies (flashcards, interactive games, and music) and their effectiveness in helping fifth grade students memorize the basic multiplication facts. Many teachers face a serious problem when their…

  14. Facts about Omphalocele

    Science.gov (United States)

    ... label> Information For… Media Policy Makers Facts about Omphalocele Language: English (US) Español (Spanish) Recommend on ... hardly ever is open or broken. What is Omphalocele? Omphalocele, also known as exomphalos, is a birth ...

  15. Effects of diabetes and cardiopulmonary bypass on expression of adherens junction proteins in human peripheral tissue.

    Science.gov (United States)

    Feng, Jun; Liu, Yuhong; Singh, Arun K; Ehsan, Afshin; Sellke, Nicholas; Liang, Justin; Sellke, Frank W

    2017-03-01

    We investigated the changes in adherens junction proteins, such as vascular endothelial-cadherin and β-catenin, of skeletal muscle and vessels in patients with or without diabetes in the setting of cardiopulmonary bypass and cardiac operation. Skeletal muscle tissue samples were harvested pre- and post-cardiopulmonary bypass from nondiabetic (hemoglobin A1c: 5.4 ± 0.1), controlled diabetic (hemoglobin A1c: 6.3 ± 0.1), and uncontrolled diabetic patients (hemoglobin A1c: 9.6 ± 0.3) undergoing coronary artery bypass grafting operation (n = 8 per group). The expression/phosphorylation of adherens junction proteins vascular endothelial-cadherin and β-catenin were assessed by immunoblotting and immuno-histochemistry. Endothelial function of skeletal muscle arterioles was determined by videomicroscopy in response to the vasodilator substance P. The protein expression of total vascular endothelial-cadherin was not changed at baseline or between pre-and post-cardiopulmonary bypass among groups. The pre-cardiopulmonary bypass level of phospho-vascular endothelial-cadherin was found to be significantly increased in the uncontrolled diabetic patients group compared with the nondiabetic or controlled diabetic groups (P cardiopulmonary bypass levels of phospho-vascular endothelial-cadherin were significantly increased compared with pre-cardiopulmonary bypass in all groups (P cardiopulmonary bypass in all 3 groups (P cardiopulmonary bypass in all 3 groups (P cardiopulmonary bypass. The enhanced phosphorylation of vascular endothelial-cadherin and degradation of β-catenin indicate deterioration of these proteins and damage of the cell-cell endothelial junctions, specifically in the diabetic peripheral vessels. These alterations may contribute to the increases in peripheral vascular permeability and endothelial dysfunction. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Deep-water sediment bypass

    NARCIS (Netherlands)

    Stevenson, Christopher J.; Jackson, Christopher A L; Hodgson, David M.; Hubbard, Stephen M.; Eggenhuisen, Joris T.|info:eu-repo/dai/nl/322850274

    Submarine gravity flows are a key process for transporting large volumes of sediment from the continents to the deep sea. The location, volume, and character of the sediment bypassed by these flows dictates the areal extent and thickness of the associated deposits. Despite its importance, sediment

  17. Outcomes of coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Anna Louise Hawkes

    2006-12-01

    Full Text Available Anna Louise Hawkes1,3, Madeleine Nowak1, Benjamin Bidstrup2, Richard Speare11School of Public Health, Tropical, Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia (3Currently Queensland Cancer Fund; 2John Flynn Hospital, Gold Coast, Queensland, AustraliaAbstract: This review article summarizes the major studies that have investigated the outcomes of coronary artery bypass graft surgery (CABG. The article includes a review of the literature in the areas of: history of CABG; indications for CABG; and measurement of quality of life following CABG, including prolongation of life, physical functioning (ie, relief from angina and dyspnea, physical activity, as well as complications of surgery and re-hospitalization, psychological functioning, and social functioning. Overall, the literature demonstrates that the outcomes of CABG have historically been measured in terms of mortality and morbidity; however, it has now been well recognized that adjustment to CABG is a multidimensional phenomenon that is not fully explained by medical factors. Therefore, in addition to studying mortality and morbidity outcomes following CABG, many recent studies have identified that it is important to investigate various physical, psychological, and social variables that have a significant impact on post-operative adjustment to CABG. Keywords: coronary artery bypass graft surgery, outcomes, quality of life, recovery

  18. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... with Alzheimer's >> Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download the Infographic: English Spanish Share the facts: Quick Facts Prevalence Mortality Caregivers ...

  19. Brain Aneurysm Statistics and Facts

    Science.gov (United States)

    ... Statistics and Facts A- A A+ Brain Aneurysm Statistics and Facts An estimated 6 million people in ... Understanding the Brain Warning Signs/ Symptoms Brain Aneurysm Statistics and Facts Seeking Medical Attention Risk Factors Aneurysm ...

  20. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download the Infographic: English Spanish Share the facts: Quick Facts Prevalence Mortality Caregivers Costs Special Report Alzheimer's in each state Quick ...

  1. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download the ... Costs Special Report Alzheimer's in each state Quick Facts Share the facts: Prevalence The number of Americans ...

  2. Facts about Measles for Adults

    Science.gov (United States)

    ... a Glance Adolescent Vaccination Recommendation: MMR About Measles Facts about Measles for Adults What is measles? Measles ... are pregnant or severely immunosuppressed. Disease and vaccine facts FACT: Measles can be prevented with a safe ...

  3. Concentrating Solar Power Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-12-01

    This fact sheet is an overview of the Concentrating Solar Power (CSP) subprogram at the U.S. Department of Energy SunShot Initiative. CSP is a dispatchable, renewable energy option that uses mirrors to focus and concentrate sunlight onto a receiver, from which a heat transfer fluid carries the intense thermal energy to a power block to generate electricity. CSP systems can store solar energy to be used when the sun is not shining. It will help meet the nation’s goal of making solar energy fully cost-competitive with other energy sources by the end of the decade. Worldwide, CSP activity is rapidly scaling, with approximately 10 gigawatts (GW) in various stages of operation or development. In the United States alone, nearly 2 GW of CSP are in operation.

  4. Biomolecular Science (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2012-04-01

    A brief fact sheet about NREL Photobiology and Biomolecular Science. The research goal of NREL's Biomolecular Science is to enable cost-competitive advanced lignocellulosic biofuels production by understanding the science critical for overcoming biomass recalcitrance and developing new product and product intermediate pathways. NREL's Photobiology focuses on understanding the capture of solar energy in photosynthetic systems and its use in converting carbon dioxide and water directly into hydrogen and advanced biofuels.

  5. Honda Civic fact sheet

    Energy Technology Data Exchange (ETDEWEB)

    NREL

    1999-05-01

    The U.S. Department of Energy (DOE) is promoting the use of alternative fuels and alternative fuel vehicles (AFVs). The National Renewable Energy Laboratory (NREL) has been directed to conduct projects to evaluate the performance and acceptability of light-duty AFVs. This fact sheet describes the test results on 1998 Honda Civics: one dedicated CNG and a gasoline model as closely matched as possible.

  6. Faith, Fact, and Behaviorism.

    Science.gov (United States)

    Staddon, J E R

    2013-01-01

    David Hume argued that ought cannot be derived from is. That is, no set of facts, no amount of scientific knowledge, is by itself sufficient to urge us to action. Yet generations of well-meaning scientists (more and more as secular influences grow in the West) seem to have forgotten Hume's words of wisdom. All motivated action depends ultimately on beliefs that cannot be proved by the methods of science, that is, on faith.

  7. Facts controllers in power transmission and distribution

    CERN Document Server

    Padiyar, KR

    2007-01-01

    About the Book: The emerging technology of Flexible AC Transmission System (FACTS) enables planning and operation of power systems at minimum costs, without compromising security. This is based on modern high power electronic systems that provide fast controllability to ensure ''flexible'' operation under changing system conditions. This book presents a comprehensive treatment of the subject by discussing the operating principles, mathematical models, control design and issues that affect the applications. The concepts are explained often with illustrative examples and case studies. In partic

  8. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

    Full Text Available Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability.

  9. Fact Book 2012

    Science.gov (United States)

    2012-01-01

    Environments and Simulation MS Network Operations MS Operations Research MS Operations Research (Energy) MS Remote Sensing Intelligence MS Software...1 Georgia 1 Germany 13 Greece 23 Hungary 1 Latvia 2 Lithuania 1 Moldova 1 Netherlands 1 Norway 7 Romania 1 Serbia 2 Slovakia 1 Sweden 3 Turkey 58...Ukraine 2 Total 121 FAR/NEAR EAST India 2 Japan 1 Korea 4 Malaysia 1 Maldives 1 Nepal 1 Philippine 1 Singapore 41 Sri Lanka 3 Taiwan 14 Thailand 1 Total

  10. Chernobyl: the facts

    Energy Technology Data Exchange (ETDEWEB)

    Stanbridge, R. (Stockholm Univ. (Sweden) Dept. of Journalism, Media and Communication Studies)

    1993-08-01

    In these Search Strategies, searchers from different countries and professions are given a question to answer, a budget of Pounds 50 and a time in which to produce their report. We hope that these blow-by-blow accounts, together with the hints and tips picked up along the way, will help readers to develop their own search strategies. Journalists are more and more coming to use online services and here the author gives a journalist's account of tracking down the elusive facts surrounding the Chernobyl disaster. (author).

  11. Insulation fact sheet

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    Electricity bills, oil bills, gas bills - all homeowners pay for one or more of these utilities, and wish they paid less. Often many of us do not really know how to control or reduce our utility bills. We resign ourselves to high bills because we think that is the price we have to pay for a comfortable home. We encourage our children to turn off the lights and appliances, but may not recognize the benefits of insulating the attic. This publication provides facts relative to home insulation. It discusses where to insulate, what products to use, the decision making process, installation options, and sources of additional information.

  12. Arteriosclerosis: facts and fancy.

    Science.gov (United States)

    Fishbein, Michael C; Fishbein, Gregory A

    2015-01-01

    Arterial vascular diseases comprise the leading cause of death in the industrialized world. Every physician learns about the pathology of these diseases in medical school. All pathologists evaluate arterial disease in surgical pathology and/or autopsy specimens. All clinicians encounter patients with clinical manifestations of these diseases. With such a common and clinically-important group of entities one would think there would be a general understanding of the "known" information that exists. That is, physicians and scientists should be able to separate what is fact and what is fancy. This review article is intended to generate thought in this regard. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Arrhythmias after coronary bypass surgery.

    OpenAIRE

    Ormerod, O J; McGregor, C G; Stone, D L; Wisbey, C; Petch, M C

    1984-01-01

    Ninety patients undergoing coronary bypass surgery were studied prospectively by bedside and subsequent ambulatory electrocardiographic monitoring to investigate the incidence, possible causes, and prevention of atrial fibrillation. Patients with good left ventricular function were divided randomly into a control group or groups treated with digoxin or propranolol. In the control group the incidence of atrial fibrillation was 27% and of significant ventricular extrasystoles 3%. Propranolol re...

  14. Water: Facts without Myths

    Directory of Open Access Journals (Sweden)

    Marc Henry

    2009-08-01

    Full Text Available Among all the chemical substances available in the universe, water, with its deceptively simple formula H2O, is the most discussed subject either in science or in philosophy [1]. If you are not convinced by this affirmation, a little experiment at no cost may help you change your mind. Just open your favorite web browser and type the word “water” in any search engine. When I have done that using Google, the number of hits was about 682,000,000 (please do not try to read all the pages. In fact, the only words that seem to beat water at this little game are “air” (770,000,000 hits with Google and 3,120,000,000 with Yahoo, and “food” (689,000,000 hits with Google and 3,820,000,000 with Yahoo. Of course this should not be a surprise, as breathing, eating, drinking just mean that you are a living entity. In fact extending the water search to “eau” (French, “wasser” (German, “agua” (Spanish, Portuguese and “acqua” (Italian leads to 978,900,000 hits under Google and 3,426,000,000 hits under Yahoo, showing now that water is about as important as food. After all, as everybody knows, “water is life”, and do we really have to read about one billion documents to know at least what water really is? [...

  15. Superior epigastric artery pseudoaneurysm- a rare complication of chest drain insertion in coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Ward Nick

    2007-04-01

    Full Text Available Abstract Background Although chest drain insertion during coronary artery bypass grafting is a fairly standard procedure, however it may result in extremely rare complications. Case presentation This is the first case being reported that demonstrates a pseudoaneurysm of superior epigastric artery resulting from chest drain insertion following coronary artery bypass grafting. Conclusion Adequate caution should be used along with good understanding of the anatomical landmarks during apparently simple and standard operative procedures.

  16. Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience.

    Science.gov (United States)

    Coggia, Marc; Javerliat, Isabelle; Di Centa, Isabelle; Colacchio, Giovanni; Leschi, Jean Pascal; Kitzis, Michel; Goëau-Brissonnière, Olivier A

    2004-11-01

    We describe our experience with a new technique of total laparoscopic bypass surgery to treat aortoiliac occlusive lesions. From November 2000 to December 2003, 93 total laparoscopic bypass procedures were performed to treat TASC (TransAtlantic Inter-Society Consensus document) grade C or D aortoiliac occlusive lesions. We also reimplanted 2 inferior mesenteric arteries, and performed 3 prosthesis-superior mesenteric bypasses and 2 suprarenal aorta endarterectomies. Our technique includes a sloping right lateral decubitus installation, which enables a simple transperitoneal left retrocolic or retrorenal approach to the infrarenal abdominal aorta. In patients with a hostile abdomen a retroperitoneal videoscopic approach was used. Aorta-prosthesis laparoscopic anastomoses are performed simply, which averts any trauma to the suture material. Patients included 76 men and 17 women, with median patient age 61 years (range, 38-79 years). The approach to the aorta was always possible, in particular, in obese patients. It enabled stable aortic exposure during performance of the laparoscopic aorta-prosthesis anastomosis. Median operative time was 240 minutes (range, 150-450 minutes). Median aortic clamping time measured to unclamping of the first prosthetic limb was 67.5 minutes (range, 30-135 minutes). Median duration of aorta-prosthesis anastomosis was 30 minutes (range, 12-90 minutes). The longest durations were mainly observed during the learning curve. Thirty-day postoperative mortality was 4% (4 of 93 patients). Two patients died of myocardial infarction. One patient with American Society of Anesthesiologists grade 4 disease operated on to treat critical ischemia died of multiple organ system failure, and 1 patient died of colonic ischemia. Major nonlethal postoperative complications were observed in 4 patients, and included lung atelectasia in 2 patients, graft infection in 1 patient operated on emergently to treat aortic occlusion, and secondary spleen rupture at day

  17. Numerical simulation of an alternative to prevent hydrates formation in a bypass section

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Lucilla Coelho; Oliveira Junior, Joao Americo Aguirre; Fonte, Clarissa Bergman [Engineering Simulation and Scientific Software Ltda. (ESSS), Florianopolis, SC (Brazil); Silva, Fabricio Soares da; Moraes, Carlos Alberto Capela [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    This work presents the use of Computational Fluid Dynamics to evaluate the feasibility of MEG (monoethylene glycol) injection as an alternative to prevent hydrate formation in a bypass section, present in an inlet module of a separation device of a subsea separation system. As the bypass section is open to the main pipeline, MEG will probably be dragged due to secondary flows generated by the main flow stream. The MEG removal rate is estimated, as well as the internal heat transfer between the currents and the heat loss to the external environment in order to estimate the temperature in the equipment. In a first step, the MEG removal was evaluated considering the heat transfer between the liquid phase (composed of water, oil and MEG) and the gas phase as well as the heat transfer by forced convection to the external environment. In a second step, the influence of a thermal insulation layer around the bypass line, reducing the heat loss to the external environment, was studied. Both simulations (with or without thermal insulation) showed the establishment of secondary flows in the open connection between the main line and bypass line, promoting the removal of MEG from the bypass section and enabling other components of the liquid phase and/or gas to enter in the bypass line. This MEG removal is faster when thermal isolation was considered, due to the fact that higher temperatures are established in the bypass, maintaining the liquid phase with lower densities and viscosities. With regard to temperature, the insulation was able to keep higher temperatures at the bypass line than those obtained without insulation, indicating that the combination of MEG injection and thermal insulation may be able to avoid the critical condition for hydrate formation. (author)

  18. Cardiopulmonary bypass for pediatric cardiac surgery.

    Science.gov (United States)

    Hirata, Yasutaka

    2017-11-28

    The management of cardiopulmonary bypass for pediatric cardiac surgery is more challenging than that in adults due to the smaller size, immaturity, and complexity of the anatomy in children. Despite major improvements in cardiopulmonary bypass, there remain many subjects of debate. This review article discusses the physiology of cardiopulmonary bypass for pediatric and congenital heart surgery, including topics related to hemodilution, hypothermia, acid-base strategies, inflammatory response, and myocardial protection.

  19. Psychoacoustics Facts and Models

    CERN Document Server

    Fastl, Hugo

    2007-01-01

    Psychoacoustics – Facts and Models offers a unique, comprehensive summary of information describing the processing of sound by the human hearing system. It includes quantitative relations between sound stimuli and auditory perception in terms of hearing sensations, for which quantitative models are given, as well as an unequalled collection of data on the human hearing system as a receiver of acoustic information. In addition, many examples of the practical application of the results of basic research in fields such as noise control, audiology, or sound quality engineering are detailed. The third edition includes an additional chapter on audio-visual interactions and applications, plus more on applications throughout. Reviews of previous editions have characterized it as "an essential source of psychoacoustic knowledge," "a major landmark ," and a book that "without doubt will have a long-lasting effect on the standing and future evolution of this scientific domain."

  20. Photovoltaics Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-02-01

    This fact sheet is an overview of the Photovoltaics (PV) subprogram at the U.S. Department of Energy SunShot Initiative. The U.S. Department of Energy (DOE)’s Solar Energy Technologies Office works with industry, academia, national laboratories, and other government agencies to advance solar PV, which is the direct conversion of sunlight into electricity by a semiconductor, in support of the goals of the SunShot Initiative. SunShot supports research and development to aggressively advance PV technology by improving efficiency and reliability and lowering manufacturing costs. SunShot’s PV portfolio spans work from early-stage solar cell research through technology commercialization, including work on materials, processes, and device structure and characterization techniques.

  1. Soft Costs Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-05-01

    This fact sheet is an overview of the systems integration subprogram at the U.S. Department of Energy SunShot Initiative. Soft costs can vary significantly as a result of a fragmented energy marketplace. In the U.S., there are 18,000 jurisdictions and 3,000 utilities with different rules and regulations for how to go solar. The same solar equipment may vary widely in its final installation price due to process and market variations across jurisdictions, creating barriers to rapid industry growth. SunShot supports the development of innovative solutions that enable communities to build their local economies and establish clean energy initiatives that meet their needs, while at the same time creating sustainable solar market conditions.

  2. Gastric bypass reduces fat intake and preference

    Science.gov (United States)

    Bueter, Marco; Theis, Nadine; Werling, Malin; Ashrafian, Hutan; Löwenstein, Christian; Athanasiou, Thanos; Bloom, Stephen R.; Spector, Alan C.; Olbers, Torsten; Lutz, Thomas A.

    2011-01-01

    Roux-en-Y gastric bypass is the most effective therapy for morbid obesity. This study investigated how gastric bypass affects intake of and preference for high-fat food in an experimental (rat) study and within a trial setting (human). Proportion of dietary fat in gastric bypass patients was significantly lower 6 yr after surgery compared with patients after vertical-banded gastroplasty (P = 0.046). Gastric bypass reduced total fat and caloric intake (P bypass rats displayed much lower preferences for Intralipid concentrations > 0.5% in an ascending concentration series (0.005%, 0.01%, 0.05%, 0.1%, 0.5%, 1%, 5%) of two-bottle preference tests (P = 0.005). This effect was demonstrated 10 and 200 days after surgery. However, there was no difference in appetitive or consummatory behavior in the brief access test between the two groups (P = 0.71) using similar Intralipid concentrations (0.005% through 5%). Levels of glucagon-like peptide-1 (GLP-1) were increased after gastric bypass as expected. An oral gavage of 1 ml corn oil after saccharin ingestion in gastric bypass rats induced a conditioned taste aversion. These findings suggest that changes in fat preference may contribute to long-term maintained weight loss after gastric bypass. Postingestive effects of high-fat nutrients resulting in conditioned taste aversion may partially explain this observation; the role of GLP-1 in mediating postprandial responses after gastric bypass requires further investigation. PMID:21734019

  3. Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2002-01-01

    above the knee popliteal artery in 4 subjects. After both types of reconstruction, extirpation of infected grafts from the groin was performed (Figure 2. The control examination was performed using physical and Doppler ultrasonographic examinations, one, 3, 6, 12 months, and then every year after the operation. In cases with suspected graft infection or thrombosis, control angography was also performed. One intraoperative perforation of the urinary bladder has been done accidentally during obturator bypass reconstruction. The mean follow-up period for patients with obturator bypasses was 2.3 years, while 2.1 years for patients with "lateral" bypasses. Comparing with "lateral" bypass, obturator bypass showed statistically significant lower (p < 0.05 30- day mortality and early graft infection rate, as well as statistically significant better early and total limb salvage rate. There were no statistically significant differences (p > 0.05 between obturator and "lateral" bypass procedures having in mind, late graft infection rate, as well as early and late graft patency (Figures 3 and 4. In cases with infected vascular prostheses in the groin, the authors recommend obturator bypass comparing with "lateral" bypass.

  4. A comparison of haemodynamics between subcranial-intracranial bypass and the traditional extracranial-intracranial bypass.

    Science.gov (United States)

    Yu, Zaitao; Yang, Yang; Shi, Xiang'en; Qian, Hai; Liu, Fangjun

    2017-12-01

    Ischemic cerebrovascular diseases are traditionally treated using an extracranial-intracranial (EC-IC) bypass. The use of the internal maxillary artery (IMA) in the subcranial-intracranial (SC-IC) bypass was recently described as an alternative treatment. However, the haemodynamics of this new approach have not been defined. The haemodynamic parameters (flow volume [FV], internal diameter [ID], time-averaged mean velocity [TAM], pulsatility index [PI] and resistance index [RI]) of the IMA-radial artery graft (RAG)-middle cerebral artery (MCA) (n = 12) bypass and superficial temporal artery (STA)-MCA bypass (n = 18) were measured using intraoperative duplex ultrasonography and compared. The FV was 81.36 ± 30.41 (62.05-100.70) ml/min for the IMA-RAG-MCA bypass. This was significantly higher than that of the STA-MCA bypass (27.25 ± 9.32 (22.62-31.88) ml/min; P bypass were higher than in the STA-MCA bypass (P bypass and 94% for the STA-MCA bypass. The IMA-RAG-MCA bypass provides moderate to high blood flow to the revascularized territory and blood flow was higher by this method than the STA-MCA bypass.

  5. HIPPOCRATES: FACTS AND FICTION 1. INTRODUCTION

    African Journals Online (AJOL)

    This article considers the historicity of Hippocrates, the Father of Me- dicine, distinguishes fact from fiction and assesses his contribution to the discipline in the ..... things) condoned abortion, did not condemn euthanasia by means of poison, and permitted certain surgical operations. It has thus been ar- gued that the Oath is ...

  6. Main facts 1995; Faits marquants 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    This report presents the main facts of the studies carried out by the Direction des Etudes et Recherches (DER) of Electricite de France: new applications of electricity, classical and nuclear thermal power plants, electrical equipment, environment protection, monitoring and plants operations.

  7. Bypassing birthing centres for child birth: a community-based study in rural Chitwan Nepal

    Directory of Open Access Journals (Sweden)

    Rajani Shah

    2016-10-01

    Full Text Available Abstract Background Child delivery in a health facility is important to reduce maternal mortality. Bypassing nearby birthing facility to deliver at a hospital is common in developing countries including Nepal. Very little is known about the extent and determinants of bypassing the birthing centres in Nepal. This study measures the status of bypassing, characteristics of bypassers and their reasons for bypassing. Methods A community-based cross-sectional study was carried out in six rural village development committees of Chitwan district of Nepal. Structured interviews were conducted with 263 mothers who had given birth at a health facility and whose nearest facility was a birthing centre. Descriptive statistics, univariate and multivariable logistic regression analysis were performed. Results More than half of the mothers had bypassed the nearer birthing centres to deliver at hospital. Living in plain area [aOR: 2.467; 95 % CI: 1.005–6.058], higher wealth index [aOR: 4.981; 95 % CI: 2.482–9.999], advantaged caste/ethnicity [aOR: 2.172; 95 % CI: 1.153–4.089], older age [aOR: 2.222; 95 % CI: 1.050–4.703] and first birth [aOR: 2.032; 95 % CI: 1.060–3.894] were associated with higher likelihood of bypassing. Among the reasons of bypassing as reported by the bypassers, lack of operation, video x-ray, and blood test facilities were the most common ones, followed by the lack of medicines/drugs and equipment, lack of skilled service provider, and inadequate physical facilities, among others. Conclusions Quality of service at the birthing centres needs to be given a high consideration to increase their use as well as to ensure an equitable access to the quality care by all.

  8. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Alzheimer's in each state Quick Facts Share the facts: Prevalence The number of Americans living with Alzheimer's disease is growing — and growing fast. An estimated 5.5 million Americans of all ...

  9. Ethanol : separating fact from fiction

    Science.gov (United States)

    1999-08-01

    This fact sheet presents documented information that dispels some of the myths that people have developed about ethanol. Once the facts are revealed, it becomes clear that using and producing ethanol for transportation is good for the country's econo...

  10. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts in Each State The 2017 Alzheimer's Disease Facts and Figures report contains data on the impact of this disease in every ...

  11. Rubella - Fact Sheet for Parents

    Science.gov (United States)

    ... this page: About CDC.gov . Redirect for the Rubella fact sheet page. The current fact sheet can ... http://www.cdc.gov/vaccines/parents/diseases/child/rubella.html Print page Share Compartir File Formats Help: ...

  12. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... RESEARCH. Read More Alzheimer's Disease Facts in Each State The 2017 Alzheimer's Disease Facts and Figures report ... mail addresses with third parties. Please read our security and privacy policy . Plan ahead Get help and ...

  13. Use the Nutrition Facts Label

    Science.gov (United States)

    ... Features Spokespeople News Archive eNewsletters Calendar Use the Nutrition Facts Label You can help your family eat ... to some of their favorite foods. Use the Nutrition Facts label found on food packages to make ...

  14. Facts, values, and journalism.

    Science.gov (United States)

    Gilbert, Susan

    2017-03-01

    At a time of fake news, hacks, leaks, and unverified reports, many people are unsure whom to believe. How can we communicate in ways that make individuals question their assumptions and learn? My colleagues at The Hastings Center and many journalists and scientists are grappling with this question and have, independently, reached the same first step: recognize that facts can't be fully understood without probing their connection to values. "Explaining the basics is important, of course, but we also need to diversify our approach to the coverage of science-particularly as it intersects with the matrix of cultural, religious, social, and political values of our readers," said an article in Undark, an online magazine of science journalism. An editorial in Nature called for scientists to engage directly with citizens in debates over climate change and genome editing, noting that "the ethical issues can be critically dependent on the science, for example, in understanding where the boundaries between non-heritable and heritable genome modifications might be." We're here to help. © 2017 The Hastings Center.

  15. Utilising cardiopulmonary bypass for cancer surgery. Malignancy-induced protein C deficiency and thrombophilia.

    LENUS (Irish Health Repository)

    Marshall, C

    2012-02-03

    Cardiopulmonary bypass has evolved over the last 30 years. It is an important tool for the cardiac surgeon today and also has applications in non-cardiac operations such as surgery to extract tumours. Such patients undergoing surgery for cancer may be at an increased risk of a thromboembolic event post surgery, due to disturbances in the normal clotting pathway leading to hypercoagulability. One such disturbance is malignancy-induced Protein C deficiency. A deficiency of Protein C can cause hypercoagulabitity. Recent studies have examined cardiopulmonary bypass and inherited Protein C deficiency. However, surgery for cancer patients with a malignancy-induced Protein C deficiency involving cardiopulmonary bypass has not been reported. Surgery using CPB in these patients may result in increased morbidity and mortality. The objective of this article is to review the literature in order to discuss the occurrence, the aetiology and possible management of cancer patients with malignancy-induced Protein C deficiencies that require cardiopulmonary bypass for their surgery.

  16. Scintigraphic assessment of focal platelet accumulations following infrainguinal bypass surgery in humans

    DEFF Research Database (Denmark)

    Nielsen, Tina G; Hesse, B; Eiberg, J

    1997-01-01

    Enothelial injury is assumed to be of pathogenetic significance in the development of graft stenoses, which remain a major cause of failure of peripheral bypasses. The aim of this study was to assess endothelial injury related to infrainguinal bypass surgery by indium-111 platelet scintigraphy....... In 28 patients undergoing in situ vein (n = 24), composite vein-polytetrafluoroethylene (PTFE) (n = 1) or PTFE (n = 3) bypass surgery, assumed vascular injuries were recorded intraoperatively. Autologous indium-111-labelled platelets were injected into the inflow artery immediately after restoration...... antiplatelet therapy or vein graft diameter. Only 2 of the 20 intragraft platelet depositions occurred in areas where intra-operative vascular injury was suspected. In the composite graft and the PTFE grafts, diffuse activity was observed throughout the entire bypass. In conclusion, focal activity...

  17. John Searle on Institutional Facts

    Directory of Open Access Journals (Sweden)

    m Abdullahi

    2010-09-01

    Here we argue that the essence of institutional facts is status functions. Humans recognize these functions which contain a set of deontic powers through collective intentionality. Therefore, institutional facts are ontologically subjective and epistemologically objective. Nevertheless, objectivity of institutional facts totally depends on language which itself is a fundamental institution for other institutions.

  18. MRI: A method to detect minor brain damage following coronary bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vik, A.; Brubakk, A.O. (Trondheim Univ. (Norway). Dept. of Biomedical Engineering); Rinck, P.A. (Trondheim Univ. (Norway). MR Center); Sande, E.; Levang, O.W. (Trondheim Univ. Hospital (Norway). Dept. of Surgery); Sellevold, O. (Trondheim Univ. Hospital (Norway). Dept. of Anaesthesiology)

    1991-10-01

    In order to assess the occurrence of minor focal brain lesions after coronary bypass surgery, magnetic resonance imaging (MRI) was used. Nine male patients (age 42-63) with angina pectoris were investigated at 0.5 Tesla. The investigation was performed one to seven weeks prior to the operation and one month after the operation. Before surgery, the images demonstrated more than five high intensity spots in the white matter of the brain in all but two patients. No additional spots were found after operation. This pilot study indicates that it might be difficult to use MRI to detect minor parenchymal lesions after cardiopulmonary bypass surgery. (orig.).

  19. Are laparoscopic gastric bypass after gastroplasty and primary laparoscopic gastric bypass similar in terms of results?

    Science.gov (United States)

    Cadière, Guy-Bernard; Himpens, Jacques; Bazi, Michel; Cadière, Benjamin; Vouche, Michael; Capelluto, Elie; Dapri, Giovanni

    2011-06-01

    This retrospective study compares the results of primary gastric bypass (PGB) versus secondary gastric bypass (SGB) performed after gastroplasty. Between January 2004 and August 2008, 576 consecutive patients benefited from laparoscopic gastric bypass (LGB) in our hospital. Four hundred seventy patients (81.6%) were available for full evaluation. Primary outcome measures were operative time, conversion to open surgery and mortality, hospital stay, early and late complications, reoperations, efficacy, and patient satisfaction. Three hundred sixty-two patients benefited from a PGB and 108 from SGB. Median preoperative BMI was 42 kg/m2 (34.8-63.5; PGB) and 39 kg/m2 (20.9-64.5; SGB; p = 0.002). Median operative time was 109 min (40-436; PGB) and 194 min (80-430; SGB; p < 0.001). There was no conversion to open surgery or mortality in either group. Median hospital stay was 4 days (3-95; PGB) and 5 days (2-114; SGB; p < 0.001). Early complications were recorded in 37 patients (10.2%) after PGB and in 24 patients (22.2%) after SGB (p < 0.001). Reoperation was necessary in 12 patients (3.3%) after PGB and in 9 patients (8.3%) after SGB (p = 0.03). Median follow-up was 35 months (12-66; PGB), and 34 months (12-66; SGB; NS). Late complications were achieved in 46 patients (12.7%) after PGB and in 33 patients (30.6%) after SGB (p < 0.001). Reoperation was necessary in 17 patients (4.7%) after PGB and in 11 patients (10.2%) after SGB (p = 0.03). Mean % EWL was 74.2% after PGB and 69.9% after SGB (NS). After PGB, 89% of the patients was satisfied, 4% neutral, and 6% unsatisfied; after SGB, 79% was satisfied, 10% neutral, and 11% unsatisfied (p = 001). Weight loss after PGB and SGB is not statistically significantly different. Otherwise, operative time, hospital stay, complications, and revision rate are statistically significantly higher after SGB (p < 0.001).

  20. Strategies for optimisation of paediatric cardiopulmonary bypass

    NARCIS (Netherlands)

    Somer, Filip Maria Jan Jozef De

    2003-01-01

    The aim of this thesis is to address different aspects of paediatric cardiopulmonary bypass in detail and to propose modifications in order to reduce cardiopulmonary bypass related morbidity and by doing so, improve patient outcome. We will focus on four major items: (1) vascular access, (2) mass

  1. Multimodality imaging of coronary artery bypass grafts

    NARCIS (Netherlands)

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after

  2. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the

  3. Immunonutrition - fact or fad.

    Science.gov (United States)

    Schneider, H; Atkinson, S W

    2000-01-01

    Suggestions that modifications to the diet may have a beneficial effect on health are not new. recent work demonstrates that nutritional supplements may effect immune function. This review examines the evidence for the effects of these supplements including arginine, glutamine, nucleotides and omega - 3 fatty acids. In particular, clinical trials with patients in multiple organ failure are discussed. The evidence published thus far suggests that immunonutrition, if absorbed in adequate amounts both pre- and post-operatively, reduces septic complications and improves surrogate measures of ourcome, including length of stay and requirements for mechanical ventilation.

  4. Livstruende underernæring efter gastrisk bypass behandlet med reetablering af normal tarmanatomi

    DEFF Research Database (Denmark)

    Poulsen, Inge Marie; Hansen, Dorte Lindqvist; Grønbæk, Karin Elmegård

    2014-01-01

    We present a case report of a woman who had repeating episodes of severe life-threatening malnutrition four years after a laparoscopic gastric bypass operation for severe overweight. Despite several normal examinations her condition remained unstable. She was offered a laparoscopic operation reve...... of patients in a competent multidisciplinary team....

  5. Strain: Fact or Fiction?

    Science.gov (United States)

    Heilbronner, Renée

    2017-04-01

    2017 marks the 50th anniversary of the publication of John Ramsay's well known textbook "Folding and Fracturing of Rocks" - ... and the 30th anniversary of the rejection of a rather less well known paper entitled "Strain: Fact or Fiction?" submitted by Renée Panozzo to the Journal of Structural Geology. The gist of the paper was simple and straight forward: it was argued that not every fabric that can be observed in deformed rocks is necessarily a measure of the amount of strain the rock incurred. A distinction was made between a general "fabric", i.e., the traceable geometry of grain boundaries, for example, and a so-called "strain fabric", i.e., the model geometry that would result from homogeneously straining an initially isotropic fabric and that would exhibit at least orthorhombic symmetry. To verify if a given fabric was indeed a strain fabric it was therefore suggested to use the SURFOR method (published by Panozzo) and to carry out a so-called strain test, i.e., a check of symmetry, before interpreting the results of a fabric analysis in terms of strain. The problem with the paper was that it was very obviously written out of frustration. The frustration came form having reviewed a number of manuscripts which tried to use the then novel SURFOR method for strain analysis without first checking if the the fabric was a indeed a "strain fabric" or not, and then blaming the SURFOR method for producing ambiguous results. As a result, the paper was not exactly well balanced and carefully thought out. It was considered "interesting but not scholarly" by one of the reviewers and down-right offensive by the second. To tell the truth, however, the paper was not formally rejected. The editor Sue Treagus strongly encouraged Panozzo to revise the paper, ... and 30 years later, I will follow her advise and offer a revised paper as a tribute to John Ramsay. To quote from the original manuscript: "We should be a little more impressed that strain works so well, and less

  6. Pinellas Plant facts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1990-11-01

    The Pinellas Plant, near St. Petersburg, Florida, is wholly owned by the United States Government. It is operated for the Department of Energy (DOE) by GE Aerospace, Neutron Devices (GEND). This plant was built in 1956 to manufacture neutron generators, a principal component in nuclear weapons. The neutron generators built at Neutron Devices consist of a miniaturized linear ion accelerator assembled with the pulsed electrical power supplies required for its operation. Production of these devices has necessitated the development of several uniquely specialized areas of competence and supporting facilities. The ion accelerator, or neutron tube, requires ultra clean, high vacuum technology; hermetic seals between glass, ceramic, glass-ceramic, and metal materials; plus high voltage generation and measurement technology. The existence of these capabilities at Neutron Devices has led directly to the assignment of other weapon application products: the lightning arrester connector, specialty capacitor, vacuum switch, and crystal resonator. Other product assignments such as active and reserve batteries and the radioisotopically-powered thermoelectric generator evolved from the plant`s materials measurement and controls technologies which are required to ensure neutron generator life.

  7. Revisional Gastric Bypass for Failed Restrictive Procedures: Comparison of Single-Anastomosis (Mini-) and Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Almalki, Owaid M; Lee, Wei-Jei; Chen, Jung-Chien; Ser, Kong-Han; Lee, Yi-Chih; Chen, Shu-Chun

    2017-11-03

    Ten to 50% of patients who received restrictive bariatric operations may require reoperation for unsatisfactory weight loss or weight regain. Failed restrictive procedures are usually managed with conversion to another bariatric procedure with a favor of conversion to laparoscopic gastric bypass. Our aim is to evaluate two different bypass techniques, laparoscopic RY gastric bypass (RYGB) versus single-anastomosis (mini-) gastric bypass (SAGB) as a revision option (R-RYGB and R-SAGB) for failed restrictive bariatric operations. From May 2001 to December 2015, a total of 116 patients with failed restrictive bariatric operations underwent laparoscopic revisional bypass surgery (81 R-SAGB and 35 R-RYGB). Among them, 81 were failed after vertical banded gastroplasty (VBG) and 35 were after adjustable gastric band (AGB). The demographic data, surgical parameters, and outcomes were studied. The average age at revision surgery was 35.7 years (range 22-56), and the average body mass index (BMI) before reoperation was 37.2 kg/m2 (29.0-51.8). Revision surgery was performed after 58.8 months from the primary surgery on average (14-180 months). The main reasons for the revisions were weight regain (50.9%), inadequate weight loss (31%), and intolerance (18.1%). All of the procedures were completed laparoscopically as one-stage procedure. R-RYGB had significantly longer operative times than R-SAGB. Major complication occurred in 12 (10%) patients without significant difference between R-SAGB group and R-RYGB group. At 1 year follow-up, weight loss was better in R-SAGB than R-RYGB (76.8 vs. 32.9% EWL; p = 0.001). At 5 year follow-up, a significantly lower hemoglobin level was found in R-SAGB group (p = 0.03). Both SAGB and RYGB are acceptable options for revising a restrictive type of bariatric procedures with equal safety profile. R-SAGB was shown to be a simpler procedure with better weight reduction than R-RYGB but anemia is a considerable complication at long

  8. FACT. Energy spectrum of the Crab Nebula

    Energy Technology Data Exchange (ETDEWEB)

    Temme, Fabian; Einecke, Sabrina; Buss, Jens [TU Dortmund, Experimental Physics 5, Otto-Hahn-Str.4, 44221 Dortmund (Germany); Collaboration: FACT-Collaboration

    2016-07-01

    The First G-APD Cherenkov Telescope is the first Imaging Air Cherenkov Telescope which uses silicon photon detectors (G-APDs aka SiPM) as photo sensors. With more than four years of operation, FACT proved an application of SiPMs is suitable for the field of ground-based gamma-ray astronomy. Due to the stable flux at TeV energies, the Crab Nebula is handled as a ''standard candle'' in Cherenkov astronomy. The analysis of its energy spectrum and comparison with other experiments, allows to evaluate the performance of FACT. A modern analysis chain, based on data stream handling and multivariate analysis methods was developed in close cooperation with the department of computer science at the TU Dortmund. In this talk, this analysis chain and its application are presented. Further to this, results, including the energy spectrum of the Crab Nebula, measured with FACT, are shown.

  9. Aortic bypass surgery for asymptomatic patients awaiting a kidney transplant: a word of caution.

    Science.gov (United States)

    Franquet, Q; Terrier, N; Pirvu, A; Rambeaud, J-J; Long, J-A; Janbon, B; Tetaz, R; Malvezzi, P; Jouve, T; Descotes, J-L; Fiard, G

    2018-02-02

    In the presence of severe aorto-iliac calcification, aortic bypass surgery can be mandatory to allow kidney transplantation. The aim of our study was to evaluate the safety and outcomes of this strategy among asymptomatic patients. We retrospectively reviewed the files of all patients that had undergone vascular bypass surgery prior to kidney transplantation between November 2004 and March 2016. All patients undergoing aortic bypass surgery prior to kidney transplantation without any vascular-related symptoms were included. Twenty-one asymptomatic patients were included. Ten patients (48%) have not received a kidney transplant. Four patients died before kidney transplantation, including two deaths related to the bypass surgery (9.5%). Early post-operative morbidity involved 11 cases. Eleven patients (52%) were transplanted. Transplanted patients were significantly younger (median age 60 (56-61) versus 67 (60-72) years, p=0 .04) at the time of bypass and were less frequently treated for coronary heart disease (9% versus 50%, p=0.06). Aortic bypass surgery performed prior to kidney transplantation among asymptomatic patients has significant mortality and morbidity rates. When transplantation is possible, the results are satisfying. Larger studies are required to define the selection criteria, such as age and coronary heart disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Variations of Occipital Artery-Posterior Inferior Cerebellar Artery Bypass: Anatomic Consideration.

    Science.gov (United States)

    Matsushima, Ken; Matsuo, Satoshi; Komune, Noritaka; Kohno, Michihiro; Lister, J Richard

    2017-07-07

    Advances in diagnosis of posterior inferior cerebellar artery (PICA) aneurysms have revealed the high frequency of distal and/or dissecting PICA aneurysms. Surgical treatment of such aneurysms often requires revascularization of the PICA including but not limited to its caudal loop. To examine the microsurgical anatomy involved in occipital artery (OA)-PICA anastomosis at various anatomic segments of the PICA. Twenty-eight PICAs in 15 cadaveric heads were examined with the operating microscope to take morphometric measurements and explore the specific anatomy of bypass procedures. OA bypass to the p2, p3, p4, or p5 segment was feasible with a recipient vessel of sufficient diameter. The loop wandering near the jugular foramen in the p2 segment provided sufficient length without requiring cauterization of any perforating arteries to the brainstem. Wide dissection of the cerebellomedullary fissure provided sufficient exposure for the examination of some p3 segments and all p4 segments hidden by the tonsil. OA-p5 bypass was placed at the main trunk before the bifurcation in 5 hemispheres and at the larger hemispheric trunk in others. Understanding the possible variations of OA-PICA bypass may enable revascularization of the appropriate portion of the PICA when the parent artery must be occluded. A detailed anatomic understanding of each segment clarifies important technical nuances for the bypass on each segment. Dissection of the cerebellomedullary fissure helps to achieve sufficient exposure for the bypass procedures on most of the segments.

  11. Pattern and predictors of dual antiplatelet use after coronary artery bypass graft surgery.

    Science.gov (United States)

    Mori, Makoto; Shioda, Kayoko; Yun, James J; Mangi, Abeel A; Darr, Umer; Geirsson, Arnar

    2018-02-01

    Resumption of dual antiplatelet therapy after coronary artery bypass grafting in patients presenting with acute coronary syndrome is recommended, but the current practice pattern in the United States remains unknown. We aimed to investigate the current pattern of dual antiplatelet therapy use after coronary artery bypass grafting at the Yale-New Haven Hospital. We conducted a single-center retrospective review of patients who presented with acute coronary syndrome and underwent coronary artery bypass grafting between 2014 and 2016. The primary outcome was hospital discharge with dual antiplatelet therapy. Mixed-effect multivariate logistic regression was used to evaluate predictors of dual antiplatelet therapy use or nonuse, accounting for surgeon-specific preference. The discriminatory ability of the model was evaluated with receiver operating characteristics analysis. Of 572 patients included, only 29% were discharged with dual antiplatelet therapy. In the mixed-effect multivariate model isolating surgeon preferences, increase in age (odds ratio, 0.95; 95% confidence interval, 0.92-0.98; P bypass grafting compared with on-pump coronary artery bypass grafting was associated with increased odds of dual antiplatelet therapy use (odds ratio, 31.5; 95% confidence interval, 12.8-77.2; P bypass grafting was low and variable among surgeons. The use or nonuse was guided by previously established risk factors of recurrent ischemia and bleeding, along with surgeon preference. Published by Elsevier Inc.

  12. Cardiopulmonary Bypass and Oxidative Stress

    Science.gov (United States)

    Zakkar, Mustafa; Guida, Gustavo; Suleiman, M-Saadeh; Angelini, Gianni D.

    2015-01-01

    The development of the cardiopulmonary bypass (CPB) revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress. PMID:25722792

  13. Capacity analysis of a bypass of roundabouts

    Science.gov (United States)

    Sedlačik, Ivan; Slabý, Petr

    2017-09-01

    The capacity of the roads network mainly depends on the capacity of its nodal points - intersections. A connecting branch or a bypass is a lane or lanes inserted between two adjacent branches of a roundabout, providing redirection of vehicles, that would otherwise burden a circular lane. A bypass effect to the capacity of roundabouts, but also other types of level intersections, is undeniable. A connecting branch increases the total capacity of an intersection that takes a part of vehicles performing a manoeuver of the first right turn completely out of an intersection area. Redirecting vehicles reduces delay times at intersections and reduces queues at the entrance to an intersection. Bypasses improve the quality of transport. Limiting for the capacity of bypasses is the point of disconnection from the entrance into the roundabout and the connection point into the exit from the roundabout. Central parts of the bypasses have minimal effects on the capacity. The length of a bypass has to match with the maximum length of a queue of waiting vehicles at a given intensity level. The article deals with analysis of the bypass capacity at the roundabouts.

  14. Augmented reality-assisted bypass surgery: embracing minimal invasiveness.

    Science.gov (United States)

    Cabrilo, Ivan; Schaller, Karl; Bijlenga, Philippe

    2015-04-01

    The overlay of virtual images on the surgical field, defined as augmented reality, has been used for image guidance during various neurosurgical procedures. Although this technology could conceivably address certain inherent problems of extracranial-to-intracranial bypass procedures, this potential has not been explored to date. We evaluate the usefulness of an augmented reality-based setup, which could help in harvesting donor vessels through their precise localization in real-time, in performing tailored craniotomies, and in identifying preoperatively selected recipient vessels for the purpose of anastomosis. Our method was applied to 3 patients with Moya-Moya disease who underwent superficial temporal artery-to-middle cerebral artery anastomoses and 1 patient who underwent an occipital artery-to-posteroinferior cerebellar artery bypass because of a dissecting aneurysm of the vertebral artery. Patients' heads, skulls, and extracranial and intracranial vessels were segmented preoperatively from 3-dimensional image data sets (3-dimensional digital subtraction angiography, angio-magnetic resonance imaging, angio-computed tomography), and injected intraoperatively into the operating microscope's eyepiece for image guidance. In each case, the described setup helped in precisely localizing donor and recipient vessels and in tailoring craniotomies to the injected images. The presented system based on augmented reality can optimize the workflow of extracranial-to-intracranial bypass procedures by providing essential anatomical information, entirely integrated to the surgical field, and help to perform minimally invasive procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Protective effect of ambroxol on pulmonary function after cardiopulmonary bypass.

    Science.gov (United States)

    Ulas, Mahmut Mustafa; Hizarci, Mustafa; Kunt, Aysegul; Ergun, Kumral; Kocabeyoglu, Sabit Sinan; Korkmaz, Kemal; Lafci, Gokhan; Gedik, Selcuk; Cagli, Kerim

    2008-12-01

    To evaluate whether ambroxol administered orally during the perioperative period has a protective effect against postoperative pulmonary dysfunction in on-pump coronary artery bypass surgery. Fifty younger patients without known pulmonary disease were randomly assigned into 2 groups. In ambroxol group (n = 25), patients were given ambroxol for a week before and after the elective coronary artery bypass grafting. In control group (n = 25), placebo was given. Groups were compared with respect to pulmonary function tests (PFTs), lecithin/sphingomyelin (L/S) ratio in the bronchoalveolar lavage fluid, arterial blood gases, and incidence of perioperative morbidity. PFTs were performed before medication and repeated on the postoperative seventh day. Bronchoalveolar lavage fluid was obtained just before cardiopulmonary bypass and within the first postoperative hour. Room air arterial blood gases were checked before and 2 days after the operation. Postoperative lecithin/sphingomyelins were significantly lower than the preoperative values in both groups, but differences between the groups in either preoperative or postoperative measurements were not significant. Although preoperative PaO2 in both groups was similar, it was significantly lower in control group on postoperative second day (62.4 +/- 7.1 vs. 55.2 +/- 6.4 mm Hg, P ambroxol improves postoperative PFTs and PaO2 levels without any significant clinical implication, and it exerts these effects possibly in ways other than surfactant modulation.

  16. Thermodynamic Cycle Analysis of Magnetohydrodynamic-Bypass Hypersonic Airbreathing Engines

    Science.gov (United States)

    Litchford, R. J.; Cole, J. W.; Bityurin, V. A.; Lineberry, J. T.

    2000-01-01

    The prospects for realizing a magnetohydrodynamic (MHD) bypass hypersonic airbreathing engine are examined from the standpoint of fundamental thermodynamic feasibility. The MHD-bypass engine, first proposed as part of the Russian AJAX vehicle concept, is based on the idea of redistributing energy between various stages of the propulsion system flow train. The system uses an MHD generator to extract a portion of the aerodynamic heating energy from the inlet and an MHD accelerator to reintroduce this power as kinetic energy in the exhaust stream. In this way, the combustor entrance Mach number can be limited to a specified value even as the flight Mach number increases. Thus, the fuel and air can be efficiently mixed and burned within a practical combustor length, and the flight Mach number operating envelope can be extended. In this paper, we quantitatively assess the performance potential and scientific feasibility of MHD-bypass engines using a simplified thermodynamic analysis. This cycle analysis, based on a thermally and calorically perfect gas, incorporates a coupled MHD generator-accelerator system and accounts for aerodynamic losses and thermodynamic process efficiencies in the various engin components. It is found that the flight Mach number range can be significantly extended; however, overall performance is hampered by non-isentropic losses in the MHD devices.

  17. Risk of stroke after coronary artery bypass grafting: effect of age and comorbidities

    DEFF Research Database (Denmark)

    Mérie, Charlotte; Køber, Lars; Olsen, Peter Skov

    2012-01-01

    The risk of stroke after coronary artery bypass grafting (CABG) is known to increase dramatically with age. During recent years, the age of patients operated on has increased and concomitant therapy has changed. Therefore, we have re-evaluated the risk of stroke after CABG.......The risk of stroke after coronary artery bypass grafting (CABG) is known to increase dramatically with age. During recent years, the age of patients operated on has increased and concomitant therapy has changed. Therefore, we have re-evaluated the risk of stroke after CABG....

  18. 21 CFR 870.4205 - Cardiopulmonary bypass bubble detector.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass bubble detector. 870.4205... bypass bubble detector. (a) Identification. A cardiopulmonary bypass bubble detector is a device used to detect bubbles in the arterial return line of the cardiopulmonary bypass circuit. (b) Classification...

  19. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class II...

  20. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is... through the cardiopulmonary bypass circuit. (b) Classification. Class II (performance standards). ...

  1. 21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass accessory equipment. 870... Cardiopulmonary bypass accessory equipment. (a) Identification. Cardiopulmonary bypass accessory equipment is a device that has no contact with blood and that is used in the cardiopulmonary bypass circuit to support...

  2. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass cardiotomy return sucker... Cardiopulmonary bypass cardiotomy return sucker. (a) Identification. A cardiopulmonary bypass cardiotomy return... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class II...

  3. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange... the FDA guidance document entitled “Guidance for Cardiopulmonary Bypass Oxygenators 510(k) Submissions...

  4. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass coronary pressure gauge... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing...

  5. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow... device is placed in a cardiopulmonary bypass circuit downstream from the oxygenator. (b) Classification...

  6. Use and Outcomes of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Gastric Bypass: Analysis of the American College of Surgeons NSQIP.

    Science.gov (United States)

    Young, Monica T; Gebhart, Alana; Phelan, Michael J; Nguyen, Ninh T

    2015-05-01

    Laparoscopic sleeve gastrectomy is gaining popularity in the United States. However, few studies have examined outcomes of sleeve gastrectomy compared with those of the "gold standard" bariatric operation: Roux-en-Y gastric bypass. Using the American College of Surgeons National Surgical Quality Improvement Program database, clinical data were obtained for all patients who underwent laparoscopic sleeve gastrectomy or laparoscopic gastric bypass between 2010 and 2011. Main outcomes measures were risk-adjusted 30-day serious morbidity and mortality. We analyzed 24,117 patients who underwent laparoscopic sleeve gastrectomy or laparoscopic gastric bypass for the treatment of morbid obesity. Gastric bypass comprised 79.5% of cases and sleeve gastrectomy comprised 20.5%; the proportion of sleeve gastrectomy cases increased from 14.6% in 2010 to 25.8% in 2011. On univariate analysis, sleeve gastrectomy had a shorter mean operative time (101 vs 133 minutes, p sleeve gastrectomy, gastric bypass patients had higher risk-adjusted 30-day serious morbidity (odds ratio [OR] 1.32; 95% CI1.11 to 1.56, p sleeve vs 0.15% for bypass). Use of laparoscopic sleeve gastrectomy is increasing on a national level. Compared with laparoscopic gastric bypass, laparoscopic sleeve gastrectomy is associated with lower 30-day risk-adjusted serious morbidity and equivalent 30-day mortality. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Cardiopulmonary bypass and edema: physiology and pathophysiology.

    Science.gov (United States)

    Hirleman, E; Larson, D F

    2008-11-01

    Edema is a common morbidity following cardiopulmonary bypass (CPB) and can result in injury to many organs, including the heart, lungs, and brain. Generalized edema is also common and can lead to increased post-operative hospital stay and other morbidities. Pediatric patients are more susceptible to post-CPB edema and the consequences are more severe for this population. Hemodilution and systemic inflammatory responses are two suspected causes of CPB-related edema; however, the mechanisms involved are far from understood. Also, the common strategies to improve edema have not been completely successful and there is a need for new strategies at maintaining a fluid balance of patients as close to physiological as possible, especially for pediatric patients. An integrative approach to understanding edema is necessary as the forces involved in fluid homeostasis are dynamic and interdependent. Therefore, this review will focus on the physiology of fluid homeostasis and the pathologies of fluid shifts during CPB which lead to general edema as well as tissue-specific edema.

  8. Coronary Bypass Surgery in a 105-Year-Old Patient with Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Temucin Noyan Ogus

    2010-01-01

    Full Text Available Coronary artery bypass grafting is one of the routine daily surgical procedures in the current era. Parallel to the increasing life expectancy, cardiac surgery is commonly performed in octogenarians. However, literature consists of only seldom reports of coronary artery bypass grafting in patients above 90 years of age. In this report, we present our management strategy in a 105-year-old patient who underwent coronary artery bypass grafting at our institution.

  9. Perioperative risk factors for prolonged mechanical ventilation and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Zahra S Faritous

    2011-01-01

    Full Text Available Background: Prolonged mechanical ventilation is an important recognized complication occurring during cardiovascular surgery procedures. This study was done to assess the perioperative risk factors related to postoperative pulmonary complications and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass. Methods: It was a retrospective study on 5,497 patients, including 31 patients with prolonged ventilatory support and 5,466 patients without it; from the latter group, 350 patients with normal condition (extubated in 6-8 hours without any complication were selected randomly. Possible perioperative risk factors were compared between the two groups using a binary logistic regression model. Results: Among the 5,497 women undergoing coronary artery bypass graft (CABG, 31 women needed prolonged mechanical ventilation (PMV, and 15 underwent tracheostomy. After logistic regression, 7 factors were determined as being independent perioperative risk factors for PMV. Discussion: Age ≥70 years old, left ventricular ejection fraction (LVEF ≤30%, preexisting respiratory or renal disease, emergency or re-do operation and use of preoperative inotropic agents are the main risk factors determined in this study on women undergoing CABG.

  10. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts in Each State The 2017 Alzheimer's Disease Facts and Figures report contains data on the impact of this disease in every state across the ...

  11. Math Fact Strategies Research Project

    Science.gov (United States)

    Boso, Annie

    2011-01-01

    An action research project was conducted in order to determine effective math fact strategies for first graders. The traditional way of teaching math facts included using timed tests and flashcards, with most students counting on their fingers or a number line. Six new research-based strategies were taught and analyzed to decide which methods…

  12. Ventilation during cardiopulmonary bypass did not attenuate inflammatory response or affect postoperative outcomes.

    Science.gov (United States)

    Durukan, Ahmet Baris; Gurbuz, Hasan Alper; Salman, Nevriye; Unal, Ertekin Utku; Ucar, Halil Ibrahim; Yorgancioglu, C E M

    2013-07-01

    Cardiopulmonary bypass causes a series of inflammatory events that have adverse effects on the outcome. The release of cytokines, including interleukins, plays a key role in the pathophysiology of the process. Simultaneously, cessation of ventilation and pulmonary blood flow contribute to ischaemia-reperfusion injury in the lungs when reperfusion is maintained. Collapse of the lungs during cardiopulmonary bypass leads to postoperative atelectasis, which correlates with the amount of intrapulmonary shunt. Atelectasis also causes post-perfusion lung injury. In this study, we aimed to document the effects of continued low-frequency ventilation on the inflammatory response following cardiopulmonary bypass and on outcomes, particularly pulmonary function. Fifty-nine patients subjected to elective coronary bypass surgery were prospectively randomised to two groups, continuous ventilation (5 ml/kg tidal volume, 5/min frequency, zero end-expiratory pressure) and no ventilation, during cardiopulmonary bypass. Serum interleukins 6, 8 and 10 (as inflammatory markers), and serum lactate (as a marker for pulmonary injury) levels were studied, and alveolar- arterial oxygen gradient measurements were made after the induction of anaesthesia, and immediately, one and six hours after the discontinuation of cardiopulmonary bypass. There were 29 patients in the non-ventilated and 30 in the continuously ventilated groups. The pre-operative demographics and intra-operative characteristics of the patients were comparable. The serum levels of interleukin 6 (IL-6) increased with time, and levels were higher in the nonventilated group only immediately after discontinuation of cardiopulmonary bypass. IL-8 levels significantly increased only in the non-ventilated group, but the levels did not differ between the groups. Serum levels of IL-10 and lactate also increased with time, and levels of both were higher in the non-ventilated group only immediately after the discontinuation of

  13. Exhaust gas bypass valve control for thermoelectric generator

    Science.gov (United States)

    Reynolds, Michael G; Yang, Jihui; Meisner, Greogry P.; Stabler, Francis R.; De Bock, Hendrik Pieter Jacobus; Anderson, Todd Alan

    2012-09-04

    A method of controlling engine exhaust flow through at least one of an exhaust bypass and a thermoelectric device via a bypass valve is provided. The method includes: determining a mass flow of exhaust exiting an engine; determining a desired exhaust pressure based on the mass flow of exhaust; comparing the desired exhaust pressure to a determined exhaust pressure; and determining a bypass valve control value based on the comparing, wherein the bypass valve control value is used to control the bypass valve.

  14. Environmental impact case study : Martinsville bypass.

    Science.gov (United States)

    1971-01-01

    At the request of the Environmental Quality Division, the Environmental and Economics Section of the Virginia Highway Research Council conducted an environmental impact study of the proposed Route 220 bypass around Martinsville. This evaluation of th...

  15. Bypass diode for a solar cell

    Science.gov (United States)

    Rim, Seung Bum [Palo Alto, CA; Kim, Taeseok [San Jose, CA; Smith, David D [Campbell, CA; Cousins, Peter J [Menlo Park, CA

    2012-03-13

    Bypass diodes for solar cells are described. In one embodiment, a bypass diode for a solar cell includes a substrate of the solar cell. A first conductive region is disposed above the substrate, the first conductive region of a first conductivity type. A second conductive region is disposed on the first conductive region, the second conductive region of a second conductivity type opposite the first conductivity type.

  16. [Plasma ionized magnesium concentration following cardiopulmonary bypass].

    Science.gov (United States)

    Amaya, Fumimasa; Fukui, Michihiko; Tsuruta, Hiroshi; Kooguchi, Kunihiko; Shimosato, Goshun

    2002-06-01

    We performed a retrospective study to analyze plasma ionized magnesium concentration following cardiopulmonary bypass. Severe decrease of ionized magnesium concentration associated with frequent abnormal ECG sign was found in a patient with magnesium-free cardioplegia. Cardioplegia containing 16 mmol.l-1 of magnesium ion maintained ionized magnesium concentration within normal ranges without postoperative magnesium loading. Use of cardioplegia containing magnesium or adequate magnesium supplement is thought to be essential for patients receiving cardiopulmonary bypass.

  17. Monsanto may bypass NIH in microbe test.

    Science.gov (United States)

    Sun, Marjorie

    1985-01-11

    The Monsanto Company is planning to ask the Environmental Protection Agency for clearance to field test a genetically engineered microbial pesticide, bypassing the traditional approval process of the National Institutes of Health. Although only federally funded institutions are required to obtain NIH approval for genetic engineering tests, Monsanto is the first company to bypass the NIH regulatory process, which has become mired in a lawsuit brought by Jeremy Rifkin.

  18. [Outcome of gastric bypass surgery in Iceland 2001-2015].

    Science.gov (United States)

    Thorarinsdottir, Rosamunda; Palmason, Vilhjalmur; Leifsson, Bjorn Geir; Gislason, Hjortur

    2016-01-01

    Laparoscopic roux-en-y gastric bypass (LRYGB) has been performed at Landspitali University Hospital (LSH) since 2001. The procedure represents an important treatment option for morbidly obese patients. The aim of this study is to evaluate the long-term results of these operations in Iceland. All 772 consecutive patients undergoing LRYGB at LSH during 2001-2015 were included. Information was collected from a prospective database. Successful weight loss was defined as body mass index (BMI) less than 33 kg/m2 or excess body mass index loss (EBMIL) more than 50%. Mean age of patients was 41 years and 83% were females. Mean pre-operative weight was 127 kg (±20) and mean BMI was 44 (±6). Mean %EBMIL was 80% after 1.5 year, 70% after 5 years and 64% after 10-13 years. 85% of patients had successful weight loss with a mean follow-up time of 7.4 years. Pre-operatively patients on average had 2.8 obesity related comorbid diseases. 71% of patients with type 2 diabetes were in full remission after surgery. One third of patients with hypertension and one third of patients with hyperlipidemia achieved full remission after surgery. 37 patients (5%) had an early complication and 174 (25%) had a late complication that frequently needed surgical solution. Most patients (78%) needed repeated adjustment of vitamins and minerals often many years after surgery. Majority of patients achieved a successful weight loss and most obesity related comorbidities are still in remission 7.4 years after surgery. Early complications were rare but one fourth of patients had late complications. Life long follow-up is of utmost importance after gastric bypass surgery. Key words: gastric bypass surgery in Iceland 2001-2015. Correspondence: Hjörtur Gíslason, hjorturg@landspitali.is.

  19. [Hiatal hernia incarceration during cardiopulmonary bypass in patient with acute aortic dissection--a case report].

    Science.gov (United States)

    Hasegawa, Y; Saito, T; Horimi, H; Kato, M; Kawashima, T; Fuse, K

    1995-09-01

    A 67-year-old woman was admitted to our hospital under diagnosis of Stanford type A acute aortic dissection. Chest CT showed aortic dissection from the ascending to descending aorta, and large hiatal hernia. Operation was undergone under cardiopulmonary bypass and circulatory arrest with retrograde cerebral perfusion. A graft replacement was carried out from the ascending to transverse arch aorta. After the release of the cross-clamping of aorta, the heart was gradually oppressed anteriorly by extrapericardial mass, so that the patient could not be weaned from the cardiopulmonary bypass. The mass was revealed incarcerated hiatal hernia by ultrasonography. After laparotomy, diaphragm and hiatus were incised, the incarceration was relieved and the diaphgragm was repaired with a Goretex sheet. Then the patient could be weaned from cardiopulmonary bypass. Her postoperative course was uneventful except for acute renal failure, and she was discharged 60 days after the operation. The incarceration of hiatal hernia was thought to be caused by tissue edema and small bleeding during cardiopulmonary bypass. This is the first reported case with the incarceration of hiatal hernia which occurred during cardiopulmonary bypass.

  20. The Role of Extra-Anatomic Bypass in the Surgical Treatment of Acute Abdominal Aortic Occlusion.

    Science.gov (United States)

    Ilhan, Gokhan; Bozok, Şahin; Ergene, Şaban; Karakisi, Sedat Ozan; Tufekci, Nebiye; Kazdal, Hızır; Ogullar, Sabri; Kucuker, Seref Alp

    2015-06-01

    Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillobifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2±9.4 months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up. To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

  1. The Role of Extra-Anatomic Bypass in the Surgical Treatment of Acute Abdominal Aortic Occlusion

    Directory of Open Access Journals (Sweden)

    Gokhan Ilhan

    2015-06-01

    Full Text Available Background: Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. Methods: Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillo-bifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. Results: In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2±9.4 months (range, 6 to 36 months. Amputation was not warranted for any patient during postoperative follow-up.. Conclusion: To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

  2. [Simplified laparoscopic gastric bypass. Initial experience].

    Science.gov (United States)

    Hernández-Miguelena, Luis; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Ríos-Cruz, Daniel; Marín-Domínguez, Raúl; Castillo-González, Armando

    2014-01-01

    Obesity surgery includes various gastrointestinal procedures. Roux-en-Y gastric bypass is the prototype of mixed procedures being the most practiced worldwide. A similar and novel technique has been adopted by Dr. Almino Cardoso Ramos and Dr. Manoel Galvao called "simplified bypass," which has been accepted due to the greater ease and very similar results to the conventional technique. The aim of this study is to describe the results of the simplified gastric bypass for treatment of morbid obesity in our institution. We performed a descriptive, retrospective study of all patients undergoing simplified gastric bypass from January 2008 to July 2012 in the obesity clinic of a private hospital in Mexico City. A total of 90 patients diagnosed with morbid obesity underwent simplified gastric bypass. Complications occurred in 10% of patients; these were more frequent bleeding and internal hernia. Mortality in the study period was 0%. The average weight loss at 12 months was 72.7%. Simplified gastric bypass surgery is safe with good mid-term results and a loss of adequate weight in 71% of cases.

  3. Research Facts on Homeschooling. General Facts and Trends

    Science.gov (United States)

    Ray, Brian D.

    2006-01-01

    This fact sheet presents the following general facts and trends. Homeschooling may be the fastest-growing form of education in the United States and it is also growing around the world in many nations. There are about 2 million homeschool students in the United States. There were an estimated 1.9 to 2.4 million children (in grades K to 12) home…

  4. Cost Benefit Analysis: Bypass of Prešov city

    Directory of Open Access Journals (Sweden)

    Margorínová Martina

    2017-01-01

    Full Text Available The paper describes decision making process based on economic evaluation, i.e. Cost Benefit Analysis for motorway bypass of the Prešov city. Three variants were evaluated by means of the Highway Development and Management Tool (HDM-4. HDM-4 is a software system for evaluating options for investing in road transport infrastructure. Vehicle operating costs and travel time costs were monetized with the use of the software. The investment opportunities were evaluated in terms of Cost Benefit Analysis results, i.e. economic indicators.

  5. Relevant Physicochemical Descriptors of "Soft Nanomedicines" to Bypass Biological Barriers.

    Science.gov (United States)

    Nino-Pariente, Amaya; Nebot, Vicent J; Vicent, Maria J

    2016-01-01

    Herein, we present an overview on the current status of the characterization techniques and methodologies used to study the physicochemical descriptors that influence the final clinical performance of a given nanomedicine. The described techniques were selected based on their suitability to operate under relevant "native" conditions that mimic the physiological environment. Special emphasis is placed on those techniques that hold a greater potential to unravel dynamic, structural, and compositional features of soft organic nanomedicines relevant to the ability to bypass biological barriers, and hence allow for the rational design of drug delivery platforms with improved biological output.

  6. Coronary artery bypass grafting in a patient with Gilbert syndrome

    Directory of Open Access Journals (Sweden)

    Kemal Korkmaz

    2012-12-01

    Full Text Available Here in we present a case of a postoperative jaundicedue to Gilbert’s syndrome in a patient who was sufferingfrom coronary artery disease and undergone coronaryartery bypass grafting operation. Signs and symptoms ofjaundice developed on the postoperative first day andresolved spontaneously after 7 days. The diagnosis andcharacteristics of Gilbert’s syndrome and other relatedabnormalities and factors relevant to anesthesia and cardiopulmonaryby-pass, which affect bilirubin metabolism,are discussed. J Clin Exp Invest 2012; 3(4: 555-557Key words: Coronary artery disease, coronary artery bypassgrafting, Gilbert’s syndrome

  7. Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages.

    Science.gov (United States)

    Carvalho Filho, Elio Barreto de; Marson, Fernando Augusto de Lima; Costa, Loredana Nilkenes Gomes da; Antunes, Nilson

    2014-01-01

    Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas.

  8. Investigation on the Core Bypass Flow in a Very High Temperature Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, Yassin

    2013-10-22

    Uncertainties associated with the core bypass flow are some of the key issues that directly influence the coolant mass flow distribution and magnitude, and thus the operational core temperature profiles, in the very high-temperature reactor (VHTR). Designers will attempt to configure the core geometry so the core cooling flow rate magnitude and distribution conform to the design values. The objective of this project is to study the bypass flow both experimentally and computationally. Researchers will develop experimental data using state-of-the-art particle image velocimetry in a small test facility. The team will attempt to obtain full field temperature distribution using racks of thermocouples. The experimental data are intended to benchmark computational fluid dynamics (CFD) codes by providing detailed information. These experimental data are urgently needed for validation of the CFD codes. The following are the project tasks: • Construct a small-scale bench-top experiment to resemble the bypass flow between the graphite blocks, varying parameters to address their impact on bypass flow. Wall roughness of the graphite block walls, spacing between the blocks, and temperature of the blocks are some of the parameters to be tested. • Perform CFD to evaluate pre- and post-test calculations and turbulence models, including sensitivity studies to achieve high accuracy. • Develop the state-of-the art large eddy simulation (LES) using appropriate subgrid modeling. • Develop models to be used in systems thermal hydraulics codes to account and estimate the bypass flows. These computer programs include, among others, RELAP3D, MELCOR, GAMMA, and GAS-NET. Actual core bypass flow rate may vary considerably from the design value. Although the uncertainty of the bypass flow rate is not known, some sources have stated that the bypass flow rates in the Fort St. Vrain reactor were between 8 and 25 percent of the total reactor mass flow rate. If bypass flow rates are on the

  9. Optimal Reactive Power Dispatch Considering FACTS Devices

    Directory of Open Access Journals (Sweden)

    Ismail MAROUANI

    2011-06-01

    Full Text Available Because their capability to change the network parameters with a rapid response and enhanced flexibility, flexible AC transmission system (FACTS devices have taken more attention in power systems operations as improvement of voltage profile and minimizing system losses. In this way, this paper presents a multi-objective evolutionary algorithm (MOEA to solve optimal reactive power dispatch (ORPD problem with FACTS devices. This nonlinear multi-objective problem (MOP consists to minimize simultaneously real power loss in transmission lines and voltage deviation at load buses, by tuning parameters and searching the location of FACTS devices. The constraints of this MOP are divided to equality constraints represented by load flow equations and inequality constraints such as, generation reactive power sources and security limits at load buses. Two types of FACTS devices, static synchronous series compensator (SSSC and unified power flow controller (UPFC are considered. A comparative study regarding the effects of an SSSC and an UPFC on voltage deviation and total transmission real losses is carried out. The design problem is tested on a 6-bus system.

  10. Facts about Meningococcal Disease for Adults

    Science.gov (United States)

    ... Meningococcal Disease Facts about Meningococcal Disease for Adults Facts about Meningococcal Disease for Adults What is meningococcal ... risks associated with the vaccines. Disease and vaccine facts FACT: Quadrivalent meningococcal vaccine (A, C, W, and ...

  11. Changes in adhesion molecule expression and oxidative burst activity of granulocytes and monocytes during open-heart surgery with cardiopulmonary bypass compared with abdominal surgery

    DEFF Research Database (Denmark)

    Toft, P; Nielsen, C H; Tønnesen, Else Kirstine

    1998-01-01

    Cardiac and major abdominal surgery are associated with granulocytosis in peripheral blood. The purpose of the present study was to describe the granulocyte and monocyte oxidative burst and the expression of adhesion molecules following cardiac surgery with cardiopulmonary bypass and abdominal...... during cardiopulmonary bypass was observed. The percentage of CD11a-positive granulocytes increased from 30% pre-operatively to 75% following cardiopulmonary bypass, while CD44-positive granulocytes increased from 5% to 13%. Despite the extent of the changes, these were not significant. The oxidative...... to an increased per-operative oxidative burst activity, and the induction of adhesion molecules on granulocytes associated with the cardiopulmonary bypass and surgery. In conclusion, open-heart surgery with cardiopulmonary bypass was associated with a rapid and pronounced activation of leukocytes which may play...

  12. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Alzheimer's >> Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download ... spending. Take action. Become an advocate SPECIAL REPORT — ALZHEIMER'S DISEASE: THE NEXT FRONTIER In the history of medicine, ...

  13. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: Download ... Take action. Become an advocate SPECIAL REPORT — ALZHEIMER'S DISEASE: THE NEXT FRONTIER In the history of medicine, ...

  14. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Facts and Figures report contains data on the impact of this disease in every state across the nation. Click below to see the effect that Alzheimer's is having in your state. Read ...

  15. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... and treated before irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts ... a Tribute Read past editions . Sign up for our e-newsletter Stay up-to-date on the ...

  16. Alzheimer's Disease Facts and Figures

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    Full Text Available ... Facts and Figures report contains data on the impact of this disease in every state across the ... Alzheimer's treatments, care and research. Get tips for living with Alzheimer's as well as simple ...

  17. Alzheimer's Disease Facts and Figures

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    Full Text Available ... every 33 seconds. GET INVOLVED. Join the cause Mortality Alzheimer's disease is the sixth-leading cause of ... Facts and Figures report contains data on the impact of this disease in every state across the ...

  18. State Fact Sheets on COPD

    Science.gov (United States)

    ... Submit Search The CDC Chronic Obstructive Pulmonary Disease (COPD) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . COPD Homepage Data and Statistics Fact Sheets Publications Publications ...

  19. The Housing Bubble Fact Sheet

    OpenAIRE

    Dean Baker

    2005-01-01

    This paper explains the basic facts about the current housing market. It lays out the evidence that the rise in housing prices constitutes a housing bubble - and explains what can be expected when it inevitably collapses.

  20. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... pocket spending. Take action. Become an advocate SPECIAL REPORT — ALZHEIMER'S DISEASE: THE NEXT FRONTIER In the history ... State The 2017 Alzheimer's Disease Facts and Figures report contains data on the impact of this disease ...

  1. Tuberculosis Facts - Testing for TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Testing for TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  2. Tuberculosis Facts - Exposure to TB

    Science.gov (United States)

    Tuberculosis (TB) Facts Exposure to TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  3. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... 2017 Alzheimer's Disease Facts and Figures report contains data on the impact of this disease in every ... with third parties. Please read our security and privacy policy . Plan ahead Get help and support I ...

  4. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Alzheimer's >> Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: ... twice as high. Invest in a world without Alzheimer's. Donate Caregivers In 2016, 15.9 million family ...

  5. Alzheimer's Disease Facts and Figures

    Science.gov (United States)

    ... Alzheimer's >> Home Text size: A A A 2017 Alzheimer's Disease Facts and Figures Download the Full Report: ... twice as high. Invest in a world without Alzheimer's. Donate Caregivers In 2016, 15.9 million family ...

  6. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Facts and Figures report contains data on the impact of this disease in every state across the nation. Click below to see the effect that Alzheimer's is having in your state. Leave ...

  7. Alzheimer's Disease Facts and Figures

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    Full Text Available ... your state. FIND YOUR WALK Read past editions . Sign up for our e-newsletter Stay up-to- ... researcher Message boards Get the facts 10 warning signs & symptoms What is dementia What is Alzheimer's 7 ...

  8. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... is having in your state. Read past editions . Sign up for our e-newsletter Stay up-to- ... researcher Message boards Get the facts 10 warning signs & symptoms What is dementia What is Alzheimer's 7 ...

  9. 2010 public transportation fact book

    Science.gov (United States)

    2010-04-01

    The Public Transportation Fact Book, published annually, contains national aggregate statistical data covering all aspects of the transit industry in the United States and Canada. Two appendices, also available, provide additional in-depth informatio...

  10. NJ transportation fact book, 2007

    Science.gov (United States)

    2010-01-01

    The New Jersey Transportation Fact Book 2006-07 presents information about the New Jersey Department of Transportation : and other agencies that provide transportation services in New Jersey. We hope it will prove helpful.

  11. 2008 public transportation fact book

    Science.gov (United States)

    2008-06-01

    This Public Transportation Fact Book presents statistics describing the entire United States transit industry for 1995 : through 2006 with additional detail and overview presentations for 2006. Also included are definitions of reported data : items.

  12. Four FACTs Spiritual Assessment Tool.

    Science.gov (United States)

    LaRocca-Pitts, Mark

    2015-01-01

    The Four FACTs Spiritual Assessment Tool combines the Four Fs and the FACT Spiritual Assessment Tool of LaRocca-Pitts into a single tool. The Four FACTs Tool is specifically designed for beginning students, but can also meet the needs of professional chaplains. Though designed for use in an acute care setting, it can be easily adapted for other settings. The Four FACTs Tool is easy to learn and to use and it gathers and evaluates relevant clinical information that can then be used to develop a plan of care. In its shortened form, as ACT, it informs how the chaplain can be fully present with patients and their families, especially in a time of crisis.

  13. 2008 Swimming Season Fact Sheets

    Science.gov (United States)

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  14. 2010 Swimming Season Fact Sheets

    Science.gov (United States)

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  15. 2009 Swimming Season Fact Sheets

    Science.gov (United States)

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  16. 2007 Swimming Season Fact Sheets

    Science.gov (United States)

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  17. 2006 Swimming Season Fact Sheets

    Science.gov (United States)

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  18. Get the Facts about Radiation

    Science.gov (United States)

    ... this issue Looking Inside Get the Facts About Radiation Send us your comments Radiation can be dangerous, but it can also save lives. How can that be? Harnessed properly, radiation can help diagnose and even treat disease. So ...

  19. Filtering Dialysis Myths from Facts

    Science.gov (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z ... the area if needed. Myth: Dialysis is a death sentence. Fact: Dialysis is a treatment that helps ...

  20. Alzheimer's Disease Facts and Figures

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    Full Text Available ... treated before irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts in ... is a not-for-profit 501(c)(3) organization. Copyright © 2017 Alzheimer's Association ® . All rights reserved. Our ...

  1. Definition and Facts for Constipation

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Definition & Facts for Constipation What is Constipation? Constipation is ... bright red blood in your stool, on toilet paper, or in the toilet after a bowel movement. ...

  2. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... Caring for someone with Alzheimer's? Get Resources Cost to Nation The costs of health care and long- ... before irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts in Each ...

  3. Industrial Stormwater Fact Sheet Series

    Science.gov (United States)

    Fact sheets for the industrial sectors regulated by the MSGP. Each describes the types of facilities included in the sector, typical pollutants associated with the sector, and types of stormwater control measures used to minimize pollutant discharge.

  4. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... action. Become an advocate SPECIAL REPORT — ALZHEIMER'S DISEASE: THE NEXT FRONTIER In the history of medicine, one ... physician I am a researcher Message boards Get the facts 10 warning signs & symptoms What is dementia ...

  5. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... irrevocable disability occurs. LEARN ABOUT OUR COMMITMENT TO RESEARCH. Read More Alzheimer's Disease Facts in Each State ... news and advances in Alzheimer's treatments, care and research. Get tips for living with Alzheimer's as well ...

  6. Property description and fact-finding report for NPR-3 Natrona County, Wyoming. Addendum to 22 August 1996 study of alternatives for future operations of the naval petroleum and oil shale reserves NPR-3

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    The U.S. Department of Energy has asked Gustavson Associates, Inc. to serve as an Independent Petroleum Consultant under contract DE-AC01-96FE64202. This authorizes a study and recommendations regarding future development of Naval Petroleum Reserve No. 3 (NPR-3) in Natrona County, Wyoming. The report that follows is the Phase I fact-finding and property description for that study. The United States of America owns 100 percent of the mineral rights and surface rights in 9,321-acre NPR-3. This property comprises the Teapot Dome oil field and related production, processing and other facilities. Discovered in 1914, this field has 632 wells producing 1,807 barrels of oil per day. Production revenues are about $9.5 million per year. Remaining recoverable reserves are approximately 1.3 million barrels of oil. Significant plugging and abandonment (P&A) and environmental liabilities are present.

  7. NMOS-Based Integrated Modular Bypass for Use in Solar Systems (NIMBUS: Intelligent Bypass for Reducing Partial Shading Power Loss in Solar Panel Applications

    Directory of Open Access Journals (Sweden)

    Pieter Bauwens

    2016-06-01

    Full Text Available NMOS-based Integrated Modular Bypass for Use in Solar systems (NIMBUS is designed as a replacement for the traditional bypass diode, used in common solar panels. Because of the series connection between the individual solar cells, the power output of a photovoltaic (PV panel will drop disproportionally under partial shading. Currently, this is solved by dividing the PV panel into substrings, each with a diode bypass placed in parallel. This allows an alternative current path. However, the diodes still have a significant voltage drop (about 350 mV, and due to the fairly large currents in a panel, the diodes are dissipating power that we would rather see at the output of the panel. The NIMBUS chip, being a low-voltage-drop switch, aims to replace these diodes and, thus, reduce that power loss. NIMBUS is a smart bypass: a completely stand-alone system that detects the failing of one or more cells and activates when necessary. It is designed for a 100-mV voltage drop under a 5-A load current. When two or more NIMBUS chips are placed in parallel, an internal synchronization circuit ensures proper operation to provide for larger load currents. This paper will elaborate on the operation, design and implementation of the NIMBUS chip, as well as on the first measurements.

  8. Elevated fasting and postprandial C-terminal telopeptide after Roux-en-Y gastric bypass.

    Science.gov (United States)

    Maghsoodi, Negar; Alaghband-Zadeh, Jamshid; Cross, Gemma F; Werling, Malin; Fändriks, Lars; Docherty, Neil G; Olbers, Torsten; Dew, Tracy; Sherwood, Roy A; Vincent, Royce P; le Roux, Carel W

    2017-07-01

    Background Roux-en-Y gastric bypass increases circulating bile acid concentrations, known mediators of postprandial suppression of markers of bone resorption. Long-term data, however, indicate that Roux-en-Y gastric bypass confers an increased risk of bone loss on recipients. Methods Thirty-six obese individuals, median age 44 (26-64) with median body mass index at baseline of 42.5 (40.4-46) were studied before and 15 months after Roux-en-Y gastric bypass. After an overnight fast, patients received a 400 kcal mixed meal. Blood samples were collected premeal then at 30-min periods for 120 min. Pre and postmeal samples were analysed for total bile acids, parathyroid hormone and C-terminal telopeptide. Results Body weight loss post Roux-en-Y gastric bypass was associated with a median 4.9-fold increase in peak postprandial total bile acid concentration, and a median 2.4-fold increase in cumulative food evoked bile acid response. Median fasting parathyroid hormone, postprandial reduction in parathyroid hormone and total parathyroid hormone release over 120 min remained unchanged after surgery. After surgery, median fasting C-terminal telopeptide increased 2.3-fold, peak postprandial concentrations increased 3.8-fold and total release was increased 1.9-fold. Conclusions Fasting and postprandial total bile acids and C-terminal telopeptide are increased above reference range after Roux-en-Y gastric bypass. These changes occur in spite of improved vitamin D status with supplementation. These results suggest that post-Roux-en-Y gastric bypass increases in total bile acids do not effectively oppose an ongoing resorptive signal operative along the gut-bone axis. Serial measurement of C-terminal telopeptide may be of value as a risk marker for long-term skeletal pathology in patients post Roux-en-Y gastric bypass.

  9. Efficiency and safety of leukocyte filtration during cardiopulmonary bypass for cardiac surgery

    NARCIS (Netherlands)

    Smit, JJJ; de Vries, AJ; Gu, YJ; van Oeveren, W

    Background. Leukocyte filtration of systemic blood during cardiopulmonary bypass surgery to reduce post-operative morbidity has not yet been established because of the enormous leukocyte release from the third space. This study was designed to examine the efficiency and safety of leukocyte

  10. Effects of hypothermic cardiopulmonary bypass on the pharmacodynamics and pharmacokinetics of rocuronium

    NARCIS (Netherlands)

    Smeulers, NJ; Wierda, MKH; vandenBroek, L; Huet, RCGG; Hennis, PJ

    1995-01-01

    Objective: To study the influence of hypothermic cardiopulmonary bypass (CPB) on the pharmacodynamics and pharmacokinetics of rocuronium. Design: Prospective, descriptive study. Setting: Operating room at a university hospital. Participants: Ten ASA class III end IV patients, ranging in age from 35

  11. Prevalence and impact of dumping syndrome on qol after primary gastric bypass surgery

    NARCIS (Netherlands)

    Emous, M.; Ubels, F.L.; Apers, J.A.; Wolffenbuttel, B.H.R.; Totté, E.; Van Beek, A.P.

    2014-01-01

    Introduction: Worldwide gastric bypass is still the most frequent performed weight loss operations for morbid obesity and it's effectively is proven. Although dumping has been widely recognized as complication after RYGB, almost no data are available on the prevalence and the consequences of this

  12. Acute renal insufficiency and renal replacement therapy after pediatric cardiopulmonary bypass surgery

    NARCIS (Netherlands)

    Kist-van Holthe tot Echten, J. E.; Goedvolk, C. A.; Doornaar, M. B.; van der Vorst, M. M.; Bosman-Vermeeren, J. M.; Brand, R.; van der Heijden, A. J.; Schoof, P. H.; Hazekamp, M. G.

    2001-01-01

    The aim of the study was to investigate renal function and renal replacement therapy after cardiopulmonary bypass surgery in children. Patient characteristics (sex, age, diagnosis), operation type, and death were listed. The study was performed retrospectively using serum creatinine level before,

  13. Prognostic information in administrative co-morbidity data following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Hvelplund, Anders; Rasmussen, Søren

    2010-01-01

    The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded in a clinical...

  14. Radical nephrectomy and vena caval thrombectomy with the use of cardiopulmonary bypass.

    Science.gov (United States)

    Raman, Avi; Jawale, Atul; Grant, Alexander

    2014-01-01

    This study aimed to report on the experience of a single surgeon in a regional Australian centre with radical nephrectomy and vena caval thrombectomy with the use of cardiopulmonary bypass. Fifteen consecutive patients undergoing radical nephrectomy and vena caval thrombectomy with cardiopulmonary bypass over a 13-year period were identified. Retrospective analysis of prospectively collected data was used. Data were collected on intra-operative and pathological findings as well as post-operative complications. Oncological outcomes and long-term follow-up were analysed retrospectively in this study. All patients had a radical nephrectomy and vena caval thrombectomy with cardiopulmonary bypass. The median operating time was 336 min (mean 326.1 min), and median transfusion of packed red blood cells was 8 units (mean 6.9). The median bypass time was 107 min (mean 112.3 min), and the median circulation arrest time was 25 min (mean 25.3 min). Median length of hospital stay was 11 days (mean 14.5 days). Minor complications were seen in two patients and major complications seen in six, with one intra-operative death. Disease recurrence was seen in 1 of 14 patients who were considered completely resected at the time of operation. The overall 5-year survival rate was 84%. Median follow-up was 32 months (range 0-158). Median survival time was 135 months. Radical nephrectomy with caval thrombectomy with cardiopulmonary bypass can be performed in a regional centre with acceptable post-operative morbidity and mortality. Long-term survival is possible in some patients. © 2014 Royal Australasian College of Surgeons.

  15. Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

    2013-04-01

    Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

  16. Internal Maxillary Bypass for Complex Pediatric Aneurysms.

    Science.gov (United States)

    Wang, Long; Lu, Shuaibin; Qian, Hai; Shi, Xiang'en

    2017-07-01

    Complex pediatric aneurysms (PAs) are an unusual clinicopathologic entity. Data regarding the use of a bypass procedure to treat complex PAs are limited. Internal maxillary artery-to-middle cerebral artery bypass with radial artery graft was used to isolate PAs. Bypass patency and aneurysm stability were evaluated using intraoperative Doppler ultrasound, indocyanine green videoangiography, and postoperative angiography. Modified Rankin Scale was used to assess neurologic function. Over a 5-year period, 7 pediatric patients (≤18 years old) were included in our analysis. Mean age of patients was 14.4 years (range, 12-18 years), and mean size of PAs was 23.6 mm (range, 9-37 mm). All cases manifested with complex characteristics. Proximal artery occlusion was performed in 3 cases, complete excision following aneurysmal distal internal maxillary artery bypass was performed in 2 cases, and combined proximal artery occlusion and aneurysm excision was performed in the 2 remaining cases. Mean intraoperative blood flow was 61.6 mL/minute (range, 40.0-90.8 mL/minute). Graft patency rate was 100% during postoperative recovery and at the last follow-up examination (mean, 20 months; range, 7-45 months). All patients had excellent outcomes except for 1 patient who died of multiple-organ failure. Internal maxillary artery bypass is an essential technique for treatment of selected cases of complex PAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Risk Factors of On-Pump Conversion during Off-Pump Coronary Artery Bypass Graft.

    Science.gov (United States)

    Yoon, Sung Sil; Bang, Jung Hee; Jeong, Sang Seok; Jeong, Jae Hwa; Woo, Jong Soo

    2017-10-01

    Off-pump coronary artery bypass grafting (OPCABG) procedures can avoid the complications of an on-pump bypass. However, some cases unexpectedly require conversion to cardiopulmonary bypass during OPCABG. The risk factors associated with a sudden need for cardiopulmonary bypass were analyzed. This retrospective study included 283 subjects scheduled for OPCABG from 2001 to 2010. These were divided into an OPCABG group and an on-pump conversion group. Preoperative, operative, and postoperative variables were compared between the 2 groups. Of the 283 patients scheduled for OPCABG, 47 (16%) were switched to on-pump coronary artery bypass grafting (CABG). The mortality of the both the OPCABG and on-pump conversion groups was not significantly different. The major risk factors for conversion to on-pump CABG were congestive heart failure (CHF) (odds ratio [OR], 3.5; p=0.029), ejection fraction (EF) pump conversion, while preoperative BB administration could help prevent conversions from OPCABG to on-pump CABG.

  18. Vertical Banded Gastroplasty vs Gastric Bypass in the Treatment of Obesity

    Science.gov (United States)

    Fobi, Mathias A.L.; Fleming, Arthur W.

    1986-01-01

    Two hundred consecutive patients undergoing surgical intervention for morbid obesity had either the gastric bypass or the vertical banded gastroplasty. Both groups were similar in patient composition. In the vertical banded gastroplasty patients, operating room time was lessened by 70 minutes, blood loss lessened by 225 mL, and hospital stay shortened by two days as compared with the gastric bypass patients. At 30 months, a 64-percent mean excess weight loss was observed in the gastric bypass vs a 56-percent mean excess weight loss in the vertical banded gastroplasty group. The vertical banded gastroplasty procedure is preferred because there is no late stomal dilation with weight gain, no vitamin B12 deficiency, and most important, this procedure leaves the remainder of the stomach and duodenum available for endoscopic and radiologic evaluation. PMID:3795288

  19. Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass

    Directory of Open Access Journals (Sweden)

    Karimi Fatemeh

    2007-01-01

    Full Text Available Abstract Background Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. Methods 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male underwent preoperative ultrasonography for assessment of carotid artery wall thickness. Results Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8% had significant ( Conclusion Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

  20. Simple hyperaemia test as a screening method in the postoperative surveillance of infrainguinal in situ vein bypasses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; Sillesen, H; Schroeder, T V

    1995-01-01

    OBJECTIVES: To develop a simple protocol for ultrasound Duplex surveillance of infrainguinal vein bypasses. DESIGN: The value of three Doppler waveform parameters, obtained from a single point of the bypass, for identification of stenoses was studied in 91 in situ vein bypasses. Midgraft peak...... systolic velocity (PSV), pulsatility index (PI) and ratio of hyperaemic and resting time-average mean velocities (TAMV), (TAMV ratio = TAMVhyperaemia/TAMVrest) were correlated with the presence and severity of stenoses as assessed by conventional Duplex scanning and ankle-brachial index (ABI) measurements....... The optimal value of the waveform parameters for discrimination between bypasses with and without evidence of stenoses was determined by receiver operating characteristics (ROC) analysis. MAIN RESULTS: Complete Duplex scanning of the entire graft revealed an increase in the peak systolic velocity by a factor...

  1. Are patients bypassing paediatric cardiology outreach clinics?

    Science.gov (United States)

    Fletcher, Alexander; Samson, Ray; McLeod, Karen

    2017-07-01

    Previous studies have identified that receiving specialist care close to home can positively influence patients' experience. Despite this, a review of cardiology outpatient appointments at the Royal Hospital for Children in Glasgow demonstrated that a large number of families are bypassing their local children's cardiology centre to attend cardiac clinics at the specialist children's surgical centre. We used patient questionnaire, audit of local facilities, and examined the relationship between diagnosis and bypass numbers to better understand factors influencing this trend. Our results suggest that patient preference, short travelling distance to specialist children's cardiac centre, a more severe cardiac diagnosis, and inconsistent local facilities, expertise, and support are likely to influence a family's decision to bypass their local children's cardiology centre.

  2. Doppler spectral characteristics of infrainguinal vein bypasses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, F; Sillesen, H

    1993-01-01

    of arteriovenous fistulas the initially antegrade diastolic velocity was replaced by a retrograde flow within 3 months, whereas a forward flow in diastole was sustained in grafts with patent fistulas. Abnormal Duplex findings in 31 patients led to angiography and revision in 13 cases. Four revised grafts failed......, while nine remained patent at follow-up 1-12 months later. Ten (56%) of 18 non-revised bypasses with abnormal Duplex findings failed within 9 months compared to 1 (1%) of 76 bypasses with a normal velocity profile (p ... valuable information concerning haemodynamics of infrainguinal vein bypasses and identifies grafts at risk of thrombosis. Inclusion of low resistance index (detection of stenoses appears to improve the sensitivity of Duplex scanning....

  3. Minimally invasive coronary artery bypass grafting: a systematic review.

    Science.gov (United States)

    Kikuchi, Keita; Mori, Makoto

    2017-06-01

    To minimize surgical morbidity in coronary artery bypass grafting, minimally invasive cardiac surgery has gained popularity. Minimally invasive coronary artery bypass grafting offers unique advantages compared to conventional off-pump coronary artery bypass or minimally invasive direct coronary artery bypass in that it enables the surgeon to harvest and graft bilateral internal thoracic arteries via a small thoracotomy while being conducted completely off-pump. This review focuses on current evidence behind off-pump coronary artery bypass, multi-arterial revascularization, patient populations that would most benefit from bilateral internal thoracic artery minimally invasive coronary artery bypass grafting, the surgical technique, and early outcomes. By overcoming the perceived inability to utilize bilateral internal thoracic arteries in minimally invasive coronary artery bypass grafting, the new technique further expands the armamentarium of surgeons and cardiologists. Hybrid coronary revascularization with bilateral internal thoracic artery minimally invasive coronary artery bypass grafting further augments the appeal of the next generation of minimally invasive cardiac surgery.

  4. Gastric Bypass Surgery: What Happens If I Regain the Weight?

    Science.gov (United States)

    ... happens if you gain back weight after gastric bypass surgery? Answers from Katherine Zeratsky, R.D., L. ... If you begin to regain weight after gastric bypass surgery, talk to your doctor. You may have ...

  5. Analgesic Treatment in Laparoscopic Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Andersen, Lars P H; Werner, Mads U; Rosenberg, Jacob

    2014-01-01

    This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines. The litera......This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines...

  6. Performance of FACTS equipment in Meshed systems

    Energy Technology Data Exchange (ETDEWEB)

    Lerch, E.; Povh, D. [Siemens AG, Berlin (Germany)

    1994-12-31

    Modern power electronic devices such as thyristors and GTOs have made it possible to design controllable network elements, which will play a considerable role in ensuring reliable economic operation of transmission systems as a result of their capability to rapidly change active and reactive power. A number of FACTS elements for high-speed active and reactive power control will be described. Control of power system fluctuations in meshed systems by modulation of active and reactive power will be demonstrated using a number of examples. (author) 7 refs., 11 figs.

  7. Postoperative Hydrocortisone Infusion Reduces the Prevalence of Low Cardiac Output Syndrome After Neonatal Cardiopulmonary Bypass.

    Science.gov (United States)

    Robert, Stephen M; Borasino, Santiago; Dabal, Robert J; Cleveland, David C; Hock, Kristal M; Alten, Jeffrey A

    2015-09-01

    Neonatal cardiac surgery with cardiopulmonary bypass is often complicated by morbidity associated with inflammation and low cardiac output syndrome. Hydrocortisone "stress dosing" is reported to provide hemodynamic benefits in some patients with refractory shock. Development of cardiopulmonary bypass-induced adrenal insufficiency may provide further rationale for postoperative hydrocortisone administration. We sought to determine whether prophylactic, postoperative hydrocortisone infusion could decrease prevalence of low cardiac output syndrome after neonatal cardiac surgery with cardiopulmonary bypass. Double-blind, randomized control trial. Pediatric cardiac ICU and operating room in tertiary care center. Forty neonates undergoing cardiac surgery with cardiopulmonary bypass were randomized (19 hydrocortisone and 21 placebo). Demographics and known risk factors were similar between groups. After cardiopulmonary bypass separation, bolus hydrocortisone (50 mg/m²) or placebo was administered, followed by continuous hydrocortisone infusion (50 mg/m²/d) or placebo tapered over 5 days. Adrenocorticotropic hormone stimulation testing (1 μg) was performed before and after cardiopulmonary bypass, prior to steroid administration. Blood was collected for cytokine analysis before and after cardiopulmonary bypass. Subjects receiving hydrocortisone were less likely to develop low cardiac output syndrome (5/19, 26% vs 12/21, 57%; p = 0.049). Hydrocortisone group had more negative net fluid balance at 48 hours (-114 vs -64 mL/kg; p = 0.01) and greater urine output at 0-24 hours (2.7 vs 1.2 mL/kg/hr; p = 0.03). Hydrocortisone group weaned off catecholamines and vasopressin sooner than placebo, with a difference in inotrope-free subjects apparent after 48 hours (p = 0.033). Five placebo subjects (24%) compared with no hydrocortisone subjects required rescue steroids (p = 0.02). Thirteen (32.5%) had adrenal insufficiency after cardiopulmonary bypass. Patients with adrenal

  8. Pancreatic and Intestinal Function Post Roux-en-Y Gastric Bypass Surgery for Obesity

    DEFF Research Database (Denmark)

    O'Keefe, Stephen J D; Rakitt, Tina; Ou, Junhai

    2017-01-01

    OBJECTIVES: Despite the fact that the most effective treatment for morbid obesity today is gastric bypass surgery, some patients develop life-threatening nutritional complications associated with their weight loss. METHODS: Here we examine the influence of the altered anatomy and digestive...... physiology on pancreatic secretion and fat absorption. Thirteen post Roux-en-Y gastric bypass (RYGB) patients who had lost >100 lbs in the first year following surgery and who gave variable histories of gastrointestinal (GI) dysfunction, were selected for study. Food-stimulated pancreatic enzyme secretion....... CONCLUSIONS: Our investigations revealed a wide spectrum of gastrointestinal abnormalities, including fat malabsorption, impaired food stimulated pancreatic secretion, ileal brake stimulation, and bacterial overgrowth, in patients following RYGB which could be attributed to the breakdown of the normally...

  9. A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Trethowan Brian A

    2011-11-01

    Full Text Available Abstract Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION, posterior ischaemic optic neuropathy (PION, and central retinal artery occlusion (CRAO. These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass; general surgery; urology; gynaecology; liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone, alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.

  10. The impact of avoiding cardiopulmonary by-pass during coronary artery bypass surgery in elderly patients: the Danish On-pump Off-pump Randomisation Study (DOORS

    Directory of Open Access Journals (Sweden)

    Schmidt Thomas

    2009-07-01

    Full Text Available Abstract Background Coronary Artery Bypass Graft operation for ischemic heart disease provides improved quality of life and, in some patients, prolonged survival. Concern has, however, been raised about complications that may be related to the use of cardiopulmonary by-pass (CPB and aortic cross-clamping. It has been hypothesized that when coronary artery by-pass grafting is performed without the use of CPB, the rate of serious complications is reduced. Methods/Design The trial is designed as an open, randomized, controlled, clinical trial with blinded assessment of end-points. Patients at or above 70 years of age, referred for surgical myocardial revascularisation, are included and randomised to receive coronary artery by-pass grafting either with or without the use of CPB and aortic cross-clamping. Follow-up is performed by clinical, biochemical, electrocardiographic, and angiographic data that are evaluated by independent committees that are blinded with respect to the result of the randomisation. End points include mortality, stroke, myocardial infarction, graft patency, quality of life, and cost-effectiveness. The trial is performed in four different Danish, cardiac surgery centres. Trial registration ClinicalTrials.gov NCT00123981

  11. Facts, principles, and (real) politics

    NARCIS (Netherlands)

    Rossi, E.

    2016-01-01

    Should our factual understanding of the world influence our normative theorising about it? G.A. Cohen has argued that our ultimate normative principles should not be constrained by facts (e.g. about feasibility, human nature, and so on). Many others have defended or are committed to various versions

  12. High Blood Pressure Fact Sheet

    Science.gov (United States)

    ... High Blood Pressure Salt Cholesterol Million Hearts® WISEWOMAN High Blood Pressure Fact Sheet Language: English (US) Español (Spanish) Recommend ... time. High blood pressure is also called hypertension. High Blood Pressure in the United States Having high blood pressure ...

  13. NASA Facts, The Viking Mission.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC. Educational Programs Div.

    Presented is one of a series of publications of National Aeronautics and Space Administration (NASA) facts about the exploration of Mars. The Viking mission to Mars, consisting of two unmanned NASA spacecraft launched in August and September, 1975, is described. A description of the spacecraft and their paths is given. A diagram identifying the…

  14. NASA Facts, Mars and Earth.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC. Educational Programs Div.

    Presented is one of a series of National Aeronautics and Space Administration (NASA) facts about the exploration of Mars. In this publication, emphasis is placed on the sun's planetary system with note made that there is no one theory for the origin and subsequent evolution of the Solar System that is generally accepted. Ideas from many scientists…

  15. Facts about Rubella for Adults

    Science.gov (United States)

    ... of an infected person. If a woman gets rubella during pregnancy, particularly during the first three months, her baby ... exhibit symptoms. FACT: If a pregnant woman gets rubella during the first three months of pregnancy, her baby has a good chance of having ...

  16. Norms and facts in measurement

    NARCIS (Netherlands)

    Brakel, J. van

    1984-01-01

    Publications concerned with the foundations of measurement often accept uncritically the theory/observation and the norm/fact distinction. However, measurement is measurement-in-a-context. This is analysed in the first part of the paper. Important aspects of this context are: the purpose of the

  17. Higher Education Act. Fact Sheet.

    Science.gov (United States)

    National Council on Disability, 2004

    2004-01-01

    This fact sheet highlights the challenges for students with disabilities in the nation's university system and recommends solutions that would result in better support systems for postsecondary students with disabilities. This document discusses several interrelated issues that impact student preparation and access to postsecondary education. The…

  18. Facts About: College Mental Health.

    Science.gov (United States)

    National Inst. of Mental Health (DHEW), Rockville, MD.

    Facts about college mental health are presented in response to frequently asked questions. Areas of concern include common conditions interfering with student effectiveness, why students seek help and where they can get it, the frequency of severe mental illness in college students, the suicide problem, the limitations of nonprofessional help, the…

  19. Thorndike Revisited--Some Facts

    Science.gov (United States)

    Tuinman, J. Jaap

    1971-01-01

    Examines some historical facts surrounding Thorndike's 1917 article, Reading as Reasoning: A Study of Mistakes in Paragraph Reading," (republished in Reading Research Quarterly, 1971, 6, 425-48), in an attempt to put the article in its proper perspective both as a research study and as a contribution to the psychology of reading. (VJ)

  20. Alzheimer's Disease Facts and Figures

    Medline Plus

    Full Text Available ... the number of people with this disease. As research advances a biomarker-based method for diagnosis and treatment at the earliest stages of Alzheimer's disease, we envision a future in which Alzheimer's disease is placed in the same category ... More Alzheimer's Disease Facts in Each State ...

  1. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood or...

  2. 21 CFR 870.4230 - Cardiopulmonary bypass defoamer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass defoamer. 870.4230 Section... bypass defoamer. (a) Identification. A cardiopulmonary bypass defoamer is a device used in conjunction... entitled “Guidance for Extracorporeal Blood Circuit Defoamer 510(k) Submissions.” [45 FR 7907-7971, Feb. 5...

  3. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger. (b...

  4. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4400 Cardiopulmonary bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in...

  5. 21 CFR 870.4300 - Cardiopulmonary bypass gas control unit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass gas control unit. 870.4300... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4300 Cardiopulmonary bypass gas control unit. (a) Identification. A cardiopulmonary bypass gas control unit is a device used...

  6. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass intracardiac suction....4430 Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary bypass intracardiac suction control is a device which provides the vacuum and control for a cardiotomy return sucker...

  7. Outcomes after off-pump coronary bypass surgery

    NARCIS (Netherlands)

    Dijk, Diederik van

    2002-01-01

    The complications associated with in coronary artery bypass surgery (CABG) using cardiopulmonary bypass (CPB) have led to a renewed interest in coronary bypass surgery on the beating heart. The primary objective of the Octopus Study was to compare cognitive outcome between patients randomized to

  8. Complete Immediate Paraplegia Reversal after Performing Aorto-Lumbar Bypass on the Patient who Underwent Aortoiliac Reconstruction.

    Science.gov (United States)

    Banzic, Igor; Sladojevic, Milos; Ilic, Nikola; Koncar, Igor; Davidovic, Lazar; Brankovic, Milos

    2016-08-01

    Although both internal iliac arteries were saved during operation, the patient developed paraplegia immediately after aortoiliac reconstruction due to the spinal cord ischemia. We report a successfully treated immediate postoperative paraplegia by performing second operation and creating bypass from the bifurcated Dacron graft to the previously detected nonpaired huge lumbar artery. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting.

    Science.gov (United States)

    Teloh, Johanna Katharina; Dohle, Daniel-Sebastian; Sönmez, Serhat; Tsagakis, Konstantinos; Verhaegh, Rabea; Petersen, Miriam; Jakob, Heinz; de Groot, Herbert

    2017-04-01

    Dilutional acidosis may result from the introduction of a large fluid volume into the patients' systemic circulation, resulting in a considerable dilution of endogenous bicarbonate in the presence of a constant carbon dioxide partial pressure. Its significance or even existence, however, has been strongly questioned. Blood gas samples of patients operated on with standard cardiopulmonary bypass (CPB) were analyzed in order to provide further evidence for the existence of dilutional acidosis. Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with CPB were enrolled in this prospective observational study. Blood gas samples taken regularly after CPB initiation were analyzed for dilutional effects and acid-base changes. After CPB initiation, hemoglobin concentration dropped from an average initial value of 12.8 g/dl to 8.8 g/dl. Before the beginning of CPB, the mean value of the patients' pH and base excess (BE) value averaged 7.41 and 0.5 mEq/l, respectively. After the onset of CPB, pH and BE values significantly dropped to a mean value of 7.33 (p < 0.0001) and -3.3 mEq/l (p < 0.0001), respectively, within the first 20 min. In the following period during CPB they recovered to 7.38 and -0.5 mEq/l, respectively, on average. Patients did not show overt lactic acidosis. The present data underline the general existence of dilutional acidosis, albeit very limited in its duration. In patients undergoing coronary artery bypass grafting it seems to be the only obvious disturbance in acid-base homeostasis during CPB.

  10. Marijuana: Facts Parents Need to Know

    Science.gov (United States)

    ... Parents Need to Know » A Letter to Parents Marijuana: Facts Parents Need to Know Email Facebook Twitter ... their children to review the scientific facts about marijuana: (1) Marijuana: Facts Parents Need to Know and ( ...

  11. Oral Health in the US: Key Facts

    Science.gov (United States)

    ... Policy Oral Health in the U.S.: Key Facts Oral Health in the U.S.: Key Facts Published: Jun 01, ... Email Print This fact sheet provides data on oral health care coverage and access for children, nonelderly adults ...

  12. Vitamin and Mineral Supplement Fact Sheets

    Science.gov (United States)

    ... website Submit Search NIH Office of Dietary Supplements Vitamin and Mineral Supplement Fact Sheets Search the list ... Supplements: Background Information Botanical Dietary Supplements: Background Information Vitamin and Mineral Fact Sheets Botanical Supplement Fact Sheets ...

  13. Bypassing BDD Construction for Reliability Analysis

    DEFF Research Database (Denmark)

    Williams, Poul Frederick; Nikolskaia, Macha; Rauzy, Antoine

    2000-01-01

    In this note, we propose a Boolean Expression Diagram (BED)-based algorithm to compute the minimal p-cuts of boolean reliability models such as fault trees. BEDs make it possible to bypass the Binary Decision Diagram (BDD) construction, which is the main cost of fault tree assessment....

  14. Planetary science: Bypassing the habitable zone

    Science.gov (United States)

    Ingersoll, Andrew P.

    2017-08-01

    In our own solar system, Venus is too hot, Mars is too cold and Earth is just right. Simulations show that making an icy planet habitable is not as simple as melting its ice: many icy bodies swing from too cold to too hot, bypassing just right.

  15. A Survey of Cache Bypassing Techniques

    Directory of Open Access Journals (Sweden)

    Sparsh Mittal

    2016-04-01

    Full Text Available With increasing core-count, the cache demand of modern processors has also increased. However, due to strict area/power budgets and presence of poor data-locality workloads, blindly scaling cache capacity is both infeasible and ineffective. Cache bypassing is a promising technique to increase effective cache capacity without incurring power/area costs of a larger sized cache. However, injudicious use of cache bypassing can lead to bandwidth congestion and increased miss-rate and hence, intelligent techniques are required to harness its full potential. This paper presents a survey of cache bypassing techniques for CPUs, GPUs and CPU-GPU heterogeneous systems, and for caches designed with SRAM, non-volatile memory (NVM and die-stacked DRAM. By classifying the techniques based on key parameters, it underscores their differences and similarities. We hope that this paper will provide insights into cache bypassing techniques and associated tradeoffs and will be useful for computer architects, system designers and other researchers.

  16. Post-Bypass Extensive Ascites due to Splanchnic Bypass and the Effectiveness of Hyperalimentation Treatment

    Directory of Open Access Journals (Sweden)

    Veysel Temizkan

    2013-04-01

    Full Text Available Reperfusion edema may develop in the early periods of chronic ischemic tissue reperfusion. Reperfusion edema may be represented after the splanchnic bypass with ascites, abdominal distension, and liver and kidney function impairment. In this article, we are reporting the hyperalimentation treatment and its results for the common ascites and hepatorenal syndrome, after a coeliac and superior mesenteric artery bypass. [Arch Clin Exp Surg 2013; 2(2.000: 124-128

  17. Five Indisputable Facts on Modern Power Systems

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, Aaron P [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Brinkman, Gregory L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lopez, Anthony J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holttinen, Hannele [VTT Technical Research Centre of Finland; Helman, Udi [Helman Analytics; Summers, Kate [Pacific Hydro; Bakke, Jordan [Midcontinent Independent System Operator

    2017-08-01

    This presentation overviews five indisputable facts about modern power systems: Fact one: The grid can handle more renewable generation than previously thought. Fact two: Geographic and resource diversity provide additional reliability to the system. Fact three: Wind and solar forecasting provide significant value. Fact four: Our electric power markets were not originally designed for variable renewables -- but they could be adapted. Fact five: Modern power electronics are creating new sources of essential reliability services.

  18. Distal polytetrafluoroethylene bypasses in patients older than 75 years.

    Science.gov (United States)

    Illuminati, G; Bertagni, A; Caliò, F G; Papaspyropoulos, V

    2000-07-01

    Polytetrafluoroethylene (PTFE) alone is justified for infrapopliteal arterial grafting in elderly patients with critical ischemia of the lower limbs who lack a suitable, autogenous saphenous vein. A consecutive sample clinical study with a mean follow-up of 16 months. The surgical department of an academic tertiary care center and an affiliated secondary care center. Thirty-one patients older than 75 years with critical ischemia of the lower limbs received 34 PTFE bypass grafts to the infrapopliteal arteries: 12 patients to the anterior tibial, 8 to the peroneal, 8 to the posterior tibial, and 2 to the dorsalis pedis artery. Cumulative survival, primary graft patency, and limb salvage rates expressed by standard life-table analysis. Operative mortality rate was 3%. Cumulative survival rate was 80% at 2 years (SE, 9.2%) and 43% at 3 years (SE, 11.4%). Cumulative primary patency rate was 67% at 2 years (SE 9.1%), and 61% at 3 years (SE, 12.7%). Cumulative limb salvage rate was 77% at 2 years (SE, 8.7%) and 70% at 3 years (SE, 12.8%). Polytetrafluoroethylene alone is justified as graft material for infrapopliteal bypass grafts in elderly patients with critical ischemia of the lower limbs and without a suitable autogenous saphenous vein.

  19. Effect of diabetes on outcome and changes in quality of life after coronary artery bypass grafting.

    Science.gov (United States)

    Järvinen, Otso; Julkunen, Juhani; Saarinen, Timo; Laurikka, Jari; Tarkka, Matti R

    2005-03-01

    An increasing proportion of patients undergoing coronary artery bypass grafting are diabetics who are known to carry a higher mortality and morbidity in association with operation, but data on whether health-related quality of life improves similarly after coronary artery bypass grafting in diabetic and nondiabetic patients are limited. We assessed in detail changes in health-related quality of life (RAND-36 Health Survey) during the first year after coronary artery bypass grafting. Seventy-four of the 508 patients (14.6%) operated on in a single institution had a history of diabetes and were compared to nondiabetics. The RAND-36 Health Survey was used as an indicator of quality of life. Assessments were made preoperatively and repeated 12 months later. Thirty-day mortality was 2.7% versus 1.6% (p = 0.511) and one-year survival was 94.6% versus 97.0% (p = 0.287) in the diabetics and nondiabetics, respectively. Diabetics improved significantly (p diabetics as well as in nondiabetics. Both groups experienced closely similar freedom from anginal symptoms at one year (86.2% vs 90.5%, p = 0.280). Although diabetic patients differ from nondiabetics having slightly inferior quality of life before and one year after coronary artery bypass grafting, they gain similar improvement of quality of life in one year after surgery when compared to nondiabetics.

  20. Leptomeningeal contrast enhancement in moyamoya: its potential role in postoperative assessment of circulation through the bypass

    Energy Technology Data Exchange (ETDEWEB)

    Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yasui, T. [Dept. of Neurosurgery, Osaka City General Hospital (Japan); Kitano, S.; Sakamoto, H. [Dept. of Paediatric Neurosurgery, Osaka City General Hospital (Japan)

    2001-01-01

    Leptomeningeal contrast enhancement (LMCE) is one of the MRI features of moyamoya. Its clinical significance, however, is not elucidated. Our purpose was to characterise LMCE on MRI and to evaluate its role in the assessment of circulation through a surgically established bypass in moyamoya. We studied 16 patients with idiopathic moyamoya (seven males, nine females, includingt four children, aged 7 to 54 years, mean 24 years) who underwent T1-weighted MRI before and after intravenous contrast medium. The presence of LMCE, its intensity and anatomical distribution, catheter angiographic findings, and relation of LMCE to the bypass surgery were assessed. More LMCE was seen in the cerebrum in most patients with moyamoya than in normal controls. LMCE in the brain stem and cerebellum was minimal, similar to that seen in the controls. LMCE was less prominent following surgery than before operation or in patients who did not undergo surgery. In three patients examined both before and after operation LMCE became less prominent following bypass surgery. As LMCE becomes less prominent after ''effective'' bypass surgery, this may be used for evaluation of effectiveness of surgery in moyamoya. (orig.)

  1. Cirurgia de revascularização do miocárdio usando apenas tomografia computadorizada como angiograma pré-operatório Cirugía de revascularización del miocardio usando sólo tomografía computada como angiograma preoperatorio Coronary artery bypass using only computed tomography as pre-operative angiogram

    Directory of Open Access Journals (Sweden)

    Diego Felipe Gaia

    2009-09-01

    Full Text Available A cirurgia de revascularização do miocárdio (CRM é um procedimento bem estabelecido com indicações atuais precisas. O advento e a disseminação dessa técnica foram possíveis após a introdução do angiograma coronário. Embora muitos métodos de avaliação tenham evoluído nos últimos anos, nenhum conseguiu substituir o angiograma coronário invasivo como exame pré-operatório. A tomografia computadorizada (TC emergiu como uma alternativa ao angiograma coronário invasivo. O presente relato descreve dois casos de CRM realizadas usando-se apenas a TC como técnica de avaliação anatômica das artérias coronárias pré-operatória.La cirugía de revascularización del miocardio (CRM es un procedimiento bien establecido con indicaciones actuales precisas. El advenimiento y la divulgación de esta técnica fueron posibles después de la introducción del angiograma coronario. Aunque muchos métodos de evaluación hayan evolucionados en los últimos años, ninguno ha conseguido sustituir al angiograma coronario invasivo como examen preoperatorio. La tomografía computada (TC surgió como una alternativa al angiograma coronario invasivo. El presente informe describe dos casos de CRM realizadas usando sólo la TC como técnica de evaluación anatómica de las arterias coronarias preoperatoria.Coronary artery bypass graft (CABG is a well established procedure with current precise indications. The advent and spread of this technique was possible after the introduction of the coronary angiogram. Although many evaluation methods have been developed in the past years, to date, none have been able to replace the invasive coronary angiogram as a pre-operative exam. Computed tomography angiography (CTA has emerged as an alternative to invasive coronary angiogram. In this report we describe two CABG cases that were performed using only this technique as a pre-operative anatomic coronary arteries evaluation.

  2. Food intolerance- facts and myths

    OpenAIRE

    Ptáčková, Zuzana

    2017-01-01

    This bachelor's thesis focuses on the facts and myths about two kinds of food intolerance: celiac disease and lactose intolerance. The thesis consists of a practical and a theoretical part. The theoretical part is further divided into three sections. The first one focuses on celiac disease and describes gluten, epidemiology, etiology, pathogenesis, symptoms of the disease, diagnostics, dietary solutions, celiac disease screening, other similar diseases and also a comparison of allergy to glut...

  3. Technology to Market Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-02-01

    This fact sheet is an overview of the Technology to Market subprogram at the U.S. Department of Energy SunShot Initiative. The SunShot Initiative’s Technology to Market subprogram builds on SunShot’s record of moving groundbreaking and early-stage technologies and business models through developmental phases to commercialization. Technology to Market targets two known funding gaps: those that occur at the prototype commercialization stage and those at the commercial scale-up stage.

  4. International waste management fact book

    Energy Technology Data Exchange (ETDEWEB)

    Amaya, J P; LaMarche, M N; Upton, J F

    1997-10-01

    Many countries around the world are faced with nuclear and environmental management problems similar to those being addressed by the US Department of Energy. The purpose of this Fact Book is to provide the latest information on US and international organizations, programs, activities and key personnel to promote mutual cooperation to solve these problems. Areas addressed include all aspects of closing the commercial and nuclear fuel cycle and managing the wastes and sites from defense-related, nuclear materials production programs.

  5. CT perfusion assessment of Moyamoya syndrome before and after direct revascularization (superficial temporal artery to middle cerebral artery bypass)

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yueqin [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Hospital of Jining Medical College, CT Department, Jining (China); Xu, Wenjian [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Guo, Xiang; Shi, Zhitao; Sun, Zhanguo; Wang, Jiehuan [Hospital of Jining Medical College, CT Department, Jining (China); Gao, Lingyun [Hospital of Jining Medical College, MR Department, Jining (China); Jin, Feng [Hospital of Jining Medical College, Department of Neurosurgery, Jining (China); Chen, Weijian; Yang, Yunjun [Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou (China)

    2016-01-15

    To evaluate the utility of CT perfusion (CTP) for the assessment of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with Moyamoya syndrome (MMS). Twenty-four consecutive MMS patients, who underwent unilateral STA-MCA bypass surgery, received CTP before and after surgery. The relative perfusion parameter values of surgical hemispheres before treatment were compared with post-treatment values. All patients underwent CT angiography (CTA) before and after surgery in order to confirm the patency of bypass. The follow-up CTA after surgery clearly demonstrated 20 (20/24, 83.3 %) bypass arteries, whereas four (16.7 %) bypass arteries were occluded or very small. Postoperative rMTT and rTTP values (P < 0.05) of the surgical side were significantly lower than pre-operation. In patients (n = 20) with bypass patency, postoperative rCBF, rMTT and rTTP values (P < 0.05) of the surgical side were significantly improved. However, the differences of all parameters were not significant (P > 0.05) in the patients (n = 4) without bypass patency after revascularization. This study demonstrates that CTP can provide a crucial quantitative assessment of cerebral haemodynamic changes in MMS before and after STA-MCA anastomosis. (orig.)

  6. Spacecraft Radiator Freeze Protection Using a Regenerative Heat Exchanger with Bypass Setpoint Temperature Control

    Science.gov (United States)

    Ungar, Eugene K.

    2008-01-01

    Spacecraft radiators are sized for their maximum heat load in their warmest thermal environment, but must operate at reduced heat loads and in colder environments. For systems where the radiator environment can be colder than the working fluid freezing temperature, radiator freezing becomes an issue. Radiator freezing has not been a major issue for the Space Shuttle and the International Space Station (ISS) active thermal control systems (ATCSs) because they operate in environments that are warm relative to the freezing point of their external coolants (Freon-21 and ammonia, respectively). For a vehicle that lands at the Lunar South Pole, the design thermal environment is 215K, but the radiator working fluid must also be kept from freezing during the 0 K sink of transit. A radiator bypass flow control design such as those used on the Space Shuttle and ISS requires more than 30% of the design heat load to avoid radiator freezing during transit - even with a very low freezing point working fluid. By changing the traditional ATCS architecture to include a regenerating heat exchanger inboard of the radiator and by using a regenerator bypass flow control valve to maintain system setpoint, the required minimum heat load can be reduced by more than half. This gives the spacecraft much more flexibility in design and operation. The present work describes the regenerator bypass ATCS setpoint control methodology. It includes analytical results comparing the performance of this system to the traditional radiator bypass system. Finally, a summary of the advantages of the regenerator bypass system are presented.

  7. Is totally endoscopic coronary artery bypass safe, feasible and effective?

    Science.gov (United States)

    Acharya, Metesh Nalin; Ashrafian, Hutan; Athanasiou, Thanos; Casula, Roberto

    2012-12-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether totally endoscopic coronary artery bypass (TECAB) is safe, effective and feasible. A total of 171 papers were found, of which eight represented the best evidence. The authors, date, journal, study type, population, main outcome measures and results are tabulated. The da Vinci robotic system was utilized in seven retrospective studies and one multicentre prospective trial, comprising 724 patients undergoing TECAB. Patient-related outcomes, including the incidence of major adverse cardiac events, graft patency and survival, were investigated. From the studies evaluated, TECAB appears to be safe operation with low complication rates and excellent early- and mid-term graft patencies. The incidence of internal thoracic artery injury was documented in four studies and ranged from 0 to 10%. Re-exploration for bleeding was necessary in 1-15% of patients. Conversion to open techniques was performed in 0-24% of cases. There was no in-hospital mortality in the majority of studies, but this reached 2.1% in a large series of 228 patients. Target-vessel reintervention rates varied between 0 and 12.1% according to the institutional experience. Pre- and post-discharge graft patencies were excellent at 93-100 and 92-100%, respectively. Intraoperative variables, such as time taken for internal thoracic artery harvest, anastomosis, cross-clamp, cardiopulmonary bypass (CPB) and the overall operation were as follows: internal thoracic artery harvest time (range 5-187 min), anastomosis time (range 6-82 min), cross-clamp time (range 30-223 min), CPB time (range 41-268 min) and operative time (range 84-600 min). TECAB is a technically demanding and time-consuming procedure associated with a significant learning curve. Proctoring and structured training programmes are currently supported by European and international societies to encourage wider uptake of the procedure. In conclusion

  8. Diabetes resolution after one anastomosis gastric bypass.

    Science.gov (United States)

    Abu-Abeid, Adam; Lessing, Yonatan; Pencovich, Niv; Dayan, Danit; Klausner, Joseph M; Abu-Abeid, Subhi

    2018-02-01

    Diabetes and other obesity-related diseases are a worldwide pandemic that transcends geographic borders as well as socioeconomic levels. Currently, it is well known that medical treatment alone is insufficient to ensure adequate and sustainable weight loss and co-morbidity resolution. It has been well proven that bariatric surgery can produce almost immediate resolution of diabetes and other co-morbidities as well as long-term weight loss. Here, we present our experience with the one anastomosis gastric bypass (OAGB) in terms of weight loss and diabetes resolution with 1 year of follow-up. Large, metropolitan, tertiary, university hospital. A retrospective analysis of all patients who underwent OAGB between March 2015 and March 2016 was performed. Patient demographic characteristics, co-morbidities, operative and postoperative data, as well as first year outcomes were collected and analyzed. There were 407 patients who underwent OAGB (254 females, average age 41.8 ± 12.05 yr, body mass index = 41.7 ± 5.77 kg/m 2 ). Of patients, 102 (25.1%) had diabetes with average glycosylated hemoglobin of 8.64 ± 1.94 g%, 93 (22.8%) had hypertension, 123 (28.8%) had hyperlipidemia, and 35 patients (8.6%) had obstructive sleep apnea. The average length of hospital stay was 2.2 ± .84 days (range, 2-10 d). The average excess weight loss 1 year after surgery was 88.9 ± 27.3. After 1 year, follow-up data were available for more than 85% of the study's general population. Of 102 diabetic patients, only 8 (7.8%) were still considered diabetic and taking antidiabetic medication, with an average glycosylated hemoglobin of 5.4 ± 0.6. OAGB may be performed safely and with promising efficacy as both a primary and a revisional bariatric surgery, and it offers excellent resolution of diabetes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Patients' strategies for eating after gastric bypass surgery: a qualitative study.

    Science.gov (United States)

    Hillersdal, L; Christensen, B J; Holm, L

    2016-04-01

    There is considerable variation in the amount of weight patients lose after gastric bypass surgery, and this may be related to the way they adjust to the operation in their daily eating practices. Little is known about how this varies. On the basis of a qualitative research design, this study therefore explores how patients deal with gastric bypass surgery in their daily lives. The study is based on interviews with 24 men and women in Denmark diagnosed with morbid obesity who have had, Roux-en-Y gastric bypass surgery. The interviews were transcribed, coded and analysed using 'grounded theory' methodology. Three strategies used by patients to cope with postoperative changes were identified. In the first strategy, patients treat surgery as time-out, using the operation to facilitate a change in their ordinary habits of daily life, but not as a solution to overweight in itself. Patients adopting the second strategy of surgery as solution would expect their smaller stomach to hinder excess food intake automatically. The third strategy of abstaining was adopted by patients who were afraid to experience negative side effects, or who believed they might 'ruin the operation'. Patients adjust to their postoperative condition in very different ways. The variation in the ways patients comprehend and cope with the operation and in its effects on their eating routines and practices needs to be further investigated and compared more systematically with the outcomes of the operation in terms of weight loss and overall well-being.

  10. Portal-to-right portal vein bypass for extrahepatic portal vein obstruction.

    Science.gov (United States)

    Long, Li; Jinshan, Zhang; Zhen, Chen; Qi, Li; Ning, Dong; Mei, Diao; Wei, Cheng

    2017-11-04

    Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts. Eight children (age 6.1years, range 3.5-8.9years) who underwent Rex shunts developed recurrent gastrointestinal bleeding and hypersplenism 13months (11-30months) postoperatively. After ultrasound confirmation of blocked shunt, they underwent exploration. Three patients were found to have right portal vein agenesis. Five patients (62.5%) were found to have the patent right portal vein, with the diameter of 3-6mm. Four patients underwent bypass between the main portal vein in the hepatoduodenal ligament and the right portal vein by interposing an inferior mesenteric vein autograft, whereas the remaining patient underwent a bypass using ileal mesenteric vein autograft. The operations took 2.3h (1.9-3.5h). The estimated blood loss was 50ml (30-80ml), with no complication. The portal venous pressure dropped from 34.6cmH2O (28-45 cmH2O) before the bypass to 19.6cmH2O (14-24cmH2O) after the bypass. The 5 patients were followed up for 10.2months (4-17months) and the post-operative ultrasound and CT angiography confirmed the patency of all the grafts and disappearance of the portal venous cavernova in all five patients. The portal-to-right portal vein bypass technique is feasible and safe for treatment of children with EHPVO who have had failed Rex shunts. Our preliminary result indicates that this technique extends the success of Rex shunt from left portal vein to right portal vein and open a new indication of physiological shunt for some of the children who not only have had failed Rex

  11. Concomitant aorto-right subclavian artery bypass with off-pump coronary artery bypass grafting: a case report.

    Science.gov (United States)

    Tazume, Hirokazu; Okamoto, Ken; Fukui, Toshihiro

    2017-10-11

    Atherosclerotic stenosis of the brachiocephalic artery sometimes occurs in patients with coronary artery disease, and can cause stroke during the perioperative period of coronary artery bypass grafting. We describe the case of a 77-year old male with severe stenosis of the brachiocephalic artery and severe coronary artery disease. He successfully underwent aorto-right subclavian artery bypass that was performed concomitantly with off-pump coronary artery bypass. Concomitant aorto-subclavian artery bypass with off-pump coronary artery bypass grafting is a therapeutic option that minimizes the risk of perioperative stroke in patients with brachiocephalic artery stenosis and coronary artery disease.

  12. SUrgical versus PERcutaneous Bypass : SUPERB-trial; Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Lensvelt, Mare M. A.; Holewijn, Suzanne; Fritschy, Wilbert M.; Wikkeling, Otmar R. M.; van Walraven, Laurens A.; de Vries, Bas M. Wallis; Zeebregts, Clark J.; Reijnen, Michel M. P. J.

    2011-01-01

    Background: Endovascular treatment options for the superficial femoral artery are evolving rapidly. For long lesions, the venous femoropopliteal bypass considered to be superior above the prosthetic bypass. An endoluminal bypass, however, may provide equal patency rates compared to the prosthetic

  13. SUrgical versus PERcutaneous Bypass: SUPERB-trial; Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Holewijn, S.; Fritschy, W.M.; Wikkeling, O.R.; Walraven, L.A. van; Wallis de Vries, B.M.; Zeebregts, C.J.A.; Reijnen, M.M.P.J.

    2011-01-01

    BACKGROUND: Endovascular treatment options for the superficial femoral artery are evolving rapidly. For long lesions, the venous femoropopliteal bypass considered to be superior above the prosthetic bypass. An endoluminal bypass, however, may provide equal patency rates compared to the prosthetic

  14. Meaning, Memory, and Multiplication: Integrating Patterns and Properties with Basic Facts

    Science.gov (United States)

    Ploger, Don; Hecht, Steven

    2012-01-01

    Although learning mathematics certainly depends upon accurate understanding of the facts of multiplication, it requires much more. This study examines the relationship between a meaningful understanding of arithmetic operations and the mastery of basic facts. The study began with a joke about a mistaken mathematical fact. The children appreciated…

  15. Totally Robotic Reversal of Omega-Loop Gastric Bypass to Normal Anatomy.

    Science.gov (United States)

    Reche, Fabian; Mancini, Adrian; Borel, Anne-Laure; Faucheron, Jean-Luc

    2016-08-01

    using the DaVinci Si™ system by Intuitive Surgical Inc ®, Sunnyvale, CA. In this high definition video, we present step-by-step robotic reversal of the omega-loop gastric bypass. The procedure began with a careful adhesiolysis of the left lobe of the liver, small gastric pouch, and omega-loop. Then, the gastro-jejunostomy was transected with a 45-mm Endo GIA endocutter with purple staples. The key-point was the creation of a gastro-gastric anastomosis between the small gastric pouch and the excluded stomach. Omega-loop jejunum was resected and the anastomosis was performed in order to avoid intestinal stenosis. The operative time was 232 min. Postoperative course was uneventful and the patient was discharged in postoperative day 8. One month after the procedure, she has gained 10 kg (albumin 34 g/l) and stabilized her nutritional status without further nutritional support. This is the first case described in the literature of a reversal omega-loop gastric bypass into normal anatomy and the first description of the use of a robotic approach. This intervention is challenging, but a feasible procedure. This technology may increase the number of surgeons who are able to provide the benefits of minimal invasive surgery to their patients without the increased risks of complications associated with initial learning curves. The three-dimensional robotic vision, a stable camera, and the multiples degrees of freedom of the robotic instruments are the features that seem to provide greater surgical precision for these complex laparoscopic operations.

  16. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Vision Facts and Myths How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A A A en ... nutricionales (video) Most packaged foods come with a Nutrition Facts label. These labels have a lot of ...

  17. Off-Pump Triple Coronary Artery Bypass Grafting in a Patient with Situs Inversus Totalis: Case Presentation and a Brief Review of the Brazilian and the International Experiences

    Directory of Open Access Journals (Sweden)

    Carlos Junior Toshiyuki Karigyo

    Full Text Available Abstract A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition.

  18. Low preoperative cholesterol level is a risk factor of sepsis and poor clinical outcome in patients undergoing cardiac surgery with cardiopulmonary bypass.

    Science.gov (United States)

    Lagrost, Laurent; Girard, Claude; Grosjean, Sandrine; Masson, David; Deckert, Valérie; Gautier, Thomas; Debomy, Frédérique; Vinault, Sandrine; Jeannin, Aline; Labbé, Jérôme; Bonithon-Kopp, Claire

    2014-05-01

    Systemic inflammatory response syndrome and sepsis frequently occur after cardiac surgery with cardiopulmonary bypass. The aim of the present study was to investigate whether preoperative cholesterol levels can predict sepsis onset and postoperative complications in patients undergoing cardiac surgery with cardiopulmonary bypass. Prospective observational study. Surgical ICU of a French university hospital. Two hundred and seventeen consecutive patients older than 18 years admitted for planned cardiac surgery with cardiopulmonary bypass. Measurements of plasma blood lipids and inflammation markers before anesthesia induction (baseline), at cardiopulmonary bypass start, at cardiopulmonary bypass end, and 3 and 24 hours after cardiac surgery. Outcomes were compared in systemic inflammatory response syndrome patients with sepsis (n = 15), systemic inflammatory response syndrome patients without sepsis (n = 95), and non-systemic inflammatory response syndrome patients (n = 107). A gradual decrease in plasma cholesterol concentration occurred during surgery with cardiopulmonary bypass but was no longer present after correction for hemodilution. Corrected cholesterol levels were significantly lower at baseline in sepsis patients than in other subgroups, and it remained lower in the sepsis group during and after cardiopulmonary bypass. With regard to sepsis, the discriminatory power of baseline cholesterol was fairly good as indicated by receiver operating characteristic curve analysis (area under the curve, 0.78; 95% CI, 0.72-0.84). The frequency of sepsis progressively decreased with increasing baseline cholesterol level quintiles (18.6% and 0% in the bottom and top quintiles, respectively, p = 0.005). In multivariate analysis, baseline cholesterol levels and cardiopulmonary bypass duration were significant and independent determinants of the 3-hour postcardiopulmonary bypass increase in concentrations of procalcitonin and interleukin-8, but not of interleukin-6. Low

  19. Contrasting effects of subtotal enteric bypass, enterectomy, and colectomy on azoxymethane-induced intestinal carcinogenesis.

    Science.gov (United States)

    Williamson, R C; Bauer, F L; Terpstra, O T; Ross, J S; Malt, R A

    1980-03-01

    Compensatory hyperplasia after extensive loss of functioning small or large intestine might predispose to the development of neoplasia in the residual adapted bowel. To test this hypothesis, male Fischer rats were randomized to receive 85 to 90% jejunoileal resection or bypass, subtotal colectomy, or no operation (controls). One week later, the first of six weekly s.c. injections of azoxymethane (15 mg/kg/week) was given. At the 36th week postoperatively, mean body weight after enterectomy or colectomy it was 78 to 79% of control. Adaptation after all three operations was characterized by 22 to 84% increments in villous height and crypt depth in the residual functioning ileum (p = 0.05 to 0.001); the depth of colonic crypts was unchanged. Fewer rats developed intestinal tumors after enteric bypass (36%) than after any of the other treatments (80 to 91%) (p = 0.01 to 0.001); the depth of colonic crypts was unchanged. Fewer rats developed intestinal tumors after enteric bypass (36%) than after any of the other treatments (80 to 91%) (p = 0.01 to 0.001). Compared with controls, bypass reduced the number of colonic tumors by 77% (p less than 0.001). Although resection did not affect colonic tumor yield, it tripled the incidence of tumors in the duodenum and jejunum (p = 0.025). Colectomy promoted rectal carcinogenesis (p less than 0.05). Anastomotic tumors were commoner after intestinal resection. the lower frequency of tumors after jejunoileal bypass contrasts with enhanced carcinogenesis after enterectomy or colectomy. Profound reduction in body weight may prevent the promotional effect of adaptive hyperplasia.

  20. Completion of the Three-Stage Fontan Pathway Without Cardiopulmonary Bypass.

    Science.gov (United States)

    Mainwaring, Richard D; Reddy, V Mohan; Hanley, Frank L

    2014-07-01

    The three-stage surgical approach is now accepted as the standard for management of children born with functional single ventricle. However, there is little consensus on the cardiopulmonary bypass strategies employed for these procedures. We have attempted to avoid cardiopulmonary bypass in patients with single ventricle whenever possible to eliminate the adverse effects that are induced by this process. The purpose of this study was to review our experience in patients who underwent all three stages of the Fontan pathway without ever being exposed to bypass. A total of 52 patients with single ventricle underwent "off-pump" treatment at all three stages of their surgical management. The time period of the study was from 2002 to 2013. There were 31 males and 21 females. Anatomic diagnoses included double inlet left ventricle (n = 11), pulmonary atresia with intact ventricular septum (n = 11), tricuspid atresia (n = 10), double outlet right ventricle (n = 9), and other (n = 11). There was no operative mortality in the 52 patients undergoing Fontan completion. The patients have been followed for an average of 5.1 ± 2.5 years, with one late mortality. The median length of hospital stay for the three stages was 17, 5, and 9 days, respectively. Of the 52 patients, 42 were able to undergo all three stages without the need for a blood transfusion. This series demonstrates the feasibility of achieving a Fontan circulation without patients exposed to cardiopulmonary bypass. There was no operative mortality and low mid-term mortality. It is notable that 80% of patients never required a blood transfusion with this approach. The elimination of cardiopulmonary bypass provides several potential clinical benefits in this highly select subset of patients with single ventricle. © The Author(s) 2014.

  1. Can cardiopulmonary bypass system with blood priming become a new standard in coronary surgery?

    Science.gov (United States)

    Mak, Marek A; Smołka, Adam; Kowalski, Jan; Kuc, Alicja; Klausa, Filip; Kremens, Karol; Jarek, Dariusz; Bachowski, Ryszard; Skiba, Jacek

    2016-01-01

    Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator, and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with the patient's own blood has a fundamental impact on the outcome. A comparison of cardiopulmonary bypass filled with the patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids. Non-randomised trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with use of cardiopulmonary bypass system with the patient's own blood priming, and a control group operated on with standard technique. Levels of haemoglobin (HGB), haematocrit (HCT), platelets, leukocytes, creatinine, protein, C-reactive protein, procalcitonin, volume of transfused blood products, postoperative drain output, time to extubation, and consumption of catecholamines were compared. The results of a study comparing the classical system with the blood-filled system (n = 60) showed a significantly smaller decrease in HGB and HCT levels (p = 0.001), resulting in reduction of blood product transfusions by 75% (p = 0.03). The new type of extracorporeal circulation reduced the total postoperative drain output by approximately 28% (p = 0.003). The systemic inflammatory response syndrome (SIRS) was less pronounced and the tissue perfusion was better due to smaller degree of haemodilution leading to better organ and heart protection. The patients required shorter mechanical ventilation times in the perioperative period. The use of a new system of cardiopulmonary bypass filled with the patient's blood reduces the postoperative decrease in HGB and HCT, the amount of transfused blood products, and total postoperative drain output. It also shortens the time spent on mechanical ventilatory support.

  2. Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages

    Science.gov (United States)

    de Carvalho Filho, Élio Barreto; Marson, Fernando Augusto de Lima; da Costa, Loredana Nilkenes Gomes; Antunes, Nilson

    2014-01-01

    Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas. PMID:25140478

  3. The Metaphysical Instincts & Spiritual Bypassing in Integral Psychology

    Directory of Open Access Journals (Sweden)

    Bahman A.K. Shirazi

    2013-09-01

    Full Text Available Instincts are innate, unconscious means by which Nature operates in all forms of life including animals and human beings. In humans however, with progressive evolution of consciousness, instincts become increasingly conscious and regulated by egoic functions. Biological instincts associated with the lower-unconscious such as survival, aggressive, and reproductive instincts are well known in general psychology. The higher-unconscious, which is unique to human beings, may be said to have its own instinctual processes referred to here as the ‘metaphysical instincts’. In traditional spiritual practices awakening the metaphysical instincts has often been done at the expense of suppressing the biological instincts—a process referred to as spiritual bypassing. This essay discusses how the metaphysical instincts initially expressed as the religious impulse with associated beliefs and behaviors may be transformed and made fully conscious, and integrated with the biological instincts in integral yoga and psychology in order to achieve wholeness of personality.

  4. Obese patients with type 2 diabetes submitted to banded gastric bypass: greater incidence of dumping syndrome.

    Science.gov (United States)

    Padoin, Alexandre Vontobel; Galvão Neto, Manoel; Moretto, Myriam; Barancelli, Fabiano; Schroer, Caroline Eckerdt; Mottin, Cláudio Corá

    2009-11-01

    Dumping syndrome is one of ten most common complications in morbidly obese patients operated. Recent studies in relation to type 2 diabetes mellitus (DM2) in patients submitted to gastric bypass led us to examine the different outcomes in this group of patients. Our objective was to determine the difference in the prevalence of dumping syndrome in patients with DM2 submitted to gastric bypass. In this retrospective study, 49 diabetic and 54 non-diabetic morbidly obese patients were submitted to gastric bypass and followed up at 3, 6, and 12 months after surgery. The occurrence of dumping was determined by the patient's medical chart, where it was considered positive if recorded in at least one of three evaluations. The 103 patients evaluated had a mean BMI of 49.5 +/- 9.3 kg/m(2) and mean age of 38 +/- 9.7 years, with 75.7% being women. The prevalence of dumping syndrome in this population was 24.3%. The prevalence of dumping was greater in patients with DM2 (44.9%) when compared to the control group (5.6%; p dumping syndrome. Dumping syndrome is a common postoperative complication in gastric bypass. Patients with DM2 show a greater postoperative prevalence of dumping.

  5. Arachnoid Membrane Suturing for Prevention of Subdural Fluid Collection in Extracranial-intracranial Bypass Surgery.

    Science.gov (United States)

    Kim, Gun Woo; Joo, Sung Pil; Kim, Tae Sun; Moon, Hyung Sik; Jang, Jae Won; Seo, Bo Ra; Lee, Jung Kil; Kim, Jae Hyoo; Kim, Soo Han

    2014-06-01

    Water-tight closure of the dura in extracranial-intracranial (EC-IC) bypass is impossible because the superficial temporal artery (STA) must run through the dural defect. Consequently, subdural hygroma and subcutaneous cerebrospinal fluid (CSF) collection frequently occur postoperatively. To reduce these complications, we prospectively performed suturing of the arachnoid membrane after STA-middle cerebral artery (STA-MCA) and evaluated the clinical usefulness. Between Mar. 2005 and Oct. 2010, extracranial-intracranial arterial bypass (EIAB) with/without encephalo-myo-synangiosis was performed in 88 cases (male : female = 53 : 35). As a control group, 51 patients (57 sides) underwent conventional bypass surgery without closure of the arachnoid membrane. Postoperative computed tomography (CT) scan was performed twice in three days and seven days later, respectively, for evaluation of the presence of subdural fluid collection and other mass lesions. The surgical result was excellent, with no newly developing ischemic event until recent follow-up. The additional time needed for arachnoid suture was five to ten minutes, when three to eight sutures were required. Post-operative subdural fluid collection was not seen on follow-up computed tomography scans in all patients. Arachnoid suturing is simple, safe, and effective for prevention of subdural fluid collection in EC-IC bypass surgery, especially the vulnerable ischemic hemisphere.

  6. [Robot-assisted Coronary Artery Bypass Grafting].

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2016-07-01

    The application for robot-assisted coronary surgery ranges from internal thoracic artery (ITA) harvesting with hand-sewn anastomoses to totally endoscopic coronary artery bypass grafting (TECAB), either on- or off-pump. The bilateral IMA can be harvested with the aid of a surgical robot and then multivessel bypass grafting can follow. Such robot-assisted minimally invasive direct coronary artery bypass grafting is called "ThoraCAB". Surgical robots cannot only endoscopically harvest the ITA but they can also anastomose the coronary artery in TECAB. But TECAB still has the difficulties, such as narrow surgical field in Japanese patients. Both procedures have the significant advantages of minimizing surgical trauma, such as reduced comlications, faster return back to normal activities and being improved cosmesis, and which have resulted in the development of minimally invasive surgery. Robot-assisted cardiac surgery for structural heart disease has been approved by the Ministry of Health, Labour and Welfare (MHLW) since December 2015, however, robot-assisted cardiac surgery for TECAB has not been approved yet in Japan.

  7. Patient's Perception About Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Kelminda Maria Bulhões Mendonça

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: The diagnosis of coronary artery disease referred for heart surgery has an important psychological component. The purpose of this study was to access the difficulties experienced by individuals awaiting coronary artery bypass grafting and to determine strategies that facilitate adaptation to a new lifestyle, modified by the disease. METHODS: A qualitative, exploratory study involving patients admitted to a university teaching hospital in the city of Salvador, Bahia, Brazil, awaiting coronary artery bypass grafting. Semi-structured interviews were performed in accordance with a previously defined script based on the study objective. Each transcription was read in its entirety to verify the representativeness, homogeneity and pertinence of the data obtained (pre-analysis, followed by separation of categories of analysis. RESULTS: The descriptions of this study show that patients admitted to the completion of coronary artery bypass grafting experience a wide range of psychological difficulties, considering that surgery acquires interpretations that vary according to individuals' subjectivity. The patients recognized the benefit of being able to discuss their feelings as a means of diminishing their fear and anxiety. CONCLUSION: Helping patients find resources to confront more positively the daily hospitalization is an important aspect for the health care professionals who assist them. This goal can be achieved through modification of the biomedical model of care for a biopsychosocial view. The investment of time and attention is of fundamental importance and aims to overcome existing deficiencies that interfere with the outcome of patients after cardiac surgery.

  8. A fixed by-pass for the regulation of low temperature space heating systems; Un bipasse fixe pour la regulation des systemes de chauffage a basse temperature

    Energy Technology Data Exchange (ETDEWEB)

    Didier, G.

    2003-06-01

    A fixed by-pass is an important element of the regulation of a water space heating installation. It allows to stabilize the temperature, to reduce the diameter of the regulation valves and to improve their operation. This technical article makes a numerical comparison between different space heating loops involving a three-way mixing valve or a two-way mixing valve with or without a fixed by-pass. (J.S.)

  9. Katyn Massacre – Basic Facts

    Directory of Open Access Journals (Sweden)

    Monika Komaniecka

    2013-09-01

    Full Text Available Katyn is a symbol of the criminal policy of the Soviet system against the Polish nation. The present study aims to demonstrate the basic facts of Katyn massacre – the execution of almost 22,000 people: Polish prisoners of war in Katyn, Kharkov, Kalinin (Tver and also other Polish prisoners (soldiers and civilians, which took place in the spring of 1940 in different places of the Soviet Ukraine and Belarus republics based on the decision of the Soviet authorities, that is the Political Bureau of All-Union Communist Party (Bolsheviks of March 5, 1940. This article refers not only to the massacre itself, but also its origin, historical processes and the lies accompanying Katyn massacre.

  10. Barrier creams: facts and controversies.

    Science.gov (United States)

    Corazza, Monica; Minghetti, Sara; Bianchi, Anna; Virgili, Annarosa; Borghi, Alessandro

    2014-01-01

    Barrier creams (BCs) represent devices aiming to protect the skin from contact with exogenous hazardous substances, especially under working conditions. By preventing penetration and absorption of contaminants, BCs are designed to reduce the risk of developing both irritant and allergic contact dermatitis. In fact, BCs should improve stratum corneum hydration as well as provide emolliency to maintain skin integrity and to restore and repair the epidermis barrier function. The formulation and ingredients of the available BCs vary widely, and thus the choice of a BC should depend on the kind of contaminants, occupational conditions, and skin dysfunction. Although BCs are commonly recommended to prevent occupational contact dermatitis, their real benefit remains controversial. The aims of this review are to help the choice of appropriate BCs and to analyze the actual effectiveness in maintaining an intact skin barrier, preventing contact dermatitis, and speeding up the healing of barrier-impaired skin.

  11. Contraception. Myths, facts and methods.

    Science.gov (United States)

    Perlman, S E; Richmond, D M; Sabatini, M M; Krueger, H; Rudy, S J

    2001-02-01

    After reading this article, the reader should be able to: 1. Recognize the mechanism of action, side effects, contraindications, precautions and instructions for use of a variety of contraceptive methods. 2. Understand the advantages and disadvantages of the various contraceptive methods. 3. List the common myths and misconceptions about conception and contraception, and recognize how they can influence contraceptive decisions. Unintended pregnancy is a serious problem in the United States. Counseling a patient about conception and contraception involves more than simply imparting information and answering questions. Clinicians should actively detect and correct any myths and misapprehensions on the patient's part. These myths are quite common and can interfere with treatment if not attended to. This article summarizes common myths about pregnancy and contraception and reviews the key facts about both.

  12. Influence of Bypass on Thermo-Hydraulics of VVER 440 Fuel Assembly

    Directory of Open Access Journals (Sweden)

    Jakubec Jakub

    2017-04-01

    Full Text Available The paper deals with CFD modelling and simulation of coolant flow within the nuclear reactor VVER 440 fuel assembly. The influence of coolant flow in bypass on the temperature distribution at the outlet of the fuel assembly and pressure drop was investigated. Only steady-state analyses were performed. Boundary conditions are based on operating conditions. ANSYS CFX is chosen as the main CFD software tool, where all analyses are performed.

  13. AEA Technologies Battery Cell By-pass Device Activation: An Update

    Science.gov (United States)

    Keys, Denney; Rao, Gopalakrishna M.; Sullivan, David; Wannemacher, Harry; Day, John H. (Technical Monitor)

    2001-01-01

    The objectives are to: (1) Verify the Performance of AEA Cell Bypass Protection Device (CBPD) under simulated EOS-Aqua/Aura flight hardware configuration; (2) Assess the Safety of the hardware under an inadvertent firing of CBPD switch, as well as the closing of CBPD switch under simulated high cell impedance; and (3) Confirm that the mode of operation of CBPD switch is the formation of a continuous low impedance path (a homogeneous low melting point alloy).

  14. Beating heart axillocoronary bypass for management of the untouchable ascending aorta in coronary artery bypass grafting.

    Science.gov (United States)

    Bonatti, J; Hangler, H; Oturanlar, D; Posch, L; Müller, L C; Voelckel, W; Schwarz, B; Bodner, G

    1999-11-01

    Cannulation and clamping of a severely atherosclerotic ascending aorta during coronary artery bypass grafting (CABG) can lead to cerebral embolization of atheromatous debris and should therefore be avoided whenever possible. A variety of surgical techniques including performance of extraanatomical coronary bypass conduits has been described to solve this problem. We report on a preliminary series of four patients in whom the axillary artery was used as an inflow vessel for venous coronary artery bypass grafts which were performed on the beating heart in order to achieve an aortic no touch concept. The axillary artery was exposed between the pectoralis major muscle and the deltoid muscle via an infraclavicular incision. A saphenous vein graft of at least 40 cm in length was sutured to the axillary artery and then brought into the pericardial cavity following an intercostal and transpleural route. The graft was anastomosed to the target vessel using local coronary occlusion. The procedure was carried out via sternotomy in three patients who also received additional internal mammary artery in situ grafts for adequate coronary revascularization. In one high risk patient an isolated axillocoronary bypass was performed in a minimally invasive fashion via anterolateral minithoracotomy. The procedure was completed without major technical difficulties in all four patients. The mean graft length required was 33.2 +/- 1.6 cm, postoperative ultrasonic duplex scans of the axillocoronary grafts revealed a mean flow of 62.5 +/- 23.6 ml/min. No stroke or brachial plexus injury occurred. Three patients are in angina class I (Canadian Cardiovascular Society Classification), one patient is in class II postoperatively. After a mean follow-up of 11.5 +/- 6.6 months postoperatively all grafts remain patent. Axillocoronary bypass grafting can be easily performed for management of the untouchable ascending aorta. Straightforward surgical technique and the accessibility to noninvasive

  15. Stylized Facts in the Social Sciences

    Directory of Open Access Journals (Sweden)

    Daniel Hirschman

    2016-07-01

    Full Text Available Stylized facts are empirical regularities in search of theoretical, causal explanations. Stylized facts are both positive claims (about what is in the world and normative claims (about what merits scholarly attention. Much of canonical social science research can be usefully characterized as the production or contestation of stylized facts. Beyond their value as grist for the theoretical mill of social scientists, stylized facts also travel directly into the political arena. Drawing on three recent examples, I show how stylized facts can interact with existing folk causal theories to reconstitute political debates and how tensions in the operationalization of folk concepts drive contention around stylized fact claims.

  16. Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses

    DEFF Research Database (Denmark)

    Nielsen, Tina G; Djurhuus, Christian Born; Morre-Pedersen, Erik

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... hemodynamic conditions of a more severe stenosis. Assessment of the hemodynamic impact of fistulas must be undertaken in the evaluation of in situ vein bypass stenoses....

  17. Extra-intracranial standard bypass in the elderly

    DEFF Research Database (Denmark)

    Sandow, Nora; von Weitzel-Mudersbach, Paul; Rosenbaum, Sverre

    2013-01-01

    Patients with chronic atherosclerotic vessel occlusion and cerebrovascular hemodynamic insufficiency may benefit from extra-intracranial (EC-IC) bypass surgery. Due to demographic changes, an increasing number of elderly patients presents with cerebrovascular hemodynamic insufficiency. So far......, little data for EC-IC bypass surgery in elderly patients suffering occlusive cerebrovascular disease are available. We therefore designed a retrospective study to address the question whether EC-IC bypass is a safe and efficient treatment in a patient cohort ≥70 years....

  18. Combined abdominal aortic aneurysm repair and coronary artery bypass: presentation of 13 cases and review of the literature.

    Science.gov (United States)

    Wolff, Thomas; Baykut, Doan; Zerkowski, Hans-Reinhand; Stierli, Peter; Gürke, Lorenz

    2006-01-01

    Coronary artery disease remains the major cause of perioperative mortality after abdominal aortic aneurysm (AAA) repair. The beneficial effect of coronary artery bypass (CAB) before AAA repair in patients with severe coronary artery disease has been proven. The coexistence of a very large or symptomatic AAA and coronary artery disease remains a therapeutic challenge since there is the risk of AAA rupture in the interval between CAB and AAA repair. Combined CAB and aortic aneurysm repair has been suggested for these cases, and results on several series of patients have been published. However, the exact indication for the combined operation remains to be clarified. We present a series of 13 patients who underwent CAB on cardiopulmonary bypass and aortic aneurysm repair as a one-stage procedure. The indication was a large AAA in seven patients and a symptomatic AAA in six patients. In four patients, the aortic reconstruction was performed without the use of cardiopulmonary bypass; in nine patients, the aortic reconstruction was performed under partial cardiopulmonary bypass. Thirty-day mortality was 15%. Major morbidity was 31%. All major complications were due to excessive bleeding and occurred in patients who had AAA repair performed with partial cardiopulmonary bypass, suggesting that prolonged bypass time represents a major source of morbidity. A detailed review of the literature is presented. From the evidence available we suggest that the combined procedure can be recommended only for patients with very high rupture risk, such as in symptomatic AAA. In all other cases, the staged approach--CAB followed by AAA repair 2-4 weeks later--is preferable. During the combined procedure, cardiopulmonary bypass support during AAA repair should be used only in patients with clear evidence of hemodynamic instability.

  19. Determinants for early mortality in patients awaiting coronary artery bypass graft surgery: a case-control study

    NARCIS (Netherlands)

    Suttorp, M. J.; Kingma, J. H.; Vos, J.; Koomen, E. M.; Tijssen, J. G.; Vermeulen, F. E.; Ascoop, C. A.; Ernst, J. M.

    1992-01-01

    A total of 1124 consecutive patients who were selected for coronary artery bypass graft surgery were studied. Of patients awaiting surgery (mean waiting time 98 days) 25 patients (2.2%) died before operation (mean waiting time 63 days). To assess patient characteristics predictive for early

  20. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Skovlund, Charlotte Wessel; Lidegaard, Ojvind

    2014-01-01

    OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population. DESIGN: Historical controlled cohort study. SETTING: Denmark. POPULATION: All women undergoing gastric bypass during...... the period 1996-2011, and subsequently giving birth. METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women. RESULTS: In 415 women giving birth after gastric bypass we found...

  1. Reference change values of plasma and urine NGAL in cardiac surgery with cardiopulmonary bypass.

    Science.gov (United States)

    Bataille, Aurélien; Tiepolo, Ambre; Robert, Tiphaine; Boutten, Anne; Longrois, Dan; Dehoux, Monique; Provenchère, Sophie

    2017-09-23

    As with any biomarker, interpretation of changes of NGAL concentration must consider its variability in a specific clinical setting. The aim of this study was to calculate the reference change value (RCV) and the index of individuality (II) of plasma and urine NGAL in the context of coronary artery bypass graft surgery with cardiopulmonary bypass, in patients without postoperative acute kidney injury. This prospective single-center observational study included patients with a preoperative glomerular filtration rate of >30mlmin(-1) 1.73m(-2), scheduled for elective coronary artery bypass graft with cardiopulmonary bypass and free from postoperative renal injury according to KDIGO criteria during hospital stay or a plasma creatinine Δ<0 (Δ=day1-induction). Plasma and urine NGAL were measured at anesthesia induction, 4h after intensive care admission and on the first and 2nd postoperative day and normalized to plasma proteins or urine creatinine. The RCV was given by the formula: 1.96×√2×√(CVa(2)+CVi(2)), were CVi is the intra-individual variability and CVa the reported analytical coefficient of variation of 5%. The II was calculated using the formula II=CVi/CVg for the four previous parameters, where CVg is the inter-individual variability. Of the 100 patients enrolled in the study, 73 or 25 were considered free from acute kidney injury (KDIGO and Δ creatinine criteria, respectively) and included in the analysis. The RCV was 104% and 109% for plasma NGAL and 321% and 608% for urine NGAL. The II was <0.6 for both plasma and urine NGAL. In patients who underwent coronary artery bypass grafting with normal post-operative kidney function, two-fold change in plasma NGAL and three to six-fold change in urine NGAL occur. In this specific clinical context, pathological variations must consider this biological "noise" for correct interpretation. Copyright © 2017. Published by Elsevier Inc.

  2. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Whitlock, Richard P; Devereaux, P J; Teoh, Kevin H; Lamy, Andre; Vincent, Jessica; Pogue, Janice; Paparella, Domenico; Sessler, Daniel I; Karthikeyan, Ganesan; Villar, Juan Carlos; Zuo, Yunxia; Avezum, Álvaro; Quantz, Mackenzie; Tagarakis, Georgios I; Shah, Pallav J; Abbasi, Seyed Hesameddin; Zheng, Hong; Pettit, Shirley; Chrolavicius, Susan; Yusuf, Salim

    2015-09-26

    Cardiopulmonary bypass initiates a systemic inflammatory response syndrome that is associated with postoperative morbidity and mortality. Steroids suppress inflammatory responses and might improve outcomes in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. We aimed to assess the effects of steroids in patients at high risk of morbidity and mortality undergoing cardiopulmonary bypass. The Steroids In caRdiac Surgery (SIRS) study is a double-blind, randomised, controlled trial. We used a central computerised phone or interactive web system to randomly assign (1:1) patients at high risk of morbidity and mortality from 80 hospital or cardiac surgery centres in 18 countries undergoing cardiac surgery with the use of cardiopulmonary bypass to receive either methylprednisolone (250 mg at anaesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients were assigned with block randomisation with random block sizes of 2, 4, or 6 and stratified by centre. Patients aged 18 years or older were eligible if they had a European System for Cardiac Operative Risk Evaluation of at least 6. Patients were excluded if they were taking or expected to receive systemic steroids in the immediate postoperative period or had a history of bacterial or fungal infection in the preceding 30 days. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcomes were 30-day mortality and a composite of death and major morbidity (ie, myocardial injury, stroke, renal failure, or respiratory failure) within 30 days, both analysed by intention to treat. Safety outcomes were also analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00427388. Patients were recruited between June 21, 2007, and Dec 19, 2013. Complete 30-day data was available for all 7507 patients randomly assigned to methylprednisolone (n=3755) and to placebo (n=3752). Methylprednisolone, compared

  3. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Deal With Death Long-Term Complications of Diabetes How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A ...

  4. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Pregnancy Healthy Food Shopping Healthy Drinks for Kids How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A ...

  5. Vehicle Technologies’ Fact of the Week 2013

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Stacy Cagle [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Diegel, Susan W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Sheila A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Boundy, Robert Gary [Roltek, Inc., Clinton, TN (United States)

    2014-04-01

    Each week the U.S. Department of Energy’s Vehicle Technology Office (VTO) posts a Fact of the Week on their website: http://www1.eere.energy.gov/vehiclesandfuels/ . These Facts provide statistical information, usually in the form of charts and tables, on vehicle sales, fuel economy, gasoline prices, and other transportation-related trends. Each Fact is a stand-alone page that includes a graph, text explaining the significance of the data, the supporting information on which the graph was based, and the source of the data. A link to the current week’s Fact is available on the VTO homepage, but older Facts are archived and still available at: http://www1.eere.energy.gov/vehiclesandfuels/facts/. This report is a compilation of the Facts that were posted during calendar year 2013. The Facts were written and prepared by staff in Oak Ridge National Laboratory's Center for Transportation Analysis.

  6. Vehicle Technologies Fact of the Week 2013

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Stacy Cagle [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Williams, Susan E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Sheila A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Boundy, Robert Gary [Roltek, Inc., Clinton, TN (United States)

    2014-03-01

    Each week the U.S. Department of Energy s Vehicle Technology Office (VTO) posts a Fact of the Week on their website: http://www1.eere.energy.gov/vehiclesandfuels/ . These Facts provide statistical information, usually in the form of charts and tables, on vehicle sales, fuel economy, gasoline prices, and other transportation-related trends. Each Fact is a stand-alone page that includes a graph, text explaining the significance of the data, the supporting information on which the graph was based, and the source of the data. A link to the current week s Fact is available on the VTO homepage, but older Facts are archived and still available at: http://www1.eere.energy.gov/vehiclesandfuels/facts/. This report is a compilation of the Facts that were posted during calendar year 2013. The Facts were written and prepared by staff in Oak Ridge National Laboratory's Center for Transportation Analysis.

  7. Electronic Nicotine Delivery Systems Key Facts Infographic

    Data.gov (United States)

    U.S. Department of Health & Human Services — Explore the Electronic Nicotine Delivery Systems Key Facts Infographic which outlines key facts related to electronic nicotine delivery systems (ENDS), including...

  8. Michigan transportation facts & figures : public transportation

    Science.gov (United States)

    2002-08-16

    This on-line document is part of a series, Transportation Facts & Figures, by the Michigan Department of Transportation (MDOT). The Public Transit section of Transportation Facts & Figures cover such topics as intercity bus service, intercity rail se...

  9. Fiscal Facts, Trends, and Forecasts.

    Science.gov (United States)

    Minter, John

    1991-01-01

    The prosperous 1980s will be followed by an economic slowdown challenging to higher education. Faced with slower public, private, and endowment revenue growth and increasing operating costs, institutions will have to make tough choices. Data on government contributions, private gifts, endowments, expenditures, and shifting allocations are offered…

  10. Laparoscopic gastric bypass as a revision procedure after transoral gastroplasty.

    Science.gov (United States)

    Closset, Jean; Germanova, Desy; Loi, Patrizia; Mehdi, Abdellah; Moreno, Christophe; Devière, Jacques

    2011-01-01

    Transoral gastroplasty (TOGA) has been offered as an investigational alternative restrictive procedure in our hospital for the last 3 years. Since laparoscopic Roux-en-Y gastric bypass (LRYGBP) can be performed as a revisional surgery after failure of a restrictive surgery, this study reports on the feasibility of conversion of TOGA into a LRYGBP in case of failure of the endoscopic procedure. Since 2006, 71 TOGA procedures were performed in morbidly obese patients. Four patients underwent an LRYGBP after TOGA procedure for unsatisfactory results after 1-year observation. All of them had undergone a second procedure in which additional TOGA restrictions were placed to attempt to tighten the pouch before being referred for LRYGBP. The surgical outcome of these patients was analysed. All four patients were easily converted to a LRYGBP with no major complication and no mortality. The operative results (operating time, morbidities, follow-up) of all LRYGBP post TOGA were similar to primary LRYGBP performed by the same operator. LRYGBP post-TOGA apparently can be done without any trouble. The performance of TOGA does not seem to interfere with the short-term results of the LRYGBP.

  11. Photobiology Research Laboratory (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2012-06-01

    This fact sheet provides information about Photobiology Research Laboratory capabilities and applications at NREL. The photobiology group's research is in four main areas: (1) Comprehensive studies of fuel-producing photosynthetic, fermentative, and chemolithotrophic model microorganisms; (2) Characterization and engineering of redox enzymes and proteins for fuel production; (3) Genetic and pathway engineering of model organisms to improve production of hydrogen and hydrocarbon fuels; and (4) Studies of nanosystems using biological and non-biological materials in hybrid generation. NREL's photobiology research capabilities include: (1) Controlled and automated photobioreactors and fermenters for growing microorganisms under a variety of environmental conditions; (2) High-and medium-throughput screening of H{sub 2}-producing organisms; (3) Homologous and heterologous expression, purification, and biochemical/biophysical characterization of redox enzymes and proteins; (4) Qualitative and quantitative analyses of gases, metabolites, carbohydrates, lipids, and proteins; (5) Genetic and pathway engineering and development of novel genetic toolboxes; and (6) Design and spectroscopic characterization of enzyme-based biofuel cells and energy conversion nanodevices.

  12. The Individual Basic Facts Assessment Tool

    Science.gov (United States)

    Tait-McCutcheon, Sandi; Drake, Michael

    2015-01-01

    There is an identified and growing need for a levelled diagnostic basic facts assessment tool that provides teachers with formative information about students' mastery of a broad range of basic fact sets. The Individual Basic Facts Assessment tool has been iteratively and cumulatively developed, trialled, and refined with input from teachers and…

  13. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... With a Parent's Suicide? How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A A A en ... nutricionales (video) Most packaged foods come with a Nutrition Facts label. These labels have a lot of ...

  14. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Games, and the Internet How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A A A en ... nutricionales (video) Most packaged foods come with a Nutrition Facts label. These labels have a lot of ...

  15. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... News How to Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) Print A A A en español Cómo leer las etiquetas de datos nutricionales (video) Most packaged foods come with a Nutrition Facts ...

  16. Indications and Outcomes of Prophylactic and Therapeutic Extracranial-to-intracranial Arterial Bypass for Cerebral Revascularization

    Directory of Open Access Journals (Sweden)

    Emre Gazyakan, MD, MSc

    2015-04-01

    Conclusions: The collaboration of neurosurgeons and plastic surgeons in performing EC-IC bypass can result in excellent outcomes with a high bypass patency rate and few complications, particularly for prophylactic EC-IC bypass.

  17. Retrieval-induced forgetting of multiplication facts and identity rule.

    Science.gov (United States)

    Campbell, Jamie I D; Dufour, Kate D; Chen, Yalin

    2015-05-01

    This research investigated retrieval-induced interference between counterpart multiplication (2 × 3 = 6) and addition facts (2 + 3 = 5). Adults (N =72) repeatedly solved either a set of simple addition (0 + 2, 1 + 5, 2 + 3) or multiplication problems (0 × 2, 1 × 5, 2 × 3) during a practice phase and then switched operations during a test phase that included counterparts to the practiced problems and control problems. The paradigm afforded measurement in response time both of inter-operation retrieval-induced forgetting (RIF) and generalization of practice across different problems within operations. The experiment demonstrated generalization of practice for the rule-based 0 + N = N problems (e.g., practicing 0 + 2 facilitated performance on 0 + 7) as well as for problems governed by the multiplicative identity principle (1 × N = N) and zero-product principle (0 × N = 0), but not the fact-based 1 + N problems. The experiment also demonstrated for the first time inter-operation RIF of fact-based multiplication, which was as large as the effect observed for fact-based addition. The 0 × N, 0 + N, and 1 + N problems did not present item-specific RIF from practice of cross-operation counterparts, but 1 × N problems did, despite the generalization-of-practice evidence that 1 × N problems were solved using an item-general procedure. The item-specific RIF for 1 × N = N must reflect item-specific interference rather than item-level competitor inhibition given that there is no item-level representation of 1 × N = N facts in long-term memory.

  18. Reoperative coronary bypass grafting without cardiopulmonary bypass through a small thoracotomy

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    Background. The danger of coronary reoperations is mainly hidden in the reopening of the sternum and in the manipulation of the heart and the old grafts. Therefore, the minimally invasive direct coronary artery bypass procedure seems an ideal technique for coronary reoperations if only the left

  19. Bypassing the bandwidth theorem with PT symmetry

    CERN Document Server

    Ramezani, Hamidreza; Ellis, F M; Guenther, Uwe; Kottos, Tsampikos

    2012-01-01

    The beat time {\\tau}_{fpt} associated with the energy transfer between two coupled oscillators is dictated by the bandwidth theorem which sets a lower bound {\\tau}_{fpt}\\sim 1/{\\delta}{\\omega}. We show, both experimentally and theoretically, that two coupled active LRC electrical oscillators with parity-time (PT) symmetry, bypass the lower bound imposed by the bandwidth theorem, reducing the beat time to zero while retaining a real valued spectrum and fixed eigenfrequency difference {\\delta}{\\omega}. Our results foster new design strategies which lead to (stable) pseudo-unitary wave evolution, and may allow for ultrafast computation, telecommunication, and signal processing.

  20. TRAS principles blight arterial bypass and plasty.

    Directory of Open Access Journals (Sweden)

    Kothari M

    1997-04-01

    Full Text Available A new concept--Tissue Requisitions (Principle I/Relinquishes (Principle II Arterial Supply--of TRAS principles is introduced to help appreciate the failures/successes of modern medicine′s attempts at restoring arterial flow in luminally compromised coronary/carotid fields, an invasive branch rightly called vascular ReRheology, which comprises diagnosing/treating arterial blocks. The technical wizardry of arterial reconstruction (bypass or lumen--restoration (plasty has to reckon with the TRAS principles all the time.

  1. Flow characteristics in narrowed coronary bypass graft

    Energy Technology Data Exchange (ETDEWEB)

    Bernad, S. I. [Romanian Academy – Timisoara Branch, Mihai Viteazul Str. 24, RO-300223, Timisoara (Romania); Bosioc, A.; Totorean, A. F. [University Politehnica of Timisoara, Department of Hydraulic Machinery, Mihai Viteazul Str. 1, RO-300222, Timisoara (Romania); Bernad, E. S.; Petre, I. [University of Medicine and Pharmacy Victor Babes Timisoara, P-ta Eftimie Murgu, 2, Timisoara (Romania)

    2016-06-08

    Tortuous saphenous vein graft (SVG) hemodynamics was investigated using computational fluid dynamics (CFD) techniques. Computed tomography (CT) technology is used for non-invasive bypass graft assessment 7 days after surgery. CT investigation shown two regions with severe shape remodelling first is an elbow type contortion and second is a severe curvature with tortuous area reduction. In conclusion, the helical flow induced by vessel torsion may stabilize the blood flow in the distal part of the SVG, reducing the flow disturbance and suppressing the flow separation, but in the distal end of the graft, promote the inflammatory processes in the vessels.

  2. Work on the Geneva motorway bypass

    CERN Multimedia

    État de Genève, DCTI, Direction du génie civil

    2006-01-01

    Work on the airport section of the Geneva motorway bypass is continuing and will require the temporary closure of two sliproads allowing traffic to make a U-turn near the airport and the Palexpo exhibition centre. The sliproads on the French and Lausanne sides will be closed until autumn 2006. U-turns will still be possible via clearly marked deviations. For further information: www.autoroute-aeroport.ch We would like to thank you in advance for your understanding. Civil Engineering Department, DCTI, State of Geneva

  3. How safe is it to train residents to perform off-pump coronary artery bypass surgery?

    Science.gov (United States)

    Smith, Tanya A; Asimakopoulos, George

    2015-05-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, in [patients undergoing off-pump CABG] are [postoperative mortality and morbidity outcomes] acceptable when performed by [trainees]? Altogether more than 597 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. Six retrospective cohort studies directly compared the performance of trainees and experienced surgeons in off-pump coronary artery bypass graft surgery. Of the remaining papers, one recorded the performance of trainees in on- and off-pump operations and finally one paper evaluated a single trainee's performance in off-pump coronary artery bypass graft surgery, both supervised and unsupervised, over a 1-year period. It is important to note that the two respective cohort studies included in our analysis compared similar cohorts of patients. However, both studies were included in our paper as they provide additional information regarding trainee performance. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Although a heterogeneous range of postoperative complications were recorded in the identified studies, we were able to determine that, overall, there was no significant difference in the 30-day mortality seen in operations performed by trainees or experienced surgeons. The incidence of myocardial infarction and stroke were also similar among cases performed by both groups. However, senior surgeons were more likely to operate on patients with more complex or severe disease, or those requiring more urgent operations. Therefore, it was not possible to directly compare outcomes between trainees and experienced surgeons in operations of similar complexity. However, we conclude that despite the absence of randomized controlled trials comparing the performance of trainees and

  4. Adolescence and abstinence. Fact sheet.

    Science.gov (United States)

    1997-01-01

    This fact sheet presents statistics on adolescent sexual activity in the US and a brief description of comprehensive sex education and abstinence-only programs. The statistical profile indicates that over 50% of teenagers are virgins until at least 17 years of age. 20% of boys and 24% of girls are virgins by the age of 20 years. Only 6.9% of men 18-59 years old and 21% of women 18-59 years old were still virgins on their wedding night. However, among a sample of high school students, over 33% of male and female virgins had engaged in some form of heterosexual genital sexual activity in the preceding year. 29% of virgins had masturbated a partner of the opposite gender. 31% had been masturbated by a partner of the opposite gender. 9% had engaged in fellatio with ejaculation with a partner of the opposite gender. 10% had engaged in cunnilingus with a partner of the opposite gender. 1% had engaged in anal intercourse with a partner of the opposite gender. Comprehensive sex education aims to help adolescents postpone sexual intercourse until they are ready for mature relationships by helping them develop interpersonal skills to resist premature sexual involvement. Messages include information about sexual abstinence, contraception, and safer sex. A 1993 study found that sexual abstinence messages were one of the most frequently covered topics in state curricula and guidelines. Other key topics were families, decision making, and sexually transmitted diseases including AIDS. The least covered topics were sexual identity, shared sexual behavior, sexual response, masturbation, and abortion. There were only six studies of abstinence-only programs, of which at least two showed no impact on sexual or contraceptive behavior. The National Institute of Health says that abstinence-only programs ignore the success of other programs and conflict with science.

  5. Vehicle Technologies Fact of the Week 2015

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Stacy C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Diegel, Susan W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Sheila A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Boundy, Robert G. [Roltek, Inc., Clinton, TN (United States)

    2016-05-01

    Each week the U.S. Department of Energy s Vehicle Technology Office (VTO) posts a Fact of the Week on their website: http://www1.eere.energy.gov/vehiclesandfuels/ . These Facts provide statistical information, usually in the form of charts and tables, on vehicle sales, fuel economy, gasoline prices, and other transportation-related trends. Each Fact is a stand-alone page that includes a graph, text explaining the significance of the data, the supporting information on which the graph was based, and the source of the data. A link to the current week s Fact is available on the VTO homepage, but older Facts (back to 2009) are archived and still available at: http://energy.gov/eere/vehicles/current-and-past-years-facts-week. Each Fact of the Week website page includes a link to an Excel file. That file contains the data from the Supporting Information section of the page so that researchers can easily use data from the Fact of the Week in their work. Beginning in August of 2015, a subscription list is available on the DOE website so that those interested can sign up for an email to be sent each Monday which includes the text and graphic from the current week s Fact. This report is a compilation of the Facts that were posted during calendar year 2015. The Facts were created, written and prepared by staff in Oak Ridge National Laboratory's Center for Transportation Analysis.

  6. Diagnostic tools for post-gastric bypass hypoglycaemia

    NARCIS (Netherlands)

    Emous, M.; Ubels, F. L.; van Beek, A. P.

    2015-01-01

    In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the

  7. Lower leg electrical impedance after distal bypass surgery

    DEFF Research Database (Denmark)

    Belanger, G K; Bolbjerg, M L; Heegaard, N H

    1998-01-01

    Electrical impedance was determined in 13 patients following distal bypass surgery to evaluate lower leg oedema as reflected by its circumference. Tissue injury was assessed by the plasma concentration of muscle enzymes. After surgery, the volume of the control lower leg increased from 1250 (816...... to be a useful method for the evaluation of lower leg oedema after distal bypass surgery....

  8. Inpatient healthcare provider bypassing by women and their ...

    African Journals Online (AJOL)

    Introduction: bypassing refers to a person's decision to seek care at a healthcare facility that is not the nearest one of its type to the person's home. Methods: this study examined inpatient care facility bypassing in urban Bo, Sierra Leone using data from 1,980 women with children 15 years of age and younger who were ...

  9. Reverse bias protected solar array with integrated bypass battery

    Science.gov (United States)

    Landis, Geoffrey A (Inventor)

    2012-01-01

    A method for protecting the photovoltaic cells in a photovoltaic (PV) array from reverse bias damage by utilizing a rechargeable battery for bypassing current from a shaded photovoltaic cell or group of cells, avoiding the need for a bypass diode. Further, the method mitigates the voltage degradation of a PV array caused by shaded cells.

  10. Basics of cardiopulmonary bypass: normal and abnormal postoperative CT appearances.

    Science.gov (United States)

    El-Sherief, Ahmed H; Wu, Carol C; Schoenhagen, Paul; Little, Brent P; Cheng, Allen; Abbara, Suhny; Roselli, Eric E

    2013-01-01

    Cardiothoracic surgical procedures with and without cardiopulmonary bypass are becoming more commonly performed as surgical techniques improve and the population ages. Changes related to cardiopulmonary bypass are often depicted at routine postoperative computed tomographic (CT) studies performed for various reasons. The purpose of this article is to present knowledge critical to the accurate postoperative evaluation of the patient who has undergone cardiopulmonary bypass. This article will review the surgical technique for cardiopulmonary bypass, as well as the associated normal and abnormal postoperative imaging findings. Common cannulation sites used for cardiopulmonary bypass include the ascending aorta, axillary artery, right atrium, superior vena cava, and inferior vena cava. Normal postoperative findings related to cardiopulmonary bypass include (a) felt pledgets, which are used to reinforce cannulation sites; (b) oversewn side grafts; and (c) oversewn graft side branches. These normal postoperative findings can be mistaken for abnormalities. Abnormal postoperative findings related to cardiopulmonary bypass include pseudoaneurysm formation at cannulation sites, aortic dissection, and seroma formation. An awareness of normal and abnormal postoperative CT findings related to cardiopulmonary bypass is critical for all radiologists who interpret chest CT studies, to help prevent unnecessary further evaluation and to help direct prompt treatment when warranted.

  11. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery

    NARCIS (Netherlands)

    Vos, Pieter C.; Riordan, Alan J.; Smit, Ewoud J.; de Jong, Hugo W. A. M.; van der Zwan, Albert; Velthuis, BK; Viergever, Max A.; Dankbaar, Jan Willem

    Objective: Perfusion imaging is increasingly used for postoperative evaluation of extracranial to intracranial (EC-IC) bypass surgery. Altered hemodynamics and delayed arrival of the contrast agent in the area fed by the bypass can influence perfusion measurement. We compared perfusion asymmetry

  12. What to Expect during Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... an illustration, go to the Health Topics Heart Surgery article. The surgeon will take an artery or vein from your body—for example, from your chest or leg—to use as the bypass graft. For surgeries with several bypasses, both artery and vein grafts ...

  13. The Effect of Magnetohydrodynamic (MHD) Energy Bypass on Specific Thrust for a Supersonic Turbojet Engine

    Science.gov (United States)

    Benyo, Theresa L.

    2010-01-01

    This paper describes the preliminary results of a thermodynamic cycle analysis of a supersonic turbojet engine with a magnetohydrodynamic (MHD) energy bypass system that explores a wide range of MHD enthalpy extraction parameters. Through the analysis described here, it is shown that applying a magnetic field to a flow path in the Mach 2.0 to 3.5 range can increase the specific thrust of the turbojet engine up to as much as 420 N/(kg/s) provided that the magnitude of the magnetic field is in the range of 1 to 5 Tesla. The MHD energy bypass can also increase the operating Mach number range for a supersonic turbojet engine into the hypersonic flight regime. In this case, the Mach number range is shown to be extended to Mach 7.0.

  14. Gastric bypass surgery: Improving psoriasis through a GLP-1-dependent mechanism?

    DEFF Research Database (Denmark)

    Faurschou, Annesofie; Zachariae, Claus; Skov, Lone

    2011-01-01

    surgery. This most likely contributes importantly to the acute remission of type 2 diabetes, which is often induced by gastric bypass operations. The hormone is not hypersecreted after the purely restrictive bariatric procedure gastric banding and no case reports exist on improvement in psoriasis......, both a direct anti-inflammatory effect of GLP-1 as well as an indirect effect through weight loss could contribute to improvement in psoriasis. A potential involvement of GLP-1 in the remission of psoriasis observed after bariatric surgery offers exciting possibilities for research and eventually...... bypass surgery in patients with psoriasis may result in complete remission of the disease. A substantial weight loss is achieved in the months following surgery, which is likely to reduce psoriasis symptoms and risk of comorbidities. Interestingly, however, it has been described that improvement...

  15. Cardiopulmonary bypass in the pediatric population.

    Science.gov (United States)

    Whiting, David; Yuki, Koichi; DiNardo, James A

    2015-06-01

    Cardiopulmonary bypass (CPB) facilitates the repair of cardiac lesions in adults and children. Surgical mortality has decreased with improvements in technique allowing for the successful repair of complex heart defects in neonates of increasingly low body weight and gestational age. The physiological effects of CPB are more significant in children. The presence of intracardiac shunts and other anatomic variants further complicates CPB in patients with congenital heart disease. Special techniques and monitors are often necessary. Protocols are often established within individual institutions to standardize the approach to CPB. The anesthesiologist caring for the patient must understand the physiology of CPB to facilitate the initiation and separation from bypass, and to be able to treat complications. Evidence supporting a particular technique of CPB in pediatric population is still largely from uncontrolled or nonrandomized trials, observational studies, extrapolation from adult studies, and expert opinion. The heterogeneity of congenital heart disease makes randomized controlled trials or meta-analyses challenging, and thus they are limited in the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine.

    Science.gov (United States)

    Passaroni, Andréia Cristina; Silva, Marcos Augusto de Moraes; Yoshida, Winston Bonetti

    2015-01-01

    To provide a brief review of the development of cardiopulmonary bypass. A review of the literature on the development of extracorporeal circulation techniques, their essential role in cardiovascular surgery, and the complications associated with their use, including hemolysis and inflammation. The advancement of extracorporeal circulation techniques has played an essential role in minimizing the complications of cardiopulmonary bypass, which can range from various degrees of tissue injury to multiple organ dysfunction syndrome. Investigators have long researched the ways in which cardiopulmonary bypass may insult the human body. Potential solutions arose and laid the groundwork for development of safer postoperative care strategies. Steady progress has been made in cardiopulmonary bypass in the decades since it was first conceived of by Gibbon. Despite the constant evolution of cardiopulmonary bypass techniques and attempts to minimize their complications, it is still essential that clinicians respect the particularities of each patient's physiological function.

  17. Outcome of off-pump coronary artery bypass in renal dialysis patients.

    Science.gov (United States)

    Liu, J-F; Lin, C-H; Chua, C-H; Chiang, S-S; Hung, H-F; Lu, M-J; Hung, C-R

    2008-10-01

    Renal dialysis patients are a subgroup at major operative risk when undergoing coronary artery bypass grafting (CABG). Even though CABG without cardiopulmonary bypass (CPB) has decreased the surgical risk and provided good short-term results, the long-term survival seems uncertain. We report here on the long-term outcome of CABG without CPB in renal dialysis patients. From 1998 to 2002, 44 renal dialysis patients underwent elective CABG without CPB, including 17 minimally invasive direct coronary artery bypass (MIDCAB) and 27 off-pump CABG (OPCAB) procedures. There were 5 one-vessel, 12 two-vessel and 27 multi-vessel coronary artery disease patients, who mainly had left internal thoracic artery (LITA) to left anterior descending coronary artery (LAD) grafting with an additional saphenous vein graft to non-LAD coronaries. All 44 patients were followed up for 44.4 +/- 31.2 months. Three (6.8 %) surgical deaths within 30 days occurred and 25 late mortalities happened over a period of 2 - 79 months. The 5-year cumulative rate of total survival is 38.2 % and the freedom from cardiac death is 70.9 %. Using hazard analysis, old age (> 60 years) and incomplete coronary revascularization was found to significantly affect the total survival. CABG without CPB provided an acceptable surgical mortality and morbidity. The high incidence of non-cardiac death associated with dialysis complications had an adverse impact on the overall outcome. The LITA bypass operation method combined with intensive care for dialysis complications would hopefully fulfill the goal to improve the short- and long-term results in this subgroup.

  18. 30-day readmission rates at a high volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass.

    Science.gov (United States)

    Saunders, John K; Ballantyne, Garth H; Belsley, Scott; Stephens, Daniel; Trivedi, Amit; Ewing, Douglas R; Iannace, Vincent; Capella, Rafael F; Wasielewski, Annette; Moran, S; Schmidt, Hans J

    2007-09-01

    Recent studies suggest that weight loss operations may actually increase the costs to society due to increased hospital readmission rates. The purpose of this study was to determine the 30-day readmission rates following bariatric operations at a high volume bariatric surgery program. Records for all patients undergoing bariatric operations during a 3-year period were harvested from the hospital electronic medical database. All hospital readmissions within 30 days of surgery were reviewed to determine the cause, demographics, and patient characteristics. Logistic regression analysis assessed the impact of various factors on the risk of readmission. 2,823 consecutive patients were identified using the corrected operative log. Of these patients, 165 (5.8%) patients required 184 (6.5%) readmissions within 30 days of their index bariatric operation. Laparoscopic adjustable gastric banding (LAGB) had the lowest patient readmission rate of 3.1%; vertical banded gastroplasty-Roux-en-Y gastric bypass (VBG-RYGBP) 6.8% and Laparoscopic Roux-en-Y gastric bypass (LRYGBP) 7.3%. Technical considerations were the most common cause for readmission (41% of readmissions). White race and undergoing LAGB decreased the odds for readmission, while total operating-room time >120 minutes, initial hospital stay of >3 days and deep venous thrombosis increased the odds for readmission. This study found an overall 30-day readmission rate of 6.5% following bariatric operations at a high volume bariatric surgery program. This study supports the concept of bariatric surgery Centers of Excellence and accreditation of Bariatric Surgery Programs based on hospital volume of bariatric operations.

  19. Intussusception after Laparoscopic Gastric Bypass Surgery: An Underrecognized Complication

    Directory of Open Access Journals (Sweden)

    Smit Singla

    2012-01-01

    Full Text Available Introduction. Intussusception after bariatric surgery is an uncommon complication that is now being frequently reported. Most people consider dysmotility to be the causative mechanism in the absence of obvious etiology. Material and Methods. A worldwide search identified literature describing intussusception after bariatric surgery. We also included our own patients and analyzed information regarding demographic profile, risk factors, presentation, diagnosis, and post treatment course. Results. Seventy one patients were identified between 1991 and 2011. Majority of the affected patients were females (=70, 98.6%; median time to presentation after gastric bypass surgery was 36 months. Most patients presented with abdominal pain, nausea and vomiting, but without obvious peritonitis. Sixty eight patients (96% required surgery; 48 (70.6% underwent revision of anastomosis, 16 (23.5% had reduction without resection, while 4 patients (5.9% had plication only. Amongst these, most patients (=51, 75% were found to have retrograde intussusception. Post-operatively, 9 patients presented with recurrence (range, 0.5–32 months. Five patients, who had earlier been treated without resection, eventually required revision of the anastomosis. There was no mortality noted. Conclusion. Intussusception after bariatric surgery is uncommon and its diagnosis is based on a combination of physicial, radiological and operative findings. An early surgical intervention reduces morbidity and prevents recurrence.

  20. Coronary artery bypass surgery in the diabetic patient.

    LENUS (Irish Health Repository)

    Maher, M

    2012-02-03

    Coronary artery and peripheral occlusive arterial disease frequently complicate diabetes mellitus, with death due to atherosclerotic coronary artery disease being three times more likely in diabetic compared to non-diabetic patients. The profile of 32 diabetic patients and 32 matched controls who underwent coronary artery bypass (CABG) is studied and their early and late postoperative outcomes are described. The mean age was 61 +\\/- 1 year in both groups. The diabetic group comprised 26 non-insulin dependent and 6 insulin dependent diabetics, who had a mean duration of diabetes of 8.5 years (range 2 months--35 years). The median number of grafts per patient performed in the diabetic group and the control group was 3.5 and 3 respectively. There was no mortality in the series, however considerably greater wound morbidity rates were encountered in the diabetic group when compared to matched controls. One renal transplant patient in the diabetic group suffered irreversible acute tubular necrosis and became dialysis dependent post-operatively. Longterm follow-up showed no longterm mortality in either group, with full relief of angina achieved in 75% of diabetic patients compared with 87.5% of matched controls. In addition diabetic patients suffered greater longterm cardiac morbidity than the control group (21.8% versus 12.5%). The results of this study suggest that CABG is a safe operation for the diabetic patient. Diabetic patients receive satisfactory symptomatic relief of angina, but suffer increased perioperative wound complications and greater incidence of longterm cardiac morbidity.

  1. [Flowmetric assessment of coronary bypass grafts in the conditions of artificial circulation and on the beating heart].

    Science.gov (United States)

    Bazylev, V V; Nemchenko, E V; Karnakhin, V A; Pavlov, A A; Mikulyak, A I

    2016-01-01

    Advantages and shortcomings of aortocoronary bypass grafting on the beating heart and in the conditions of artificial circulation (AC) have long been discussed. The data on patency of bypass grafts in the remote period are indicative of comparable results of operations with and without AC or advantages of using AC. In order to determine benefits of each method it is necessary to reveal intraoperative predictors of bypass grafts occlusion in the remote period. We analyzed the results of ultrasound flowmetry of the blood flow through the left internal thoracic artery during bypass grafting of the anterior descending artery with the use of AC and on the beating heart. A retrospective study included a total of 352 patients subdivided into 2 groups: Group One was composed of 120 patients undergoing surgery in the conditions of AC and Group Two comprised 232 patients subjected to similar operations on the beating heart. Blood flow was measured with the help of flowmeter VeryQ MediStim® after termination of AC and inactivation of heparin by protamine, with systolic pressure of 100-110 mm Hg. There were no statistically significant differences between the groups by the diameter and degree of stenosis of the anterior descending artery, diameter of the left internal thoracic artery. The mean volumetric blood flow velocity (Qmean) along the shunts in Group One was higher (p=0.01). No statistically significant differences by the pulsatility index (PI) between the groups were revealed (p=0.2). A conclusion was drawn that coronary bypass grafting of the anterior descending artery by the left internal thoracic artery in the conditions of artificial circulation made it possible to achieve higher volumetric velocity of blood flow through the conduit as compared with operations on the beating heart, with similar resistance index. The immediate results of the operations with the use of the both techniques did not differ.

  2. The impact of haemodilution and bypass pump flow on cerebral oxygen desaturation during cardiopulmonary bypass--A comparison of two systems of cardiopulmonary bypass.

    Science.gov (United States)

    Bennett, M J; Weatherall, M; Webb, G; Dudnikov, S F; Lloyd, C T

    2015-07-01

    To determine the influence of haemodilution, bypass flow rates and calculated oxygen delivery during cardiopulmonary bypass (CPB) with either a conventional CPB (C-CPB) circuit or a miniaturised (Mini-CPB) circuit on cerebral oxygen desaturation. The effect of minimal haemodilution with a Mini-CPB was investigated. Eighty patients scheduled for elective cardiac surgery. Oxygenated haemoglobin (O2Hb) and tissue oxygenation index (TOI) were measured with near-infrared spectroscopy (NIRS). The average indexed bypass pump flow was significantly lower with Mini-CPB. When combined with haemoglobin concentration, the average oxygen delivery was the same between groups. Patients in the C-CPB group had a greater duration and severity of cerebral desaturation to a level bypass, whereas desaturation with Mini-CPB was associated with low perioperative haemoglobin concentration. © The Author(s) 2014.

  3. Energy Imbalance Markets (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2012-09-01

    The anticipated increase in variable renewable generation, such as wind and solar power, over the next several years has raised concerns about how system operators will maintain balance between electricity production and demand in the Western Interconnection, especially in its smaller balancing authority areas (BAAs). Given renewable portfolio standards in the West, it is possible that more than 50 gigawatts of wind capacity will be installed by 2020. Significant quantities of solar generation are likely to be added as well. Meanwhile, uncertainties about future load growth and challenges siting new transmission and generation resources may add additional stresses on the Western Interconnection of the future. One proposed method of addressing these challenges is an energy imbalance market (EIM). An EIM is a means of supplying and dispatching electricity to balance fluctuations in generation and load. It aggregates the variability of generation and load over multiple balancing areas (BAs).

  4. Fleet DNA Project (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2012-10-01

    The Fleet DNA Project - designed by the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) in partnership with Oak Ridge National Laboratory - aims to accelerate the evolution of advanced vehicle development and support the strategic deployment of market-ready technologies that reduce costs, fuel consumption, and emissions. At the heart of the Fleet DNA Project is a clearinghouse of medium- and heavy-duty commercial fleet transportation data for optimizing the design of advanced vehicle technologies or for selecting a given technology to invest in. An easy-to-access online database will help vehicle manufacturers and fleets understand the broad operational range for many of today's commercial vehicle vocations.

  5. Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias.

    Science.gov (United States)

    Newcomb, W L; Polhill, J L; Chen, A Y; Kuwada, T S; Gersin, K S; Getz, S B; Kercher, K W; Heniford, B T

    2008-10-01

    Obesity may be the most predominant risk factor for recurrence following ventral hernia repair. This is secondary to significantly increased intra-abdominal pressures, higher rates of wound complications, and the technical difficulties encountered due to obesity. Medically managed weight loss prior to surgery is difficult. One potential strategy is to provide a surgical means to correct patient weight prior to hernia repair. After institutional review board approval, we reviewed the medical records of all patients who underwent gastric bypass surgery prior to the definitive repair of a complex ventral hernia at our medical center. Twenty-seven morbidly obese patients with an average of 3.7 (range 1-10) failed ventral hernia repairs underwent gastric bypass prior to definitive ventral hernia repair. Twenty-two of the gastric bypasses were open operations and five were laparoscopic. The patients' average pre-bypass body mass index (BMI) was 51 kg/m2 (range 39-69 kg/m2), which decreased to an average of 33 kg/m2 (range 25-37 kg/m2) at the time of hernia repair at a mean of 1.3 years (range 0.9-3.1 years) after gastric bypass. Seven patients had hernia repair at the same time as their gastric bypass (four sutured, three biologic mesh), all of which recurred. Of the 27 patients, 19 had an open hernia repair and eight had a laparoscopic repair. Panniculectomy was performed concurrently in 15 patients who had an open repair. Prior to formal hernia repair, one patient required an urgent operation to repair a hernia incarceration and a small-bowel obstruction 11 months after gastric bypass. The average hernia and mesh size was 203 cm2 (range 24-1,350 cm2) and 1,040 cm2 (range 400-2,700 cm2), respectively. There have been no recurrences at an average follow-up of 20 months (range 2 months-5 years). Gastric bypass prior to staged ventral hernia repair in morbidly obese patients with complex ventral hernias is a safe and definitive method to effect weight loss and facilitate a

  6. Usefulness of one-stage coronary artery bypass grafting on the beating heart and abdominal aortic aneurysm repair.

    Science.gov (United States)

    Morimoto, Keisuke; Taniguchi, Iwao; Miyasaka, Shigeto; Aoki, Tetsuya; Kato, Ippei; Yamaga, Takeshi

    2004-02-01

    Abdominal aortic aneurysm (AAA) is commonly associated with coronary artery disease (CAD). Simultaneous coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under cardiac arrest and AAA repair may be considerably invasive. Recently CABG under the beating heart without CPB has been reported as a less invasive method. We report the combined operation of CABG on a beating heart and AAA repair for AAA patients with CAD, and compare it with a separate operation. A retrospective review of the records of consecutive patients who underwent elective combined procedure or single operation for CABG on a beating heart and/or repair of the AAA between May 1999 and October 2001 was carried out. Ten patients underwent combined procedures. A single operation, CABG on a beating heart or repair of AAA, were performed in 27 or 19 patients. There were no significant differences with regard to intraoperative blood loss, transfusion and postoperative intubation time among the three groups. There was no operative mortality for any of the three groups. All cases were discharged without severe complications and with patent coronary bypass grafts. There was a decrease in mean total hospital costs for the combined operation group compared with the CABG group plus AAA repair group (3.34 million versus 5.87 million yen). Combined CABG on a beating heart and AAA repair on a one-step approach appears to be a safe and useful therapeutic strategy for AAA patients with CAD.

  7. Management of super-super obese patients: comparison between one anastomosis (mini) gastric bypass and Roux-en-Y gastric bypass.

    Science.gov (United States)

    Parmar, Chetan; Abdelhalim, Mohamed A; Mahawar, Kamal K; Boyle, Maureen; Carr, William R J; Jennings, Neil; Small, Peter K

    2017-09-01

    Gastric bypass can be technically challenging in super-super obese patients. Both Roux-en-Y gastric bypass (RYGB) and one anastomosis (mini) gastric bypass (OAGB/MGB) have been described in these patients, but direct comparisons are lacking. The purpose of this study was to compare the early outcomes with these two procedures in patients with body mass index (BMI) of ≥60 kg/m2 in our unit. We identified all super-super obese patients who underwent either OAGB/MGB or RYGB from our prospectively maintained database. Information was also obtained from the case notes and from hospital computerized records. We obtained data regarding patient demographics, operative details, complications, and weight loss, in both groups, and compared them using standard statistical methods. This study compares our results with 19 OAGB/MGB and 47 RYGB super-super obese patients performed in our unit between October 2012 and June 2015. OAGB/MGB group patients had a significantly higher weight and body mass index. There was no mortality or major complication in either group. There were two late complications in the OAGB/MGB group compared to six in the RYGB group. One patient in the OAGB/MGB group needed conversion to RYGB for persistent reflux symptoms. OAGB/MGB patients achieved a significantly higher EWL of 70.4% at 2 years compared to 57.1% in the RYGB group. The difference between TWL of 44.4 and 33.4%, respectively, was also significant at 2 years. TWL of 43.0 and 29.3%, respectively, in OAGB/MGB and RYGB groups at 18 months was also significantly different, but the difference in EWL at 18 months did not reach significance. One anastomosis (mini) gastric bypass yields superior weight loss at 18 and 24 months in comparison with Roux-en-Y gastric bypass in patients with BMI of ≥60 kg/m2. Findings need confirmation in larger randomized studies.

  8. Mini Bypass and Proinflammatory Leukocyte Activation: A Randomized Controlled Trial.

    Science.gov (United States)

    Nguyen, Bao A V; Fiorentino, Francesca; Reeves, Barnaby C; Baig, Kamran; Athanasiou, Thanos; Anderson, Jon R; Haskard, Dorian O; Angelini, Gianni D; Evans, Paul C

    2016-04-01

    Coronary artery bypass grafting (CABG) with conventional cardiopulmonary bypass (CPB) induces systemic inflammation. Miniaturized CPB may attenuate systemic inflammatory activation. The intracellular signaling pathways promoting inflammation in cardiac operations and the relative effects of CPB on these processes are uncertain. In this study, induction of reactive oxygen species (ROS) and activation of nuclear factor (NF)-κB, p38 mitogen-activated protein kinase (MAPK) within leukocytes, and leukocyte accumulation in cantharidin-induced blisters was compared in patients exposed to miniaturized CPB (mCPB) and those who underwent conventional CPB (cCPB). Patients undergoing CABG were randomized to receive either cCPB (n = 13) or mCPB (n = 13). Blood samples were collected preoperatively and 5 times after initiating CPB (up to 5 hours) and analyzed by flow cytometry for intracellular markers of activation (ROS, p38-MAPK, and NF-κB phosphorylation). ROS in lymphocytes were elevated in cCPB compared with mCPB (p < 0.01), whereas ROS in granulocytes and monocytes were similar between groups. After initiation of CPB, p38-MAPK was higher in patients receiving cCPB compared with those receiving mCPB (p < 0.05). NF-κB phosphorylation in leukocyte subsets was similar in patients exposed to cCPB and those exposed to mCPB. Leukocyte accumulation in cantharidin-induced blisters, white cell counts, and serum C-reactive protein (CRP) was enhanced in response to cardiac operations, but no differences were observed between mCPB and cCPB groups. Postoperative serum creatinine levels were reduced in the mCPB group compared with the cCPB group (p < 0.05). Both p38-MAPK activation and ROS were attenuated with the use of mCPB compared with cCPB, providing a potential mechanism for reduced inflammation in association with CPB miniaturization. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Can pregnant women be safely placed on cardiopulmonary bypass?

    Science.gov (United States)

    Sepehripour, Amir H; Lo, Tammy T; Shipolini, Alex R; McCormack, David J

    2012-12-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether cardiopulmonary bypass can be used safely with satisfactory maternal and foetal outcomes in pregnant patients undergoing cardiac surgery. A total of 679 papers were found using the reported searches of which 14 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated. Reported measures were maternal and foetal mortality and complications, mode of delivery, cardiopulmonary bypass and aortic cross-clamp times, perfusate flow rate and temperature and maternal NYHA functional class. The most recent of the best evidence studies, a retrospective observational study of 21 pregnant patients reported early and late maternal mortalities of 4.8 and 14.3%, respectively, and a foetal mortality of 14.3%. Median cardiopulmonary bypass and aortic cross-clamp times were 53 and 35 min, respectively, and the median bypass temperature was 37°C. Three larger retrospective reviews of the literature reported maternal mortality rates of 2.9-5.1% and foetal mortality rates of 19-29%. Mean cardiopulmonary bypass times ranged from 50.5 to 77.8 min. Another retrospective observational study reported maternal mortality of 13.3% and foetal mortality of 38.5%. Mean cardiopulmonary bypass and aortic cross-clamp times were 89.1 and 62.8 min, respectively, with a mean bypass temperature of 31.8°C. A retrospective case series reported no maternal mortality and one case of foetal mortality. Median cardiopulmonary bypass and aortic cross-clamp times were 101 and 88 min, respectively. Eight case reports described 10 patients undergoing cardiopulmonary bypass. There were no reports of maternal mortality and one report of foetal mortality. Mean cardiopulmonary bypass and aortic cross-clamp times were 105 and 50 min, respectively. We conclude that while the use of cardiopulmonary bypass

  10. Successful staged operation for acute type A aortic dissection with paraplegia.

    Science.gov (United States)

    Ando, Takashi; Abe, Hiroyuki; Nagata, Tokuichiro; Makuuchi, Haruo

    2013-06-01

    A 75-year-old man presented with both paraplegia and acute occlusion of the abdominal aorta at onset. Extraanatomical bypass was performed following spinal drainage. After 3 days, the ascending aorta replaced under cardiopulmonary bypass using the extraanatomical bypass graft for arterial cannulation. The abdominal aorta was replaced after 6 months. A staged operation is one of the options for acute aortic dissection with paraplegia and acute occlusion of the abdominal aorta.

  11. Low serum sodium level during cardiopulmonary bypass predicts increased risk of postoperative stroke after coronary artery bypass graft surgery.

    Science.gov (United States)

    Munoz, Elizandro; Briggs, Holly; Tolpin, Daniel A; Lee, Vei-Vei; Crane, Terry; Elayda, Macarthur A; Collard, Charles D; Pan, Wei

    2014-04-01

    Rapid decreases in serum sodium levels are associated with altered mental status, seizures, and coma. During cardiac surgery, serum sodium levels decrease rapidly when cardiopulmonary bypass is initiated because cardiopulmonary bypass causes hemodilution. However, whether this decrease influences neurologic outcome after cardiac surgery remains unclear. We investigated whether the average serum sodium level during cardiopulmonary bypass is independently predictive of postoperative stroke or 30-day all-cause mortality in patients who undergo primary coronary artery bypass grafting. In a single-institution, retrospective cohort of 2348 consecutive patients who underwent primary, isolated coronary artery bypass grafting, sequential multivariate logistic regression was performed to determine the threshold below which the average serum sodium level during cardiopulmonary bypass independently predicts postoperative stroke or early death. To further test the validity of this threshold and to control for selection bias, stepwise multivariate logistic regression was also performed on propensity score-matched patients (n = 924). An average serum sodium level less than 130 mEq/L during cardiopulmonary bypass was independently predictive of stroke, both in the entire study cohort (1.44% vs 2.92%; odds ratio, 2.09; 95% confidence interval, 1.1-4.1; P = .03) and in the propensity-matched patients (0.9% vs 3.0%; odds ratio, 4.1; 95% confidence interval, 1.3-13.0; P = .02). The average serum sodium level during cardiopulmonary bypass was not independently associated with early death, regardless of what threshold value was used. An average serum sodium level of less than 130 mEq/L during cardiopulmonary bypass is independently associated with an increased risk of postoperative stroke in patients who undergo primary coronary artery bypass grafting. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  12. Heart and Lungs Protection Technique for Cardiac Surgery with Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Vladimir Pichugin

    2014-12-01

    Full Text Available Introduction: Cardioplegic cardiac arrest with subsequent ischemic-reperfusion injuries can lead to the development of inflammation of the myocardium, leucocyte activation, and release of cardiac enzymes. Flow reduction to the bronchial arteries, causing low-flow lung ischemia, leads to the development of a pulmonary regional inflammatory response. Hypoventilation during cardiopulmonary bypass (CPB is responsible for development of microatelectasis, hydrostatic pulmonary edema, poor compliance, and a higher incidence of infection. Based on these facts, prevention methods of these complications were developed. The aim of this study was to evaluate constant coronary perfusion (CCP and the “beating heart” in combination with pulmonary artery perfusion (PAP and “ventilated lungs” technique for heart and lung protection in cardiac surgery with CPB.Methods. After ethical approval and written informed consent, 80 patients undergoing cardiac surgery with normothermic CPB were randomized in three groups. In the first group (22 patients, the crystalloid cardioplegia without lung ventilation/perfusion techniques were used. In the second group (30 patients, the CCP and “beating heart” without lung ventilation/perfusion techniques were used. In the third group (28 patients, the CCP with PAP and lung ventilation techniques were used. Clinical, functional parameters, myocardial damage markers (CK MB level, oxygenation index, and lung compliance were investigated.Results. There were higher rates of spontaneous cardiac recovery and lower doses of inotrops in the second and third groups. Myocardial contractility function was better preserved in the second and third groups. The post-operative levels of CK-MB were lower than in control group.  Three hours after surgery CK-MB levels in the second and third  groups were lower by 38.1% and 33.3%, respectively. Eight hours after surgery, CK-MB levels were lower in the second and third groups by 45.9% and

  13. Incidence of major amputations, bypass procedures and percutaneous transluminal angioplasties (PTA) in the treatment of peripheral arterial occlusive disease in a German referral center 1996-2003; Inzidenzen von Major-Amputationen, Bypass-Operationen und perkutanen transluminalen Angioplastien (PTA) zur Behandlung der peripheren arteriellen Verschlusskrankheit in einer deutschen Klinik der Maximalversorgung 1996-2003

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A. [Klinik fuer Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg (Germany); Inst. fuer Medizinmanagement und Gesundheitswissenschaften, Univ. Bayreuth (Germany); Freitag, M.H. [Inst. fuer Medizinmanagement und Gesundheitswissenschaften, Univ. Bayreuth (Germany); Woelfle, K.D. [Chirurgisches Zentrum, Klinik fuer Gefaesschirurgie, Zentralklinikum Augsburg (Germany); Bohndorf, K.; Kirchhof, K. [Klinik fuer Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg (Germany)

    2006-09-15

    Purpose: To determine the current incidence of major amputations, bypass procedures and percutaneous transluminal angioplasties (PTA) in a study population of patients with peripheral arterial occlusive disease in a German referral center. Materials and Methods: In a retrospective study, we recruited patients with peripheral arterial occlusive disease who underwent an amputation, bypass procedure, or PTA in the region of the pelvis or lower limbs between 1996 and 2003 at the Augsburg Medical Center. Patients were identified via the hospital database. This was performed with the help of the International Classification of Diseases (ICD 9 and 10), the operation code (OPS), and appropriate invoices. The incidence of PTAs was further estimated with 200 charts. Results: Of 5379 patients, 627 underwent amputation, 1832 a bypass procedure, and 2920 a PTA. The incidence of PTAs increased during the study period from 51.3/100 000/year to 64.4/100 000/year (p<0.01), while the number of amputations and bypass procedures remained stable. The incidence of PTAs was exceeded by that of bypass procedures only in patients older than 85 years. The age of the amputees decreased during the study period from 72.2 to 70.5 years (p<0.01). The age of patients who underwent a bypass procedure increased from 67.2 to 69.4 years, and the age of patients who underwent PTA increased form 66.3 to 69.8 years (p<0.01). Bypass procedures and PTAs were performed in men 6.3 years earlier than in women (p<0.01). Conclusion: The result is a population-corrected need of 8.4/100 000/year major amputations, 23/100 000/year bypass procedures and 64.4/100 000/year PTAs for patients with peripheral arterial occlusive disease within the referral area of our hospital. The performance of major amputations and bypass procedures stagnates, while the incidence of PTAs is increasing. (orig.)

  14. Definition and Facts for Irritable Bowel Syndrome

    Science.gov (United States)

    ... For Health Professionals Diabetes Discoveries & Practice Blog Health Communication Programs FAQs ... Syndrome (IBS) Definition & Facts Related Topics Section Navigation Irritable Bowel Syndrome ( ...

  15. Segmental wall motion abnormalities during telerobotic totally endoscopic coronary artery bypass grafting.

    Science.gov (United States)

    Mierdl, Stephan; Byhahn, Christian; Dogan, Selami; Aybek, Tayfun; Wimmer-Greinecker, Gerhard; Kessler, Paul; Meininger, Dirk; Westphal, Klaus

    2002-04-01

    In addition to single-lung ventilation (SLV), intrathoracic CO2 insufflation is mandatory for adequate exposure during totally endoscopic coronary artery bypass grafting. With transesophageal echocardiography, we investigated biventricular myocardial wall motion in 25 patients with isolated disease of the left anterior descending coronary artery who underwent totally endoscopic coronary artery bypass grafting with the "Da Vinci" robotic surgical system. At distinct time points during the operation, a cine loop of both ventricles was registered from a transgastric mid-short-axis view. Myocardial wall motion analysis was performed according to an established segmentation model of the left ventricle and to an established five-point scale for wall motion (1, normal; 5, dyskinesia). Significant alterations from preoperative baseline wall motion were visible in the septal, inferior, and anterior segments of the left ventricle at some time during the prebypass period, combined with a markedly decreased PaO2 under SLV and increased intrathoracic pressure. The same findings applied to the right ventricle; however, wall motion abnormalities were more pronounced here. After myocardial revascularization, weaning from cardiopulmonary bypass, CO2 deflation, and return to double-lung ventilation, myocardial wall motion recovered to baseline values. Clinically significant hemodynamic instability did not occur. The data suggest that robot-assisted coronary artery bypass grafting leads to significant prebypass alterations of biventricular segmental wall motion. On the basis of our data, it cannot be definitively stated whether the observed results were due to reduced oxygenation during SLV and thus "real" myocardial ischemia, intrathoracic CO2 insufflation with positive pressure leading to mechanical compromise of the heart, absolute or relative hypovolemia, or a combination of these factors. However, in this cohort, which consisted of patients with single-vessel disease and good

  16. Oxygen delivery and consumption during on-bypass cabg in htea and central analgesia

    Directory of Open Access Journals (Sweden)

    Віталій Олексійович Собокарь

    2015-04-01

    Full Text Available Objective. Despite some advantages, the use of high thoracic epidural anesthesia (HTEA during on-bypass cardiac surgery may be discouraged by fear of adverse hemodynamic effects and associated disturbances of oxygen delivery.Aim. To compare oxygen delivery and consumption during on-bypass coronary artery bypass grafting in settings of HTEA and central analgesia (CA.Methods. 132 patients were assigned into two groups – study group (n=85, where the surgery was performed under HTEA and control group (n=47 - where the surgery was carried out under CA. Using data of transesophageal cardiac ultrasound and blood oximetry blood oxygen delivery (DO2, oxygen consumption (VO2, oxygen extraction coefficient (CEO2 were calculated at four stages of the surgery: after induction, sternotomy, cardiopulmonary bypass and at the end of the surgery.Results. In the initial stages of the surgery DO2 and VO2 were reduced relative to reference values with a tendency to increase in the course of the operation and achievement of the normal or supernormal level (VO2, study group in the final stage. The decrease was due to moderate hypodynamic circulation and hemodilution. After sternotomy DO2 in the study group was higher than that of the control: 356 (279; 458 vs 317±89 ml·min-1·m-2, (р=0,021. After cardiopulmonary bypass oxygen saturation of venous blood (SatvO2, in the study group was 71 ± 9 % compared with 68 ± 10 % in the control group. At the end of the surgery SatvO2 in the study group was 71 (66; 75 vs 59 (53; 70 % in the control (р = 0,005 and oxygen tension of venous blood (РvО2 was correspondingly 39 ± 6 and 33 (30; 38 mm Hg (р = 0,027. Despite the decrease in DO2 and VO2, oxygen extraction indices - CEO2, pvO2, SatvO2, and remained within the reference range, except that of the control group at the end of the surgery. Furthermore, at no stage lactate rise or acid-base deviations was observed in the both groups.Conclusions. In patients operated

  17. Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Amor, Imed Ben; Petrucciani, Niccolo; Kassir, Radwan; Al Munifi, Abdullah; Piche, Thierry; Debs, Tarek; Gugenheim, Jean

    2017-05-01

    One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the esophagus. Medical treatment of gastroesophageal reflux disease was ineffective. We decided to convert the OAGB to a Roux-en-Y gastric bypass (RYGB). In this video, we show how to revise an OAGB to treat chronic bile reflux, by converting the procedure to a standard RYGB. The intervention starts by restoring the normal anatomy of the small bowel, with the resection of the gastrojejunal anastomosis, which was located at 250-cm du Treitz's ligament. Then, the gastric pouch is created. A standard Roux-en-Y gastric bypass is performed. The resection of the gastrojejunal anastomosis allows fashioning the Roux-en-Y limb with the classical measures. This technique allows a conversion to a standard RYGB and is effective in treating the biliary reflux.

  18. Transient Diabetes Insipidus Following Cardiopulmonary Bypass.

    Science.gov (United States)

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus (DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery.

  19. Recent Advances in Pediatric Cardiopulmonary Bypass.

    Science.gov (United States)

    McRobb, Craig M; Mejak, Brian L; Ellis, W Cory; Lawson, D Scott; Twite, Mark D

    2014-06-01

    There have been numerous recent advances geared specifically toward the practice of pediatric cardiopulmonary bypass (CPB). These advances include the development of the first oxygenator intended solely for the neonatal CPB patient; pediatric oxygenators with low prime volumes and surface areas, which allow flows up to 2 L/min; pediatric oxygenators with integrated arterial filters; and miniature ultrafiltration (UF) devices, which allow for high rates of ultrafiltrate removal. When used in combination with heart lung machines with mast-mounted pumps, these advances can result in significant decreases in CPB circuit surface areas and prime volumes. This may attenuate CPB-associated hemodilution and decrease or eliminate the need for homologous red blood cells during or after CPB. In addition to these equipment-related advances, changes in myocardial protection strategies and the technique of modified UF as it relates to these advances are discussed. © The Author(s) 2014.

  20. Ultra by-pass ratio engine

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Masanori; Sugiyama, Shichihisa

    1986-12-10

    A engine where ratio of fan's or propeller's air flow rate to air flow rate through engine combustion chamber is more than 15 is generally named the ultra bypass ratio engine (UBE). This engine employs the exhaust gas from the engine separately to the fan or propeller and jet nozzle exhaust to obtain higher total thrust efficiency. The increase rate of thrust by using UBE is equal to the improvement rate of fuel comsumption. Much efforts are continuously made to develop UBE toward the 21 century by many companies and it is necessary to develop the core engine of high specific output and high heat efficiency, and variable pitch / high aspect ratio fan or propeller and to reseach the integrated system technology. (5 refs, 9 figs)

  1. Impact of Norepinephrine on Regional Cerebral Oxygenation During Cardiopulmonary Bypass.

    Science.gov (United States)

    Hagen, Ove Andreas; Høiseth, Lars Øivind; Roslin, André; Landsverk, Svein Aslak; Woldbaek, Per Reidar; Pripp, Are Hugo; Hanoa, Rolf; Kirkebøen, Knut Arvid

    2016-04-01

    Norepinephrine is used to increase mean arterial pressure during cardiopulmonary bypass. However, it has been suggested that norepinephrine could constrict cerebral arteries, reducing cerebral blood flow. The aim of this study, therefore, was to explore whether there was an association between doses of norepinephrine to maintain mean arterial pressure at ≈80 mmHg during cardiopulmonary bypass and cerebral oxygen saturation measured using near-infrared spectroscopy. Observational study. University hospital. Patients undergoing cardiac surgery (n = 45) using cardiopulmonary bypass. Norepinephrine was administered to maintain mean arterial pressure ≈80 mmHg during cardiopulmonary bypass. From initiation of cardiopulmonary bypass to removal of the aortic cross-clamp, norepinephrine dose, mean arterial pressure, partial pressure of arterial carbon dioxide, partial pressure of arterial oxygen, hemoglobin, and pump flow values were averaged over 1 minute, giving a total of 3,460 data points entered as covariates in a linear mixed model for repeated measurements, with cerebral oxygen saturation measured using near-infrared spectroscopy as outcome. There was no statistically significant association between norepinephrine dose to maintain mean arterial pressure and cerebral oxygen saturation (p = 0.46) in this model. Administration of norepinephrine to maintain mean arterial pressure ≈80 mmHg during cardiopulmonary bypass was not associated with statistically significant changes in cerebral oxygen saturation. These results indicated that norepinephrine could be used to increase mean arterial pressure during cardiopulmonary bypass without reducing cerebral oxygen saturation. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Study of transient turbine shot without bypass in a BWR; Estudio del transitorio disparo de turbina sin bypass en un BWR

    Energy Technology Data Exchange (ETDEWEB)

    Vallejo Q, J. A.; Martin del Campo M, C.; Fuentes M, L.; Francois L, J. L., E-mail: amhed_jvq@hotmail.com [UNAM, Facultad de Ingenieria, Departamento de Sistemas Energeticos, Ciudad Universitaria, 04510 Ciudad de Mexico (Mexico)

    2015-09-15

    The study and analysis of operational transients are important for predicting the behavior of a system to short-terms events and the impact that would cause this transition. For the nuclear industry these studies are indispensable due to economic, environmental and social impacts that could result in an accident during the operation of a nuclear reactor. In this paper the preparation, simulation and analysis of results of a turbine shot transient, which is not taken into operation the bypass is presented. The study is realized for a BWR of 2027 MWt, to an intermediate cycle life and using the computer code Simulate-3K a depressurization stage of the vessel is created which shows the response of other security systems and gives a coherent prediction to the event presented type. (Author)

  3. Comparison of safety and effectiveness between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy: A meta-analysis and systematic review.

    Science.gov (United States)

    Wang, Fu-Gang; Yu, Zhao-Peng; Yan, Wen-Mao; Yan, Ming; Song, Mao-Min

    2017-12-01

    The laparoscopic mini-gastric bypass is a newly emerged surgical procedure in recent years. Owe to safe and simple process and effective outcomes, laparoscopic mini-gastric bypass has quickly become one of the most popular procedures in some countries. The safety and effectiveness of laparoscopic mini-gastric bypass versus laparoscopic sleeve gastrectomy remain unclear. A systematic literature search was performed in PubMed, Embase, Cochrane library from inception to May 20, 2017. The methodological quality of Randomized Controlled Trials and non-Randomized Controlled Trials were, respectively, assessed by Cochrane Collaboration's tool for assessing risk of bias and Newcastle-Ottawa scale. The meta-analysis was performed by RevMan 5.3 software. Patients receiving mini-gastric bypass had a lot of advantageous indexes than patients receiving sleeve gastrectomy, such as higher 1-year EWL% (excess weight loss), higher 5-year EWL%, higher T2DM remission rate, higher hypertension remission rate, higher obstructive sleep apnea (OSA) remission rate, lower osteoarthritis remission rate, lower leakage rate, lower overall late complications rate, higher ulcer rate, lower gastroesophageal reflux disease (GERD) rate, shorter hospital stay and lower revision rate. No significant statistical difference was observed on overall early complications rate, bleed rate, vomiting rate, anemia rate, and operation time between mini-gastric bypass and sleeve gastrectomy. Mini-gastric bypass is a simpler, safer, and more effective bariatric procedure than laparoscopic sleeve gastrectomy. Due to the biased data, small sample size and short follow-up time, our results may be unreliable. Large sample and multicenter RCT is needed to compare the effectiveness and safety between mini-gastric bypass and sleeve gastrectomy. Future study should also focus on bile reflux, remnant gastric cancer, and long term effectiveness of mini-gastric bypass. Copyright © 2017 The Authors. Published by Wolters

  4. The Staphylococcus aureus FASII bypass escape route from FASII inhibitors.

    Science.gov (United States)

    Morvan, Claire; Halpern, David; Kénanian, Gérald; Pathania, Amit; Anba-Mondoloni, Jamila; Lamberet, Gilles; Gruss, Alexandra; Gloux, Karine

    2017-10-01

    Antimicrobials targeting the fatty acid synthesis (FASII) pathway are being developed as alternative treatments for bacterial infections. Emergence of resistance to FASII inhibitors was mainly considered as a consequence of mutations in the FASII target genes. However, an alternative and efficient anti-FASII resistance strategy, called here FASII bypass, was uncovered. Bacteria that bypass FASII incorporate exogenous fatty acids in membrane lipids, and thus dispense with the need for FASII. This strategy is used by numerous Gram-positive low GC % bacteria, including streptococci, enterococci, and staphylococci. Some bacteria repress FASII genes once fatty acids are available, and "constitutively" shift to FASII bypass. Others, such as the major pathogen Staphylococcus aureus, can undergo high frequency mutations that favor FASII bypass. This capacity is particularly relevant during infection, as the host supplies the fatty acids needed for bacteria to bypass FASII and thus become resistant to FASII inhibitors. Screenings for anti-FASII resistance in the presence of exogenous fatty acids confirmed that FASII bypass confers anti-FASII resistance among clinical and veterinary isolates. Polymorphisms in S. aureus FASII initiation enzymes favor FASII bypass, possibly by increasing availability of acyl-carrier protein, a required intermediate. Here we review FASII bypass and consequences in light of proposed uses of anti-FASII to treat infections, with a focus on FASII bypass in S. aureus. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  5. Development of the Current Bypassing Methods into the Transverse Direction in Non-insulation HTS Coils

    Science.gov (United States)

    Tanaka, K.; Kim, S. B.; Ikoma, H.; Kanemoto, D.

    In the case of motors and generators, the benefits of using high temperature superconducting (HTS) coils can be represented by the reduction of 50% in both losses and sizes compared to conventional machines. However, it is hard to establish quench detection and protection devices for the HTS coils applied to the rotors of motors and generators. So, the stability of the coils is lower than for the quiescent coils applied to NMR, MRI and so on. Therefore, it is important to improve the self-protection ability of HTS coils. We have studied the methods to improve the self-protection ability of HTS coils by removing the layer-to-layer insulation and inserting metal tape instead of the electrical insulation. The operating current in the non-insulated HTS coil was bypassed into the transverse direction by the generated normal region because of their electrical contact among the winding. In this study, we examined the method to control the current bypassing on layer-to-layer for controlling the inductance of the non-insulated HTS coil. The current bypassing properties on non-insulated HTS coil wound with 2G wires will be discussed.

  6. Indications, new surgical technique and results of colon interposition or bypass in esophageal surgery.

    Science.gov (United States)

    Cseke, L; Horváth, O P

    1997-01-01

    Over a 5-year period, 29 patients with esophageal disease underwent colon interposition or bypass. The indication was cure of cancer in 11 patients, who underwent earlier a gastric resection. Other indications was benign stricture in 7 patients, bypass for unrespectable cancer in 6, having a caustic injury in 3 and after an esophageal perforation in 2. In 14 patients the left colon, in 15 the right colon was used. The colon was transected without dividing the mesentery other than just along its mesenteric border. This preserves additional blood supply from the marginal artery, also improves the function of the graft in transporting food. Anastomosis leakage occurred in 4 cases (13.7%). Graft necrosis occurred in 2 of 29 patients, one of whom alter underwent a successful second reconstruction. The 30 day operative mortality rate was 13.7%. A colon interposition provides good quality of deglution, and is the organ of choice for patients who require an esophageal substitute and are potential candidates for long survival, or when the stomach is unsuited for replacement or bypass.

  7. Simulation study on bypass and therapeutic occlusion in the posterior circulation.

    Science.gov (United States)

    Nagasawa, S; Ohta, T; Kikuchi, H; Nagayasu, S

    1995-01-01

    A hydraulic vascular model of the vertebrobasilar artery with an autoregulatory mechanism was constructed. The haemodynamic effect of superficial temporal artery (STA)-posterior cerebral artery (PCA) bypass was investigated in cases of bilateral vertebral artery (VA) occlusion and basilar artery (BA) occlusion. Assuming therapeutic BA occlusion for basilar bifurcation aneurysms, the flow volume through the P1 segment of the PCA was determined in relation to diameters of the posterior communicating artery (PCom). The bypass increases both flow volume and intraluminal pressure in the presence range below 60 mm Hg, while it increases only pressure in the autoregulatory range above 60 mm Hg. Its haemodynamic effect is more marked in BA occlusion than in VA occlusion. The averaged values of the increase in flow volume are 29.0 +/- 4.3% (mean +/- SD) and 16.5 + 1.0%, respectively. The total flow volume increase of the vertebrobasilar system is usually lower than the flow volume measured at the bypassed STA. The difference between the two is equal to the simultaneous decrease in flow volume through the PComs. Flow volume through the P1 segment can be expressed as a function of the PComs diameter ratio squared. A hydraulic simulation study will be useful for speculating on the haemodynamic effects of these operative procedures.

  8. Proximal enterectomy stimulates distal hyperplasia more than bypass or pancreaticobiliary diversion.

    Science.gov (United States)

    Williamson, R C; Bauer, F L; Ross, J S; Malt, R A

    1978-01-01

    To determine the contribution of intraluminal factors to postresectional intestinal hyperplasia, cell proliferation in the distal intestine of male rats was studied after 50% proximal enterectomy or 50% proximal bypass and also after transposition of the duodenal papilla to the mid small bowel. Within 48 hr all three operations increased RNA and DNA content s in the ileal mucosa 16 to 50% over control values. At 48 hr and 1 week the response distal to resection exceeded that of bypass or pancreaticobiliary diversion; nucleic acid contents, DNA specific activity, villous height, crypt depth, and luminal circumference were greatest 1 week after resection. By 1 month, however, chemical and histological values after resection were equalled or surpassed by those in the other two groups. In excluded jejunum itself, mucosal atrophy lowered RNA and DNA contents to 60% of control levels 1 month postoperatively. Neither pancreaticobiliary diversion nor proximal enteric bypass produces the same rate of distal hyperplasia as proximal resection. Modest colonic hyperplasia may contribute to intestinal adaptation after proximal enterectomy. Adaptive postrescetional cell proliferation appears not to be mediated simply by intraluminal nutrition or enteric secretions; hormonal factors may also be important.

  9. Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting.

    Science.gov (United States)

    Borges, Daniel Lago; Nina, Vinícius José da Silva; Costa, Marina de Albuquerque Gonçalves; Baldez, Thiago Eduardo Pereira; Santos, Natália Pereira dos; Lima, Ilka Mendes; Figuerêdo, Eduardo Durans; Lula, Josimary Lima da Silva

    2013-01-01

    To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when Pventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.

  10. Vena saphena magna in situ-bypass til ankel og fod. En prospektiv opg|relse af resultaterne af 101 procedurer hos 94 amputationstruede patienter

    DEFF Research Database (Denmark)

    Røder, Ole Christian; Jensen, L P; Schroeder, T V

    1997-01-01

    The results of 101 in situ by-pass operations to the ankle and foot are given. Seventy-five percent of the patients had other arteriosclerotic manifestations and 55% were diabetics. Ninety-nine percent of the operations were limb salvage surgery. The accumulative secondary patency rate was 87......% after one month and 65% after three years. The results did not differ from by-pass surgery to the crural arteries. The wound complication rate was 16% with an infection rate of 7% and the major amputation rate was 8% after one month and 10% after three years. The survival of this selected group...

  11. Location of facts devices from a dynamic perspective; Ubicacion de dispositivos FACTS desde una perspectiva dinamica

    Energy Technology Data Exchange (ETDEWEB)

    Coronado Gallegos, Ixtlahuatl

    2001-09-15

    In this work techniques for the location of FACTS devices (Flexible Systems of AC Transmission) in a multi-machine power system in order to improve the electromechanical transient behavior is presented. In the first part, a brief introduction is presented about the FACTS devices, in which are mentioned some of the main characteristics, classification and advantages that their utilization represents. In the next part, the formulation of the matrix of state in the context of machine-infinite bar considering the possibility of including a power system stabilizer is developed. Later the formulation is extended to a multi-machine system. Additionally the form of including a series capacitor controlled by thyristors (TCSC) as well as a unified controller of power flows (UPFC) is analyzed. An analysis of the UPFC is carried out in conditions of stationary and dynamic state in a system machine-infinite bar in order to know its operating characteristics and its capacity for dampening power oscillations through its entrances of control when using local signals. In the last part of the work a methodology is proposed to attack the problem of the location of FACTS devices, which is based in the technique of response to the system frequency. In order to validate this proposal some cases of study are used and the results obtained with the ones provided by other techniques are compared. Also some auxiliary means are proposed for obtaining the feasible locations utilizing other mathematical tools such as the singular values and the sensitivities. Finally, simulations in the time are carried out to corroborate the results obtained. [Spanish] En este trabajo se presentan tecnicas para la localizacion de dispositivos FACTS (Sistemas Flexibles de Transmision de C.A) en un sistema de potencia multimaquinas a fin de mejorar el comportamiento transitorio electromecanico. En la primera parte se presenta una breve introduccion acerca de los dispositivos FACTS, en la cual se mencionan

  12. A Study of Hydraulic Resistance of Viscous Bypass Gap in Magnetorheological Damper

    Directory of Open Access Journals (Sweden)

    Michal Kubík

    2016-01-01

    Full Text Available The paper presents hydraulic resistance of viscous bypass hole in magnetorheological damper. The suitable design of bypass hole is essential for efficient function of MR damper in automotive industry. In the paper analytical hydraulic model of bypass gap is compared with experiments. The commonly used hydraulic model of bypass gap does not agree with experiments.

  13. Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease

    DEFF Research Database (Denmark)

    Møller, Christian H; Penninga, Luit; Wetterslev, Jørn

    2012-01-01

    Coronary artery bypass grafting (CABG) is performed both without and with cardiopulmonary bypass, referred to as off-pump and on-pump CABG respectively. However, the preferable technique is unclear.......Coronary artery bypass grafting (CABG) is performed both without and with cardiopulmonary bypass, referred to as off-pump and on-pump CABG respectively. However, the preferable technique is unclear....

  14. 21 CFR 870.4260 - Cardiopulmonary bypass arterial line blood filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass arterial line blood filter... Cardiopulmonary bypass arterial line blood filter. (a) Identification. A cardiopulmonary bypass arterial line... entitled “Guidance for Cardiopulmonary Bypass Arterial Line Blood Filter 510(k) Submissions.” [45 FR 7907...

  15. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Folic Acid and Pregnancy Medical Care ... Read a Nutrition Facts Label (Video) KidsHealth > For Parents > How to Read a Nutrition Facts Label (Video) ...

  16. Tuberculosis Facts - TB Can Be Treated

    Science.gov (United States)

    Tuberculosis (TB) Facts TB Can Be Treated What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Page 1 of 2 TB Facts: TB ...

  17. Tuberculosis Facts - You Can Prevent TB

    Science.gov (United States)

    Tuberculosis (TB) Facts You Can Prevent TB What is TB? “TB” is short for a disease called tuberculosis. TB is spread through the air from one ... Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination TB Facts: You Can Prevent TB What ...

  18. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... Educators Search English Español How to Read a Nutrition Facts Label (Video) KidsHealth / For Parents / How to Read a Nutrition Facts Label (Video) Print en español Cómo leer ...

  19. How to Read a Nutrition Facts Label

    Medline Plus

    Full Text Available ... for Educators Search English Español How to Read a Nutrition Facts Label (Video) KidsHealth / For Parents / How to Read a Nutrition Facts Label (Video) Print en español Cómo ...

  20. Quick Facts for 2013-2014

    Science.gov (United States)

    Alabama Department of Education, 2014

    2014-01-01

    The Alabama Department of Education presents "Quick Facts," an annual snapshot of general state statistics, facts about public schools, the State Board of Education, and general financial data. The data presented in this report covers the school year 2013-2014.