WorldWideScience

Sample records for direct ecc bypass

  1. Advanced DVI for ECC direct bypass mitigation

    International Nuclear Information System (INIS)

    Kwon, Tae-Soon; Song, Chul-Hwa; Baek, Won-Pil

    2009-01-01

    An ECC direct bypass fraction during a late reflood phase of a LBLOCA is strongly dependent on the characteristics of the cross flow and the geometrical configuration of a DVI in the downcomer of a pressurized light water reactor. The important design parameters of a DVI are the elevation, the azimuthal angle, and the separator to prevent a steam-water interaction. An ECC sub-channel to separate or to isolate an ECC water from a high-speed cross flow is one of the important design features to mitigate the ECC bypass phenomena. A dual core barrel cylinder as an ECC flow separator is located between a reactor vessel and a core barrel outer wall in the downcomer annulus. A new narrow gap between the core barrel and the additional dual core barrel plays the role of a downward ECC flow channel or an ECC flow separator in a high-speed cross flow field of the downcomer annulus. The flow zone around a broken cold leg in the downcomer annulus has the role of a high ECC direct bypass due to a strong suction force while the wake zone of a hot leg has the role of an ECC penetration. Thus, the relative azimuthal angle of the DVI nozzle from the broken cold leg is an important design parameter. A large azimuthal angle from a cold leg to a hot leg needs to avoid a high suction flow zone when an ECC water is being injected. The other enhancing mechanism of an ECC penetration is a grooved core barrel which has small rectangular-shaped grooves vertically arranged on the core barrel wall of the reactor vessel downcomer annulus. These grooves have the role for a generation of a vortex induced by a high-speed cross flow. Since the stagnant flow in a lateral direction and rotational vortex provides the pulling force of an ECC drop or film to flow down into the lower downcomer annulus by gravity, the ECC direct bypass fraction is reduced when compared to the current design of a smoothed wall. An open channel of grooves generates a stagnant vortex, while a closed channel of grooves

  2. Direct ECC bypass phenomena in the MIDAS test facility during LBLOCA reflood phase

    International Nuclear Information System (INIS)

    Yun, B. J.; Kweon, T. S.; Ah, D. J.; Ju, I. C.; Song, C. H.; Park, J. K.

    2001-01-01

    This paper describes the experimental results of ECC Direct Bypass Phenomena in the downcomer during the late reflood phase of LBLOCA of the reactor that adopts Direct Vessel Injection as a ECC system. The experiments have been performed in MIDAS test facility using superheated steam and water. The test condition was determined, based on the preliminary analysis of TRAC code, from modified linear scaling method of 1/4.93 length scale. To measure the direct bypass fraction according to the nozzle location, separate effect tests have been performed in case of DVI-4(farthest from broken cold leg) injection, DVI-2(closest to broken cold leg) injection, and DVI-2 and 4 injection, respectively. Also the test was carried out varying the steam flow rate greatly to investigate the effect of steam flow rate on the direct bypass fraction of ECC water. Test results show that the direct bypass fraction of ECC water depends significantly on the injected steam mass flow rate. DVI-4 tests show that the direct bypass fraction increases drastically as the steam flow rate increases. However, in DVI-2 test most of the injected ECC water penetrates into lower downcomer. The direct bypass characteristic in each of DVI-2 and DVI-4 tests is reflected into the direct bypass characteristic curve of DVI-2 and 4 test. The steam condensation reaches to the theoretically allowable maximum value

  3. Evaluation of ECC bypass data with a nonlinear constrained MLE technique

    International Nuclear Information System (INIS)

    Bishop, T.A.; Collier, R.P.; Kurth, R.E.

    1980-01-01

    Recently, Battelle's Columbus Laboratories have been involved in scale-model tests of emergency core cooling (ECC) systems for hypothesized loss-of-coolant accidents in pressurized water reactors (PWR). These tests are intended to increase our understanding of ECC bypass, which can occur when steam flow from the reactor core causes the emergency coolant to bypass the core and flow directly to the break. One objective of these experiments is the development of a correlation which relates the flow rate of water penetrating to the core to the steam flow rate. This correlation is derived from data obtained from a 2/15 scale model PWR at various ECC water injection rates, subcoolings, pressures, and steam flows. The general form of the correlation being studied is a modification of the correlation first proposed by Wallis. The correlation model is inherently nonlinear and implicit in form, and the model variables are all subject to error. Therefore, the usual nonlinear analysis techniques are inappropriate. A nonlinear constrained maximum-likelihood-estimation technique has been used to obtain estimates of the model parameters, and a Battelle-developed code, NLINMLE, has been used to analyze the data. The application of this technique is illustrated by sample calculations of estimates of the model parameters and their associated confidence intervals for selected experimental data sets. 5 figures, 7 tables

  4. A study of ECC water bypass reduction technology for an improvement of core cooling capability

    International Nuclear Information System (INIS)

    Song, C. G.; Kwon, T. S.; Yun, B. J.

    2006-02-01

    The research for the reduction of ECC water bypass fraction was mainly performed to develop the flow mechanisms that ECC water can penetrate more effectively into a lower downcomer. Evaluation were carried out for the effect of major parameters on the bypass of ECC water in the downcomer with DVI. The following various physical models were derived for the reduction of the bypass fraction of ECC water: models of changing DVI injection angle, models of rearranging relative angles of DVI nozzles, model of grooved-and-subchannel type core barrel, model of dual core barrel. CFD analysis and MARS design verification were performed for the derived models as a first step performance estimation. Through out air-water verification experiments, quantitative evaluation were performed for each model, and three most efficient models were suggested. Examination were carried out for the requirement of structural modification and the change in structural integrity due to the adoption of one of the schemes

  5. A PWR reactor downcomer modification for reduction of ECC bypass flow during LOCA

    International Nuclear Information System (INIS)

    Popov, N.; Bosevski, T.

    1986-01-01

    The ECC bypass phenomenon in the PWR reactor down-comer, which delays the reactor vessel refilling, after cold leg large break LOCA accident, has been subject of analysis in this paper. In the paper, a particular construction modification of the reactor down-comer has been suggested by inserting vertical ribs, aimed to intensify the reactor ECC refilling following the LOCA accident, and to advance the thermal-hydraulics safety of post-accidental cooling of the PWR reactors. To verify the effectiveness of the suggested down-comer construction modification, some properly selected results, obtained by corresponding verified mathematical model, have been presented in this paper. (author)

  6. Assessment of some interfacial shear correlations in a model of ECC bypass flow in PWR reactor downcomer

    International Nuclear Information System (INIS)

    Popov, N.K.; Rohatgi, U.S.

    1987-01-01

    The bypass/refill process in the PWR reactor downcomer, following a large rupture of a cold leg coolant supply pipe, is a complicated thermo-hydraulic two-phase flow phenomenon. Mathematical modeling of such phenomena is always accompanied with a difficult task of selection of suitable constitutive correlations. In a typically hydrodynamic phenomenon, like ECC refill process of the reactor lower plenum is considered, the phasic interfacial friction is the most influential constitutive correlation. Therefore, assessment of the well-known widely-used interfacial friction constitutive correlations in the model of ECC bypass/refill process, is the subject of this paper

  7. Direct vessel inclined injection system for reduction of emergency core coolant direct bypass in advanced reactors

    International Nuclear Information System (INIS)

    Yoon, Sang H.; Lee, Jong G.; Suh, Kune Y.

    2006-01-01

    Multidimensional thermal hydraulics in the APR1400 (Advanced Power Reactor 1400 MWe) downcomer during a large-break loss-of-coolant accident (LBLOCA) plays a pivotal role in determining the capability of the safety injection system. APR1400 adopts the direct vessel injection (DVI) method for more effective core penetration of the emergency core cooling (ECC) water than the cold leg injection (CLI) method in the OPR1000 (Optimized Power Reactor 1000 MWe). The DVI method turned out to be prone to occasionally lack in efficacious delivery of ECC to the reactor core during the reflood phase of a LBLOCA, however. This study intends to demonstrate a direct vessel inclined injection (DVII) method, one of various ideas with which to maximize the ECC core penetration and to minimize the direct bypass through the break during the reflood phase of a LBLOCA. The 1/7 scaled down THETA (Transient Hydrodynamics Engineering Test Apparatus) tests show that a vertical inclined nozzle angle of the DVII system increases the downward momentum of the injected ECC water by reducing the degree of impingement on the reactor downcomer, whereby lessening the extent of the direct bypass through the break. The proposed method may be combined with other innovative measures with which to ensure an enough thermal margin in the core during the course of a LBLOCA in APR1400

  8. UPTF-TRAM test A3. Turn-over of the hot-leg injected ECC in the steam generator direction

    International Nuclear Information System (INIS)

    Tenckhoff; Brand, B.; Weiss, P.

    1993-06-01

    The UPTF TRAM test A3 was a separate effects test to investigate the interaction between the hot leg-injected ECC and the single-phase or two-phase natural circulation in the hot leg in the case of an SBLOCA in a PWR. The experimental investigation of 7 runs was mainly concentrated on the following phenomena: - Transport of hot leg injected ECC water to the upper plenum or in the direction of steam generator, depending on the loop mass flow, -Utilization of the condensation potential of ECC water, - Mixing of the saturated water with the ECC water, - Effect of hot leg injection on the flow phenomena in the hot leg, - Effect of pressure (3 and 15 bar) on the scaling and hence the verification of the scaling concept applied. A preliminary evaluation of the test is presented in the Quick Look Report. (orig.) [de

  9. Multi-dimensional analysis of the ECC behavior in the UPI plant Kori Unit 1

    International Nuclear Information System (INIS)

    Bae, Sungwon; Chung, Bub-Dong; Bang, Young Seok

    2008-01-01

    A multi-dimensional transient analysis during the LBLOCA of the Kori Unit 1 has been performed by using the MARS code. Based on 1-D nodalization of the Kori Unit 1, the reactor vessel nodalizations have been replaced by the multi-dimensional component. The multi-dimensional component for the reactor vessel is designed as 5 radial, 8 peripheral, and 21 vertical grids. It is assumed that the fuel assemblies are homogeneously distributed in inner 3 radial grids. The outer 1 radial grid region is modeled as the core bypass. The outer-model 1 radial grid is used for the downcomer region. The corresponding heat structures and fuels are modified to fit for the multi-dimensional reactor vessel model. The form drag coefficients for the upper plenum and the core have been designated as 0.6 and 9.39, respectively. The form drag coefficients for the radial and peripheral directions are assigned to the same on the assumption of homogeneous distribution of the flow obstacles. After obtaining the 102% power steady operation condition, cold leg LOCA simulation is performed during 400 second period. The multi-dimensional steady run results show no severe differences compared to the traditional 1-D nodalization results. After the ECC injection starts, a liquid pool is maintained at the upper plenum because the ECCS water can not overcome the upward gas flow that comes from the reactor core through the upper tie plate. The depth of ECCS water pool is predicted as about 20% of the total height from the upper tie plate and the center line of the hot leg pipe. At the vicinity region of the active ECCS show higher depth of liquid pool. The accumulated water flow rate passing the upper tie plate is calculated by the transient result. Much downward water flow is obtained at the outer-most region of upper plenum space. The downward flow dominant region is about 32.3% of the total upper tie plate area. The accumulated ECCS bypass ratio is predicted as 27.64% at 300 second. It is calculated

  10. Diablo Canyon ECCS enhancements

    International Nuclear Information System (INIS)

    Lin, A.; Lee, T.P.; Walter, L.E.

    2004-01-01

    Diablo Canyon Power Plant (DCPP) operated by Pacific Gas and Electric Co. (PG and E) is a Westinghouse designed four loop plant. In recent years, several issues were identified regarding the compliance of the Emergency Core Cooling System (ECCS) surveillance tests to the ECCS analyses assumptions. These concerns are related mostly to the High Head Safety Injection (HHSI) and the Intermediate Head Safety Injection (IHSI) systems where the injection line throttle valves are adjusted during outage surveillance testing to ensure compliance with the Technical Specifications (TS). To resolve all of the identified issues PG and E performed an ECCS reanalysis and upgraded the ECCS surveillance test program and also had Westinghouse perform a containment reanalysis using their latest model. As a result of these plant specific enhancement efforts, DCPP widened the operating window for TS surveillance testing, lowered the ECCS pumps' acceptance performance curves, and re-gained Peak Clad Temperature (PCT) and containment peak pressure margins. These enhancements are generically applicable to other plants and are addressed in this paper. (author)

  11. Perioperative outcomes in minimally invasive direct coronary artery bypass versus off-pump coronary artery bypass with sternotomy.

    Science.gov (United States)

    Tekin, Ali İhsan; Arslan, Ümit

    2017-09-01

    Surgical treatment of isolated left anterior descending coronary artery disease can be performed with either minimally invasive direct coronary artery bypass via a left anterior thoracotomy (MIDCAB) or off-pump coronary artery bypass via a median sternotomy (OPCAB). To compare the perioperative outcomes of patients undergoing MIDCAB or OPCAB surgery. Patients who underwent either MIDCAB or OPCAB for isolated left anterior descending (LAD) coronary artery disease between October 2013 and December 2015 were retrospectively evaluated. Operations were carried out by the same surgical team. Preoperative, intraoperative and postoperative data of the patients were recorded for analyses. Twenty-three patients (7 females, 16 males) underwent MIDCAB surgery, and 24 patients (4 female, 20 males) underwent OPCAB surgery. The two groups were comparable regarding preoperative patient characteristics. Duration of mechanical ventilation (5.1 ±0.7 h vs. 6.6 ±0.9 h), intensive care unit stay (19.4 ±2.5 h vs. 45.8 ±5.4 h) and hospital stay (4.3 ±0.4 days vs. 5.6 ±0.8 days) were significantly shorter in the MIDCAB group (p < 0.01). Patients in the OPCAB group required significantly more blood transfusions (1.83 ±0.38 units vs. 0.17 ±0.38 units) and fresh frozen plasma use (2.33 ±0.96 units vs. 0.69 ±0.76 units) (p < 0.01). Conversion to sternotomy was not required in the MIDCAB group. There was no mortality, conversion to cardiopulmonary bypass or serious complication in either group. We believe that the MIDCAB technique is more advantageous than the OPCAB technique in the treatment of patients with a critical LAD lesion.

  12. ECC cusp analysis

    Energy Technology Data Exchange (ETDEWEB)

    Pregliasco, R.G. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina)); Garibotti, C.R. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina)); Barrachina, R. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina))

    1994-03-01

    We measured the ionization double differential cross section for the H[sup +][yields]He 100 keV collision at the proximities of the ECC cusp and all around 0 . We propose an angular function expansion and a procedure for data analysis. We demonstrate that, in this way, the difficulties and shortcomings presented in the standard data processing are overcome. In our experimental results we distinguish the presence of characteristic shapes for the ionization depending on whether the module of the electron velocity is greater or smaller than the projectile velocity. (orig.)

  13. Core-power and decay-time limits for disabled automatic-actuation of LOFT ECCS

    International Nuclear Information System (INIS)

    Hanson, G.H.

    1978-01-01

    The Emergency Core Cooling System (ECCS) for the LOFT reactor may need to be disabled for modifications or repairs of hardware or instrumentation or for component testing during periods when the reactor system is hot and pressurized, or it may be desirable to enable the ECCS to be disabled without the necessity of cooling down and depressurizing the reactor. LTR 113-47 has shown that the LOFT ECCS can be safely bypassed or disabled when the total core power does not exceed 25 kW. A modified policy involves disabling the automatic actuation of the LOFT ECCS, but still retaining the manual activation capability. Disabling of the automatic actuation can be safely utilized, without subjecting the fuel cladding to unacceptable temperatures, when the LOFT power decays to 70 kW; this power level permits a maximum delay of 20 minutes following a LOCA for the manual actuation of ECCS

  14. Preliminary test conditions for KNGR SBLOCA DVI ECCS performance test

    International Nuclear Information System (INIS)

    Bae, Kyoo Whan; Song, Jin Ho; Chung, Young Jong; Sim, Suk Ku; Park, Jong Kyun

    1999-03-01

    The Korean Next Generation Reactor (KNGR) adopts 4-train Direct Vessel Injection (DVI) configuration and injects the safety injection water directly into the downcomer through the 8.5'' DVI nozzle. Thus, the thermal hydraulic phenomena such as ECCS mixing and bypass are expected to be different from those observed in the cold leg injection. In order to investigate the realistic injection phenomena and modify the analysis code developed in the basis of cold leg injection, thermal hydraulic test with the performance evaluation is required. Preliminarily, the sequence of events and major thermal hydraulic phenomena during the small break LOCA for KNGR are identified from the analysis results calculated by the CEFLASH-4AS/REM. It is shown from the analysis results that the major transient behaviors including the core mixture level are largely affected by the downcomer modeling. Therefore, to investigate the proper thermal hydraulic phenomena occurring in the downcomer with limited budget and time, the separate effects test focusing on this region is considered to be effective and the conceptual test facility based on this recommended. For this test facility the test initial and boundary conditions are developed using the CEFLASH-4AS/REM analysis results that will be used as input for the preliminary test requirements. The final test requirements will be developed through the further discussions with the test performance group. (Author). 10 refs., 18 tabs., 4 figs

  15. Evaluation of mispositioned ECCS valves

    International Nuclear Information System (INIS)

    Hill, R.A.; O'Brien, J.F.; McIntire, D.C.; Barlow, R.T.

    1977-09-01

    In October of 1975, Westinghouse submitted NS-CE-787, dated October 17, 1975, to the Nuclear Regulatory Commission (NRC) and entered into discussions with them concerning the spurious movement of certain motor-operated valves (MOV's) in the Emergency Core Cooling System (ECCS) to a position defeating the ECCS function at a time when this function is required. On November 25, 1975, the discussion turned to the possible movement of a manually controlled, motor-operated valve due to a fault in its electrical circuitry and the NRC staff expressed concerns about other possible failure modes that might lead to such a valve movement. The NRC meeting minutes document these concerns. This report is an item-by-item response to the concerns expressed by the NRC staff at that meeting and incorporates the original electrical fault analysis

  16. Experiments on injection performance of SMART ECC facility using SWAT

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Il; Cho, Seok; Ko, Yung Joo; Min, Kyoung Ho; Shin, Yong Cheol; Kwon, Tae Soon; Yi, Sung Jae; Lee, Won Jae [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    SMART (System-integrated Modular Advanced ReacTor), an advanced integrated PWR is now in the under developing stages by KAERI. Such integral PWR excludes large-size piping of the primary system of conventional PWR and incorporates the SGs into RPV, which means no LBLOCA could occur in SMART. Therefore, the SBLOCA is considered as a major DBA (Design Basis Accident) in SMART and it is mainly analyzed by using TASS/SMR computer code. The TASS/SMR code should be validated using experimental data from both Integral Effect Test and Separate Effect Test facilities. To investigate injection performance of the ECC system, on SET facility, named as SWAT (SMART ECC Water Asymmetric Two-phase choking test facility), has been constructed at KAERI. The SWAT simulates the geometric configurations of the SG-side upper downcomer annulus and ECCSs of those of SMART. It is designed based on the modified linear scaling method with a scaling ratio of 1/5, to preserve the geometrical similarity and minimize gravitational distortion. The purpose of the SWAT tests is to investigate the safety injection performance, such as the ECC bypass in the downcomer and the penetration rate in the core during the SBLOCA, and hence to produce experimental data to validate and the prediction capability of safety analysis codes, TASS/SMR

  17. Method of controlling ECCS system in reactors

    International Nuclear Information System (INIS)

    Oohashi, Hideaki; Ikehara, Morihiko.

    1982-01-01

    Purpose: To eliminate the risk of misoperation and thereby improve the reliability of ECCS system upon accident. Method: ECCS system for nuclear reactor is automatically started by either of signals from a water level detector in a pressure vessel or from a pressure detector in a reactor container. Further, the ECCS system is started or stopped by the manual operation irrespective of the signals, and the signals from the pressure detector are isolated from the ECCS-starting signal by the contacts which actuate interlocked with the stopping operation of the manual operation switch. Then, after stopping the ECCS system by the manual operation, the ECCS system is started by the signals from the water level detector irrespective of the signals from the pressure detector. (Seki, T.)

  18. ECC delivery to lower plenum under downcomer injection part 2. RELAP5 assessment

    International Nuclear Information System (INIS)

    Bang, Young Seok; Shin, An Dong; Kim, Hho Jung

    2000-01-01

    In the present study, the capability of the thermal-hydraulic codes, RELAP5/MOD3.2.2 gamma, in predicting the steam-water interaction and the related ECC delivery to lower plenum under downcomer injection condition during refill phase is evaluated using the experimental data of the UPTF Test 21A. The facility is modeled in detail, and the test condition simulated for code calculations. The calculation result is compared with the applicable measurement data and discussed for the pressure response, ECC bypass behavior, lower plenum delivery, global water mass distribution, and local behavior in downcomer

  19. Development of Calculation Algorithm for ECCS Kinematic Shock

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung-Chan; Yoon, Duk-Joo; Ha, Sang-Jun [KHNP-CRI, Daejeon (Korea, Republic of)

    2014-10-15

    The void fraction of inverted U-pipes in front of SI(Safety Injection) pumps impact on the pipe system of ECCS(Emergency Core Cooling Systems). This phenomena is called as 'Kinematic Shock'. The purpose of this paper is to achieve the more exactly calculation when the kinematic shock is calculated by simplified equation. The behavior of the void packet of the ECCS pipes is illustrated by the simplified (other name is kinematic shock equation).. The kinematic shock is defined as the depth of total length of void clusters in the pipes of ECCS when the void cluster is continually reached along the part of pipes in vertical direction. In this paper, the simplified equation is evaluated by comparing calculation error each other.]. The more exact methods of calculating the depth of the kinematic shock in ECCS is achieved. The error of kinematic shock calculation is strongly depended on the calculation search gap and the order of Taylor's expansion. From this study, to select the suitable search gap and the suitable calculation order, differential root method, secant method, and Taylor's expansion form are compared one another.

  20. Use of the guidelines directed medical therapy after coronary artery bypass graft surgery in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Khalid A. Alburikan

    2017-09-01

    Full Text Available Background: incidence of cardiovascular diseases in Saudi Arabia is growing and more patients are expected to have cardiac revascularization surgery. Optimal pharmacotherapy management with Guideline Directed Medical Therapy (GDMT post coronary artery bypass grafting (CABG plays an important role in the prevention of adverse cardiovascular outcomes. The objective of this study was to assess the utilization of GDMT for secondary prevention in CABG patients and determine whether specific patients' characteristics can influence GDMT utilization. Method: A retrospective chart review of patients discharged from the hospital after CABG surgery from April 2015 to April 2016. The primary outcome was the utilization of secondary prevention GDMT after CABG surgery - aspirin, B-blockers, statin and angiotensin-converting enzyme inhibitors (ACEI (or angiotensin receptor blockers (ARB in ACEI-intolerant patients. The proportions of eligible and ideal patients who received treatment were calculated, and mixed-effects logistic regression was used to estimate odds ratios (OR for the association of age, gender or patient nationality with the use of GDMT. Results: A total number of 119 patients included in the analysis. The median age of the cohort was 57.3 ± 11 years, and 83% were male (83.2%. Nearly 69.7% of patients had diabetes, and 82% had a previous diagnosis of hypertension. Nearly 91% received aspirin therapy and the rate was lower for B-blocker and statin. The rate of GDMT utilization did not change with the change in patient’s age, gender or nationality. Conclusion: Despite adjustments for contraindications to GDMT, the rate of GDMT utilization was suboptimal.

  1. Is 300 Seconds ACT Safe and Efficient during MiECC Procedures?

    Science.gov (United States)

    Bauer, Adrian; Hausmann, Harald; Schaarschmidt, Jan; Szlapka, Michal; Scharpenberg, Martin; Eberle, Thomas; Hasenkam, J Michael

    2017-12-31

     The recommended minimum activated clotting time (ACT) level for cardiopulmonary bypass (CPB) of 480 seconds originated from investigations with bubble oxygenators and uncoated extracorporeal circulation (ECC) systems. Modern minimal invasive ECC (MiECC) systems are completely closed circuits containing a membrane oxygenator and a tip-to-tip surface coating. We hypothesized that surface coating and the "closed-loop" design allow the MiECC to safely run with lower ACT levels and that an ACT level of 300 seconds can be safely applied without thromboembolic complications. The aim of this study was to investigate the potential risks during application of reduced heparin levels in patients undergoing coronary surgery.  In this study, 68 patients undergoing coronary artery bypass grafting with MiECC were randomized to either the study group with an ACT target of 300 seconds or the control group with an ACT of 450 seconds. All other factors of MiECC remained unchanged.  The study group received significantly less heparin and protamine (heparin [international units] median [min-max], Red_AC: 32,800 [23,000-51,500] vs. Full_AC: 50,000 [35,000-65,000] p  ACT in the study group was significantly lower at the start of MiECC (mean ± standard deviation: study group 400 ± 112 vs. control group 633 ± 177; p  ACT levels were: study group 344 ± 60 versus control group 506 ± 80. In both groups, the values of the endogenous thrombin potential (ETP) decreased simultaneously. None of the study participants experienced thromboembolic complications.  Since no evidence of increased thrombin formation (ETP) was found from a laboratory standpoint, we concluded that the use of MiECC with a reduced anticoagulation strategy seems possible. This alternative anticoagulation strategy leads to significant reduction in dosages of both heparin and protamine. We can confidently move forward with investigating this anticoagulation concept. However, to

  2. Measurement and analysis of the ECC cusp structure

    Energy Technology Data Exchange (ETDEWEB)

    Pregliasco, R.G.; Garibotti, C.R.; Barrachina, R.O. (Comision Nacional de Energia Atomica, San Carlos de Bariloche (Argentina). Centro Atomico Bariloche)

    1994-03-28

    We measured the electron capture to the continuum (ECC) peak in the ionization of He atoms by the collision of 50, 100 and 200 keV H[sup +] and 100 keV amu[sup -1]He[sup 2+]. We exhaustively scanned the double differential cross section between the angles -1.5[sup o] to 10[sup o] and within the velocities (1 [+-] 0.15)[upsilon][sub i] where [upsilon][sub i] is the impact velocity. We propose a new method for analysing the ECC structure which is independent of the spectrometer transmission function modellization and enables a direct comparison with the available theories. Furthermore, we distinguish two regimes for the ionization process, depending on whether the electron velocity is larger or smaller than the projectile velocity. (Author).

  3. Investigation of Characteristics of Impinging Jet for 1/5-Scale ECC injection

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Byung Soo; Ko, Yung Joo; Bae, Hwang; Kwon, Tae Soon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2010-05-15

    In ECCS of SMART reactor, safety injection pump discharges cooling water into the core to maintain the water level by filling the amount of loss of coolant under emergency situation such as SBLOCA. Once the ECCS starts to operate, the injected water will be impinged to the upper wall of core support barrel (CBS). And the water will fall along the wall forming liquid film or droplets as shown in Fig. 1(b) due to high Reynolds number. The breakup and film flow will be bypassed by high temperature and pressure steam-water mixture cross flow from RCP discharge into the atmosphere through broken injection nozzle. Then, the flow phenomena in the downcomer is very complex situation with including jet impingement, jet breakup, liquid entrainment, steam condensation, counter-current flow and etc. In this study, the hydraulic features of impinging jet were investigated through visualization for full scale test for simulation of SMART ECC jet and SWAT test of 1/5 simulated test for ECCS of SMART reactor and measurement of the film width. And the scaling method for SWAT test was discussed considering jet break up and other phenomena

  4. ECC2K-130 on NVIDIA GPUs

    NARCIS (Netherlands)

    Bernstein, D.J.; Chen, H.-C.; Cheng, C.M.; Lange, T.; Niederhagen, R.F.; Schwabe, P.; Yang, B.Y.

    2012-01-01

    [Updated version of paper at Indocrypt 2010] A major cryptanalytic computation is currently underway on multiple platforms, including standard CPUs, FPGAs, PlayStations and GPUs, to break the Certicom ECC2K-130 challenge. This challenge is to compute an elliptic-curve discrete logarithm on a Koblitz

  5. ECC2K-130 on NVIDIA GPUs

    NARCIS (Netherlands)

    Bernstein, D.J.; Chen, H.-C.; Cheng, C.M.; Lange, T.; Niederhagen, R.F.; Schwabe, P.; Yang, B.Y.; Gong, G.; Gupta, K.C.

    2010-01-01

    A major cryptanalytic computation is currently underway on multiple platforms, including standard CPUs, FPGAs, PlayStations and Graphics Processing Units (GPUs), to break the Certicom ECC2K-130 challenge. This challenge is to compute an elliptic-curve discrete logarithm on a Koblitz curve over $\\rm

  6. Plasma macrophage colony-stimulating factor levels during cardiopulmonary bypass with extracorporeal circulation

    Directory of Open Access Journals (Sweden)

    Y. Denizot

    1996-01-01

    Full Text Available Leukocytosis and thrombocytopenia occur during cardiopulmonary bypass (CPB with extracorporeal circulation (ECC. Elevated circulating concentrations of macrophage colony-stimulating factor (M-CSF are reported during thrombocytopenia and leukopenia of different origins. We have assessed M-CSF concentrations in 40 patients undergoing CPB with ECC. Plasma M-CSF concentrations were stable during ECC and increased at the 6th (7.3 ± 0.7 IU/μg protein and 24th (8.6 ± 0.8 IU/μg protein postoperative hour compared with pre-ECC values (4.9 ± 0.5 IU/μg protein. A deep thrombocytopenia was found during ECC and until the 24th postoperative hour. A drop of leukocyte counts was found during ECC followed by an increase after ECC weaning. While no correlation was found between M-CSF concentrations and the leukocyte counts, M-CSF values were positively correlated with platelet counts only before and during ECC. Thus, M-CSF is not implicated in the thrombocytopenia and the leukopenia generated during CPB with ECC. However the elevated levels of M-CSFa few hours after the end of ECC might play a role in the inflammatory process often observed after CPB.

  7. The Heat Exchanger for Passive Part ECCS of WWER-1000 on Base of the Thermo siphons

    International Nuclear Information System (INIS)

    Kirov, V.; Chulkin, O.

    2008-01-01

    One of NPP's systems providing safe operation is the system of emergency core cooling system (ECCS), which primary function in accidents is to flood the nuclear reactor core and to assure the sub critical condition and core cooling. At injection of cold water in reactor thermal stresses and thermal fatigue in the vessel cladding and constructional materials are arise. Low temperature of the water injected in reactor is a reason of occurrence of these undesirable consequences. Some variants of the water heating in accumulators of ECCS are considered. Now at Ukrainian NPPs the electrical heating in accumulators is used. Electrical heaters create the essential additional loading to diesel generators at imposing of two accidents - the large break and losses of power supplies on own needs. It is offered to use a heater in accumulators that working by a principle two-phase thermal siphon which advantages is: small dimensions, small delay and design reliability. In such heat exchanger the heating medium is a direct steam and the heated up medium is water with boric acid from accumulators of ECCS. Under requirements of the service regulations of ECCS accumulators it is necessary to guarantee injected water heating up to 90 ?? in case of a small break and to 150 ?? in case of the large break. Results of calculations for different external diameters of a tube of thermal siphon which have allowed to define the constructive sizes of heat exchanger, providing necessary conditions for required functioning of passive part ECCS are submitted The calculation and analysis of operating modes of the changed circuit of passive part ECCS for various accidents is carried out. The calculated pressure drop indicates that changes do not have essential influence on system work as a whole. Thus, the submitted decision provides the increase of reliability of ECCS at small and large breaks accidents, i.e. in all modes stipulated by the project.(author)

  8. Method and device for controlling ECCS

    International Nuclear Information System (INIS)

    Ikeda, Takashi; Kataoka, Yoshiyuki; Murase, Michio.

    1986-01-01

    Purpose: To accomplish reactor cooling without exposing fuel assemblies out of the coolant and also without inducing counter-current flow (CCFL) brake likely to be caused by excess injection of water even in case of malfunction of one system in a loss-of-coolant accident. Method: In a BWR type reactor having more than two independent ECCS, the lower plenum water level is measured and when the lower plenum is full of water, the ECCS are kept in a fully closed state, and reversely when the lower plenum is not full of water, more coolant than the lost quantity of water will be injected into the plenum at a higher pressure than a pressure at which fuel rods just begin to be exposed to the steam phase. The subcool energy of the emergency coolant to be injected is determined by the decay heat of the core and the change rate of a container pressure. However, the quantity of the emergency coolant is controlled such that the subcool energy will always become less than the overheating energy in the core range and the lower plenum range, thus improving safety and enabling the removal of a prior-art ECCS. (Kamimura, M.)

  9. Long-Term Outcomes of Catheter-Directed Thrombolysis for Acute Lower Extremity Occlusions of Native Arteries and Prosthetic Bypass Grafts

    NARCIS (Netherlands)

    Schrijver, A. Marjolein; de Vries, Jean Paul P M; van den Heuvel, Daniel A F; Moll, Frans L.

    2016-01-01

    Background Catheter-directed thrombolysis is a well-accepted treatment for acute lower extremity occlusions of native arteries and bypass grafts. Several variables that affect outcomes of thrombolysis have been identified. The hypothesis of this study was that the long-term outcome after

  10. Two-phase flow dynamics in ECC

    International Nuclear Information System (INIS)

    Albraaten, P.J.

    1981-07-01

    The present report summarizes the achievements within the project ''Two-phase Systems and ECC''. The results during 1978 - 1980 are accounted for in brief as they have been documented in earlier reports. The results during the first half of 1981 are accounted for in greater detail. They contain a new model for the Basset force and test runs with this model using the test code RISQUE. Furthermore, test runs have been performed with TRAC-PD2 MOD 1. This code was implemented on Edwards Pipe Blowdown experiment (a standard test case) and UC-Berkeley Reflooding experiment (a non-standard test case.) (Auth.)

  11. Noise-based Stego-ECC

    Directory of Open Access Journals (Sweden)

    Rahardjo Budi

    2014-03-01

    Full Text Available A novel method of inserting noise into stream of ciphered text is proposed. The goal of inserting noise is to increase the level of uncertainty, thus making it harder for an attacker to detect data and noise. This form of steganography is implemented using Elliptic Curve Cryptography (ECC. The process of embedding the noise to the message in the encryption process and removing the noise from the message in the decryption process is proposed in this work by modifying ElGamal to allow auto detection of data and noise.

  12. Re-designating water bodies in Denmark bypasses the Water Framework Directive objectives

    DEFF Research Database (Denmark)

    Baaner, Lasse

    2015-01-01

    Despite the initially ambitious provisions of the Water Framework Directive (WFD) when it first entered into force, thousands of kilometres of Danish watercourses have now lost their legal protection through the application of the WFD’s provisions concerning the designation of water bodies....... This article describes the designation process and concludes that it does not conform to the obligation carefully to assign an environmental objective to discrete and significant water bodies as set out in the WFD. Neither does it ensure the same level of protection that existed prior to the implementation...

  13. Re-designating water bodies in Denmark bypasses the Water Framework Directive objectives

    DEFF Research Database (Denmark)

    Baaner, Lasse

    2017-01-01

    Despite the initially ambitious provisions of the Water Framework Directive (WFD) when it first entered into force, thousands of kilometres of Danish watercourses have now lost their legal protection through the application of the WFD’s provisions concerning the designation of water bodies....... This article describes the designation process and concludes that it does not conform to the obligation carefully to assign an environmental objective to discrete and significant water bodies as set out in the WFD. Neither does it ensure the same level of protection that existed prior to the implementation...

  14. Shear behavior of reinforced Engineered Cementitious Composites (ECC) beams

    DEFF Research Database (Denmark)

    Paegle, Ieva; Fischer, Gregor

    2010-01-01

    This paper describes an experimental investigation of the shear behavior of beams consisting of steel reinforced Engineered Cementitious Composites (ECC). Based on the strain hardening and multiple cracking behavior of ECC, this study investigates the extent to which ECC can improve the shear...... capacity of beams loaded primarily in shear and if ECC can partially or fully replace the conventional transverse steel reinforcement in beams. However, there is a lack of understanding of how the fibers affect the shear carrying capacity and deformation behavior of structural members if used either...

  15. 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.)

  16. Nicorandil directly and cyclic GMP-dependently opens K+ channels in human bypass grafts

    Directory of Open Access Journals (Sweden)

    Marija Marinko

    2015-06-01

    Full Text Available As we previously demonstrated the role of different K+ channels in the action of nicorandil on human saphenous vein (HSV and human internal mammary artery (HIMA, this study aimed to analyse the contribution of the cGMP pathway in nicorandil-induced vasorelaxation and to determine the involvement of cGMP in the K+ channel-activating effect of nicorandil. An inhibitor of soluble guanylate cyclase (GC, ODQ, significantly inhibited nicorandil-induced relaxation, while ODQ plus glibenclamide, a selective ATP-sensitive K+ (KATP channel inhibitor, produced a further inhibition of both vessels. In HSV, ODQ in combination with 4-aminopyridine, a blocker of voltage-gated K+ (KV channels, did not modify the concentration-response to nicorandil compared with ODQ, whereas in HIMA, ODQ plus iberiotoxin, a selective blocker of large-conductance Ca2+-activated K+ (BKCa channels, produced greater inhibition than ODQ alone. We showed that the cGMP pathway plays a significant role in the vasorelaxant effect of nicorandil on HSV and HIMA. It seems that nicorandil directly opens KATP channels in both vessels and BKCa channels in HIMA, although it is possible that stimulation of GC contributes to KATP channels activation in HIMA. Contrary, the activation of KV channels in HSV is probably due to GC activation and increased levels of cGMP.

  17. Electronic bypass of spinal lesions: activation of lower motor neurons directly driven by cortical neural signals.

    Science.gov (United States)

    Li, Yan; Alam, Monzurul; Guo, Shanshan; Ting, K H; He, Jufang

    2014-07-03

    Lower motor neurons in the spinal cord lose supraspinal inputs after complete spinal cord injury, leading to a loss of volitional control below the injury site. Extensive locomotor training with spinal cord stimulation can restore locomotion function after spinal cord injury in humans and animals. However, this locomotion is non-voluntary, meaning that subjects cannot control stimulation via their natural "intent". A recent study demonstrated an advanced system that triggers a stimulator using forelimb stepping electromyographic patterns to restore quadrupedal walking in rats with spinal cord transection. However, this indirect source of "intent" may mean that other non-stepping forelimb activities may false-trigger the spinal stimulator and thus produce unwanted hindlimb movements. We hypothesized that there are distinguishable neural activities in the primary motor cortex during treadmill walking, even after low-thoracic spinal transection in adult guinea pigs. We developed an electronic spinal bridge, called "Motolink", which detects these neural patterns and triggers a "spinal" stimulator for hindlimb movement. This hardware can be head-mounted or carried in a backpack. Neural data were processed in real-time and transmitted to a computer for analysis by an embedded processor. Off-line neural spike analysis was conducted to calculate and preset the spike threshold for "Motolink" hardware. We identified correlated activities of primary motor cortex neurons during treadmill walking of guinea pigs with spinal cord transection. These neural activities were used to predict the kinematic states of the animals. The appropriate selection of spike threshold value enabled the "Motolink" system to detect the neural "intent" of walking, which triggered electrical stimulation of the spinal cord and induced stepping-like hindlimb movements. We present a direct cortical "intent"-driven electronic spinal bridge to restore hindlimb locomotion after complete spinal cord injury.

  18. A LOCA analysis for AHWR caused by ECCS header rupture

    International Nuclear Information System (INIS)

    Chatterjee, B.; Gawai, Amol; Gupta, S.K.; Kushwaha, H.S.

    2000-01-01

    Loss of coolant accident (LOCA) analyses for the proposed 750 MWth Advanced Heavy Water Reactor (AHWR), initiated by the rupture of 8 inch NB ECCS header has been carried out. This paper narrates the description of AHWR and associated ECCS, postulated scenario with which the analyses is carried out, results, discussion and conclusion

  19. 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 - ...

  20. ECCE Toolkit: Prototyping Sensor-Based Interaction

    Directory of Open Access Journals (Sweden)

    Andrea Bellucci

    2017-02-01

    Full Text Available Building and exploring physical user interfaces requires high technical skills and hours of specialized work. The behavior of multiple devices with heterogeneous input/output channels and connectivity has to be programmed in a context where not only the software interface matters, but also the hardware components are critical (e.g., sensors and actuators. Prototyping physical interaction is hindered by the challenges of: (1 programming interactions among physical sensors/actuators and digital interfaces; (2 implementing functionality for different platforms in different programming languages; and (3 building custom electronic-incorporated objects. We present ECCE (Entities, Components, Couplings and Ecosystems, a toolkit for non-programmers that copes with these issues by abstracting from low-level implementations, thus lowering the complexity of prototyping small-scale, sensor-based physical interfaces to support the design process. A user evaluation provides insights and use cases of the kind of applications that can be developed with the toolkit.

  1. Heart bypass surgery - minimally invasive - discharge

    Science.gov (United States)

    ... invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  2. Analysis of emergency core cooling capability of direct vessel vertical injection using CFX

    International Nuclear Information System (INIS)

    Yoon, Sang H.; Yu, Yong H.; Suh, Kune Y.

    2003-01-01

    More reliable and efficient safety injection system is of utmost importance in the design of advanced reactors such as the APR1400 (Advanced Power Reactor 1400 MWe). In this work, a new idea is proposed to inject the Emergency Core Cooling (ECC) water utilizing a dedicated nozzle with a vertically downward elbow. The Direct Vessel Injection (DVI) system is located horizontally above the cold leg in the APR1400. However, the horizontal injection method may not always satisfy the ECC penetration requirement into the core on account of rather involved multidimensional thermal and hydraulic phenomena occurring in the annular reactor downcomer such as bypass, impingement, entrainment and sweepout, condensation oscillation, etc. Thus, a novel concept is called for from the reactor safety point of view. The Direct Vessel Vertical Injection (DVVI) system is one of these efforts to penetrate as much the ECC water through the downcomer into the core as is practically achievable. The DVVI system can increase the momentum of the downward flow, thus minimizing the effect of water impingement on the core barrel and the direct bypass though the break. To support the claim of increased downward momentum of flow in the DVVI system, computational fluid dynamics analyses were performed using CFX. The new concept of the DVVI system, which can certainly help increase the core thermal margin, is found to be more efficient than DVI. If the structural problem in the manufacturing process is properly solved, this concept can safely be applied in the advanced nuclear reactor design

  3. Condensation during gravity driven ECC: Experiments with PACTEL

    Energy Technology Data Exchange (ETDEWEB)

    Munther, R.; Kalli, H. [Lappeenranta Univ. of Technology (Finland); Kouhia, J. [Technical Research Centre of Finland, Lappeenranta (Finland)

    1995-09-01

    This paper provides the results of the second series of gravity driven emergency core cooling (ECC) experiments with PACTEL (Parallel Channel Test Loop). The simulated accident was a small break loss-of-coolant accident (SBLOCA) with a break in a cold leg. The ECC flow was provided from a core makeup tank (CMT) located at a higher elevation than the main part of the primary system. The CMT was pressurized with pipings from the pressurizer and a cold leg. The tests indicated that steam condensation in the CMT can prevent ECC and lead to core uncovery.

  4. Experimental results of the SMART ECC injection performance with reduced scale of test facility

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Il; Cho, Seok; Ko, Yung Joo; Shin, Yong Cheol; Kwon, Tae Soon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-05-15

    SMART pressurized water reactor type is different from the existing integral NSSS commercial pressurized water reactor system which is equipped with the main features. In addition, RCS piping is removed and the feature of the SBLOCA is a major design break accident. SWAT (SMART ECC Water Asymmetric Two-phase choking test facility) test facility is to simulate the 2 inch SBLOCA of the SMART using with reduced scale. The Test was performed to produce experimental data for the validation of the TASS/SMR-S thermal hydraulic analysis code, and to investigate the related thermal hydraulic phenomena in the down-comer region during the 2 inch SBLOCA of the safety inject line. The particular phenomena for the observation are ECC bypass and multi-dimensional flow characteristics to verify the effectiveness and performance of the safety injection system. In this paper, the corresponding steady state test conditions, including initial and boundary conditions along with major measuring parameters, and related experimental results were described

  5. Quick Look Report of the SMART ECC injection performance test I3

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seok; Ko, Yong Ju; Cho, Young Il; Kim, Jeong Tak; Choi, Nam Hyun; Park, Choon Kyong; Kwon, Tae Soon; Lee, Sung Jae [KAERI, Daejeon (Korea, Republic of)

    2010-12-15

    The objective of this report is to describe test results of the Test I3 simulating the 2 inch SBLOCA of the SMART using the SWAT test facility. The Test I3 was performed to produce experimental data for the validation of the TASS/SMR-S thermal hydraulic analysis code, and to investigate the related thermal hydraulic phenomena in the down-comer region during the 2 inch SBLOCA of the safety inject line. The particular phenomena for the observation are ECC bypass and multi-dimensional flow characteristics to verify the effectiveness and performance of the safety injection system. In this report, the corresponding steady state test conditions, including initial and boundary conditions along with major measuring parameters, and related experimental results were described

  6. Experiment data report for Semiscale Mod-1 Test S-05-5 (alternate ECC injection test)

    International Nuclear Information System (INIS)

    Collins, B.L.; Patton, M.L. Jr.; Sackett, K.E.

    1977-04-01

    Recorded test data are presented for Test S-05-5 of the Semiscale Mod-1 alternate ECC injection test series. These tests are among several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor (PWR) system. Test S-05-5 was conducted from initial conditions of 2263 psia and 537 0 F to investigate the response of the Semiscale Mod-1 system to a depressurization and reflood transient following a simulated double-ended offset shear of the cold leg broken loop piping. During the test, cooling water was injected into the cold leg of the intact and broken loops to simulate emergency core coolant injection in a PWR. The upper plenum was vented through a reflood bypass line interconnecting the hot and cold legs of the broken loop

  7. ECCS Operability With One or More Subsystem(s) Inoperable

    International Nuclear Information System (INIS)

    Swantner, Stephen R.; Andrachek, James D.

    2002-01-01

    Plant Technical Specifications are issued by the US NRC to ensure that safe nuclear power plant operation is maintained within the assumptions for parameters and Structures, Systems, and Components (SSCs) made in the plant safety analysis reports. The Technical Specifications are made up of Limiting Conditions for Operation (LCOs), which are the minimum set of requirements that must be met based on the assumptions of the safety analysis, Actions, which are the remedial or compensatory actions that must be taken if the LCO is not met, and Surveillance Requirements, that demonstrate that the LCO is met. The Technical Specification Actions contain Completion Times (CTs) which are the time within which remedial actions must be taken, in the event that the LCO is not met. The Improved Standard Technical Specifications (ISTS) for Westinghouse plants are contained in NUREG-1431, Revision 2. Condition A of Technical Specification 3.5.2 (ECCS- Operating) in NUREG-1431, Revision 2, allows components to be taken out of service for up to 72 hours, as long as 100% of the ECCS flow equivalent to a single Operable ECCS train exists. Condition A would allow, for example, the A train low head safety injection (LHSI) and the B train high head safety injection (HHSI) pumps to be taken out of service (for 72 hours) as long as it could be demonstrated that the remaining components could provide 100% train equivalent flow capacity. The 'cross-training' allowed by this Condition in the ISTS provides flexibility when performing routine pre-planned preventive maintenance and testing, as well as during emergent corrective maintenance and testing associated with random component inoperabilities. Without this flexibility, a unit would have to initiate a plant shutdown within 1 hour, if component(s) were inoperable in different trains. In order to implement this flexibility, the various combinations of components in opposite trains must be evaluated to determine whether 100% of the ECCS flow

  8. Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

    Science.gov (United States)

    Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

    2006-08-01

    We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

  9. Application of Engineered Cementitious Composites (ECC) in modular floor panels

    DEFF Research Database (Denmark)

    Lárusson, Lárus Helgi; Fischer, Gregor; Jönsson, Jeppe

    2008-01-01

    This paper describes the design, manufacturing, and structural behavior of a prefabricated floor panel consisting of a modular assembly of a thin-walled ECC slab and steel truss girders. The features of this composite structure include light weight, the modular manufacturing process...... concept introduced in this paper aims at improvements in the manufacturing process of the panels by casting the ECC slab separately and subsequently joining it with the steel trusses. The focus of this paper is on design and manufacturing of a prototype modular panel and on its structural behavior under...

  10. Weaning mechanical ventilation after off-pump coronary artery bypass graft procedures directed by noninvasive gas measurements.

    Science.gov (United States)

    Chakravarthy, Murali; Narayan, Sandeep; Govindarajan, Raghav; Jawali, Vivek; Rajeev, Subramanyam

    2010-06-01

    Partial pressure of carbon dioxide and oxygen were transcutaneously measured in adults after off-pump coronary artery bypass (OPCAB) surgery. The clinical use of such measurements and interchangeability with arterial blood gas measurements for weaning patients from postoperative mechanical ventilation were assessed. This was a prospective observational study. Tertiary referral heart hospital. Postoperative OPCAB surgical patients. Transcutaneous oxygen and carbon dioxide measurements. In this prospective observational study, 32 consecutive adult patients in a tertiary care medical center underwent OPCAB surgery. Noninvasive measurement of respiratory gases was performed during the postoperative period and compared with arterial blood gases. The investigator was blinded to the reports of arterial blood gas studies and weaned patients using a "weaning protocol" based on transcutaneous gas measurement. The number of patients successfully weaned based on transcutaneous measurements and the number of times the weaning process was held up were noted. A total of 212 samples (pairs of arterial and transcutaneous values of oxygen and carbon dioxide) were obtained from 32 patients. Bland-Altman plots and mountain plots were used to analyze the interchangeability of the data. Twenty-five (79%) of the patients were weaned from the ventilator based on transcutaneous gas measurements alone. Transcutaneous carbon dioxide measurements were found to be interchangeable with arterial carbon dioxide during 96% of measurements, versus 79% for oxygen measurements. More than three fourths of the patients were weaned from mechanical ventilation and extubated based on transcutaneous gas values alone after OPCAB surgery. The noninvasive transcutaneous carbon dioxide measurement can be used as a surrogate for arterial carbon dioxide measurement to manage postoperative OPCAB patients. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Modeling of ECC materials using numerical formulations based on plasticity

    DEFF Research Database (Denmark)

    Dick-Nielsen, Lars; Stang, Henrik; Poulsen, Peter Noe

    2006-01-01

    scale it is shown that the cohesive law for a unidirectional fiber reinforced cementitious composite can be found through superposition of the cohesive law for mortar and the fiber bridging curve. On the meso scale I it is shown that the maximum crack opening observed during crack propagation in ECC...

  12. ECCS evaluation of B and W's 205-FA NSS

    International Nuclear Information System (INIS)

    Lowe, R.J.; Anderson, G.E. Jr.; Dunn, B.M.

    1975-06-01

    The effectiveness of the ECCS for B and W's 205-fuel assembly plants is evaluated and shown to meet all the requirements of 10 CFR 50.46. The results of various sensitivity studies, a spectrum of breaks, and an analysis to determine allowable linear heat rates under 10 CFR 50.46 are presented. (14 references) (U.S.)

  13. The JAERI code system for evaluation of BWR ECCS performance

    International Nuclear Information System (INIS)

    Kohsaka, Atsuo; Akimoto, Masayuki; Asahi, Yoshiro; Abe, Kiyoharu; Muramatsu, Ken; Araya, Fumimasa; Sato, Kazuo

    1982-12-01

    Development of respective computer code system of BWR and PWR for evaluation of ECCS has been conducted since 1973 considering the differences of the reactor cooling system, core structure and ECCS. The first version of the BWR code system, of which developmental work started earlier than that of the PWR, has been completed. The BWR code system is designed to provide computational tools to analyze all phases of LOCAs and to evaluate the performance of the ECCS including an ''Evaluation Model (EM)'' feature in compliance with the requirements of the current Japanese Evaluation Guideline of ECCS. The BWR code system could be used for licensing purpose, i.e. for ECCS performance evaluation or audit calculations to cross-examine the methods and results of applicants or vendors. The BWR code system presented in this report comprises several computer codes, each of which analyzes a particular phase of a LOCA or a system blowdown depending on a range of LOCAs, i.e. large and small breaks in a variety of locations in the reactor system. The system includes ALARM-B1, HYDY-B1 and THYDE-B1 for analysis of the system blowdown for various break sizes, THYDE-B-REFLOOD for analysis of the reflood phase and SCORCH-B2 for the calculation of the fuel assembl hot plane temperature. When the multiple codes are used to analyze a broad range of LOCA as stated above, it is very important to evaluate the adequacy and consistency between the codes used to cover an entire break spectrum. The system consistency together with the system performance are discussed for a large commercial BWR. (author)

  14. Emergency response guide-B ECCS guideline evaluation analyses for N reactor

    International Nuclear Information System (INIS)

    Chapman, J.C.; Callow, R.A.

    1989-07-01

    INEL conducted two ECCS analyses for Westinghouse Hanford. Both analyses will assist in the evaluation of proposed changes to the N Reactor Emergency Response Guide-B (ERG-B) Emergency Core System (ECCS) guideline. The analyses were a sensitivity study for reduced-ECCS flow rates and a mechanistically determined confinement steam source for a delayed-ECCS LOCA sequence. The reduced-ECCS sensitivity study established the maximum allowable reduction in ECCS flow as a function of time after core refill for a large break loss-of-coolant accident (LOCA) sequence in the N Reactor. The maximum allowable ECCS flow reduction is defined as the maximum flow reduction for which ECCS continues to provide adequate core cooling. The delayed-ECCS analysis established the liquid and steam break flows and enthalpies during the reflood of a hot core following a delayed ECCS injection LOCA sequence. A simulation of a large, hot leg manifold break with a seven-minute ECCS injection delay was used as a representative LOCA sequence. Both analyses were perform using the RELAP5/MOD2.5 transient computer code. 13 refs., 17 figs., 3 tabs

  15. Historical information on ORNL proposals for ECCS testing

    International Nuclear Information System (INIS)

    1976-01-01

    This document contains a compilation of the correspondence and preliminary report which the Oak Ridge National Laboratory submitted to the U.S. Atomic Energy Commission on the subject of in situ testing of emergency core cooling systems (ECCS) in pressurized water reactors. Most of the correspondence, which was prepared four to five years ago, deals with an ORNL proposal to evaluate the merits of conducting an in situ ECCS test in a full-scale commercial power plant. The end result of this work was to be a report in which the feasibility of conducting such an experiment would be discussed and a ''rough'' cost estimate provided. In support of this proposal, ORNL prepared a brief preliminary prospectus which identified some of the key questions that were to be addressed should the evaluation study be funded

  16. LOFT ECC Pitot Tube and Thermocouple Rake Penetration thermal analysis

    International Nuclear Information System (INIS)

    Tolan, B.J.

    1977-01-01

    A thermal analysis of the LOFT ECC Pitot Tube and Thermocouple Rake Penetration was performed using COUPLE, a two-dimensional finite element computer code. Four transients which conservatively cover all transients the rake will be exposed to were included in this analysis in order to comply with the ASME Code Section III requirements. The transients conservatively cover hot and cold leg operation, and nuclear and nonnuclear operation. The four transients include the LOCE with ECC injection transient, the single control rod drop transient, the scram transient, and the heatup with 0 to 100% load change transient. Temperature distributions in the rake were obtained for each of the four transients and several plots of node temperatures vs. time are given

  17. An overview of the BWR ECCS strainer blockage issues

    International Nuclear Information System (INIS)

    Serkiz, A.W.; Marshall, M.L. Jr.; Elliott, R.

    1996-01-01

    This Paper provides a brief overview of actions taken in the mid 1980s to resolve Unresolved Safety Issue (USI) A-43, open-quotes Containment Emergency Sump Performance,close quotes and their relationship to the BWR strainer blockage issue; the importance of insights gained from the Barseback-2 (a Swedish BWR) incident in 1992 and from ECCS strainer testing and inspections at the Perry nuclear power plant in 1992 and 1993; an analysis of an US BWR/4 with a Mark I containment; an international community sharing of knowledge relevant to ECCS strainer blockage, additional experimental programs; and identification of actions needed to resolve the strainer blockage issue and the status of such efforts

  18. The microstructure of self-healed PVA ECC under wet and dry cycles

    Directory of Open Access Journals (Sweden)

    Jia Huan Yu

    2010-06-01

    Full Text Available Self-healing of ECC (Engineered Cementitious Composites subjected to cyclic wetting and drying regimes is investigated in this paper. ECC structures subjected to outdoor environmental conditions such as wind and rain runoff can be simulated by accelerated test method of wetting and drying cycles. Uniaxial tensile tests of ECC M45 and ECC 2.8FA specimen are conducted respectively. It is found that crack width of ECC 2.8FA is around 10 μm with increased amount of fly ash, while the crack width of ECC M45 is around 100 μm. New insights about the microstructure and chemical composition analysis of ECC specimens initially cracked to 2% strain and then self-healed under wet-dry cycles are presented.

  19. Safety verification for the ECCS driven by the electrically 4 trains during LBLOCA reflood phase using ATLAS

    International Nuclear Information System (INIS)

    Park, Yusun; Park, Hyun-sik; Kang, Kyoung-ho; Choi, Nam-hyun; Min, Kyoung-ho; Choi, Ki-yong

    2014-01-01

    Highlights: • Safety improvement by adopting 4 train emergency core cooling system was validated experimentally. • General thermal hydraulic behaviors of the system during LBLOCA reflood phase were successfully demonstrated. • Key parameters such as the liquid levels, the PCTs, the quenching time, and the ECC bypass ratios were investigated. • Asymmetric effects of the different combination of safety injection were negligible during the reflood period. - Abstract: The APR1400 is equipped with four safety injection pumps driven by two emergency diesel generators. However, the design has been changed so that the four safety injection pumps are driven by 4 emergency diesel generators during the design certification process from the U.S. NRC. Thus, 4 safety injection pumps (SIPs) are completely independent electrically and mechanically and three safety injection pumps are available in a single failure condition. This design change could have a certain effects on the thermal-hydraulic phenomenon occurring in the downcomer region during the late reflood phase of a large break loss of coolant accident (LBLOCA). Thus, in this study, a verification experiment for the reflood phase of a LBLOCA was performed to evaluate the core cooling performance of the 4 train emergency core cooling system (ECCS) with an assumption of a single failure. And the different combinations of three SIPs positions were tested to investigate the asymmetric effects on the reactor core cooling performance. The overall experimental results revealed the typical thermal–hydraulic trends expected to occur during the reflood phase of a large-break LOCA scenario for the APR1400. Experiment with the injection of three SIPs showed a faster core quenching time and lower bypass ratio than that of the case in which two SIPs were injected. The RPV wall temperature distributions showed the similar trend in spite of the different SIP combinations

  20. Intercomparison of ozone measurements between Lidar and ECC-sondes

    Energy Technology Data Exchange (ETDEWEB)

    Grabbe, G.C. [Max-Planck-Institut fuer Meteorologie, Hamburg (Germany); Boesenberg, J. [Max-Planck-Institut fuer Meteorologie, Hamburg (Germany); Dier, H. [Meteorologisches Obs., Lindenberg (Germany); Goersdorf, U. [Meteorologisches Obs., Lindenberg (Germany); Matthias, V. [Max-Planck-Institut fuer Meteorologie, Hamburg (Germany); Peters, G. [Meteorologisches Obs., Lindenberg (Germany); Schaberl, T. [Hamburg Univ. (Germany). Meteorologisches Inst.; Senff, C. [Hamburg Univ. (Germany). Meteorologisches Inst.

    1996-02-01

    An intercomparison experiment for measurements of ozone vertical profiles in the lower troposphere was performed using a ground-based ozone DIAL (DIfferential Absorption Lidar) and ECC-sondes (Electrochemical Concentration Cell) attached to tethered as well as free flying balloons, which took place in June of 1994. The tethered balloon was used for ozone soundings in the planetary boundary layer up to an altitude of 500 m, while in the free troposphere free flying balloons were used. For the time series of up to 90 min obtained with the tethersondes both averages and standard deviations are compared. The mean difference for all measurements amounted to 3.5 {mu}g/m{sup 3} only, corresponding to 3.5%. For the instantaneous profiles compared to the free flying sondes the differences were only marginally larger, with a mean value of 3.6 {mu}g/m{sup 3} corresponding to 4.1%. With two exceptions all averages for a single profile stayed below 7 {mu}g/m{sup 3}. Larger individual excursions were observed. In some cases, in particular in regions of steep aerosol gradients at layer boundaries, most probably the lidar values cause the deviation, while in other cases the ECC-sonde is suspected to yield erroneous results. For the measured standard deviation those retrieved from DIAL measurements are generally larger than measured by the ECC-sondes, especially in regions of inhomogeneous aerosol distribution. For the measurements reported here, this is attributed to residual errors in the aerosol correction of the DIAL measurements. The general agreement found in this intercomparison is regarded as excellent, DIAL is proven to be a very valuable tool for detailed studies of the ozone distribution in the lower troposphere. (orig.)

  1. Using ECC DRAM to Adaptively Increase Memory Capacity

    OpenAIRE

    Luo, Yixin; Ghose, Saugata; Li, Tianshi; Govindan, Sriram; Sharma, Bikash; Kelly, Bryan; Boroumand, Amirali; Mutlu, Onur

    2017-01-01

    Modern DRAM modules are often equipped with hardware error correction capabilities, especially for DRAM deployed in large-scale data centers, as process technology scaling has increased the susceptibility of these devices to errors. To provide fast error detection and correction, error-correcting codes (ECC) are placed on an additional DRAM chip in a DRAM module. This additional chip expands the raw capacity of a DRAM module by 12.5%, but the applications are unable to use any of this extra c...

  2. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

    Directory of Open Access Journals (Sweden)

    Poonam Malhotra Kapoor

    2016-01-01

    Full Text Available Goal-directed therapy (GDT encompasses guidance of intravenous (IV fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG analysis. In addition, cardiac index (CI monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2 using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation 30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025, hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025, and Intensive Care Unit (ICU stay (3.74 ± 0.59 vs. 3.41 ± 0.75 days, P = 0.012 was significantly less in the GDT group, compared to the control group. The extra volume added and the number of inotropic dose adjustments were

  3. Disease Management of Early Childhood Caries: ECC Collaborative Project.

    Science.gov (United States)

    Ng, Man Wai; Ramos-Gomez, Francisco; Lieberman, Martin; Lee, Jessica Y; Scoville, Richard; Hannon, Cindy; Maramaldi, Peter

    2014-01-01

    Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice.

  4. Development of CANDU ECCS performance evaluation methodology and guides

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Kwang Hyun; Park, Kyung Soo; Chu, Won Ho [Korea Maritime Univ., Jinhae (Korea, Republic of)

    2003-03-15

    The objectives of the present work are to carry out technical evaluation and review of CANDU safety analysis methods in order to assist development of performance evaluation methods and review guides for CANDU ECCS. The applicability of PWR ECCS analysis models are examined and it suggests that unique data or models for CANDU are required for the following phenomena: break characteristics and flow, frictional pressure drop, post-CHF heat transfer correlations, core flow distribution during blowdown, containment pressure, and reflux rate. For safety analysis of CANDU, conservative analysis or best estimate analysis can be used. The main advantage of BE analysis is a more realistic prediction of margins to acceptance criteria. The expectation is that margins demonstrated with BE methods would be larger that when a conservative approach is applied. Some outstanding safety analysis issues can be resolved by demonstration that accident consequences are more benign than previously predicted. Success criteria for analysis and review of Large LOCA can be developed by top-down approach. The highest-level success criteria can be extracted from C-6 and from them, the lower level criteria can be developed step-by-step, in a logical fashion. The overall objectives for analysis and review are to verify radiological consequences and frequency are met.

  5. Disease Management of Early Childhood Caries: ECC Collaborative Project

    Directory of Open Access Journals (Sweden)

    Man Wai Ng

    2014-01-01

    Full Text Available Until recently, the standard of care for early childhood caries (ECC has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM approach to address ECC in preschool children was implemented as a quality improvement (QI collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice.

  6. Bypass of senescence by the polycomb group protein CBX8 through direct binding to the INK4A-ARF locus

    DEFF Research Database (Denmark)

    Dietrich, Nikolaj; Bracken, Adrian P; Trinh, Emmanuelle

    2007-01-01

    -ARF, and that ectopic expression of CBX8 leads to repression of the Ink4a-Arf locus and bypass of senescence, leading to cellular immortalization. Gene expression and location analysis demonstrate that besides the INK4A-ARF locus, CBX8 also regulates a number of other genes important for cell growth and survival...

  7. Combined group ECC protection and subgroup parity protection

    Science.gov (United States)

    Gara, Alan G.; Chen, Dong; Heidelberger, Philip; Ohmacht, Martin

    2013-06-18

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

  8. Core-power and decay-time limits for disabled automatic-actuation of LOFT ECCS

    International Nuclear Information System (INIS)

    Hanson, G.H.

    1978-01-01

    The Emergency Core Cooling System (ECCS) for the LOFT reactor may need to be disabled for modifications or repairs of hardware or instrumentation or for component testing during periods when the reactor system is hot and pressurized, or it may be desirable to enable the ECCS to be disabled without the necessity of cooling down and depressurizing the reactor. A policy involves disabling the automatic-actuation of the LOFT ECCS, but still retaining the manual actuation capability. Disabling of the automatic actuation can be safely utilized, without subjecting the fuel cladding to unacceptable temperatures, when the LOFT power decays to 33 kW; this power level permits a maximum delay of 20 minutes following a LOCA for the manual actuation of ECCS. For the operating power of the L2-2 Experiment, the required decay-periods (with operating periods of 40 and 2000 hours) are about 21 and 389 hours, respectively. With operating periods of 40 and 2000 hours at Core-I full power, the required decay-periods are about 42 and 973 hours, respectively. After these decay periods the automatic actuation of the LOFT ECCS can be disabled assuming a maximum delay of 20 minutes following a LOCA for the manual actuation of ECCS. The automatic and manual lineup of the ECCS may be waived if decay power is less than 11 kW

  9. Integrated turbine bypass system

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.H.; Dickenson, R.J.; Parry, W.T.; Retzlaff, K.M.

    1982-07-01

    Turbine steam-flow bypasses have been used for years in various sizes and applications. Because of differing system requirements, their use has been more predominant in Europe than in the United States. Recently, some utilities and consulting engineers have been re-evaluating their need for various types of bypass operation in fossil-fuelled power plants.

  10. [Clinical research of minimal extracorporeal circulation in perioperative blood conservation of coronary artery bypass graft].

    Science.gov (United States)

    Liu, Yan; Cui, Hu-jun; Tao, Liang; Chen, Xu-fa

    2011-04-01

    To analyze the clinical effect of minimal extracorporeal circulation (MECC) in blood conservation perioperatively coronary artery bypass graft (CABG). The data of 120 cases received simple CABG since August 2006 to October 2009 was analyzed retrospectively. All the patients were divided to three groups according to the mode of circulation support in-operation: MECC, conventional extracorporeal circulation (cECC) or off-pump, 40 cases in each group. Jostra MECC system with normal temperature was used in MECC group, and common membrane oxygenator with moderate hypo-temperature was used in cECC group. Collect the data of coagulation and the blood cytological examination perioperatively, the draining volume during the first 24 h after operation, and consumption of blood products perioperatively. Standard and logistic EuroSCORE were higher in MECC group than the others (P blood products in cECC group, but no difference among the three groups. MECC could reduce the ruin to blood cell and interfere to coagulation function during the conventional ECC procedure, decrease the postoperative draining volume and requirement of blood products.

  11. Predictive Eco-Cruise Control (ECC) system : model development, modeling and potential benefits.

    Science.gov (United States)

    2013-02-01

    The research develops a reference model of a predictive eco-cruise control (ECC) system that intelligently modulates vehicle speed within a pre-set speed range to minimize vehicle fuel consumption levels using roadway topographic information. The stu...

  12. Application of Interfacial Propagation and Kinking Crack Concept to ECC/Concrete Overlay Repair System

    Directory of Open Access Journals (Sweden)

    Yaw ChiaHwan

    2014-01-01

    Full Text Available Research on the application of ultraductile engineered cementitious composite (ECC as overlay in the repair of deteriorated concrete structures is performed in this paper. Also, interfacial crack kinking and trapping mechanism experimentally observed in ECC/concrete overlay repair system are described by comparison of toughness and energy release rate. The mechanism involves cycles of extension, kinking, and arrest of interfacial crack into the overlay. Experimental testing of overlay repair system reveals significant improvements in load carrying capacity and ductility over conventional concrete overlay. The commonly observed overlay system failure mode of delamination or spalling is eliminated when ECC is applied. These failure modes are suppressed when ECC is used as an ideal and durable candidate overlay repair material.

  13. Preestrita pihtimus : Friedrich Nietzsche ja tema substantsiaalne mina (Ecce homo) / Jaan Undusk

    Index Scriptorium Estoniae

    Undusk, Jaan, 1958-

    1998-01-01

    Varem ilmunud raamatu järelsõnana: Nietzsche, Friedrich. Ecce homo : kuidas saadakse selleks, mis ollakse / tlk. Jaan Undusk. Tallinn : Vagabund, 1996. Sisu: Poeetiline, filosoofiline, dionüüsiline kaanon ; Künism contra hulluskahtlus ; Antikristlik pihtimus ; Egoretoorika

  14. Alternative pathway for the development of Vα14+ NKT cells directly from CD4-CD8- thymocytes that bypasses the CD4+CD8+ stage.

    Science.gov (United States)

    Dashtsoodol, Nyambayar; Shigeura, Tomokuni; Aihara, Minako; Ozawa, Ritsuko; Kojo, Satoshi; Harada, Michishige; Endo, Takaho A; Watanabe, Takashi; Ohara, Osamu; Taniguchi, Masaru

    2017-03-01

    Although invariant V α 14 + natural killer T cells (NKT cells) are thought to be generated from CD4 + CD8 + double-positive (DP) thymocytes, the developmental origin of CD4 - CD8 - double-negative (DN) NKT cells still remains unresolved. Here we provide definitive genetic evidence obtained, through studies of mice with DP-stage-specific ablation of expression of the gene encoding the recombinase component RAG-2 (Rag2) and by a fate-mapping approach, that supports the proposal of the existence of an alternative developmental pathway through which a fraction of DN NKT cells with strong T-helper-type-1 (T H 1)-biased and cytotoxic characteristics develop from late DN-stage thymocytes, bypassing the DP stage. These findings provide new insight into understanding of the development of NKT cells and propose a role for timing of expression of the invariant T cell antigen receptor in determining the functional properties of NKT cells.

  15. Gastric bypass surgery

    Science.gov (United States)

    ... your body will not get all of the calories from the food you eat. ... to a small hole in your pouch. The food you eat will now travel ... absorb fewer calories. Gastric bypass can be done in two ways. ...

  16. 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

  17. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... lung bypass machine is used during this procedure. Robot-assisted technique. This type of procedure allows for ... driving after 3 to 8 weeks. Returning to work after 6 weeks is common unless your job ...

  18. Safety design/analysis and scenario for prevention of CDA with ECCS in lead-bismuth-cooled fast reactor

    International Nuclear Information System (INIS)

    Minoru, Takahashi; Vaclav, Dostal; Abu Khalid, Rivai; Novitrian; Yumi, Yamada

    2007-01-01

    Safety design has been developed to show safety feature of Pb-Bi-cooled direct contact boiling water small fast reactor (PBWFR). The core is designed to have negative void reactivity even if the entire core and upper plenum are voided by steam intrusion from above. In-vessel type control rod driving mechanisms are used to prevent control rods from accidental ejection due to high pressure in the reactor vessel. In cases of coolant leakage from reactor vessel and feed water pipes, Pb-Bi coolant level in the reactor vessel is kept at the required level for decay heat removal by means of closed type guard vessel. Dual pipes are adopted to avoid leak of water in the feedwater system. Pump trip in feedwater systems initiates loss of coolant flow (LOF) event, although there is no concern of loss of flow accident due to primary pump trip. Injection of high pressure water slows down the flow-coast-down of feedwater at the LOF event. It has been evaluated that the fuel temperature is kept lower than safety limits at the unprotected loss of flow and heat sink (ATWS). A scenario for prevention of the core disruptive accident (CDA) with the emergency core cooling system (ECCS) is examined. The reactor becomes super-critical when the reactor vessel is filled with water. It is necessary to use water with boric acid for the ECC system, and additional backup rods for sub-critical core in water injection. (authors)

  19. Release of soluble vascular endothelial growth factor receptor-1 (sFlt-1 during coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Orsel Isabelle

    2007-09-01

    Full Text Available Abstract Background This study was conducted to follow plasma concentrations of sFlt-1 and sKDR, two soluble forms of the vascular endothelial growth factor (VEGF receptor in patients undergoing coronary artery bypass graft (CABG surgery with extracorporeal circulation (ECC. Methods Plasma samples were obtained before, during and after surgery in 15 patients scheduled to undergo CABG. Levels of sFlt-1 and KDR levels were investigated using specific ELISA. Results A 75-fold increase of sFlt-1 was found during cardiac surgery, sFlt-1 levels returning to pre-operative values at the 6th post-operative hour. In contrast sKDR levels did not change during surgery. The ECC-derived sFlt-1 was functional as judge by its inhibitory effect on the VEGF mitogenic response in human umbilical vein endothelial cells (HUVECs. Kinetic experiments revealed sFlt-1 release immediately after the beginning of ECC suggesting a proteolysis of its membrane form (mFlt-1 rather than an elevated transcription/translation process. Flow cytometry analysis highlighted no effect of ECC on the shedding of mFlt-1 on platelets and leukocytes suggesting vascular endothelial cell as a putative cell source for the ECC-derived sFlt-1. Conclusion sFlt-1 is released during CABG with ECC. It might be suggested that sFlt-1 production, by neutralizing VEGF and/or by inactivating membrane-bound Flt-1 and KDR receptors, might play a role in the occurrence of post-CABG complication.

  20. The prevalence and risks of early childhood caries (ECC) in Toronto, Canada.

    Science.gov (United States)

    Al-Jewair, Thikriat S; Leake, James L

    2010-10-14

    To determine the prevalence and risks of early childhood caries (ECC) among children less than 71 months of age in Toronto, Canada, and to evaluate the association between parental/caregiver depression and ECC. A secondary analysis of data previously collected by the Toronto Public Health as part of the 2003 Toronto Perinatal and Child Health Survey was performed. The 90-item survey was conducted over the telephone to 1,000 families with children from zero years (birth) to six years of age. Parents/caregivers were asked about factors related to the development and health of their children. For this study, only children younger than six years of age (less than 71 months) were included (n=833). The primary outcome of interest was self-reported and measured by the response to the question of whether a physician/dentist had ever told the parent/caregiver his/her child had ECC. The prevalence of ECC was 4.7 percent (37 of 791 children). The child's age, his/her history of dental visits, teeth brushing, the use of fluoridated toothpaste, the parent's/caregiver's depressive tendencies, the language spoken at home, and the household annual income were all significant in the bivariate analysis. Multiple logistic regression identified four factors associated with ECC: the child's age (being three years of age or older), having at least one parent/caregiver with depression, not speaking English at home, and having an annual household income less than $40,000 in Canadian dollars (CAD). While a child's age, home language, and household income are known risks for ECC, the finding that parental/caregiver depression may be related to ECC is new. Multiple risk factors are involved in the development of early childhood caries. Of particular importance are demographic (e.g., child's age), social (e.g., annual household income), and psychosocial factors (e.g., parental/caregiver depression) that are indirectly linked to ECC. More attention needs to be placed on understanding the role

  1. Preliminary Evaluation Methodology of ECCS Performance for Design Basis LOCA Redefinition

    International Nuclear Information System (INIS)

    Kang, Dong Gu; Ahn, Seung Hoon; Seul, Kwang Won

    2010-01-01

    To improve their existing regulations, the USNRC has made efforts to develop the risk-informed and performance-based regulation (RIPBR) approaches. As a part of these efforts, the rule revision of 10CFR50.46 (ECCS Acceptance Criteria) is underway, considering some options for 4 categories of spectrum of break sizes, ECCS functional reliability, ECCS evaluation model, and ECCS acceptance criteria. Since the potential for safety benefits and unnecessary burden reduction from design basis LOCA redefinition is high relative to other options, the USNRC is proceeding with the rulemaking for design basis LOCA redefinition. An instantaneous break with a flow rate equivalent to a double ended guillotine break (DEGB) of the largest primary piping system in the plant is widely recognized as an extremely unlikely event, while redefinition of design basis LOCA can affect the existing regulatory practices and approaches. In this study, the status of the design basis LOCA redefinition and OECD/NEA SMAP (Safety Margin Action Plan) methodology are introduced. Preliminary evaluation methodology of ECCS performance for LOCA is developed and discussed for design basis LOCA redefinition

  2. Energy-dissipating and self-repairing SMA-ECC composite material system

    International Nuclear Information System (INIS)

    Li, Xiaopeng; Li, Mo; Song, Gangbing

    2015-01-01

    Structural component ductility and energy dissipation capacity are crucial factors for achieving reinforced concrete structures more resistant to dynamic loading such as earthquakes. Furthermore, limiting post-event residual damage and deformation allows for immediate re-operation or minimal repairs. These desirable characteristics for structural ‘resilience’, however, present significant challenges due to the brittle nature of concrete, its deformation incompatibility with ductile steel, and the plastic yielding of steel reinforcement. Here, we developed a new composite material system that integrates the unique ductile feature of engineered cementitious composites (ECC) with superelastic shape memory alloy (SMA). In contrast to steel reinforced concrete (RC) and SMA reinforced concrete (SMA-RC), the SMA-ECC beams studied in this research exhibited extraordinary energy dissipation capacity, minimal residual deformation, and full self-recovery of damage under cyclic flexural loading. We found that the tensile strain capacity of ECC, tailored up to 5.5% in this study, allows it to work compatibly with superelastic SMA. Furthermore, the distributed microcracking damage mechanism in ECC is critical for sufficient and reliable recovery of damage upon unloading. This research demonstrates the potential of SMA-ECC for improving resilience of concrete structures under extreme hazard events. (paper)

  3. Holistic care patient with Early Childhood Caries (ECC: A case report

    Directory of Open Access Journals (Sweden)

    Intan Maulani

    2016-06-01

    Full Text Available Early Childhood Caries (ECC is a specific form of severe dental caries that affects infants and young children. ECC progresses rapidly in those who are at high risk, and often goes untreated. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both primary and permanent dentitions. This case showed management holistic care for children with ECC.A five year old boy patient accompanied with her parents were reported to the Pedodontic Clinic Padjadjaran University Dental Hospital with a chief complaint of decayed upper anterior teeth and pain in the molar teeth. Clinical examinations found dental caries almost all teeth in the maxilla and mandible. Based on panoramic radiograph, treatments that can be done are strip crown glass ionomer restorations, pulp treatments, extractions and fixed space maintainer. Patients diagnosed with severe ECC, patient and parents described on this type of caries. During treatment the patient was given oral hygiene instruction and recommend daily use of tooth mouse. After all treatment were completed, fluoride topical, and fissure sealants, recall check up after three months was scheduled. Holistic care needed in handling children with ECC.

  4. Your diet after gastric bypass surgery

    Science.gov (United States)

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed the way your ...

  5. Alterations in plasma soluble vascular endothelial growth factor receptor-1 (sFlt-1 concentrations during coronary artery bypass graft surgery: relationships with post-operative complications

    Directory of Open Access Journals (Sweden)

    Orsel Isabelle

    2008-04-01

    Full Text Available Abstract Background Plasma concentrations of sFlt-1, the soluble form of the vascular endothelial growth factor receptor (VEGF, markedly increase during coronary artery bypass graft (CABG surgery with extracorporeal circulation (ECC. We investigated if plasma sFlt-1 values might be related to the occurrence of surgical complications after CABG. Methods Plasma samples were collected from the radial artery catheter before vascular cannulation and after opening the chest, at the end of ECC just before clamp release, after cross release, after weaning from ECC, at the 6th and 24th post-operative hour. Thirty one patients were investigated. The presence of cardiovascular, haematological and respiratory dysfunctions was prospectively assessed. Plasma sFlt-1 levels were measured with commercially ELISA kits. Results Among the 31 investigated patients, 15 had uneventful surgery. Patients with and without complications had similar pre-operative plasma sFlt-1 levels. Lowered plasma sFlt-1 levels were observed at the end of ECC in patients with haematological (p = 0.001, ANOVA or cardiovascular (p = 0.006 impairments, but not with respiratory ones (p = 0.053, as compared to patients with uneventful surgery. Conclusion These results identify an association between specific post-CABG complication and the lower release of sFlt-1 during ECC. sFlt-1-induced VEGF neutralisation might, thus, be beneficial to reduce the development of post-operative adverse effects after CABG.

  6. EUS-directed Transgastric ERCP (EDGE) Versus Laparoscopy-assisted ERCP (LA-ERCP) for Roux-en-Y Gastric Bypass (RYGB) Anatomy: A Multicenter Early Comparative Experience of Clinical Outcomes.

    Science.gov (United States)

    Kedia, Prashant; Tarnasky, Paul R; Nieto, Jose; Steele, Stephen L; Siddiqui, Ali; Xu, Ming-Ming; Tyberg, Amy; Gaidhane, Monica; Kahaleh, Michel

    2018-04-17

    The standard of care for managing pancreaticobiliary disease in altered Roux-en-Y gastric bypass patients is laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP), but is limited by cost and adverse events. Recently a minimally invasive, completely endoscopic approach using endoscopic ultrasound (EUS) directed transgastric ERCP (EDGE) has been described. We aim to compare EDGE to LA-ERCP in this study. Patients from May 2005 to June 2017 with Roux-en-Y gastric bypass anatomy having undergone LA-ERCP or EDGE at 4 tertiary centers were captured in a registry. Patient demographics, procedural details, and clinical outcomes were measured for each group. Seventy-two patients (n=29 EDGE, n=43 LA-ERCP) were included in this study. There was no significant difference in the technical success of EDGE gastrogastric fistula (96.5%) versus LA-gastrostomy creation (100%). The success rate of achieving therapeutic ERCP (EDGE 96.5% vs. LA-ERCP 97.7%) and number of ERCP (EDGE 1.2 vs. LA-ERCP 1.02) needed to achieve clinical resolution was similar between both groups. Adverse event rate for EDGE, 24% (7/29) and LA-ERCP, 19% (8/43) was similar. The total procedure time (73 vs. 184 min) and length of hospital stay (0.8 vs. 2.65 d) was significantly shorter for EDGE compared to LA-ERCP. The overall weight change after EDGE was -6.6 lbs at an average 28-week follow-up. This study suggests that the EDGE procedure has similar technical success and adverse events compared with LA-ERCP with the benefit of significantly shorter procedure times and hospital stay. EDGE may offer a minimally invasive, effective option, with less resource utilization, and without significant weight gain.

  7. Accomplishments of LOCA/ECCS experimental research at Japan Atomic Energy Research Institute

    International Nuclear Information System (INIS)

    Tasaka, Kanji; Murao, Yoshio; Koizumi, Yasuo

    1984-01-01

    Japan Atomic Energy Research Institute has investigated loss-of-coolant accident (LOCA)/emergency core cooling system (ECCS) from 1970. Major results of the LOCA/ECCS research are summarized in this report. ROSA-II program was LOCA/ECCS research for a pressurized water reactor (PWR) and ROSA-III program was for a boiling water reactor (BWR). The both test facilities were scaled at approximately 1/400 of the respective reference PWR and BWR. Large scale reflood test is research on reflood phenomena during a large break LOCA of PWR. The test facility is scaled at approximately 1/20 of the reference PWR and the research is still being continued. (author)

  8. On the energy shift the ECC cusp. Does the shift really exist?

    International Nuclear Information System (INIS)

    Sarkadi, L.; Barrachina, R.O.

    2004-01-01

    The cusplike 'electron capture to the continuum' (ECC) peak appearing in the spectrum of the forward emitted electrons in ion-atom collisions are generally thought to be a divergence. Recently Shah et al., however, claimed that 'the ECC cusp is indeed a cusp, and not a divergence smoothed by the experiment'. These authors measured the ECC cusp for collisions of 10- and 20-keV protons with H 2 and He, and found that the peak was shifted to lower velocity than its expected position. We also carried out CTMC calculations (for the case of 20-keV protons on He) by which we demonstrated that the shift really exists but its value depends on the angular window of the electron detection. (K.A.)

  9. Lightweight ECC based RFID authentication integrated with an ID verifier transfer protocol.

    Science.gov (United States)

    He, Debiao; Kumar, Neeraj; Chilamkurti, Naveen; Lee, Jong-Hyouk

    2014-10-01

    The radio frequency identification (RFID) technology has been widely adopted and being deployed as a dominant identification technology in a health care domain such as medical information authentication, patient tracking, blood transfusion medicine, etc. With more and more stringent security and privacy requirements to RFID based authentication schemes, elliptic curve cryptography (ECC) based RFID authentication schemes have been proposed to meet the requirements. However, many recently published ECC based RFID authentication schemes have serious security weaknesses. In this paper, we propose a new ECC based RFID authentication integrated with an ID verifier transfer protocol that overcomes the weaknesses of the existing schemes. A comprehensive security analysis has been conducted to show strong security properties that are provided from the proposed authentication scheme. Moreover, the performance of the proposed authentication scheme is analyzed in terms of computational cost, communicational cost, and storage requirement.

  10. Optimal Bypass and Cream Skimming.

    OpenAIRE

    Laffont, Jean-Jacques; Tirole, Jean

    1990-01-01

    This paper develops a normative model of regulatory policy toward bypass and cream skimming. It analyzes the effects of bypass on second-degree price discrimination, on the rent of the regulated firm, and on the welfare of low-demand customers. It shows that pricing under marginal cost may be optimal for the regulated firm, excessive cream skimming occurs if access to the bypass technology is not regulated, and the prohibition of bypass may increase or decrease the regulated firm's rent. Copy...

  11. BREASTFEEDING AND EARLY CHILDHOOD CARIES (ECC SEVERITY OF CHILDREN UNDER THREE YEARS OLD IN DKI JAKARTA

    Directory of Open Access Journals (Sweden)

    Risqa Rina Darwita

    2008-12-01

    Full Text Available The prevalence and severity of caries in children under three years old are constantly increasing. One of the cause is the increase consumption of cariogenic carbohydrate. Breast milk have buffer capacity that eventually able to prevent caries. The aims of this research are to discover the correlation between breastfeeding with the severity of Early Childhood Caries (ECC in children under three years old, to provide information on prevalence and severity of caries in children under three years, and to explain factors influencing the incidence of ECC. This research designed cross sectionally and conducted upon 565 children aged 12-38 months, selected using multistage cluster random sampling. The ECC prevalence of children under three years in DKI Jakarta is 52.7%, with average score of def-t 2.85. Bivariate analysis showed that, variables which correlate with the level of ECC are; the way to deliver (p=0,012, frequency (p=0,002, duration (p=0,002, salivary buffer capacity (p=0.013, habitual consumption of sugary diet (p=0.005, child’s dental hygiene behavior (p=0.002, and mother’s education (p=0.001. Multivariate analysis showed that ECC can be explained by these variables: age, mother’s education, the way to deliver and frequency of breast milk complements/replacement of consumtions, child’s brushing habit, plaque pH, and salivary buffer capacity. Resulting determination coefficient 32.1%. There is no significant correlation between breastfeeding and the level of Early Childhood Caries (ECC. The role of protective qualities of breastfeeding are not shown because of bias in obtaining data influence the incidence of caries.

  12. 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...

  13. 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). ...

  14. ECCS analysis of B and W's 177-FA lowered-loop NSS

    International Nuclear Information System (INIS)

    Jones, R.C.; Biller, J.R.; Dunn, B.M.

    1975-06-01

    The effectiveness for the ECCS for B and W's 177-FA Lowered-Loop NSS is shown to meet the five criteria of 10 CFR 50.46. A spectrum analysis is performed and the worst case is used to establish allowable linear heat rates as a function of elevation in the core. (U.S.)

  15. MICROORGANISMS FOUND IN SECONDARY CATARACT MATERIAL OF ECCE PATIENTS, A STUDY WITH SEM AND TEM

    NARCIS (Netherlands)

    KALICHARAN, D; JONGEBLOED, WL; LOS, LI; WORST, JGF

    1993-01-01

    Globular secondary cataract material, removed from 24 patients with ECCE after ophthalmic cleaning of the anterior capsule, were investigated with SEM and TEM. Besides spherical, somewhat oval shaped bodies of various shape and size comparable with those found in cataractous lenses, (an)aerobic

  16. Complete genome sequences of Escherichia coli strains 1303 and ECC-1470 isolated from bovine mastitis

    NARCIS (Netherlands)

    Leimbach, Andreas; Poehlein, Anja; Witten, Anika; Scheutz, Flemming; Schukken, Ynte|info:eu-repo/dai/nl/075051907; Daniel, Rolf; Dobrindt, Ulrich

    2016-01-01

    Escherichia coli is the leading causative agent of acute bovine mastitis. Here, we report the complete genome sequence of E. coli O70:H32 strain 1303, isolated from an acute case of bovine mastitis, and E. coli Ont:Hnt strain ECC-1470, isolated from a persistent infection.

  17. Cardiopulmonary bypass in pregnancy

    OpenAIRE

    Mukul Chandra Kapoor

    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. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and f...

  18. Basics of cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Manjula Sarkar

    2017-01-01

    Full Text Available Cardiopulmonary bypass (CPB provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB. However, it also has its share of complications and strategies to reduce these complications are the area of the current research.

  19. Preparation and evaluation of 68Ga-ECC as a PET renal imaging agent

    International Nuclear Information System (INIS)

    Mizaei, Alireza; Jaililan, Amir Reza; Mazidi, Mohammad; Aghanejad, Ayuob; Yousefnia, Hassan; Shabani, Gholamli; Ardaneh, Khosro; Geramifar, Patham; Beiki, Davood

    2015-01-01

    Development of a gallium-68-labeled renal tracer can be a good substitute for Tc-99m, a known SPECT tracer. In this study, effort was made to develop 68 Ga-ethylenecysteamine cysteine ( 68 Ga-ECC). Ga-ECC was prepared using generator-based 68 GaCl3 and ethylenecysteamine cysteine (ECC) at optimized conditions. Stability of the complex was checked in human serum followed by partition coefficient determination of the tracer. The biodistribution of the tracer in rats was studied using tissue counting and PET/CT imaging up to 120 min. Ga-ECC was prepared at optimized conditions in 15 min at 90 °C (radiochemical purity ≈97 ± 0.88 % ITLC, >99 % HPLC, specific activity: 210 ± 5 GBq/mM). 68 Ga-ECC was a water-soluble complex based on partition coefficient data (log P; −1.378) and was stable in the presence of human serum for 2 h at 37 °C. The biodistribution of the tracer demonstrated high kidney excretion of the tracer in 10–20 min. The SUV max ratios of the liver to left kidney were 0.38 and 0.39 for 30 and 90 min, respectively, indicating high kidney uptake. Initial biodistribution results showed significant kidney and urinary excretion of the tracer comparable to that of the homologous 99m Tc compound. The complex could be a possible PET kidney imaging agent with a fast imaging time

  20. Preparation and evaluation of {sup 68}Ga-ECC as a PET renal imaging agent

    Energy Technology Data Exchange (ETDEWEB)

    Mizaei, Alireza; Jaililan, Amir Reza; Mazidi, Mohammad; Aghanejad, Ayuob; Yousefnia, Hassan; Shabani, Gholamli; Ardaneh, Khosro [Radiation Application Research School, Nuclear Science and Technology Research Institute, Tehran (Iran, Islamic Republic of); Geramifar, Patham; Beiki, Davood [Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2015-09-15

    Development of a gallium-68-labeled renal tracer can be a good substitute for Tc-99m, a known SPECT tracer. In this study, effort was made to develop {sup 68}Ga-ethylenecysteamine cysteine ({sup 68}Ga-ECC). Ga-ECC was prepared using generator-based {sup 68}GaCl3 and ethylenecysteamine cysteine (ECC) at optimized conditions. Stability of the complex was checked in human serum followed by partition coefficient determination of the tracer. The biodistribution of the tracer in rats was studied using tissue counting and PET/CT imaging up to 120 min. Ga-ECC was prepared at optimized conditions in 15 min at 90 °C (radiochemical purity ≈97 ± 0.88 % ITLC, >99 % HPLC, specific activity: 210 ± 5 GBq/mM). {sup 68}Ga-ECC was a water-soluble complex based on partition coefficient data (log P; −1.378) and was stable in the presence of human serum for 2 h at 37 °C. The biodistribution of the tracer demonstrated high kidney excretion of the tracer in 10–20 min. The SUV{sub max} ratios of the liver to left kidney were 0.38 and 0.39 for 30 and 90 min, respectively, indicating high kidney uptake. Initial biodistribution results showed significant kidney and urinary excretion of the tracer comparable to that of the homologous {sup 99m}Tc compound. The complex could be a possible PET kidney imaging agent with a fast imaging time.

  1. A study on design of the trip computer for ECCS based on dynamic safety system

    International Nuclear Information System (INIS)

    Kim, Seog Nam

    2000-02-01

    The Emergency Core Cooling system in current nuclear power plants typically has a considerable number of complex functions and largely cumbersome operator interfaces. Functions for initiation, switch-over between various phases of operation, interlocks, monitoring, and alarming are usually performed by relay and analog comparator logic which is difficult to maintain and test. To improve problems of an analog based ECC (Emergency Core Cooling) System, the trip computer for ECCS based on Dynamic Safety System is implemented. The Dynamic Safety System (DSS) is a computer based reactor protection system that has fail-safe nature and performs a dynamic self-testing. The most important feature of the DSS is the introduction of test signal that send the system into a tripped state. The test signals are interleaved between the plant signals to produce an output which switches between a tripped and health state. The dynamic operation is a key feature of the failsafe design of the system. In this thesis, a possible implementation of the DSS using PLC is presented for a CANDU reactor. ECC System of the CANDU Reactor is selected as the reference system. The function of the DSS is implemented In PLC with the CONCEPT language. CONCEPT was developed by GROUPE SCHNEIDER as a graphic user interface programming tool for the Quantum PLC. A MMI display for ECCS based on DSS is implemented with LOOKOUT as an object driven programming tool. The Validation test has been performed by S/W Input Simulator as per Validation Test Procedure. The result of the test was checked and displayed on the MMI display. From the test results, it is shown that the DSS based ECC System operates correctly in all conditions

  2. A comparison of direct technique with the liquid stylet technique of radial artery cannulation in patients presenting for coronary artery bypass grafting

    International Nuclear Information System (INIS)

    Younus, U.; Ahmed, I.

    2012-01-01

    To compare direct technique with the liquid stylet technique of radial artery cannulation in patients undergoing coronary artery byroms grouping. We hypothesized that liquid stylet technique would lead to fewer attempts and save vital time. Study Design: Randomized controlled Trial (RCT). Place and Duration of Study: Department of Anaesthesia and Intensive Care, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, [AFIC-NIHD] Rawalpindi, between 1 July 2007 to 31 Dec 2007. Patients and Methods: One hundred patients of either sex scheduled for CABG were included and were randomized to 2 groups using random number table. Fifty patients in the direct technique group and 50 in the liquid stylet group. Results: These two groups comparable with respect to age, gender and weight were studied. The number of attempts in group 1 were 1.7+-0.5 vs 3.6+-1.6 in groups 2, (p=0.021). The time consumed in group was 3.3 +- 2.2 minutes while in groups 2 it was 8.0 +- 3.6 (p=0.022). Conclusion: We concluded that the liquid stylet technique is safe, quick and is associated with lesser number of attempts at cannulation. Secondly it can be done without fancy guide wires and other technology especially in a developing country like Pakistan. (author)

  3. Direct reperfusion of the right common carotid artery prior to cardiopulmonary bypass in patients with brain malperfusion complicated with acute aortic dissection.

    Science.gov (United States)

    Okita, Yutaka; Matsumori, Masamichi; Kano, Hiroya

    2016-04-01

    The cases of 3 patients with brain malperfusion secondary to acute aortic dissection who underwent preoperative perfusion of the right common carotid artery are presented. The patients were 64, 65 and 72 years old and 2 were female. All were in a comatose or semi-comatose state with left hemiplegia. The right common carotid artery was exposed and directly cannulated, using a 12-Fr paediatric arterial cannula. The right common femoral artery was chosen for arterial drainage, using a 14-Fr double-lumen cannula. The circuit contained a small roller pump and heat exchanger coil. Target flow was set at 90 ml/min and blood temperature at 30 °C. Durations of right carotid perfusion were 120, 100 and 45 min, respectively. All underwent partial arch replacement and survived. Postoperative neurological sequelae were minimal in all cases. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  4. Early Childhood Care and Education (ECCE) in Ethiopia ...

    African Journals Online (AJOL)

    Early childhood care and education has been for many years in Ethiopia. However, these experiences were not systematized, reflected up on and, hence, efforts were not made to extract lessons and delineate future directions. This paper has made a modest attempt to bring to light developments registered, gaps noted and ...

  5. Modifying the ECC-based grouping-proof RFID system to increase inpatient medication safety.

    Science.gov (United States)

    Ko, Wen-Tsai; Chiou, Shin-Yan; Lu, Erl-Huei; Chang, Henry Ker-Chang

    2014-09-01

    RFID technology is increasingly used in applications that require tracking, identification, and authentication. It attaches RFID-readable tags to objects for identification and execution of specific RFID-enabled applications. Recently, research has focused on the use of grouping-proofs for preserving privacy in RFID applications, wherein a proof of two or more tags must be simultaneously scanned. In 2010, a privacy-preserving grouping proof protocol for RFID based on ECC in public-key cryptosystem was proposed but was shown to be vulnerable to tracking attacks. A proposed enhancement protocol was also shown to have defects which prevented proper execution. In 2012, Lin et al. proposed a more efficient RFID ECC-based grouping proof protocol to promote inpatient medication safety. However, we found this protocol is also vulnerable to tracking and impersonation attacks. We then propose a secure privacy-preserving RFID grouping proof protocol for inpatient medication safety and demonstrate its resistance to such attacks.

  6. Scaling and design report of ECC performance test facility (SWAT) of SMART

    International Nuclear Information System (INIS)

    Cho, Seok; Ko, Yong Ju; Cho, Young Il; Kim, Jeong Tak; Choi, Nam Hyun; Shin Yong Chul; Park, Choon Kyong; Kwon, Tae Soon; Lee, Sung Jae

    2010-12-01

    SWAT (SMART ECC Water Asymmetric Two-phase choking test facility) was designed by 1/5 scaling ratio using the modified linear scaling method. The design characteristics of the SMART such that the elevation of RCP suction nozzles is the same with that of the ECC injection nozzles are maintained to reduce a distortion caused by the gravitational effect. Thermal hydraulic phenomena in a test facility designed by the modified linear scaling method can be simulated more accurately than those by the full-height and reduced area scaling method. The main part of the test section is SG-side upper down-comer. The boundary conditions are saturated steam and water flow condition and drain flow rate to control the collapsed water level in the down-comer. The test data of the SWAT can produce the well-defined boundary condition to validate the thermal hydraulic analysis code for the SMART

  7. Prosthetic Oral Rehabilitation of a Child With S-ECC: A Case Report with Histopathologic Analysis.

    Science.gov (United States)

    Tannure, P N; Moraes, G G; Borba, McU; Abrahão, A; Andrade, Mtrc; Fidalgo, Tks

    2015-01-01

    The aim of this case report is to describe the treatment planning of a young child with severe early childhood caries (S-ECC) as well as the prosthetic rehabilitation technique. A 3-year-old female child was referred to the pediatric dentistry clinic with the chief complaint of tooth pain, difficulty in eating and recurrent hospitalizations caused by dental infections. The mother reported intermittent episodes of fever and recurrent swelling of child's face. The girl presented angular cheilitis and was referred to a dietitian. The treatment plain consisted on a behavior changes in oral hygiene habits, exodontias of all primary teeth and oral rehabilitation with a prosthesis. The extracted teeth with periapical lesions were submitted to histopathologic analysis (hematoxilin and eosin staining) and revealed an inflammatory infiltrate. The aesthetic requirement of children with S-ECC has been a challenge to pediatric dentists. In the present case, the oral rehabilitation provided for the children better aesthetic, nutrition, phonation, and functional conditions.

  8. Minimum containment pressure and its effect on ECCS performance of APR-1400

    International Nuclear Information System (INIS)

    Kim, In Goo; Bang, Young S.; Kim, Hho Jung

    2004-01-01

    The containment pressure has a strong effect on the late reheat behavior for a large break LOCA, associated with the DVI issue. The downcomer boiling, which occurs during the post-reflood phase, has a negative effect on core cooling for a LBLOCA. Because the downcomer boiling is enhanced as the containment pressure decreases, how to determine containment pressure is important to the evaluation of ECCS performance. In spite of its importance of containment pressure, there are few studies on the containment pressure and the interaction between RCS and containment thermal hydraulics. To have a better knowledge of the effect of containment pressure on APR-1400 ECCS performance, a parametric study for containment pressure has been carried out. Also, the interaction between RCS and containment behavior has been also investigated

  9. Scaling and design report of ECC performance test facility (SWAT) of SMART

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seok; Ko, Yong Ju; Cho, Young Il; Kim, Jeong Tak; Choi, Nam Hyun; Shin Yong Chul; Park, Choon Kyong; Kwon, Tae Soon; Lee, Sung Jae [KAERI, Daejeon (Korea, Republic of)

    2010-12-15

    SWAT (SMART ECC Water Asymmetric Two-phase choking test facility) was designed by 1/5 scaling ratio using the modified linear scaling method. The design characteristics of the SMART such that the elevation of RCP suction nozzles is the same with that of the ECC injection nozzles are maintained to reduce a distortion caused by the gravitational effect. Thermal hydraulic phenomena in a test facility designed by the modified linear scaling method can be simulated more accurately than those by the full-height and reduced area scaling method. The main part of the test section is SG-side upper down-comer. The boundary conditions are saturated steam and water flow condition and drain flow rate to control the collapsed water level in the down-comer. The test data of the SWAT can produce the well-defined boundary condition to validate the thermal hydraulic analysis code for the SMART

  10. 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…

  11. Haemodynamics in axillobifemoral bypass grafts

    NARCIS (Netherlands)

    C.H. Wittens

    1992-01-01

    textabstractThis thesis is based on four publications on the subject of graft configuration and haemodynamics in axillobifemoral bypass grafts: 1. A clinical evaluation of 17 patients with axillobifemoral bypass graft operations, performed for various indications. Two important observations were

  12. The E.C.C. programme in the field of radioactive wastes

    International Nuclear Information System (INIS)

    Orlowski, S.

    1976-01-01

    After a description of the aims of the E.C.C. in the field of radioactive wastes, the contents and the structure of the programme developed for this purpose as well as its time schedule and financing, are presented. The state of work progress and the first results of the actions taken, whose application is marked by an active cooperation of numerous national experts are quoted [fr

  13. Audit of ECCS Availability for CANDU Reactors with an extended O/H interval

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jong Soo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2011-10-15

    KINS conducts regulatory periodic inspections of the safety and performance of each nuclear installation during the planned outage every 20 months, pursuant to the Atomic Energy Act. For CANDU reactors, planned outage or overhaul (O/H) have been performed every 15 months. KHNP has been making efforts to extend the O/H intervals of CANDU reactors into 20 months since 2001. Low ECCS availability is one of the regulatory pending issues in the related licensing

  14. A Secure-Enhanced Data Aggregation Based on ECC in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Qiang Zhou

    2014-04-01

    Full Text Available Data aggregation is an important technique for reducing the energy consumption of sensor nodes in wireless sensor networks (WSNs. However, compromised aggregators may forge false values as the aggregated results of their child nodes in order to conduct stealthy attacks or steal other nodes’ privacy. This paper proposes a Secure-Enhanced Data Aggregation based on Elliptic Curve Cryptography (SEDA-ECC. The design of SEDA-ECC is based on the principles of privacy homomorphic encryption (PH and divide-and-conquer. An aggregation tree disjoint method is first adopted to divide the tree into three subtrees of similar sizes, and a PH-based aggregation is performed in each subtree to generate an aggregated subtree result. Then the forged result can be identified by the base station (BS by comparing the aggregated count value. Finally, the aggregated result can be calculated by the BS according to the remaining results that have not been forged. Extensive analysis and simulations show that SEDA-ECC can achieve the highest security level on the aggregated result with appropriate energy consumption compared with other asymmetric schemes.

  15. Gonioscopic changes in conventional ECCE vs manual SICS: A comparative study

    Directory of Open Access Journals (Sweden)

    Surya Joseph, Sundararajan D, Rajvin Samuel Ponraj, Srinivasan M, Veluchamy

    2014-04-01

    Full Text Available The aim of the study is to observe and compare the Gonioscopic changes in the angle of the anterior chamber of the eye after surgeries namely; Conventional Extra capsular cataract extraction (ECCE with Posterior chamber Intraocular lens (PC IOL implantation, Manual Small incision Cataract Surgery with PCIOL implantation. The clinical study was undertaken after Institutional Ethical committee clearance, securing the inform consent, total number of 100 patients were enrolled in the study. 50 ECCE; 50 SICS consisting of 57 Males and 43 Females aged between 40 – 80yrs who were admitted and operated for Cataract at Meenakshi Medical college Hospital & Research institute. The following parameters are studied: Gonioscopic changes in the angle, namely the PAS formation in the quadrants, pigment dispersion in each of the methods. After this study, we arrive to a conclusion that complications in the angle of anterior chamber occur mostly in Conventional with insignificant change in manual SICS. So manual Small incision Cataract Surgery with PCIOL implantation is preferable over Conventional ECCE with PCIOL implantation.

  16. Quorum sensing in the plant pathogen Erwinia carotovora subsp. carotovora: the role of expR(Ecc).

    Science.gov (United States)

    Andersson, R A; Eriksson, A R; Heikinheimo, R; Mäe, A; Pirhonen, M; Kõiv, V; Hyytiäinen, H; Tuikkala, A; Palva, E T

    2000-04-01

    The production of the main virulence determinants of the plant pathogen Erwinia carotovora subsp. carotovora, the extracellular cell wall-degrading enzymes, is partly controlled by the diffusible signal molecule N-(3-oxohexanoyl)-L-homoserine lactone (OHHL). OHHL is synthesized by the product of the expI/carI gene. Linked to expI we found a gene encoding a putative transcriptional regulator of the LuxR-family. This gene, expR(Ecc), is transcribed convergently to the expI gene and the two open reading frames are partially overlapping. The ExpR(Ecc) protein showed extensive amino acid sequence similarity to the repressor EsaR from Pantoea stewartii subsp. stewartii (formerly Erwinia stewartii subsp. stewartii) and to the ExpR(Ech) protein of Erwinia chrysanthemi. Inactivation of the E. carotovora subsp. carotovora expR(Ecc) gene caused no decrease in virulence or production of virulence determinants in vitro. In contrast, there was a slight increase in the maceration capacity of the mutant strain. The effects of ExpR(Ecc) were probably mediated by changes in OHHL levels. Inactivation of expR(Ecc) resulted in increased OHHL levels during early logarithmic growth. In addition, overexpression of expR(Ecc) caused a clear decrease in the production of virulence determinants and part of this effect was likely to be caused by OHHL binding to ExpR(Ecc). ExpR(Ecc) did not appear to exhibit transcriptional regulation of expI, but the effect on OHHL was apparently due to other mechanisms.

  17. Intricate and Cell Type-Specific Populations of Endogenous Circular DNA (eccDNA) in Caenorhabditis elegans and Homo sapiens.

    Science.gov (United States)

    Shoura, Massa J; Gabdank, Idan; Hansen, Loren; Merker, Jason; Gotlib, Jason; Levene, Stephen D; Fire, Andrew Z

    2017-10-05

    Investigations aimed at defining the 3D configuration of eukaryotic chromosomes have consistently encountered an endogenous population of chromosome-derived circular genomic DNA, referred to as extrachromosomal circular DNA (eccDNA). While the production, distribution, and activities of eccDNAs remain understudied, eccDNA formation from specific regions of the linear genome has profound consequences on the regulatory and coding capabilities for these regions. Here, we define eccDNA distributions in Caenorhabditis elegans and in three human cell types, utilizing a set of DNA topology-dependent approaches for enrichment and characterization. The use of parallel biophysical, enzymatic, and informatic approaches provides a comprehensive profiling of eccDNA robust to isolation and analysis methodology. Results in human and nematode systems provide quantitative analysis of the eccDNA loci at both unique and repetitive regions. Our studies converge on and support a consistent picture, in which endogenous genomic DNA circles are present in normal physiological states, and in which the circles come from both coding and noncoding genomic regions. Prominent among the coding regions generating DNA circles are several genes known to produce a diversity of protein isoforms, with mucin proteins and titin as specific examples. Copyright © 2017 Shoura et al.

  18. Cardiopulmonary bypass in pregnancy.

    Science.gov (United States)

    Kapoor, Mukul Chandra

    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. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  19. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available 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. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  20. Visual Memories Bypass Normalization.

    Science.gov (United States)

    Bloem, Ilona M; Watanabe, Yurika L; Kibbe, Melissa M; Ling, Sam

    2018-05-01

    How distinct are visual memory representations from visual perception? Although evidence suggests that briefly remembered stimuli are represented within early visual cortices, the degree to which these memory traces resemble true visual representations remains something of a mystery. Here, we tested whether both visual memory and perception succumb to a seemingly ubiquitous neural computation: normalization. Observers were asked to remember the contrast of visual stimuli, which were pitted against each other to promote normalization either in perception or in visual memory. Our results revealed robust normalization between visual representations in perception, yet no signature of normalization occurring between working memory stores-neither between representations in memory nor between memory representations and visual inputs. These results provide unique insight into the nature of visual memory representations, illustrating that visual memory representations follow a different set of computational rules, bypassing normalization, a canonical visual computation.

  1. Exxon Nuclear Company ECCS evaluation of a 2-loop Westinghouse PWR with dry containment using the ENC WREM-II ECCS model. Large break example problem

    International Nuclear Information System (INIS)

    Krajicek, J.E.

    1977-01-01

    This document is presented as a demonstration of the ENC WREM-II ECCS model calculational procedure applied to a Westinghouse 2-loop PWR with a dry containment (R. E. Ginna plant, for example). The hypothesized Loss-of-Coolant Accident (LOCA) investigated was a split break with an area equal to twice the pipe cross-sectional area. The break was assumed to occur in one pump discharge pipe (DECLS break). The analyses involved calculations using the ENC WREM-II model. The following codes were used: RELAP4-EM/ENC26A for blowdown and hot channel analyses, RELAP4-EM FLOOD/ENC26A for core reflood analysis, CONTEMPT LT/22 modified for containment backpressure analysis, and TOODEE2/APR77 for heatup analysis

  2. On the energy shift of the ECC cusp. Does the shift really exist?

    International Nuclear Information System (INIS)

    Barrachina, R.O.; Sarkadi, L.

    2004-01-01

    Full text: The cusplike 'electron capture to the continuum' (ECC) peak appearing in the spectrum of the forward emitted electrons in ion-atom collisions is generally thought to be a divergence. The peak is centered at electron velocity that matches that of the projectile. Recently Illescas et al. [1] claimed, however, that 'the cusp is not a divergence smoothed by the experiment, and is slightly shifted from the impact-velocity value'. In a subsequent work Shah et al. [2] measured the ECC cusp for collisions of 10- and 20- keV protons with H2 and He, and found that the peak was indeed shifted to a velocity below its expected position. Their classical trajectory Monte Carlo (CTMC) calculations reproduced the observation well. In the present work we demonstrate by our CTMC calculations (made for the case of 20-keV protons on He) that the intensity, width and position of the ECC cusp do depend on the experimental conditions by which the electrons are detected (first of all, the acceptance angle of the electron spectrometer). We also present experimental data for this collision system. While the latter data are well reproduced by our CTMC calculations, neither the theoretical results, nor the experimental data of the present work support of the findings of Shah et al. [2]. At the same time, analyzing the problem in the framework of the general final-state interaction theory of cusp formation [3], we concluded that 'rigorously' speaking Shah et al. [2] are right when they state that the ECC cusp is not a divergence. The divergence is smeared out by the scattering of the projectile. However, this effect is negligibly small at the lowest energy that was considered in their paper, 10 keV. At this impact energy the projectile motion is smeared within an angular region Δθ th ∼ 0.06 deg, which is much smaller than the acceptance angle of the experiment, Δθ exp ∼ 1.5 deg

  3. Assessment of compliance with regulatory requirements for a best estimate methodology for evaluation of ECCS

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Un Chul; Jang, Jin Wook; Lim, Ho Gon; Jeong, Ik [Seoul National Univ., Seoul (Korea, Republic of); Sim, Suk Ku [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2000-03-15

    Best estimate methodology for evaluation of ECCS proposed by KEPCO(KREM) os using thermal-hydraulic best-estimate code and the topical report for the methodology is described that it meets the regulatory requirement of USNRC regulatory guide. In this research the assessment of compliance with regulatory guide. In this research the assessment of compliance with regulatory requirements for the methodology is performed. The state of licensing procedure of other countries and best-estimate evaluation methodologies of Europe is also investigated, The applicability of models and propriety of procedure of uncertainty analysis of KREM are appraised and compliance with USNRC regulatory guide is assessed.

  4. Compendium of ECCS [Emergency Core Cooling Systems] research for realistic LOCA [loss-of-coolant accidents] analysis: Final report

    International Nuclear Information System (INIS)

    1988-12-01

    In the United States, Emergency Core Cooling Systems (ECCS) are required for light water reactors (LWRs) to provide cooling of the reactor core in the event of a break or leak in the reactor piping or an inadvertent opening of a valve. These accidents are called loss-of-coolant accidents (LOCA), and they range from small leaks up to a postulated full break of the largest pipe in the reactor cooling system. Federal government regulations provide that LOCA analysis be performed to show that the ECCS will maintain fuel rod cladding temperatures, cladding oxidation, and hydrogen production within certain limits. The NRC and others have completed a large body of research which investigated fuel rod behavior and LOCA/ECCS performance. It is now possible to make a realistic estimate of the ECCS performance during a LOCA and to quantify the uncertainty of this calculation. The purpose of this report is to summarize this research and to serve as a general reference for the extensive research effort that has been performed. The report: (1) summarizes the understanding of LOCA phenomena in 1974; (2) reviews experimental and analytical programs developed to address the phenomena; (3) describes the best-estimate computer codes developed by the NRC; (4) discusses the salient technical aspects of the physical phenomena and our current understanding of them; (5) discusses probabilistic risk assessment results and perspectives, and (6) evaluates the impact of research results on the ECCS regulations. 736 refs., 412 figs., 66 tabs

  5. A provably-secure ECC-based authentication scheme for wireless sensor networks.

    Science.gov (United States)

    Nam, Junghyun; Kim, Moonseong; Paik, Juryon; Lee, Youngsook; Won, Dongho

    2014-11-06

    A smart-card-based user authentication scheme for wireless sensor networks (in short, a SUA-WSN scheme) is designed to restrict access to the sensor data only to users who are in possession of both a smart card and the corresponding password. While a significant number of SUA-WSN schemes have been suggested in recent years, their intended security properties lack formal definitions and proofs in a widely-accepted model. One consequence is that SUA-WSN schemes insecure against various attacks have proliferated. In this paper, we devise a security model for the analysis of SUA-WSN schemes by extending the widely-accepted model of Bellare, Pointcheval and Rogaway (2000). Our model provides formal definitions of authenticated key exchange and user anonymity while capturing side-channel attacks, as well as other common attacks. We also propose a new SUA-WSN scheme based on elliptic curve cryptography (ECC), and prove its security properties in our extended model. To the best of our knowledge, our proposed scheme is the first SUA-WSN scheme that provably achieves both authenticated key exchange and user anonymity. Our scheme is also computationally competitive with other ECC-based (non-provably secure) schemes.

  6. Experiment data report for Semiscale Mod-1 Test S-05-2 (alternate ECC injection test)

    International Nuclear Information System (INIS)

    Feldman, E.M.; Collins, B.L.; Sackett, K.E.

    1977-02-01

    Recorded test data are presented for Test S-05-2 of the Semiscale Mod-1 alternate emergency core coolant (ECC) injection test series. This test is one of several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor (PWR) system. Test S-05-2 was conducted from an initial cold leg fluid temperature of 545 0 F and an initial pressure of 2263 psia. A simulated double-ended offset shear cold leg break was used to investigate core and system response to a depressurization and reflood transient with ECC injection at the intact loop pump suction and broken loop cold leg. A reduced lower plenum volume was used for this test to more accurately represent the lower plenum of a PWR, based on system volume scaling. System flow was set to achieve a core fluid temperature differential of 65 0 F at a core power level of 1.44 MW. The flow resistance of the intact loop was based on core area scaling. An electrically heated core with a slightly peaked radial power profile was used in the pressure vessel to simulate the predicted surface heat flux of nuclear fuel rods during a loss-of-coolant accident

  7. Design Development of SMART ECC Water Asymmetric Two-phase choking test facility

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Il; Cho, Seok; Ko, Yung Joo; Shin, Yong Cheol; Kwon, Tae Soon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-05-15

    SMART pressurized water reactor type is different from the existing integral NSSS commercial pressurized water reactor system which is equipped with the main features. In addition RCS piping is removed and the feature of the SBLOCA is a major design break accident. The TASS / SMR code is analyzed SMART SBLOCA. In order to verify analysis code, SMART analysis for verification of conservatism is promoting using data for experiments with Integral Effect Test and Separate Effect. In this paper, the design feature of the SWAT (SMART ECC Water Asymmetric Two-phase choking test facility) is described. SWAT is linearly reduced to a 1/5 ratio while the geometrical shape is conserved. In major shape of SMART ECC injection performance test, distortions which caused by gravitational effects are minimized. Because both the emergency core cooling water injection nozzle height and the break nozzle height match the RCP Suction Nozzle height in test section of the main forms. The main part of the test section is SG-side upper down-comer. The boundary conditions are saturated steam and water flow condition and drain flow rate to control the collapsed water level in the down-comer

  8. Assessment of human effective absorbed dose of 67 Ga-ECC based on biodistribution rat data.

    Science.gov (United States)

    Shanehsazzadeh, Saeed; Yousefnia, Hassan; Lahooti, Afsaneh; Zolghadri, Samaneh; Jalilian, Amir Reza; Afarideh, Hossien

    2015-02-01

    In a diagnostic context, determination of absorbed dose is required before the introduction of a new radiopharmaceutical to the market to obtain marketing authorization from the relevant agencies. In this work, the absorbed dose of [67 Ga]-ethylenecysteamine cysteine [(67 Ga)ECC] to human organs was determined by using distribution data for rats. For biodistribution data, the animals were sacrificed by CO2 asphyxiation at selected times after injection (0.5, 2 and 48 h, n = 3 for each time interval), then the tissue (blood, heart, lung, brain, intestine, feces, skin, stomach, kidneys, liver, muscle and bone) were removed. The absorbed dose was determined by Medical Internal Radiation Dose (MIRD) method after calculating cumulated activities in each organ. Our prediction shows that a 185-MBq injection of (67)Ga-ECC into the humans might result in an estimated absorbed dose of 0.029 mGy in the whole body. The highest absorbed doses are observed in the spleen and liver with 33.766 and 16.847 mGy, respectively. The results show that this radiopharmaceutical can be a good SPECT tracer since it can be produced easily and also the absorbed dose in each organ is less than permitted absorbed dose.

  9. A Provably-Secure ECC-Based Authentication Scheme for Wireless Sensor Networks

    Science.gov (United States)

    Nam, Junghyun; Kim, Moonseong; Paik, Juryon; Lee, Youngsook; Won, Dongho

    2014-01-01

    A smart-card-based user authentication scheme for wireless sensor networks (in short, a SUA-WSN scheme) is designed to restrict access to the sensor data only to users who are in possession of both a smart card and the corresponding password. While a significant number of SUA-WSN schemes have been suggested in recent years, their intended security properties lack formal definitions and proofs in a widely-accepted model. One consequence is that SUA-WSN schemes insecure against various attacks have proliferated. In this paper, we devise a security model for the analysis of SUA-WSN schemes by extending the widely-accepted model of Bellare, Pointcheval and Rogaway (2000). Our model provides formal definitions of authenticated key exchange and user anonymity while capturing side-channel attacks, as well as other common attacks. We also propose a new SUA-WSN scheme based on elliptic curve cryptography (ECC), and prove its security properties in our extended model. To the best of our knowledge, our proposed scheme is the first SUA-WSN scheme that provably achieves both authenticated key exchange and user anonymity. Our scheme is also computationally competitive with other ECC-based (non-provably secure) schemes. PMID:25384009

  10. Method of injecting cooling water in emergency core cooling system (ECCS) of PWR type reactor

    International Nuclear Information System (INIS)

    Sobajima, Makoto; Adachi, Michihiro; Tasaka, Kanji; Suzuki, Mitsuhiro.

    1979-01-01

    Purpose: To provide a cooling water injection method in an ECCS, which can perform effective cooling of the reactor core. Method: In a method of injecting cooling water in an ECCS as a countermeasure against a rupture accident of a pwr type reactor, cooling water in the first pressure storage injection system is injected into the upper plenum of the reactor pressure vessel at a set pressure of from 50 to 90 atg. and a set temperature of from 80 to 200 0 C, cooling water in the second pressure storage injection system is injected into the lower plenum of the reactor pressure vessel at a pressure of from 25 to 60 atg. which is lower than the set pressure and a temperature less than 60 0 C, and further in combination with these procedures, cooling water of less than 60 0 C is injected into a high-temperature side piping, in the high-pressure injection system of upstroke of 100 atg. by means of a pump and the low-pressure injection system of upstroke of 20 atg. also by means of a pump, thereby cooling the reactor core. (Aizawa, K.)

  11. A Provably-Secure ECC-Based Authentication Scheme for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Junghyun Nam

    2014-11-01

    Full Text Available A smart-card-based user authentication scheme for wireless sensor networks (in short, a SUA-WSN scheme is designed to restrict access to the sensor data only to users who are in possession of both a smart card and the corresponding password. While a significant number of SUA-WSN schemes have been suggested in recent years, their intended security properties lack formal definitions and proofs in a widely-accepted model. One consequence is that SUA-WSN schemes insecure against various attacks have proliferated. In this paper, we devise a security model for the analysis of SUA-WSN schemes by extending the widely-accepted model of Bellare, Pointcheval and Rogaway (2000. Our model provides formal definitions of authenticated key exchange and user anonymity while capturing side-channel attacks, as well as other common attacks. We also propose a new SUA-WSN scheme based on elliptic curve cryptography (ECC, and prove its security properties in our extended model. To the best of our knowledge, our proposed scheme is the first SUA-WSN scheme that provably achieves both authenticated key exchange and user anonymity. Our scheme is also computationally competitive with other ECC-based (non-provably secure schemes.

  12. Factors predisposing to early childhood caries (ECC) in children of pre-school age in the city of Zagreb, Croatia.

    Science.gov (United States)

    Lulić-Dukić, O; Jurić, H; Dukić, W; Glavina, D

    2001-06-01

    The aim of this study was to investigate factors predisposing to early childhood caries (ECC) in pre-school children in the city of Zagreb, Croatia. The investigation was carried out on the sample of 145 children (77 boys and 68 girls) aged between 2 and 5 years, including clinical examination of dental status and survey on the habits among the parents. The overall prevalence of ECC was 30%: in girls it was 25%, and in boys 48%. The study on the risk factors was designed as a classic case-control study. The mean value of dmfs index among the cases amounted to 8.6, in comparison to 5.2 in the control group (pteeth-brushing habit after first 24 months did (p importance of early introduction of teeth-brushing and giving up the nightly consumption of sweet beverages in prevention of ECC.

  13. Mechanical interaction of Engineered Cementitious Composite (ECC) reinforced with Fiber Reinforced Polymer (FRP) rebar in tensile loading

    DEFF Research Database (Denmark)

    Lárusson, Lárus Helgi; Fischer, Gregor; Jönsson, Jeppe

    2010-01-01

    This paper introduces a preliminary study of the composite interaction of Engineered Cementitious Composite (ECC), reinforced with Glass Fiber Reinforced Polymer (GFRP) rebar. The main topic of this paper will focus on the interaction of the two materials (ECC and GFRP) during axial loading......, particularly in post cracking phase of the concrete matrix. The experimental program carried out in this study examined composite behavior under monotonic and cyclic loading of the specimens in the elastic and inelastic deformation phases. The stiffness development of the composite during loading was evaluated...

  14. Factors Predisposing to Early Childhood Caries (ECC) in Children of Pre-School Age in the City of Zagreb, Croatia

    OpenAIRE

    Lulić-Dukić, O.; Jurić, H.; Dukić, W.; Glavina, D.

    2001-01-01

    The aim of this study was to investigate factors predisposing to early childhood caries (ECC) in pre-school children in the city of Zagreb, Croatia. The investigation was carried out on the sample of 145 children (77 boys and 68 girls) aged between 2 and 5 years, including clinical examination of dental status and survey on the habits among the parents. The overall prevalence of ECC was 30%: in girls it was 25%, and in boys 48%. The study on the risk factors was designed as a c...

  15. Welded tracheal stent removal in a child under cardiopulmonary bypass.

    Science.gov (United States)

    Kao, S C; Chang, W K; Pong, M W; Cheng, K W; Chan, K H; Tsai, S K

    2003-08-01

    Metallic tracheal stents have been used in the treatment of paediatric tracheomalacia for more than a decade. We describe a case in which critical airway obstruction occurred during removal of a welded tracheal stent using a rigid bronchoscope under general anaesthesia. Life-saving cardiopulmonary bypass was instituted urgently, and the welded stent was then removed successfully by directly opening the trachea.

  16. Thermal activation of dislocations in large scale obstacle bypass

    Science.gov (United States)

    Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; Martinez, Enrique

    2017-08-01

    Dislocation dynamics simulations have been used extensively to predict hardening caused by dislocation-obstacle interactions, including irradiation defect hardening in the athermal case. Incorporating the role of thermal energy on these interactions is possible with a framework provided by harmonic transition state theory (HTST) enabling direct access to thermally activated reaction rates using the Arrhenius equation, including rates of dislocation-obstacle bypass processes. Moving beyond unit dislocation-defect reactions to a representative environment containing a large number of defects requires coarse-graining the activation energy barriers of a population of obstacles into an effective energy barrier that accurately represents the large scale collective process. The work presented here investigates the relationship between unit dislocation-defect bypass processes and the distribution of activation energy barriers calculated for ensemble bypass processes. A significant difference between these cases is observed, which is attributed to the inherent cooperative nature of dislocation bypass processes. In addition to the dislocation-defect interaction, the morphology of the dislocation segments pinned to the defects play an important role on the activation energies for bypass. A phenomenological model for activation energy stress dependence is shown to describe well the effect of a distribution of activation energies, and a probabilistic activation energy model incorporating the stress distribution in a material is presented.

  17. Collins' bypass for the main ring

    International Nuclear Information System (INIS)

    Ohnuma, S.

    1982-01-01

    Design of the bypass for the main ring at Fermilab is discussed. Specific design features discussed include space, path length, geometric closure, matching of betatron functions, and external dispersion. Bypass parameters are given

  18. Dynamic Cerebral Autoregulation after Cardiopulmonary Bypass

    DEFF Research Database (Denmark)

    Christiansen, Claus Behrend; Berg, Ronan M G; Plovsing, Ronni R

    2016-01-01

    Background Cerebral hemodynamic disturbances in the peri- or postoperative period may contribute to postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). We therefore examined dynamic cerebral autoregulation (d...

  19. Modified ECC ozone sonde for long-duration flights aboard isopicnic drifting balloons

    Science.gov (United States)

    Gheusi, Francois; Durand, Pierre; Verdier, Nicolas; Dulac, François; Attié, Jean-Luc; Commun, Philippe; Barret, Brice; Basdevant, Claude; Clénet, Antoine; Fontaine, Alain; Jambert, Corinne; Meyerfeld, Yves; Roblou, Laurent; Tocquer, Flore

    2015-04-01

    Since few years, the French space agency CNES has developed boundary-layer pressurized balloons (BLPB) with the capability to transport scientific payloads at isopicnic level over very long distances and durations (up to several weeks in absence of navigation limits). However, the autonomy of conventional electrochemical concentration cell (ECC) ozone sondes, that are widely used for tropospheric and stratospheric soundings, is limited to few hours due to power consumption and electrolyte evaporation (owing to air bubbling in the cathode solution). In collaboration with the French research community, CNES has developed a new ozone payload suited for long duration flights aboard BLPB. The mechanical elements (Teflon pump and motor) and the electrochemical cell of conventional ECC sondes have been kept but the electronic implementation is entirely new. The main feature is the possibility of programming periodic measurement sequences -- with possible remote control during the flight. To increase the ozone sonde autonomy, a strategy has been adopted of short measurement sequences (typically 2-3 min) regularly spaced in time (e.g. every 15 min, which is usually sufficient for air quality studies). The rest of the time, the sonde is at rest (pump motor off). The response time of an ECC sonde to an ozone concentration step is below one minute. Consequently, the measurement sequence is typically composed of a one-minute spin-up period after the pump has been turned on, followed by a one- to two-minute acquisition period. All time intervals can be adjusted before and during the flight. Results of a preliminary ground-based test in spring 2012 are first presented. The sonde provided correct ozone concentrations against a reference UV analyzer every 15 minutes during 4 days. Then we illustrate results from 16 BLBP flights launched in the low troposphere over the Mediterranean during summer field campaings in 2012 and 2013 (TRAQA and ChArMEx programmes). BLPB drifting

  20. Adapted ECC ozonesonde for long-duration flights aboard boundary-layer pressurised balloons

    Science.gov (United States)

    Gheusi, François; Durand, Pierre; Verdier, Nicolas; Dulac, François; Attié, Jean-Luc; Commun, Philippe; Barret, Brice; Basdevant, Claude; Clenet, Antoine; Derrien, Solène; Doerenbecher, Alexis; El Amraoui, Laaziz; Fontaine, Alain; Hache, Emeric; Jambert, Corinne; Jaumouillé, Elodie; Meyerfeld, Yves; Roblou, Laurent; Tocquer, Flore

    2016-12-01

    Since the 1970s, the French space agency CNES has developed boundary-layer pressurised balloons (BLPBs) with the capability to transport lightweight scientific payloads at isopycnic level and offer a quasi-Lagrangian sampling of the lower atmosphere over very long distances and durations (up to several weeks).Electrochemical concentration cell (ECC) ozonesondes are widely used under small sounding balloons. However, their autonomy is limited to a few hours owing to power consumption and electrolyte evaporation. An adaptation of the ECC sonde has been developed specifically for long-duration BLPB flights. Compared to conventional ECC sondes, the main feature is the possibility of programming periodic measurement sequences (with possible remote control during the flight). To increase the ozonesonde autonomy, the strategy has been adopted of short measurement sequences (2-3 min) regularly spaced in time (e.g. every 15 min). The rest of the time, the sonde pump is turned off. Results of preliminary ground-based tests are first presented. In particular, the sonde was able to provide correct ozone concentrations against a reference UV-absorption ozone analyser every 15 min for 4 days. Then we illustrate results from 16 BLBP flights launched over the western Mediterranean during three summer field campaigns of the ChArMEx project (http://charmex.lsce.ipsl.fr): TRAQA in 2012, and ADRIMED and SAFMED in 2013. BLPB drifting altitudes were in the range 0.25-3.2 km. The longest flight lasted more than 32 h and covered more than 1000 km. Satisfactory data were obtained when compared to independent ozone measurements close in space and time. The quasi-Lagrangian measurements allowed a first look at ozone diurnal evolution in the marine boundary layer as well as in the lower free troposphere. During some flight segments, there was indication of photochemical ozone production in the marine boundary layer or even in the free troposphere, at rates ranging from 1 to 2 ppbv h -1, which

  1. Large break LOCA analysis for retrofitted ECCS at MAPS using modified computer code ATMIKA

    International Nuclear Information System (INIS)

    Singhal, Mukesh; Khan, T.A.; Yadav, S.K.; Pramod, P.; Rammohan, H.P.; Bajaj, S.S.

    2002-01-01

    Full text: Computer code ATMIKA which has been used for thermal hydraulic analysis is based on unequal velocity equal temperature (UVET) model. Thermal hydraulic transient was predicted using three conservation equations and drift flux model. The modified drift flux model is now able to predict counter current flow and the relative velocity in vertical channel more accurately. Apart from this, stratification model is also introduced to predict the fuel behaviour under stratified condition. Many more improvements were carried out with respect to solution of conservation equation, heat transfer package and frictional pressure drop model. All these modifications have been well validated with published data on RD-12/RD-14 experiments. This paper describes the code modifications and also deals with the application of the code for the large break LOCA analysis for retrofitted emergency core cooling system (ECCS) being implemented at Madras Atomic Power Station (MAPS). This paper also brings out the effect of accumulator on stratification and fuel behaviour

  2. Experiment data report for Semiscale Mod-1 Test S-05-1 (alternate ECC injection test)

    International Nuclear Information System (INIS)

    Feldman, E.M.; Patton, M.L. Jr.; Sackett, K.E.

    1977-02-01

    Recorded test data are presented for Test S-05-1 of the Semiscale Mod-1 alternate ECC injection test series. These tests are among several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor (PWR) system. Test S-05-1 was conducted from initial conditions of 2263 psia and 544 0 F to investigate the response of the Semiscale Mod-1 system to a depressurization and reflood transient following a simulated double-ended offset shear of the cold leg broken loop piping. During the test, cooling water was injected into the vessel lower plenum to simulate emergency core coolant injection in a PWR, with the flow rate based on system volume scaling

  3. A Secure ECC-based RFID Mutual Authentication Protocol to Enhance Patient Medication Safety.

    Science.gov (United States)

    Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Li, Fagen

    2016-01-01

    Patient medication safety is an important issue in patient medication systems. In order to prevent medication errors, integrating Radio Frequency Identification (RFID) technology into automated patient medication systems is required in hospitals. Based on RFID technology, such systems can provide medical evidence for patients' prescriptions and medicine doses, etc. Due to the mutual authentication between the medication server and the tag, RFID authentication scheme is the best choice for automated patient medication systems. In this paper, we present a RFID mutual authentication scheme based on elliptic curve cryptography (ECC) to enhance patient medication safety. Our scheme can achieve security requirements and overcome various attacks existing in other schemes. In addition, our scheme has better performance in terms of computational cost and communication overhead. Therefore, the proposed scheme is well suitable for patient medication systems.

  4. Experiment data report for Semiscale Mod-1 Test S-05-3 (alternate ECC injection test)

    International Nuclear Information System (INIS)

    Feldman, E.M.; Patton, M.L. Jr.; Sackett, K.E.

    1977-03-01

    Recorded test data are presented for Test S-05-3 of the Semiscale Mod-1 alternate ECC injection test series. These tests are among several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor (PWR) system. Test S-05-3 was conducted from initial conditions of 2263 psia and 545 0 F to investigate the response of the Semiscale Mod-1 system to a depressurization and reflood transient following a simulated double-ended offset shear of the cold leg broken loop piping. During the test, cooling water was injected into the cold leg sides of the intact and broken loops and into the vessel upper plenum to simulate emergency core coolant injection in a PWR. For Test S-05-3, specifically the effects of upper plenum coolant injection on core thermal and system response were being investigated

  5. Interventions in Infrainguinal Bypass Grafts

    International Nuclear Information System (INIS)

    Mueller-Huelsbeck, S.; Order, B.-M.; Jahnke, T.

    2006-01-01

    The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft

  6. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    ... MIDCAB; Robot-assisted coronary artery bypass; RACAB; Keyhole heart surgery; CAD - MIDCAB; Coronary artery disease - MIDCAB ... To perform this surgery: The heart surgeon will make a 3- to 5-inch (8 to 13 centimeters) surgical cut in the left part of your chest ...

  7. Guideline on in-service testing (IST) of ECCS for nuclear power stations in Japan

    International Nuclear Information System (INIS)

    Yamashita, N.; Honjin, M.; Yamazaki, M.; Iwami, H.

    2001-01-01

    In Japan, METI (Ministry of Economy, Trade and Industry) periodic inspections are conducted every 13 months in accordance with the EUIL (Electric Utility Industry Law) for light water reactors. On the other hand, during operation, many kinds of function tests are conducted in accordance with Technical Specifications or utilities voluntary test procedures. However, these maintenance activities during outages are in other respects considered too costly and more than necessary because of its predetermined maintenance interval and its old-fashioned full scope maintenance menu. In these circumstances, the ASME O and M Codes and Standards, which are applied to nuclear power plants in the United States, came to be one of the issues to be considered among Japanese utilities. This is because the ASME O and M Codes and Standards, which are developed to verify the operational readiness of equipment or systems by condition based maintenance or performance testing without overhauls, will be considered to suggest a rational alternative to our existing maintenance activities. Because there had been no standard for function tests other than the METI inspection procedures in Japan, activities started for the development of Japanese Operation and Maintenance Guideline (hereinafter called the Japanese OM Guideline or the Guideline) for function tests and condition monitoring. The Japanese OM Guideline is not proclaimed for regulatory use, but the long-term objective is to provide a substantial basis to change the current maintenance activities including regulatory inspection. The Guideline is composed of five parts, which are general requirements, pumps, valves, snubbers and ECCS systems. This paper gives a summary of the ECCS part of the Japanese OM Guideline, in particular, focusing on the differences between the Guideline and the ASME O and M Standards, and topics or discussion during their establishment. (author)

  8. Performance-based ECCS cladding acceptance criteria: A new simulation approach

    International Nuclear Information System (INIS)

    Zoino, A.; Alfonsi, A.; Rabiti, C.; Szilard, R.H.; Giannetti, F.; Caruso, G.

    2017-01-01

    Highlights: • A new methodology to demonstrate compliance with the new ECCS acceptance criteria is described. • A wide spectrum of fuel rod initial burnup states can be analysed in the design phase. • The coupled suite PHISICS/RELAP5-3D has been used in the analyses. • A demo simulation of the equilibrium cycle, load-following and a LOCA analysis has been performed. - Abstract: The U.S. Nuclear Regulatory Commission is currently proposing rulemaking to revise the Loss Of Coolant Accident (LOCA) and therefore the Emergency Core Cooling System (ECCS) acceptance criteria, to include the effects of higher burnup on cladding performance as well as to address other technical issues. As motivated by the new rule, the need to use advanced cladding designs may be a result. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost, as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently, there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin. The study here presented has been part of a big project used to investigate technical issues and approaches for future industrial applications within the Risk-Informed Safety Margin Characterization (RISMC) Pathway. Specifically, the primary aim of this study is to lay out a roadmap to demonstrate the application of the new methodology. The present analysis shows a simplified version of the methodology of an industrial application on the Core Design and the Multi-Cycle Analysis.

  9. Equally increased hypercoagulability irrespective of using minimized or conventional ECC systems

    DEFF Research Database (Denmark)

    Steinbrüchel, Ann S; Johansson, Pär I; Rafiq, Sulman

    2012-01-01

    Minimized extracorporeal circulation systems in coronary artery bypass may have less impairing effect on hematological parameters and bleeding compared to conventional systems. The aim of this study was to investigate whether the use of mini systems does result in an increased postoperative...

  10. Incorporating Indigenous Knowledge and Practice into ECCE: A Comparison of Programs in The Gambia, Senegal and Mali

    Science.gov (United States)

    Soudee, Alicia Ranck

    2009-01-01

    Early Childhood Development (ECD) has emerged as a theme in international and African dialogue on education in recent years. UNESCO's Division of Basic Education Early Childhood promotes an integrated approach to Early Childhood Care and Education (ECCE) policy development and review. The study examines how this is implemented in three West…

  11. Simultaneous algae-polluted water treatment and electricity generation using a biocathode-coupled electrocoagulation cell (bio-ECC).

    Science.gov (United States)

    Dong, Yue; Qu, Youpeng; Li, Chao; Han, Xiaoyu; Ambuchi, John J; Liu, Junfeng; Yu, Yanling; Feng, Yujie

    2017-10-15

    How to utilize electrocoagulation (EC) technology for algae-polluted water treatment in an energy-efficient manner remains a critical challenge for its widespread application. Herein, a novel biocathode-coupled electrocoagulation cell (bio-ECC) with sacrificial iron anode and nitrifying biocathode was developed. Under different solution conductivities (2.33±0.25mScm -1 and 4.94±0.55mScm -1 ), the bio-ECC achieved almost complete removal of algae cells. The maximum power densities of 8.41 and 11.33Wm -3 at corresponding current densities of 48.03Am -3 and 66.26Am -3 were obtained, with the positive energy balance of 4.52 and 7.44Wm -3 . In addition, the bio-ECC exhibited excellent NH 4 + -N removal performance with the nitrogen removal rates of 7.28mgL -1 h -1 and 6.77mgL -1 h -1 in cathode chamber, indicating the superiority of bio-ECC in NH 4 + -N removal. Pyrosequencing revealed that nitrifiers including Nitrospira, Nitrobacter, Nitrosococcus, and Nitrosomonas were enriched in biocathode. The removal mechanisms of algae in anode chamber were also explored by AFM and SEM-EDX tests. These results provide a proof-of-concept study of transferring energy-intensive EC process into an energy-neutral process with high-efficiency algae removal and electricity recovery. Copyright © 2017. Published by Elsevier B.V.

  12. Simulation of strain-hardening in ECC uniaxial test specimen by use of a damage mechanics formulation

    DEFF Research Database (Denmark)

    Dick-Nielsen, Lars; Stang, Henrik; Poulsen, Peter Noe

    2006-01-01

    scale it is shown that the cohesive law for a unidirectional fiber reinforced cementitious composite can be found through superposition of the cohesive law for mortar and the fiber bridging curve. On the meso scale I it is shown that the maximum crack opening observed during crack propagation in ECC...

  13. Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report

    International Nuclear Information System (INIS)

    Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W.

    1995-10-01

    This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken

  14. Failure Mode and Effects Analysis (FMEA) of the Emergency Core Cooling System (ECCS) for a Westinghouse type 312, three loop pressurized water reactor

    International Nuclear Information System (INIS)

    Shopsky, W.E.

    1977-01-01

    The Emergency Core Cooling System (ECCS) is a Safeguards System designed to cool the core in the unlikely event of a Loss-of-Coolant Accident (LOCA) in the primary reactor coolant system as well as to provide additional shutdown capability following a steam break accident. The system is designed for a high reliability of providing emergency coolant and shutdown reactivity to the core for all anticipated occurrences of such accidents. The ECCS by performing its intended function assures that fuel and clad damage is minimized during accident conditions thus reducing release of fission products from the fuel. The ECCS is designed to perform its function despite sustaining a single failure by the judicious use of equipment and flow path redundancy within and outside the containment structure. By the use of an analytic tool, a Failure Mode and Effects Analysis (FMEA), it is shown that the ECCS is in compliance with the Single Failure Criterion established for active failures of fluid systems during short and long term cooling of the reactor core following a LOCA or steam break accident. An analysis was also performed with regards to passive failure of ECCS components during long-term cooling of the core following an accident. The design of the ECCS was verified as being able to tolerate a single passive failure during long-term cooling of the reactor core following an accident. The FMEA conducted qualitatively demonstrates the reliability of the ECCS (concerning active components) to perform its intended safety function

  15. 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...

  16. Bypass flow rate control method

    International Nuclear Information System (INIS)

    Kiyama, Yoichi.

    1997-01-01

    In a PWR type reactor, bypass flow rate is controlled by exchanging existent jetting hole plugs of a plurality of nozzles disposed to the upper end of incore structures in order to flow a portion of primary coolants as a bypass flow to the upper portion of the pressure vessel. Two kinds of exchange plugs, namely, a first plug and a second plug each having a jetting out hole of different diameter are used as exchange plugs. The first plug has the diameter as that of an existent plug and the second plug has a jetting out hole having larger diameter than that of the existent plug. Remained extent plugs are exchanged to a combination of the first and the second plugs without exchanging existent plugs having seizing with the nozzles, in which the number and the diameter of the jetting out holes of the second plugs are previously determined based on predetermined total bypass flow rate to be jetted from the entire plugs after exchange of plugs. (N.H.)

  17. Minimized extracorporeal circulation system in coronary artery bypass surgery: a 10-year single-center experience with 2243 patients.

    Science.gov (United States)

    Puehler, Thomas; Haneya, Assad; Philipp, Alois; Zausig, York A; Kobuch, Reinhard; Diez, Claudius; Birnbaum, Dietrich E; Schmid, Christof

    2011-04-01

    Coronary artery bypass grafting (CABG) is the gold standard for the surgical therapy of multivessel coronary artery disease. To reduce the side effects, associated with standard extracorporeal circulation (ECC), a concept of minimal extracorporeal circulation (MECC) was devised in our center. We report on our 10-year experience with the MECC for coronary revascularization. From January 1998 to August 2009, 2243 patients underwent CABG with MECC in our center. In a retrospective observational study, we analyzed indication, preoperative patient co-morbidity, postoperative clinical course, and perioperative outcome of all patients operated on with MECC. Furthermore, the risk factors for mortality in the MECC group were assessed. Patients showed a mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 4.5±0.1%. The mean age of the patients was 66.8±9.1 years. The overall 30-day mortality after CABG with MECC was 2.3%, ranging from 1.1% for elective to 13.0% for emergent patients and was significantly better than standard ECC. Only 15.3% (n=344) of patients with MECC required intra-operative blood transfusion. Postoperative catecholamine support, red blood cell transfusion, need for hemodialysis, release of creatinine kinase, incidence of stroke, and postoperative delirium were low after MECC revascularization. Ejection fraction below 30% (odds ratio (OR): 5.1), emergent operation (OR: 9.4), and high-dose catecholamine therapy (OR: 2.6) were associated predictors for mortality. MECC until now is an established concept and has become an alternative for ECC in routine CABG in our center. The use of the MECC system is associated with low mortality and conversion rate. Excellent survival rates and low transfusion requirements in the perioperative course were achieved. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  18. Estimated net value and uncertainty for automating ECCS switchover at PWRs

    International Nuclear Information System (INIS)

    Walsh, B.; Brideau, J.; Comes, L.; Darby, J.; Guttmann, H.; Sciacca, F.; Souto, F.; Thomas, W.; Zigler, G.

    1996-02-01

    Question for resolution of Generic Safety Issue No. 24 is whether or not PWRs that currently rely on a manual system for ECCS switchover to recirculation should be required to install an automatic system. Risk estimates are obtained by reevaluating the contributions to core damage frequencies (CDFs) associated with failures of manual and semiautomatic switchover at a representative PWR. This study considers each separate instruction of the corresponding emergency operating procedures (EOPs), the mechanism for each control, and the relation of each control to its neighbors. Important contributions to CDF include human errors that result in completely coupled failure of both trains and failure to enter the required EOP. It is found that changeover to a semiautomatic system is not justified on the basis of cost-benefit analysis: going from a manual to a semiautomatic system reduces the CDF by 1.7 x 10 -5 per reactor-year, but the probability that the net cost of the modification being less than $1, 000 per person-rem is about 20% without license renewal. Scoping analyses, using optimist assumptions, were performed for a changeover to a semiautomatic system with automatic actuation and to a fully automatic system; in these cases the probability of a net cost being less than $1,000/person-rem is about 50% without license renewal and over 95% with license renewal

  19. Experiment data report for semiscale Mod-1 test S-04-1 (baseline ECC test)

    International Nuclear Information System (INIS)

    Crapo, H.S.; Collins, B.L.; Sackett, K.E.

    1976-09-01

    Recorded test data are presented for Test S-04-1 of the Semiscale Mod-1 Baseline ECC Test Series. This test is among several Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor system. Test S-04-1 was conducted from an initial cold leg fluid temperature of 542 0 F and an initial pressure of 2,263 psia. A simulated double-ended offset shear cold leg break was used to investigate the system response to a depressurization and reflood transient using system volume scaled coolant injection parameters. System flow was set to achieve a core fluid temperature differential of 66 0 F at a full core power of 1.6 MW. The flow resistance of the intact loop was based on core area scaling. An electrically heated core with a flat radial power profile was used in the pressure vessel to simulate the effects of a nuclear core. During system depressurization, core power was reduced from the initial level of 1.6 MW in such a manner as to simulate the surface heat flux response of nuclear fuel rods until such time that departure from nucleate boiling might occur. Blowdown to the pressure suppression system was accompanied by simulated emergency core cooling injection into both the intact and broken loops. Coolant injection was continued until test termination at 200 seconds after initiation of blowdown

  20. A robust ECC based mutual authentication protocol with anonymity for session initiation protocol.

    Science.gov (United States)

    Mehmood, Zahid; Chen, Gongliang; Li, Jianhua; Li, Linsen; Alzahrani, Bander

    2017-01-01

    Over the past few years, Session Initiation Protocol (SIP) is found as a substantial application-layer protocol for the multimedia services. It is extensively used for managing, altering, terminating and distributing the multimedia sessions. Authentication plays a pivotal role in SIP environment. Currently, Lu et al. presented an authentication protocol for SIP and profess that newly proposed protocol is protected against all the familiar attacks. However, the detailed analysis describes that the Lu et al.'s protocol is exposed against server masquerading attack and user's masquerading attack. Moreover, it also fails to protect the user's identity as well as it possesses incorrect login and authentication phase. In order to establish a suitable and efficient protocol, having ability to overcome all these discrepancies, a robust ECC-based novel mutual authentication mechanism with anonymity for SIP is presented in this manuscript. The improved protocol contains an explicit parameter for user to cope the issues of security and correctness and is found to be more secure and relatively effective to protect the user's privacy, user's masquerading and server masquerading as it is verified through the comprehensive formal and informal security analysis.

  1. A robust ECC based mutual authentication protocol with anonymity for session initiation protocol.

    Directory of Open Access Journals (Sweden)

    Zahid Mehmood

    Full Text Available Over the past few years, Session Initiation Protocol (SIP is found as a substantial application-layer protocol for the multimedia services. It is extensively used for managing, altering, terminating and distributing the multimedia sessions. Authentication plays a pivotal role in SIP environment. Currently, Lu et al. presented an authentication protocol for SIP and profess that newly proposed protocol is protected against all the familiar attacks. However, the detailed analysis describes that the Lu et al.'s protocol is exposed against server masquerading attack and user's masquerading attack. Moreover, it also fails to protect the user's identity as well as it possesses incorrect login and authentication phase. In order to establish a suitable and efficient protocol, having ability to overcome all these discrepancies, a robust ECC-based novel mutual authentication mechanism with anonymity for SIP is presented in this manuscript. The improved protocol contains an explicit parameter for user to cope the issues of security and correctness and is found to be more secure and relatively effective to protect the user's privacy, user's masquerading and server masquerading as it is verified through the comprehensive formal and informal security analysis.

  2. FPGA implementation of PCI to CAMAC interface for Embedded CAMAC Controller (ECC)

    International Nuclear Information System (INIS)

    Jha, K.; Behere, Anita; Ghodgaonkar, M.D.

    2005-01-01

    CAMAC controllers are used for control systems and nuclear physics experiments. Control applications need more number of physically distributed crates with regular scanning of all the parameters, the control being with a centralized computer. On the other hand, nuclear physics experiments need a high throughput with a large number of parameters in one or more crates. The nature of events is random hence buffering of data in LIST mode acquisition is needed. For a large number of parameters, this translates to high transfer rate. Hence it is essential that the CAMAC readout time is minimized and also the data transfer speed is improved to achieve maximum effective throughput. The ECC is designed to achieve these objectives using an embedded controller with PC architecture having PCI bus as interface for add on logic. The PCI Add-on to CAMAC interface protocol has been implemented in an AL TERA FPGA and all the functionality coded in VHDL. This paper discusses the design aspects of the FPGA implementation of the PCI to CAMAC interface. (author)

  3. Water-hammer in the cold leg during an SBLOCA due to cold ECCS injection

    International Nuclear Information System (INIS)

    Ortiz, M.G.; Ghan, L.S.

    1991-01-01

    Water-hammer might occur in the cold leg of pressurized water reactors (PWR) during small break loss-of-coolant accidents (SBLOCA's), when cold emergency core cooling system (ECCS) water is injected into a pipe that may be partially filled with saturated steam. The water may mix with the steam and cause it to condense abruptly. Depending on the flow regime present, slugs of liquid may then be accelerated towards each other or against the piping structure. The possibility of this phenomenon is of concern to us because it may become a dominant phenomenon and change the character of the transient. In performing the code scaling, applicability, and uncertainty study (CSAU) on a SBLOCA scenario, we had to examine the possibility that the transient being analyzed could experience water-hammer and thus depart from the scope of the study. Two criteria for water-hammer initiation were investigated and tested using a RELAP5/MOD3 simulation of the transient. Our results indicated a very low likelihood of occurrence of the phenomenon. 8 refs., 6 figs

  4. Safety evaluation report on Westinghouse Electric Company ECCS evaluation model for plants equipped with upper head injection

    International Nuclear Information System (INIS)

    Lauben, G.N.; Wagner, N.H.; Israel, S.L.; McPherson, G.D.; Hodges, M.W.

    1978-04-01

    For plants which include an ice condenser containment concept, Westinghouse has planned an additional safety system known as the upper head injection (UHI) system to augment the emergency core cooling system. This system is comprised of additional accumulator tanks and piping arranged to supply cooling water to the top of the core during the blowdown period following a postulated large-break loss-of-coolant accident (LOCA). The objective of UHI is to add to the core cooling provided by the conventional emergency core cooling system (ECCS) and so permit operation at linear heat rates comparable to those permitted in plants utilizing the dry containment concept. In this way, plants which include the UHI system would have greater operating flexibility while still meeting the acceptance criteria as defined in paragraph 50.46 of 10 CFR Part 50. This review is concerned with those changes to the Westinghouse ECCS evaluation model that have been proposed for the UHI-LOCA model

  5. Risk-based assessment of the allowable outage times for the unit 1 leningrad nuclear power plant ECCS components

    International Nuclear Information System (INIS)

    Koukhar, Sergey; Vinnikov, Bronislav

    2009-01-01

    Present paper describes a method for risk - informed assessment of the Allowable Outage Times (AOTs). The AOT is the time, when components of a safety system allowed to be out of service during power operation or during shutdown operation off a plant. If the components are not restored during the time, the plant in operation must be shut down or the plant in a given shutdown mode has to go to safer shutdown mode. Application of the method is also provided for the equipment of the Unit 1 Leningrad NPP ECCS components. For solution of the problem it is necessary to carry out two series of computations using a Living PSA model, level 1. In the first series of the computations the core damage frequency (CDFb) for the base configuration of the plant is determined (there is no equipment out of service). Here the symbol 'b' means the base configuration of a plant. In the second series of the computations the core damage frequency (CDFi) for the configuration of the plant with the component (which is out of service) is calculated. That is here CDFi is determined for the failure probability of the component equal to 1.0 (component 'i' is unavailable). Then it is necessary to determine so called Risk Increase Factor (RIF) using the following ratio: RIFi = CDFi / CDFb. At last the AOT is calculated with the help of the ratio: AOTi = Tppr / RIFi, where Tppr is a period of time between two Planned Preventive Repairs (PPRs). 1. Using the risk based approach the AOTs were calculated for a set of the components of the Unit 1 Leningrad NPP ECCS components. 2. The main conclusion from the analysis is that the current deterministic AOTs for the ECCS components are conservative and should be extended. 3. The risk based extension of the AOTs for the ECCS components can prevent the Unit 1 Leningrad NPP to enter into the operating modes with increased risk. (author)

  6. Comprehensive Oral Health Care to Reduce the Incidence of Severe Early Childhood Caries (s-ECC) in Urban China.

    Science.gov (United States)

    Si, Yan; Guo, Yan; Yuan, Chao; Xu, Tao; Zheng, Shu Guo

    2016-03-01

    To explore the effectiveness of comprehensive oral health care to reduce the caries incidence for children with severe early childhood caries (s-ECC) in an urban area in China. A total of 357 children aged 3 to 4 years old and diagnosed with s-ECC were recruited in this randomised controlled, single-blinded clinical trial for 1 year. Children of two different kindergarten classes were enrolled in this study and randomly divided into a test group (205 children) and a control group (152 children). The test group received comprehensive oral health care, which included: oral health examination, oral health education, topical fluoride application and dental treatment, and the children in the control group only received the oral health examination. The evaluation of the oral health questionnaire for parents was also performed. An evaluation was carried out at the time of recruitment and 1 year later to explore the effectiveness of the comprehensive oral health care model. The differences in decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), filled tooth surfaces (fs) and the ratio of ft /(dt + ft) between the two groups were statistically significant (P comprehensive oral health care program reduces and prevents caries amongst children with s-ECC.

  7. 75 FR 71145 - San Joaquin River Restoration Program: Reach 4B, Eastside Bypass, and Mariposa Bypass Channel and...

    Science.gov (United States)

    2010-11-22

    ..., Eastside Bypass, and Mariposa Bypass Channel and Structural Improvements Project, Merced County, CA AGENCY... on the effects of the proposed Reach 4B, Eastside Bypass, and Mariposa Bypass Channel and Structural... Mariposa Bypass with the San Joaquin River (generally referred to as Reach 4B1). The improvements will...

  8. Successful use of continuous vasodilator infusion to treat critical vasospasm threatening a distal bypass

    OpenAIRE

    Gregory A. Magee, MD, MSc; Anastasia Plotkin, MD; Jeniann A. Yi, MD, MS; Kathryn E. Bowser, MD; David P. Kuwayama, MD, MPA

    2018-01-01

    Vasospasm immediately after lower extremity arterial bypass may represent an uncommon cause of early graft failure. We report a successful case of catheter-directed, intra-arterial continuous vasodilator infusion to salvage a bypass graft threatened by severe, refractory vasospasm after incomplete response to nicardipine, verapamil, and nitroglycerin boluses. A continuous nitroglycerin infusion was administered for 24 hours, by which time the vasospasm resolved. At 12 months postoperatively, ...

  9. Comparison of allele frequency for HLA-DR and HLA-DQ between patients with ECC and caries-free children

    OpenAIRE

    Bagherian A; Nematollahi H; Afshari J; Moheghi N

    2008-01-01

    Background: Early childhood caries (ECC) is one of the most common diseases of childhood. The etiology of ECC is multifactorial and both genetic and environmental factors play important roles in the pathogenesis of the disease. Genetic variations in the hosts may contribute to changes in the risk for dental caries. Genetic factors such as human leukocyte antigen (HLA) have recently been suggested as a predisposing factor. Aim: The aim of this study was to look for an association between HLA-D...

  10. 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.

  11. Effects of high temperature ECC injection on small and large break BWR LOCA simulation tests in ROSA-III program (RUNs 940 and 941)

    International Nuclear Information System (INIS)

    Suzuki, Mitsuhiro; Nakamura, Hideo; Kumamaru, Hiroshige; Anoda, Yoshinari; Yonomoto, Taisuke; Murata, Hideo; Tasaka, Kanji

    1990-03-01

    The ROSA-III program, of which principal results are summarized in a report of JAERI 1307, conducted small and large-break loss-of-coolant experiments (RUNs 940 and 941) with high water temperature of the emergency core cooling system (ECCS) are one of the parametric study with respect to the ECCS effect on core cooling. This report presents all the experiment results of these two tests and describes additional finding with respect to the hot ECC effects on core cooling phenomena. By comparing these two tests (water temperature of 393 K) with the standard ECC tests of RUNs 922 and 926 (water temperature of 313 K), it was found that the ECC subcooling variation had a small influence on the core cooling phenomena in 5 % small break tests but had larger influence on them in 200 % break tests. The ECC subcooling effects described in the previous report are reviewed and the temperature distribution in the pressure vessel is investigated for these four tests. (author)

  12. Comparison of allele frequency for HLA-DR and HLA-DQ between patients with ECC and caries-free children

    Directory of Open Access Journals (Sweden)

    Bagherian A

    2008-03-01

    Full Text Available Background: Early childhood caries (ECC is one of the most common diseases of childhood. The etiology of ECC is multifactorial and both genetic and environmental factors play important roles in the pathogenesis of the disease. Genetic variations in the hosts may contribute to changes in the risk for dental caries. Genetic factors such as human leukocyte antigen (HLA have recently been suggested as a predisposing factor. Aim: The aim of this study was to look for an association between HLA-DRB1 and HLA-DQB1 with ECC for developing new strategies for the diagnosis as well as the prevention of the disease. Design: In this study, we extracted the genomic DNAs from whole blood samples of 44 patients with ECC and 35 caries-free children by the salting-out method. We amplified the genomic DNA by PCR-SSP and then HLA-typing was performed for all alleles. Results: The results revealed a significant increase in the frequency of HLA-DRB1FNx0104 in the patient group (P = 0.019. The odds ratio for this allele was detected to be 10. The frequency of HLA-DQB1 alleles was not significantly different between the two groups. Conclusion: The above results suggest that HLA-DRB1FNx0104 is associated with the susceptibility to ECC. Thus HLA-DRB1FNx0104 detection as a molecular marker for early diagnosis of ECC may be recommended.

  13. Evaluation of the long duration efficiency of the ECC storage facility of Cogema La Hague plant

    International Nuclear Information System (INIS)

    Baganz, C.; Bouland, P.; Breton, E.

    2004-01-01

    The ECC facility of Cogema La Hague has been designed in view of the storage of 24000 CSD-C type containers produced by the ACC facility. It comprises a reception and unloading unit, and a modular storage unit (alveoles). The safety of the facility is based on: a controlled ventilation (low pressurization rooms, controlled atmosphere, heat and toxic gases evacuation), a construction ensuring the static confinement, the sub-criticality and the radiological protection, and the possibility of natural ventilation of the alveoles (earthquake-dimensioned equipments). On the basis of these safety functions, the conformability of the facility with respect to long duration has been analyzed considering three aspects of the facility: the infrastructure, the waste packages and the ventilation system. In normal operation, a foreseeable service life of at least 100 years is established: simpleness and accessibility of ventilation systems, no significant corrosion of packages, durability of the reinforced concrete structure. The demonstration of a service life greater than 100 years would require the improvement of our knowledge about concretes in terms of experience feedback. The behaviour of the facility in terms of loss of technical mastery has been considered too. The scenario retained for this situation is the prolonged stoppage (several months or years) of the nuclear ventilation after a 100 years of disposal. After this period of time, both the thermal power and the hydrogen generation from waste packages will have significantly diminished, allowing a loss of technical mastery era of several years with no impact on concretes integrity. However, during long situations of non-controlled atmosphere, the corrosion behaviour of stainless steels is not predictable. (J.S.)

  14. Experiment data report for semiscale Mod-1 test S-04-2 (baseline ECC test)

    International Nuclear Information System (INIS)

    Crapo, H.S.; Collins, B.L.; Sackett, K.E.

    1976-09-01

    Recorded test data are presented for Test S-04-2 of the Semiscale Mod-1 Baseline ECC test series. This test is among Semiscale Mod-1 experiments conducted to investigate the thermal and hydraulic phenomena accompanying a hypothesized loss-of-coolant accident in a pressurized water reactor system. Test S-04-2 was conducted from an initial cold leg fluid temperature of 542 0 F and an initial pressure of 2,263 psia. A simulated double-ended offset shear cold leg break was used to investigate the system response to a depressurization and reflood transient using emergency core coolant injection parameters based on downcomer volume scaling. System flow was set to achieve a core fluid temperature differential of 66 0 F at a full core power of 1.6 MW. The flow resistance of the intact loop was based on core area scaling. An electrically heated core with a flat radial power profile was used in the pressure vessel to simulate the effects of a nuclear core. During system depressurization, core power was reduced from the initial level of 1.6 MW to simulate the surface heat flux response of nuclear fuel rods until such sime that departure from nucleate boiling might occur. Blowdown to the pressure suppression system was accompanied by simulated emergency core coolant injection into both the intact and broken loops. Coolant injection was continued until test termination at 200 seconds after initiation of blowdown. The purpose of the report is to make available the uninterpreted data from Test S-04-2 for future data analysis and test results reporting activities. The data, presented in the form of graphs in engineering units, have been analyzed only to the extent necessary to assure that they are reasonable and consistent

  15. [Coronary artery bypass grafting without use of cardiopulmonary bypass].

    Science.gov (United States)

    Mujanović, Emir; Bergsland, Jacob; Hadziselimović, Mehdin; Softić, Muniba; Azabagic, Azur; Stanimirović-Mujanović, Sanja; Kabil, Emir

    2002-01-01

    Although it is possible to find a number of comparative studies in the world literature discussing the results of coronary artery bypass surgery (CABG) with and without cardiopulmonary bypass (CPB), until now such analysis has not been made in Bosnia and Herzegovina. The main aim of this scientific work was to compare morbidity and mortality, need for blood transfusions, length of stay in the intensive care unit and total length of hospitalisation in two groups of patients operated with these methods. One hundred and four patients with coronary artery disease operated in Cardiovascular Clinic Tuzla, from September, 1998 to September 2002 divided in two groups, were included in this study. There were 52 patients in the first group operated with CPB and 52 patients in the second group operated without CPB. The groups were matched for gender, age, ejection fraction and preoperative risk factors. The incidence of postoperative complications was lower in patients operated without CPB (5.77% vs. 21.15%). The mortality rate was reduced in patients operated without CPB (0.00% vs. 5.76%). There were reduced need for transfusion in patients operated without CPB (0.28 vs. 1.11 units of blood). The average time spent on respirators was shorter in patients operated without CPB (1.50 vs. 4.76 hours). The average time of total hospitalisation was also shorter in patients operated withouth CPB (6.53 vs. 8.13 days). In conclusion CABG without CPB has many advantages compared to the conventional method. Mortality and morbidity are reduced and there is less need for transfusion. The time spent on mechanical ventilation is reduced and less time is spent in intensive care and the total hospitalisation time is also less.

  16. In situ bypass og diabetes

    DEFF Research Database (Denmark)

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

    1993-01-01

    decreased survival rate was found in diabetics (p 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-diabetic......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...... = 0.005). Critical limb-ischaemia was more often present in diabetic than non-diabetic patients (DM:57%, NDM:36%, p = 0.0002). Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.00001). There were no differences among diabetic and non-diabetic patients...

  17. R&D Plan for RISMC Industry Application #1: ECCS/LOCA Cladding Acceptance Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Szilard, Ronaldo Henriques [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, Hongbin [Idaho National Lab. (INL), Idaho Falls, ID (United States); Epiney, Aaron Simon [Idaho National Lab. (INL), Idaho Falls, ID (United States); Tu, Lei [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-04-01

    The Nuclear Regulatory Commission (NRC) is finalizing a rulemaking change that would revise the requirements in 10 CFR 50.46. In the proposed new rulemaking, designated as 10 CFR 50.46c, the NRC proposes a fuel performance-based equivalent cladding reacted (ECR) criterion as a function of cladding hydrogen content before the accident (pre-transient) in order to include the effects of higher burnup on cladding performance as well as to address other technical issues. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee costs as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. The Idaho National Laboratory (INL) has initiated a project, as part of the DOE Light Water Reactor Sustainability Program (LWRS), to develop analytical capabilities to support the industry in the transition to the new rule. This project is called the Industry Application 1 (IA1) within the Risk-Informed Safety Margin Characterization (RISMC) Pathway of LWRS. The general idea behind the initiative is the development of an Integrated Evaluation Model (IEM). The motivation is to develop a multiphysics framework to analyze how uncertainties are propagated across the stream of physical disciplines and data involved, as well as how risks are evaluated in a LOCA safety analysis as regulated under 10 CFR 50.46c. This IEM is called LOTUS which stands for LOCA Toolkit for US, and it represents the LWRS Program’s response to the proposed new rule making. The focus of this report is to complete an R&D plan to describe the demonstration of the LOCA/ECCS RISMC Industry Application # 1 using the advanced RISMC Toolkit and methodologies. This report includes the description and development plan for a RISMC LOCA tool that fully couples advanced MOOSE tools already in development in order to characterize and optimize

  18. Numerical study of hot-leg ECC injection into the upper plenum of a pressurized water reactor

    International Nuclear Information System (INIS)

    Daly, B.J.; Torrey, M.D.; Rivard, W.C.

    1981-01-01

    In certain pressurized water reactor (PWR) designs, emergency core coolant (ECC) is injected through the hot legs into the upper plenum. The condensation of steam on this subcooled liquid stream reduces the pressure in the hot legs and upper plenum and thereby affects flow conditions throughout the reactor. In the present study, we examine countercurrent steam-water flow in the hot leg to determine the deceleration of the ECC flow that results from an adverse pressure gradient and from momentum exchange from the steam by interfacial drag and condensation. For the parameters examined in the study, water flow reversal is observed for a pressure drop of 22 to 32 mBar over the 1.5 m hot leg. We have also performed a three-dimensional study of subcooled water injection into air and steam environments of the upper plenum. The ECC water is deflected by an array of cylindrical guide tubes in its passage through the upper plenum. Comparisons of the air-water results with data obtained in a full scale experiment shows reasonable agreement, but indicates that there may be too much resistance to horizontal flow about the columns because of the use of a stair-step representation of the cylindrical guide tube cross section. Calculations of flow past single columns of stair-step, square and circular cross section do indicate excessive water deeentrainment by the noncircular column. This has prompted the use of an arbitrary mesh computational procedure to more accuratey represent the circular cross-section guide tubes. 15 figures

  19. Feeding practice among 6-36 months old in Tanzania and Uganda: reliability and relationship with early childhood caries, ECC.

    Science.gov (United States)

    Masumo, Ray; Bardsen, Asgeir; Mashoto, Kijakazi; Åstrøm, Anne Nordrehaug

    2013-09-01

    To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC. Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding. Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC. Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.

  20. 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.

  1. Assessment of extracranial-intracranial bypass patency with 64-slice multidetector computerized tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Thines, Laurent [Lille University Hospital, Department of Neurosurgery, Lille (France); Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Agid, Ronit; Da Costa, Leodante; Terbrugge, Karel G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada); Dehdashti, Amir R.; Wallace, M.C.; Tymianski, Michael [Toronto Western Hospital, Division of Neurosurgery and Department of Surgery, Toronto, ON (Canada); Toronto Western Hospital, University of Toronto Brain Vascular Malformation Study Group, Toronto, ON (Canada)

    2009-08-15

    Extracranial-intracranial (EC/IC) bypass is a useful procedure for the treatment of cerebral vascular insufficiency or complex aneurysms. We explored the role of multidetector computed tomography angiography (MDCTA), instead of digital subtraction angiography (DSA), for the postoperative assessment of EC/IC bypass patency. We retrospectively analyzed a consecutive series of 21 MDCTAs from 17 patients that underwent 25 direct or indirect EC/IC bypass procedures between April 2003 and November 2007. Conventional DSA was available for comparison in 13 cases. MDCTA used a 64-slice MDCT scanner (Aquilion 64, Toshiba). The proximal and distal patencies were analyzed independently on MDCTA and DSA by a neuroradiologist and a neurosurgeon. The bypass was considered patent when the entire donor vessel was opacified without discontinuity from proximal to distal ends and was visibly in contact with the recipient vessel. MDCTA depicted the patency status in every patient. Bypasses were patent in 22 cases, stenosed in one, and occluded in two. DSA always confirmed the results of the MDCTA (sensitivity = 100%, 95% CI = 0.655-1.0; specificity 100%, 95% CI = 0.05-1.0). MDCTA is a non-invasive and accurate exam to assess the postoperative EC/IC bypass patency and is a promising technique in routine follow-up. (orig.)

  2. Ketamine has no effect on oxygenation indices following elective coronary artery bypass grafting under cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Parthasarathi Gayatri

    2011-01-01

    Full Text Available Cardiopulmonary bypass is known to elicit systemic inflammatory response syndrome and organ dysfunction. This can result in pulmonary dysfunction and deterioration of oxygenation after cardiac surgery and cardiopulmonary bypass. Previous studies have reported varying results on anti-inflammatory strategies and oxygenation after cardiopulmonary bypass. Ketamine administered as a single dose at induction has been shown to reduce the pro-inflammatory serum markers in patients undergoing cardiopulmonary bypass. Therefore we investigated if ketamine can result in better oxygenation in these patients. This was a prospective randomized blinded study. Eighty consecutive adult patients undergoing elective coronary artery bypass grafting under cardiopulmonary bypass were included in the study. Patients were divided into two groups. Patients in ketamine group received 1mg/kg of ketamine intravenously at induction of anesthesia. Control group patients received an equal volume of saline. All patients received standard anesthesia, operative and postoperative care.Paired t test and independent sample t test were used to compare the inter-group and between group oxygenation indices respectively. Oxygenation index and duration of ventilation were analyzed. Deterioration of oxygenation index was noted in both the groups after cardiopulmonary bypass. However, there was no significant difference in the oxygenation index at various time points after cardiopulmonary bypass or the duration of ventilation between the two groups. This study shows that the administered as a single dose at induction does not result in better oxygenation after cardiopulmonary bypass.

  3. 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.

  4. AN ANALYSIS OF STUDENTS’ SPEAKING ABILITY IN ENGLISH CONVERSATION CLUB (ECC PROGRAM AT THE 3rd SEMESTER

    Directory of Open Access Journals (Sweden)

    M. Fadhly Farhy Abbas

    2017-07-01

    Full Text Available This research is based on students’ speaking ability who had followed the EnglishConversation Club (ECC program especially for the third semester of English Department. Thepurpose of this study was to analyze the students’ speaking ability at the 3rd semester in the EnglishConversation Club FKIP UNILAK Pekanbaru. The type of the research was mixed method in typeof explanatory design. The number of participant was 53 students. The researcher used twoinstruments, those were test and interview. In analyzing the data, it used in descriptive statistics.The result of the analysis showed that the average score of 3rd semester students’ speaking abilitywas 45.42. It can be concluded that the students’ speaking ability was categorized into failed . Thescore of Standard Deviation was 7.02, Variance was 49.30, and Range was 36 points . It meansthat the students’ speaking ability was homogeneous. According to the Z-Score, it can be seen that49.06% students’ ability was higher than average and 50.94% students ability was below theaverage. In conclusion, the students’ ability in learning speaking English was failed, it had beenaffected by some factors, those were lack of vocabulary, grammar and motivation. It was supportedby the interview, eventhough the students’ perception to English Conversation Club (ECCprogram was positive, but in fact, the students’ frequency to speak English was seldom, they wereless practice speaking English everyday.Keywords : Speaking , English Conversation Club (ECC

  5. Parametric Effects of Debris Source, Environments, and Design Options on the Overall Performance of ECCS Recirculation Sump

    International Nuclear Information System (INIS)

    Park, Jong Woon; Kim, Chang Hyun

    2006-01-01

    A primary safety issue regarding long-term recirculation core cooling following a LOCA (Loss of Coolant Accident) is that LOCA-generated debris may be transported to the recirculation sump screen, resulting in adverse blockage on the sump screen and deterioration of available NPSH (Net Positive Suction Head) of ECCS (Emergency Core Cooling System). USNRC identified this as Generic Safety Issue (GSI) 191 and issued the Generic Letter 04-02 to resolve the issue. The GL required that all PWR owners perform an engineering assessment of their containment recirculation sumps to ensure they will not suffer from excessive blockage. The guidance report (GR) for PWR sump performance evaluation has been developed by NEI (Nuclear Energy Institute) and approved by the USNRC. In Korea, Korea Hydro and Nuclear Power Company (KHNP) is performing the assessment of Kori unit 1 and planning for remaining plants in the near future. The objective of the assessment is to derive required plant modifications including insulation, sump screen, etc. To derive the cost-effective modification items, we have to get insight on the parametric effects of plant conditions and design. Therefore, the general effects of debris source, containment environments and debris interceptor on the performance of ECCS recirculation sump with respect to head loss are parametrically investigated

  6. [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.

  7. Brain microvascular function during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Sorensen, H.R.; Husum, B.; Waaben, J.; Andersen, K.; Andersen, L.I.; Gefke, K.; Kaarsen, A.L.; Gjedde, A.

    1987-01-01

    Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass

  8. Massive sediment bypassing on the lower shoreface offshore of a wide tidal inlet: Cat Island Pass, Louisiana

    Science.gov (United States)

    Jaffe, B.E.; List, J.H.; Sallenger, A.H.

    1997-01-01

    Analysis of a series of historical bathymetric and shoreline surveys along the Louisiana coast west of the Mississippi River mouth detected a large area of deposition in water depths of 2.0–8.5 m offshore of a 9-km-wide tidal inlet, the Cat Island Pass/Wine Island Pass system. A 59.9 · 106 m3 sandy deposit formed from the 1930s–1980s, spanning 27 km in the alongshore direction, delineating the transport pathway for sediment bypassing offshore of the inlet on the shoreface. Bypassing connected the shorefaces of two barrier island systems, the Isles Dernieres and the Bayou Lafourche.The processes responsible for formation of this deposit are not well understood, but sediment-transport modeling suggests that sediment is transported primarily by wind-driven coastal currents during large storms and hurricanes. Deposition appears to be related to changes in shoreline orientation, closing of transport pathways into a large bay to the east and the presence of tidal inlets. This newly documented type of bypassing, an offshore bypassing of the inlet system, naturally nourished the immediate downdrift area, the eastern Isles Dernieres, where shoreface and shoreline erosion rates are about half of pre-bypassing rates. Erosion rates remained the same farther downdrift, where bypassing has not yet reached. As this offshore bypassing continues, the destruction of the Isles Dernieres will be slowed.

  9. Bypass transition in compressible boundary layers

    Science.gov (United States)

    Vandervegt, J. J.

    1992-01-01

    Transition to turbulence in aerospace applications usually occurs in a strongly disturbed environment. For instance, the effects of free-stream turbulence, roughness and obstacles in the boundary layer strongly influence transition. Proper understanding of the mechanisms leading to transition is crucial in the design of aircraft wings and gas turbine blades, because lift, drag and heat transfer strongly depend on the state of the boundary layer, laminar or turbulent. Unfortunately, most of the transition research, both theoretical and experimental, has focused on natural transition. Many practical flows, however, defy any theoretical analysis and are extremely difficult to measure. Morkovin introduced in his review paper the concept of bypass transition as those forms of transition which bypass the known mechanisms of linear and non-linear transition theories and are currently not understood by experiments. In an effort to better understand the mechanisms leading to transition in a disturbed environment, experiments are conducted studying simpler cases, viz. the effects of free stream turbulence on transition on a flat plate. It turns out that these experiments are very difficult to conduct, because generation of free stream turbulence with sufficiently high fluctuation levels and reasonable homogeneity is non trivial. For a discussion see Morkovin. Serious problems also appear due to the fact that at high Reynolds numbers the boundary layers are very thin, especially in the nose region of the plate where the transition occurs, which makes the use of very small probes necessary. The effects of free-stream turbulence on transition are the subject of this research and are especially important in a gas turbine environment, where turbulence intensities are measured between 5 and 20 percent, Wang et al. Due to the fact that the Reynolds number for turbine blades is considerably lower than for aircraft wings, generally a larger portion of the blade will be in a laminar

  10. Pressure vessel fracture studies pertaining to a PWR LOCA-ECC thermal shock: experiments TSE-1 and TSE-2

    International Nuclear Information System (INIS)

    Cheverton, R.D.

    1976-09-01

    The LOCA-ECC Thermal Shock Program was established to investigate the potential for flaw propagation in pressurized-water reactor (PWR) vessels during injection of emergency core coolant following a loss-of-coolant accident. Studies thus far have included fracture mechanics analyses of typical PWRs, the design and construction of a thermal shock test facility, determination of material properties for test specimens, and two thermal shock experiments with 0.53-m-OD (21-in.) by 0.15-m-wall (6-in.) cylindrical test specimens. The PWR calculations indicated that under some circumstances crack propagation could be expected and that experiments should be conducted for cracks that would have the potential for propagation at least halfway through the wall

  11. Exxon Nuclear WREM-based NJP-BWR ECCS evaluation model and example application to the Oyster Creek Plant

    International Nuclear Information System (INIS)

    Krysinski, T.L.; Bjornard, T.A.; Steves, L.H.

    1975-01-01

    A proposed integrated ECCS model for non-jet pump boiling water reactors is presented, using the RELAP4-EM/BLOWDOWN and RELAP4-EM/SMALL BREAK portions of the Exxon Nuclear WREM-based Generic PWR Evaluation Model coupled with the ENC NJP-BWR Fuel Heatup Model. The results of the application of the proposed model to Oyster Creek are summarized. The results of the break size sensitivity study using the proposed model for the Oyster Creek Plant are presented. The application of the above results yielded the MAPLHGR curves. Included are a description of the proposed non-jet pump boiling water reaction evaluation model, justification of its conformance with TOCFR50, Appendix K, the adopted Oyster Creek plant model, and results of the analysis and sensitivity studies. (auth)

  12. Simulation of a large break loss of coolant (LBLOCA), without actuation of the emergency injection systems (ECCS) for a BWR-5

    International Nuclear Information System (INIS)

    Cardenas V, J.; Mugica R, C. A.; Lopez M, R.

    2015-09-01

    In this paper the analysis of scenario for the loss of coolant case was realized with break at the bottom of a recirculation loop of a BWR-5 with containment type Mark II and a thermal power of 2317 MWt considering that not have coolant injection. This in order to observe the speed of progression of the accident, the phenomenology of the scenario, the time to reach the limit pressure of containment venting and the amount of radionuclides released into the environment. This simulation was performed using the MELCOR code version 2.1. The scenario posits a break in one of the shear recirculation loops. The emergency core cooling system (ECCS) and the reactor core isolation cooling (Rcic) have not credit throughout the event, which allowed achieve greater severity on scenario. The venting of the primary containment was conducted via valve of 30 inches instead of the line of 24 inches of wet well, this in order to have a larger area of exhaust of fission products directly to the reactor building. The venting took place when the pressure in the primary containment reached the 4.5 kg/cm 2 and remained open for the rest of the scenario to maximize the amount released of radionuclides to the atmosphere. The safety relief valves were considered functional they do not present mechanical failure or limit their ability to release pressure due to the large number of performances in safety mode. The results of the analysis covers about 48 hours, time at which the accident evolution was observed; behavior of level, pressure in the vessel and the fuel temperature profile was analyzed. For progression of the scenario outside the vessel, the pressure and temperature of the primary containment, level and temperature of the suppression pool, the hydrogen accumulation in the container and the radionuclides mass released into the atmosphere were analyzed. (Author)

  13. Study of Impact Damage in PVA-ECC Beam under Low-Velocity Impact Loading Using Piezoceramic Transducers and PVDF Thin-Film Transducers.

    Science.gov (United States)

    Qi, Baoxin; Kong, Qingzhao; Qian, Hui; Patil, Devendra; Lim, Ing; Li, Mo; Liu, Dong; Song, Gangbing

    2018-02-24

    Compared to conventional concrete, polyvinyl alcohol fiber reinforced engineering cementitious composite (PVA-ECC) offers high-strength, ductility, formability, and excellent fatigue resistance. However, impact-induced structural damage is a major concern and has not been previously characterized in PVA-ECC structures. We investigate the damage of PVA-ECC beams under low-velocity impact loading. A series of ball-drop impact tests were performed at different drop weights and heights to simulate various impact energies. The impact results of PVA-ECC beams were compared with mortar beams. A combination of polyvinylidene fluoride (PVDF) thin-film sensors and piezoceramic-based smart aggregate were used for impact monitoring, which included impact initiation and crack evolution. Short-time Fourier transform (STFT) of the signal received by PVDF thin-film sensors was performed to identify impact events, while active-sensing approach was utilized to detect impact-induced crack evolution by the attenuation of a propagated guided wave. Wavelet packet-based energy analysis was performed to quantify failure development under repeated impact tests.

  14. Gas Turbine Engine Having Fan Rotor Driven by Turbine Exhaust and with a Bypass

    Science.gov (United States)

    Suciu, Gabriel L. (Inventor); Chandler, Jesse M. (Inventor)

    2016-01-01

    A gas turbine engine has a core engine incorporating a core engine turbine. A fan rotor is driven by a fan rotor turbine. The fan rotor turbine is in the path of gases downstream from the core engine turbine. A bypass door is moveable from a closed position at which the gases from the core engine turbine pass over the fan rotor turbine, and moveable to a bypass position at which the gases are directed away from the fan rotor turbine. An aircraft is also disclosed.

  15. 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...

  16. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Science.gov (United States)

    2010-04-01

    ... bypass oxygenator. (a) Identification. A cardiopulmonary bypass oxygenator is a device used to exchange gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during open...

  17. Redox-mediated bypass of restriction point via skipping of G1pm

    Directory of Open Access Journals (Sweden)

    Greene James J

    2006-07-01

    Full Text Available Abstract Background It is well known that cancer cells bypass the restriction point, R, and undergo uncontrolled cell proliferation. Hypothesis and evidence We suggest here that fibrosarcoma cells enter G1ps directly from M, skipping G1pm, hence bypassing R, in response to redox modulation. Evidence is presented from the published literature that demonstrate a shortening of the cycle period of transformed fibroblasts (SV-3T3 compared to the nontransformed 3T3 fibroblasts, corresponding to the duration of G1pm in the 3T3 fibroblasts. Evidence is also presented that demonstrate that redox modulation can induce the CUA-4 fibroblasts to bypass R, resulting in a cycle period closely corresponding to the cycle period of fibrosarcoma cells (HT1080. Conclusion The evidence supports our hypothesis that a low internal redox potential can cause fibrosarcoma cells to skip the G1pm phase of the cell cycle.

  18. Variable volume combustor with an air bypass system

    Science.gov (United States)

    Johnson, Thomas Edward; Ziminsky, Willy Steve; Ostebee, Heath Michael; Keener, Christopher Paul

    2017-02-07

    The present application provides a combustor for use with flow of fuel and a flow of air in a gas turbine engine. The combustor may include a number of micro-mixer fuel nozzles positioned within a liner and an air bypass system position about the liner. The air bypass system variably allows a bypass portion of the flow of air to bypass the micro-mixer fuel nozzles.

  19. 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 Section 870.4390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is...

  20. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ... 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... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240...

  1. 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 generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  2. 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... bypass gas control unit. (a) Identification. A cardiopulmonary bypass gas control unit is a device used to control and measure the flow of gas into the oxygenator. The device is calibrated for a specific...

  3. 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

  4. 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....

  5. 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

  6. Fluid distribution kinetics during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Mattias Törnudd

    2014-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass. METHODS: Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166. RESULTS: The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p<0.02. The mass balance of sodium indicated a translocation from the intracellular to the extracellular fluid space in 8 of the 10 patients, with a median volume of 236 ml. CONCLUSIONS: The distribution half-time of Ringer's solution during isovolumetric cardiopulmonary bypass was 8 minutes, which is the same as for crystalloid fluid infusions in healthy subjects. The intravascular albumin mass increased. Most patients were hypovolemic prior to the start of anesthesia. Intracellular edema did not occur.

  7. Comparison of costs of percutaneous transluminal coronary angioplasty and coronary bypass surgery for patients with angina pectoris

    NARCIS (Netherlands)

    C. van Halem; F. van den Brink; P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); H. Suryapranata (Harry); K.J. Meeter; E. Bos (Egbert); F.J. van Dalen (Frederik); M.J.B.M. van den Brand (Marcel)

    1990-01-01

    textabstractTo determine the costs of a procedure, the total costs of the department that provides the service must be considered and, in addition, the direct cost of the specific procedure. Applying this principle to the cost accounting of angioplasty and bypass surgery results in a direct, i.e.

  8. Mini-cardiopulmonary bypass impact on blood conservation strategy in coronary artery bypass grafting.

    Science.gov (United States)

    Abdel Aal, Mohamed; ElNahal, Nezar; Bakir, Bakir Moustafa; Fouda, Mohamed

    2011-04-01

    Cardiopulmonary bypass (CPB) using a closed circuit system with minimal priming volume can be a solution to ameliorate adverse effects of CPB. We hypothesize that the use of mini-bypass in routine coronary artery bypass grafting (CABG) reduces homologous blood product use and postoperative bleeding. The study is designed to determine the differences in blood loss and transfusion requirements associated with a minimized CPB circuit vs. a standard bypass circuit. From February 2009 to August 2009, 80 patients were prospectively randomized to undergo elective CABG. Group A included 40 patients who had the minimized bypass circuit (Medtronic Resting Heart Circuit). Group B had an equal number of patients who had the standard CPB circuit (Stockert III, SEC.BM). Laboratory parameters for hemoglobin, hematocrit and platelet count were measured at baseline after initiation of CPB and after bypass. Blood usage was controlled by study-specific protocol (transfusion for hemoglobin platelets (1.95±2.95 units vs. 3.23±2.85), and postoperative drainage in 24 hours (531.62±220.12 ml vs. 729±294.9 ml, P<0.05). The hematocrit was 33±5% in group A, and 27±1% in group B. There was statistical differences seen in the mean hemoglobin level which was 10.19±0.65 g/dl in group A, and 9.4±0.68 g/dl in group B. There was statistical difference in the duration of ventilation, length of ICU stay. The requirement of inotropic support was lower in group A. The adoption of mini-bypass significantly reduces morbidity including donor blood usage and postoperative bleeding in routine CABG patients.

  9. Functional Dissection of the Blocking and Bypass Activities of the Fab-8 Boundary in the Drosophila Bithorax Complex.

    Science.gov (United States)

    Kyrchanova, Olga; Mogila, Vladic; Wolle, Daniel; Deshpande, Girish; Parshikov, Alexander; Cléard, Fabienne; Karch, Francois; Schedl, Paul; Georgiev, Pavel

    2016-07-01

    Functionally autonomous regulatory domains direct the parasegment-specific expression of the Drosophila Bithorax complex (BX-C) homeotic genes. Autonomy is conferred by boundary/insulator elements that separate each regulatory domain from its neighbors. For six of the nine parasegment (PS) regulatory domains in the complex, at least one boundary is located between the domain and its target homeotic gene. Consequently, BX-C boundaries must not only block adventitious interactions between neighboring regulatory domains, but also be permissive (bypass) for regulatory interactions between the domains and their gene targets. To elucidate how the BX-C boundaries combine these two contradictory activities, we have used a boundary replacement strategy. We show that a 337 bp fragment spanning the Fab-8 boundary nuclease hypersensitive site and lacking all but 83 bp of the 625 bp Fab-8 PTS (promoter targeting sequence) fully rescues a Fab-7 deletion. It blocks crosstalk between the iab-6 and iab-7 regulatory domains, and has bypass activity that enables the two downstream domains, iab-5 and iab-6, to regulate Abdominal-B (Abd-B) transcription in spite of two intervening boundary elements. Fab-8 has two dCTCF sites and we show that they are necessary both for blocking and bypass activity. However, CTCF sites on their own are not sufficient for bypass. While multimerized dCTCF (or Su(Hw)) sites have blocking activity, they fail to support bypass. Moreover, this bypass defect is not rescued by the full length PTS. Finally, we show that orientation is critical for the proper functioning the Fab-8 replacement. Though the inverted Fab-8 boundary still blocks crosstalk, it disrupts the topology of the Abd-B regulatory domains and does not support bypass. Importantly, altering the orientation of the Fab-8 dCTCF sites is not sufficient to disrupt bypass, indicating that orientation dependence is conferred by other factors.

  10. Risk-Informed Margin Management (RIMM) Industry Applications IA1 - Integrated Cladding ECCS/LOCA Performance Analysis - Problem Statement

    Energy Technology Data Exchange (ETDEWEB)

    Szilard, Ronaldo Henriques [Idaho National Lab. (INL), Idaho Falls, ID (United States); Youngblood, Robert [Idaho National Lab. (INL), Idaho Falls, ID (United States); Frepoli, Cesare [Idaho National Lab. (INL), Idaho Falls, ID (United States); Yurko, Joseph P. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Swindlehurst, Gregg [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, Hongbin [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhao, Haihua [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bayless, Paul D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Alfonsi, Andrea [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-04-01

    The U. S. NRC is currently proposing rulemaking designated as “10 CFR 50.46c” to revise the LOCA/ECCS acceptance criteria to include the effects of higher burnup on cladding performance as well as to address some other issues. The NRC is also currently resolving the public comments with the final rule expected to be issued in the summer of 2016. The impact of the final 50.46c rule on the industry will involve updating of fuel vendor LOCA evaluation models, NRC review and approval, and licensee submittal of new LOCA evaluations or reanalyses and associated technical specification revisions for NRC review and approval. The rule implementation process, both industry and NRC activities, is expected to take 5-10 years following the rule effective date. The need to use advanced cladding designs is expected. A loss of operational margin will result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin.

  11. A photographic portrait of Father Benignus Wanat, discalced Carmelite, with Christ’s head Ecce Homo in the background

    Directory of Open Access Journals (Sweden)

    Inga Platowska-Sapetowa

    2016-12-01

    Full Text Available This photographic memory of the late Father Benignus Józef Wanat OCD is based upon a high quality photo, anonymously posted and found accidentally on Facebook on 11 April 2013 after his funeral. Investigations established that the photographer, Jacek Praśkiewicz, is a photographer from Kielce. Additionally, the work includes a descriptive analysis of various aspects of several works of art: a psycho-physical description of the character portrayed its settings and lighting, a description of the ceremonial costume used and its symbolic elements. It has been established that the photo was taken at a celebration of an anniversary held on 12 December 2008. What is crucial to emphasise is this: the relationship of the portrayed person (Fr Benignus Józef Wanat OCD with the portrait’s background, which uses a fragmented image of Christ Ecce Homo, which is of unknown provenance. This latter aspect included a description of the work which is very important, because it shows the supporting facts taken from the biography of Father Benignus, corroborated by the statements of witnesses, of his imitative attitude to Christ, in relation to God-Man suffering in humble silence and bringing aid to his fellow human even to the extent of the sacrifice of his life. [Translatio by Fr E. Wanat SDS

  12. Study on safety analysis of VVER-1200/V491 in scenario of Loss of Coolant Accidents along with partly failure of ECCS using RELAP5 code

    International Nuclear Information System (INIS)

    Hoang Minh Giang; Ha Thi Anh Dao; Hoang Tan Hung; Bui Thi Hoa; Nguyen Thi Tu Oanh; Dinh Anh Tuan; Pham Tuan Nam

    2017-01-01

    The advanced VVER-1200/V491 reactor designed with passive safety systems to deal with design extension conditions is primarily selected as priority candidate for Ninh Thuan 1 nuclear power plant project. So that, in order to enhance competence of nuclear safety and toward participation on review Safety Analysis Report (SAR) of Ninh Thuan nuclear Power project the study on safety analysis of VVER-1200/V491 in scenario of Loss of Coolant Accidents along with partly failure of ECCS is implemented. As requirement of the study, the input deck file of VVER-1200/V491 for RELAP5 and analysis report for some special case of LOCAs along with partly failure of ECCS are issued. (author)

  13. Industry Application ECCS / LOCA Integrated Cladding/Emergency Core Cooling System Performance: Demonstration of LOTUS-Baseline Coupled Analysis of the South Texas Plant Model

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongbin [Idaho National Lab. (INL), Idaho Falls, ID (United States); Szilard, Ronaldo [Idaho National Lab. (INL), Idaho Falls, ID (United States); Epiney, Aaron [Idaho National Lab. (INL), Idaho Falls, ID (United States); Parisi, Carlo [Idaho National Lab. (INL), Idaho Falls, ID (United States); Vaghetto, Rodolfo [Texas A & M Univ., College Station, TX (United States); Vanni, Alessandro [Texas A & M Univ., College Station, TX (United States); Neptune, Kaleb [Texas A & M Univ., College Station, TX (United States)

    2017-06-01

    Under the auspices of the DOE LWRS Program RISMC Industry Application ECCS/LOCA, INL has engaged staff from both South Texas Project (STP) and the Texas A&M University (TAMU) to produce a generic pressurized water reactor (PWR) model including reactor core, clad/fuel design and systems thermal hydraulics based on the South Texas Project (STP) nuclear power plant, a 4-Loop Westinghouse PWR. A RISMC toolkit, named LOCA Toolkit for the U.S. (LOTUS), has been developed for use in this generic PWR plant model to assess safety margins for the proposed NRC 10 CFR 50.46c rule, Emergency Core Cooling System (ECCS) performance during LOCA. This demonstration includes coupled analysis of core design, fuel design, thermalhydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results. Within this context, a multi-physics best estimate plus uncertainty (MPBEPU) methodology framework is proposed.

  14. Gradual Hunterian ligation for infected prosthetic bypass.

    Science.gov (United States)

    Egun, A; Slade, D; McCollum, C N

    2000-04-01

    To review gradual snare occlusion for the management of complex or recurrent graft infection. Medical records of patients treated with gradual snare occlusion following graft infection were reviewed for indication for operation, type of bypass and graft material used. In addition, infecting organism, grade of infection (Szilágyi) and outcome were recorded. Four femoropopliteal, two extra-anatomic (axillofemoral) and aortobifemoral bypasses were included in this study. All had chronic infection (Szilágyi grade III) with onset of 4 to 24 months and two of which were recurrent. The causative organisms were coagulase-negative staphylococci, Staphylococcus epidermidis and methicillin-resistant Staphylococcus aureus in three patients, with no organism isolated in the remaining cases. There was no loss of limb following gradual snare occlusion but there was only one death due to aortic stump rupture 2 weeks later. Gradual snare occlusion is an alternative for the management of chronic or recurrent graft infection. Copyright 1999 Harcourt Publishers Ltd.

  15. Simulation of a large break loss of coolant (LBLOCA), without actuation of the emergency injection systems (ECCS) for a BWR-5; Simulacion de un escenario de perdida de refrigerante grande (LBLOCA), sin actuacion de los sistemas de inyeccion de emergencia (ECCS) para un reactor BWR-5

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas V, J.; Mugica R, C. A.; Lopez M, R., E-mail: jaime.cardenas@cnsns.gob.mx [Comision Nacional de Seguridad Nuclear y Salvaguardias, Dr. Barragan 779, Col. Narvarte, 03020 Ciudad de Mexico (Mexico)

    2015-09-15

    In this paper the analysis of scenario for the loss of coolant case was realized with break at the bottom of a recirculation loop of a BWR-5 with containment type Mark II and a thermal power of 2317 MWt considering that not have coolant injection. This in order to observe the speed of progression of the accident, the phenomenology of the scenario, the time to reach the limit pressure of containment venting and the amount of radionuclides released into the environment. This simulation was performed using the MELCOR code version 2.1. The scenario posits a break in one of the shear recirculation loops. The emergency core cooling system (ECCS) and the reactor core isolation cooling (Rcic) have not credit throughout the event, which allowed achieve greater severity on scenario. The venting of the primary containment was conducted via valve of 30 inches instead of the line of 24 inches of wet well, this in order to have a larger area of exhaust of fission products directly to the reactor building. The venting took place when the pressure in the primary containment reached the 4.5 kg/cm{sup 2} and remained open for the rest of the scenario to maximize the amount released of radionuclides to the atmosphere. The safety relief valves were considered functional they do not present mechanical failure or limit their ability to release pressure due to the large number of performances in safety mode. The results of the analysis covers about 48 hours, time at which the accident evolution was observed; behavior of level, pressure in the vessel and the fuel temperature profile was analyzed. For progression of the scenario outside the vessel, the pressure and temperature of the primary containment, level and temperature of the suppression pool, the hydrogen accumulation in the container and the radionuclides mass released into the atmosphere were analyzed. (Author)

  16. Verification of LOCA/ECCS analysis codes ALARM-B2 and THYDE-B1 by comparison with RELAP4/MOD6/U4/J3

    International Nuclear Information System (INIS)

    Shimizu, Takashi

    1982-08-01

    For a verification study of ALARM-B2 code and THYDE-B1 code which are the component of the JAERI code system for evaluation of BWR ECCS performance, calculations for typical small and large break LOCA in BWR were done, and compared with those by RELAP4/MOD6/U4/J3 code. This report describes the influences of differences between the analytical models incorporated in the individual code and the problems identified by this verification study. (author)

  17. A variable current bypass shunt for electromagnets

    International Nuclear Information System (INIS)

    Berndt, M.M.; Lipari, J.J.

    1992-11-01

    An IGBT is used to control the current in bypass circuits that vary the relative strength of magnets connected in series. Each circuit consists of a water cooled assembly rated for continuous operation at 70 Volts and 0--50 Amperes DC, with 1 KV insulation between control/monitoring elements and magnets. The circuit operates as a 10KHz PWM switcher that includes filters and transient protection

  18. Hypothenar hammer syndrome and basilic bypass.

    Science.gov (United States)

    Chander, R K; Phair, J; Oza, P; Patel, M; Balar, N

    2014-12-01

    We report a case of hypothenar hammer syndrome. The case presents necessary diagnostic measures and discusses the etiology of this syndrome. Additionally, the case reviews treatments, which culminated in the eventual use of ulnar artery bypass with autogenous basilica vein to treat and resolve the ischemic fingers of the patient. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Heat and mass transfer in the stratified flow with ECCS injection

    International Nuclear Information System (INIS)

    Strubelj, L.; Tiselj, I.

    2007-01-01

    One of the most important problems in the light-water nuclear thermal-hydraulics is behaviour of the cold emergency core cooling water injected from the top or from the bottom into the horizontal section of the cold leg near the reactor vessel during the loss of coolant accident. The stratified flows appear where cold water is injected in partially or fully uncovered horizontal cold leg. The hot steam condenses on cold water surface what is also called direct contact condensation. Direct contact condensation and condensation induced water-hammer in a horizontal pipe were experimentally investigated at PMK-2 test facility of the Hungarian Atomic Energy Research Institute KFKI. The cold water is injected through small pipe into lower horizontal part of the section, and then water fills the vertical pipeline and floods the horizontal test section of the pipeline of the PMK-2 integral test facility. As liquid water floods the horizontal part of the pipeline, the counter current horizontally stratified flow is being observed. During the flooding of the pipeline, the steam-liquid interface area increases and therefore the steam condensation rate and the steam velocity also increase and can lead to bubble entrapment. Water level at one cross-section and four local void fraction and temperature at the top of horizontal test pipeline was measured and compared with simulation. Condensed steam increases the water temperature that is why the local temperature measurements are the most important information, from which condensation rate can be estimated, since mass of condensed steam was not measured. Numerical simulation of the experiment with thermal phase change is presented. Surface renewal concept with small eddies is used for calculation of condensation heat transfer coefficient. Two simulations were performed: simulation of whole experimental domain (lower horizontal, vertical and test horizontal pipeline) and simplified simulation of only upper horizontal test section

  20. 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....

  1. Evaluation of the patency of an extracranial-intracranial bypass using magnetic resonance angiography with selective presaturation of bypass vessels

    Energy Technology Data Exchange (ETDEWEB)

    Mabuchi, Shoji; Nakayama, Naoki; Isu, Toyohiko; Harata, Tatsuo; Nanbu, Toshikazu [Kushiro Rousai Hospital, Hokkaido (Japan)

    1994-06-01

    Three-dimensional time-of-flight magnetic resonance (MR) angiography using radiofrequency presaturation pulses was used to evaluate the patency of extracranial-intracranial (EC/IC) bypass in 11 patients. Presaturation causes signal loss in the vascular territory supplied by the presaturated EC/IC bypass graft. In all patients with a patent EC/IC bypass graft confirmed on conventional angiography, disappearance of the signal of the middle cerebral artery receiving blood flow from the bypass graft was clearly observed on MR angiograms with presaturation, indicating patency of the EC/IC bypass graft. MR angiography with presaturation pulses is a noninvasive and repeatable method for evaluation of the function of an EC/IC bypass graft. (author).

  2. Impossible Airway Requiring Venovenous Bypass for Tracheostomy

    Directory of Open Access Journals (Sweden)

    Johnathan Gardes

    2012-01-01

    Full Text Available The elective surgical airway is the definitive management for a tracheal stenotic lesion that is not a candidate for tracheal resection, or who has failed multiple-tracheal dilations. This case report details the management of a patient who has failed an elective awake tracheostomy secondary to the inability to be intubated as well as severe scar tissue at the surgical site. A combination of regional anesthesia and venovenous bypass is used to facilitate the surgical airway management of this patient. Cerebral oximetry and a multidisciplinary team approach aid in early detection of an oxygenation issue, as well as the emergent intervention that preserved this patient’s life.

  3. 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

  4. Perforated marginal ulcers after laparoscopic gastric bypass.

    Science.gov (United States)

    Felix, Edward L; Kettelle, John; Mobley, Elijah; Swartz, Daniel

    2008-10-01

    Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors' center was conducted to determine the incidence of PMU and whether any causative factors were present. A prospectively kept database of all patients at the authors' bariatric center was retrospectively reviewed. The complete records of patients with a PMU were examined individually for accuracy and analyzed for treatment, outcome, and possible underlying causes of the marginal perforation. Between April 1999 and August 2007, 1% of the patients (35/3,430) undergoing laparoscopic gastric bypass experienced one or more perforated marginal ulcers 3 to 70 months (median, 18 months) after LRYGB. The patients with and without perforation were not significantly different in terms of mean age (37 vs 41 years), weight (286 vs 287 lb), body mass index (BMI) (46 vs 47), or female gender (89% vs 83%). Of the patients with perforations, 2 (6%) were taking steroids, 10 (29%) were receiving nonsteroidal antiinflammatory drugs (NSAIDs) at the time of the perforation, 18 (51%) were actively smoking, and 6 of the smokers also were taking NSAIDs. Eleven of the patients (31%) who perforated did not have at least one of these possible risk factors, but 4 (36%) of the 11 patients in this group had been treated after bypass for a marginal ulcer. Only 7 (20%) of the 35 patients who had laparoscopic bypass, or 7 (0.2%) in the entire group of 3,430 patients, perforated without any warning. There were no deaths, but three patients reperforated. The incidence of a marginal ulcer perforating after LRYGB was significant (>1%) and appeared to be related to smoking or the use of NSAIDs or steroids. Because only 0.2% of all patients acutely perforated without some risk factor or warning, long-term ulcer prophylaxis or treatment may be necessary

  5. Carotid artery bypass in acute postendarterectomy thrombosis.

    Science.gov (United States)

    Paty, P S; Darling, R C; Cordero, J A; Shah, D M; Chang, B B; Leather, R P

    1996-08-01

    Carotid endarterectomy has demonstrated excellent results over the past 2 decades with combined stroke mortality of improvement in symptoms in 79% (11 of 14) of the patients and complete resolution in 57% (8 of 14). In long-term follow up (1 to 41 months), there have been no occlusions and one restenosis requiring revision at 11 months. Carotid artery bypass can be performed safely with acceptable results. The use of autogenous venous conduits allows reconstruction with an endothelial lined conduit that may improve results in patients with acute postoperative neurologic deficit secondary to thrombosis of the endarterectomized carotid artery.

  6. Progress in Management of Sediment Bypassing at Coastal Inlets: Natural Bypassing, Weir Jetties, Jetty Spurs, and Engineering Aids in Design

    National Research Council Canada - National Science Library

    Seabergh, William C; Kraus, Nicholas C

    2003-01-01

    .... Artificial bypassing mimics or preserves the pathways of sediment in the littoral zone and harmonizes the requirement for deepening navigation channels within the context of the natural sediment...

  7. Metabolic syndrome 2 years after laparoscopic gastric bypass.

    Science.gov (United States)

    Guilbert, Lizbeth; Ortiz, Cristian J; Espinosa, Omar; Sepúlveda, Elisa M; Piña, Tatiana; Joo, Paul; Zerrweck, Carlos

    2018-04-01

    The latest diabetes consensus identified obesity as key component of the metabolic syndrome. The role of bariatric surgery over such syndrome has been less explored with a lack of long term studies, and especially among Mexicans. Retrospective study including patients with metabolic syndrome submitted to laparoscopic gastric bypass at a single institution with complete data after 24 months. The objective was to analyze the improvement of the syndrome and each component. Demographic, anthropometric, biochemical and clinical parameters were analyzed at 12 and 24 months. Secondarily weight loss and other parameters were also analyzed. Finally, an analysis of syndrome improvement related to weight loss was performed. Sixty-three patients were included. The 2 most common components associated with obesity were reduced HDL and raised glucose or Type 2 diabetes. There was a significant improvement of metabolic syndrome and its components, as well as for the rest of the analyzed data, from the first check point and throughout follow-up. Prevalence of such syndrome was 6.3% at 12 and 24 months. Hypertension and raised glucose or Type 2 diabetes were the components with the greatest and fastest improvement; HDL levels and obesity were the least improved. There was a direct relationship between percentage of excess weight loss or percentage of excess BMI loss, and syndrome's improvement. Patients with metabolic syndrome improved after gastric bypass, with results lasting after 2 years; other metabolic parameters important for cardiovascular risk were also positively affected. There was a relationship between the amount of weight loss and improvement of metabolic syndrome. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  8. 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.

  9. ECCS control circuit

    International Nuclear Information System (INIS)

    Sato, Takashi.

    1986-01-01

    Purpose: To afford a sufficient margin to pressure vibrations upon starting of an automatic depressurization system by dispersing pressure vibration in suppression water due to the opening action of an automatic releaf valve in the automatic depressurization system thereby reducing the dynamic load exerted to the surface of the suppression walls. Constitution: Upon occurrence of loss of coolant accidents, an automatic releaf valve for automatic depressurization is opened to deliver the steams in the pressure vessel into the suppression pool. Since a plurality of automatic releaf valves have usually been disposed, if they are opened simultaneously, excess dynamic loads are exerted due to the pressure vibrations to the wall surface of the suppression pool. In this invention, a control circuit is disposed such that the opening timing for each of the automatic releaf valves is deviated upon occurrence of a driving signal for the automatic depressurization system to thereby disperse the pressure vibrations in the suppression water. (Kamimura, M.)

  10. 21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

    Science.gov (United States)

    2010-04-01

    ... Cardiopulmonary bypass accessory equipment. (a) Identification. Cardiopulmonary bypass accessory equipment is a... mounting bracket or system-priming equipment. (b) Classification. (1) Class I. The device is classified as class I if it does not involve an electrical connection to the patient. The device is exempt from the...

  11. Renal tubular acidosis secondary to jejunoileal bypass for morbid obesity

    DEFF Research Database (Denmark)

    Schaffalitzky de Muckadell, O B; Ladefoged, Jens; Thorup, Jørgen Mogens

    1985-01-01

    Renal handling of acid and base was studied in patients with persistent metabolic acidosis 3-9 years after jejunoileal bypass for morbid obesity. Excretion of acid was studied before and after intravenous infusion of NH4Cl and excretion of bicarbonate after infusion of NaHCO3. Bypass patients...

  12. Concomitant coronary artery revascularization and right pneumonectomy without cardiopulmonary bypass

    NARCIS (Netherlands)

    Hensens, AG; Zeebregts, C.J.A.M.; Liem, TH; Gehlmann, H; Lacquet, LK

    Combined coronary artery bypass grafting (CABG) and pneumonectomy has a high morbidity and mortality rate, especially when the right lung has to be removed. A patient is described who underwent a CABG operation through a midline sternotomy without the use of cardiopulmonary bypass (CPB), and a right

  13. Milrinone, a phosphodiesterase III inhibitor, prevents reduction of jugular bulb saturation during rewarming from hypothermic cardiopulmonary bypass.

    Science.gov (United States)

    Iritakenishi, T; Hayashi, Y; Yamanaka, H; Kamibayashi, T; Ueda, K; Mashimo, T

    2012-01-01

    Inadequate cerebral oxygen balance during cardiopulmonary bypass may cause neuropsychological dysfunction. Milrinone, a phosphodiesterase III inhibitor, augments cerebral blood flow by direct vasodilatation. We conducted a prospective, randomized study in patients undergoing cardiac surgery with cardiopulmonary bypass to clarify the clinical efficacy of milrinone in the imbalance of cerebral oxygen supply and demand during the rewarming period of cardiopulmonary bypass. This is a prospective, randomized and placebo-controlled study. After anesthesia, a 5.5 F fiberoptic oximeter catheter was inserted into the right jugular bulb retrogradely for monitoring the jugular venous oxyhemoglobin saturation (SjO(2)). Patients were randomly assigned to two groups, one receiving a continuous infusion of milrinone, 0.5 µg/kg/min during hypothermic cardiopulmonary bypass, and the other receiving saline as control. Milrinone significantly prevented the reduction of the jugular venous oxyhemoglobin saturation at 10 minutes from the start of rewarming compared with the control group, but did not do so from 10 to 20 minutes after rewarming. Milrinone suppresses the reduction of SjO(2) and improves the balance of cerebral oxygen supply and demand during the early rewarming period of hypothermic cardiopulmonary bypass.

  14. Considerations for Probabilistic Analyses to Assess Potential Changes to Large-Break LOCA Definition for ECCS Requirements

    International Nuclear Information System (INIS)

    Wilkowski, G.; Rudland, D.; Wolterman, R.; Krishnaswamy, P.; Scott, P.; Rahman, S.; Fairbanks, C.

    2002-01-01

    The U.S.NRC has undertaken a study to explore changes to the body of Part 50 of the U.S. Federal Code of Regulations, to incorporate risk-informed attributes. One of the regulations selected for this study is 10 CFR 50.46, A cceptance Criteria for Emergency Core Cooling Systems for Light-Water Nuclear Power Reactors . These changes will potentially enhance safety and reduce unnecessary burden on utilities. Specific attention is being paid to redefining the maximum pipe break size for LB-LOCA by determining the spectrum of pipe diameter (or equivalent opening area) versus failure probabilities. In this regard, it is necessary to ensure that all contributors to probabilistic failures are accounted for when redefining ECCS requirements. This paper describes initial efforts being conducted for the U.S.NRC on redefining the LB-LOCA requirements. Consideration of the major contributors to probabilistic failure, and deterministic aspects for modeling them, are being addressed. At this time three major contributors to probabilistic failures are being considered. These include: (1) Analyses of the failure probability from cracking mechanisms that could involve rupture or large opening areas from either through-wall or surface flaws, whether the pipe system was approved for leak-before-break (LBB) or not. (2) Future degradation mechanisms, such as recent occurrence of PWSCC in PWR piping need to be included. This degradation mechanism was not recognized as being an issue when LBB was approved for many plants or when the initial risk-informed inspection plans were developed. (3) Other indirect causes of loss of pressure-boundary integrity than from cracks in the pipe system also should be included. The failure probability from probabilistic fracture mechanics will not account for these other indirect causes that could result in a large opening in the pressure boundary: i.e., failure of bolts on a steam generator manway, flanges, and valves; outside force damage from the

  15. Dacron or PTFE for above-knee femoropopliteal bypass. a multicenter randomised study

    DEFF Research Database (Denmark)

    Jensen, L P; Lepäntalo, M; Fossdal, J E

    2007-01-01

    To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass.......To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass....

  16. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine

    Directory of Open Access Journals (Sweden)

    Andréia Cristina Passaroni

    2015-04-01

    Full Text Available AbstractObjective:To provide a brief review of the development of cardiopulmonary bypass.Methods: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.Results: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.Conclusion: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. Twenty-third water reactor safety information meeting. Volume 3, structural and seismic engineering, primary systems integrity, equipment operability and aging, ECCS strainer blockage research and regulatory issues

    Energy Technology Data Exchange (ETDEWEB)

    Monteleone, S. [comp.] [Brookhaven National Lab., Upton, NY (United States)

    1996-03-01

    This three-volume report contains papers presented at the Twenty- Third Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, Maryland, October 23-25, 1995. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from France, Italy, Japan, Norway, Russia, Sweden, and Switzerland. This document, Volume 3, presents topics in Structural & Seismic Engineering, Primary Systems Integrity, Equipment Operability and Aging, and ECCS Strainer Blockage Research & Regulatory Issues. Individual papers have been cataloged separately.

  18. Twenty-third water reactor safety information meeting. Volume 3, structural and seismic engineering, primary systems integrity, equipment operability and aging, ECCS strainer blockage research and regulatory issues

    International Nuclear Information System (INIS)

    Monteleone, S.

    1996-03-01

    This three-volume report contains papers presented at the Twenty- Third Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, Maryland, October 23-25, 1995. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from France, Italy, Japan, Norway, Russia, Sweden, and Switzerland. This document, Volume 3, presents topics in Structural ampersand Seismic Engineering, Primary Systems Integrity, Equipment Operability and Aging, and ECCS Strainer Blockage Research ampersand Regulatory Issues. Individual papers have been cataloged separately

  19. 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...

  20. Bypassing the Kohn-Sham equations with machine learning.

    Science.gov (United States)

    Brockherde, Felix; Vogt, Leslie; Li, Li; Tuckerman, Mark E; Burke, Kieron; Müller, Klaus-Robert

    2017-10-11

    Last year, at least 30,000 scientific papers used the Kohn-Sham scheme of density functional theory to solve electronic structure problems in a wide variety of scientific fields. Machine learning holds the promise of learning the energy functional via examples, bypassing the need to solve the Kohn-Sham equations. This should yield substantial savings in computer time, allowing larger systems and/or longer time-scales to be tackled, but attempts to machine-learn this functional have been limited by the need to find its derivative. The present work overcomes this difficulty by directly learning the density-potential and energy-density maps for test systems and various molecules. We perform the first molecular dynamics simulation with a machine-learned density functional on malonaldehyde and are able to capture the intramolecular proton transfer process. Learning density models now allows the construction of accurate density functionals for realistic molecular systems.Machine learning allows electronic structure calculations to access larger system sizes and, in dynamical simulations, longer time scales. Here, the authors perform such a simulation using a machine-learned density functional that avoids direct solution of the Kohn-Sham equations.

  1. Occurrence of Pesticides in Water, Sediment, and Soil from the Yolo Bypass, California

    Directory of Open Access Journals (Sweden)

    Kelly L. Smalling

    2007-02-01

    Full Text Available The objective of this study was to evaluate the potential sources of pesticides to the Yolo Bypass, including those that could potentially impact critical life stages of resident fish. To assess direct inputs during inundation, pesticide concentrations were analyzed in water and suspended and bed sediment samples collected from source watersheds during high-flow events. To understand inputs from direct application on fields, pesticides were also measured in soils collected from several sites within the Bypass. Thirteen current-use pesticides were detected in water samples collected in 2004 with the highest pesticide concentrations observed at the input sites to the Bypass during high-flow. Hexazinone and simazine were detected at all sites and at some of the highest concentrations. In bed and suspended sediments collected in 2004 and 2005, thirteen current-use pesticides were detected along with DDT and its metabolites. Trifluralin, DDE, and DDT were highest in the bed sediments, whereas oxyfluorfen and thiobencarb were highest in the suspended sediments. With the exception of the three organochlorine insecticides, suspended sediments had higher pesticide concentrations compared to bed sediments, indicating the potential for pesticide transport especially during high-flow events. Soil samples were dominated by DDT and its degradates but also contained a variety of current-use pesticides typically at lower concentrations. The types of pesticides detected in water and sediments were correlated with agricultural application in each watershed. Understanding the distribution of pesticides between the water and sediment is important in assessing their fate and transport within the Bypass, and in evaluating the exposure and potential effects to resident fish.

  2. 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.

  3. Bypass grafting to the anterior tibial artery.

    Science.gov (United States)

    Armour, R H

    1976-01-01

    Four patients with severe ischaemia of a leg due to atherosclerotic occlusion of the tibial and peroneal arteries had reversed long saphenous vein grafts to the patent lower part of the anterior tibial artery. Two of these grafts continue to function 19 and 24 months after operation respectively. One graft failed on the fifth postoperative day and another occluded 4 months after operation. The literature on femorotibial grafting has been reviewed. The early failure rate of distal grafting is higher than in the case of femoropopliteal bypass, but a number of otherwise doomed limbs can be salvaged. Contrary to widely held views, grafting to the anterior tibial artery appears to give results comparable to those obtained when the lower anastomosis is made to the posterior tibial artery.

  4. Rumen bypass nutrients: Manipulation and implications

    International Nuclear Information System (INIS)

    Leng, R.A.; Nolan, J.V.; Preston, T.R.

    1983-01-01

    The feeds available for ruminants in developing countries are either agro-industrial by-products or specially grown forage crops. Many of these feeds are low in protein and require supplementation with non-protein N (NPN) to maintain efficient rumen function and digestibility. The principles for utilizing high energy, low protein feeds by ruminants are discussed in relation to the supply of NPN, the establishment of efficient rumen function, maximizing feed intake by means of supplements, and increasing total energy and protein intake by using supplements which bypass the rumen. To illustrate it the application of these principles to feeding systems based on molasses, chopped whole sugar cane and derinded sugar cane is discussed. The implications of the principles in increasing the feeding value of straw are also discussed. (author)

  5. Nietzsche como destino da filosofia e da humanidade? interpretação contextual do § 1 do capítulo "por que sou um destino", de ecce homo

    Directory of Open Access Journals (Sweden)

    Werner Stegmaier

    2010-01-01

    Full Text Available The following translation is a reduced and revised version of the paper Schicksal Nietzsche? Zu Nietzsches Selbsteinschätzung als Schicksal der Philosophie und der Menschheit (Ecce Homo, Warum ich ein Schicksal bin §1" - originally published in Nietzsche-Studien 37 (2008 - which was specially prepared to be presented in lecture organized by the Grupo de Pesquisa Spinoza & Nietzsche (Spinoza & Nietzsche research group - SpiN, in the Universidade Federal do Rio de Janeiro (Rio de Janeiro's Federal University, on September 14, 2009. In the text, the autor employs his own philological-hermeneutical methodology, which is called contextual interpretation, in the purpose to clarify the concepts of the first aphorism from "Why I am a destiny", from Ecce Homo, in its own context, in the context of Ecce Homo and in the context of the entire work from Nietzsche.

  6. Complications of Laparoscopic Retroperitoneal Sutureless and Clampless Aortobifemoral Bypass

    Directory of Open Access Journals (Sweden)

    B. Segers

    Full Text Available : Introduction: This report describes our experience with early complications that occurred in two patients who underwent sutureless aortobifemoral bypass using the EndoVascular REtroperitoneoScopic Technique (EVREST. Report: Two patients who underwent EVREST for aortoiliac TASC D lesions experienced a dislocation of the proximal assembly. The first dislocation occurred four hours post-operatively and led to the death of the patient, and the second occurred during surgery and led to open conversion. Conclusion: As a result of these serious complications, we recommend the use of anchorage stitches while using an endograft connector in a sutureless aortobifemoral bypass. Keywords: Early complications, Sutureless, Clampless, Retroperitoneoscopy, Aortobifemoral bypass

  7. Intraoperative echocardiographic imaging of coronary arteries and graft anastomoses during coronary artery bypass grafting without cardiopulmonary bypass.

    Science.gov (United States)

    Suematsu, Y; Takamoto, S; Ohtsuka, T

    2001-12-01

    No accepted approach exists for the intraoperative evaluation of the quality of coronary arteries and the technical adequacy of graft anastomoses during coronary artery bypass grafting without cardiopulmonary bypass. We assessed the accuracy of high-frequency epicardial echocardiography and power Doppler imaging in evaluating coronary arteries during coronary artery bypass grafting without cardiopulmonary bypass. To validate measurements of coronary arteries and graft anastomoses by high-frequency epicardial echocardiography and power Doppler imaging, we compared luminal diameters determined by these methods with diameters determined histologically in a study of off-pump coronary artery bypass grafting in 20 dogs. Technical errors were deliberately created in 10 grafts (stenosis group). The results of these animal validation studies showed that the maximum luminal diameters of coronary arteries and graft anastomoses measured by high-frequency epicardial echocardiography (HEE) and power Doppler imaging (PDI) correlated well with the histologic measurements: HEE = 1.027 x Histologic measurements + 0.005 (P anastomoses were examined intraoperatively by high-frequency epicardial echocardiography and power Doppler imaging, and luminal diameters determined by power Doppler imaging were compared with those determined by postoperative coronary angiography. The results demonstrated that graft anastomosis by power Doppler imaging correlated well with the angiographic measurements: PDI = 1.018 x Angiographic measurements - 0.106 (P anastomoses and can detect technical errors and inadequacies during coronary artery bypass grafting without cardiopulmonary bypass.

  8. 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....

  9. Sensitivity of the downward to sweeping velocity ratio to the bypass flow percentage along a guide wall for downstream fish passage

    Science.gov (United States)

    Mulligan, Kevin; Towler, Brett; Haro, Alexander J.; Ahlfeld, David P.

    2017-01-01

    Partial-depth impermeable guidance structures (or guide walls) are used as a method to assist in the downstream passage of fish at a hydroelectric facility. However, guide walls can result in a strong downward velocity causing the approaching fish to pass below the wall and into the direction of the turbine intakes. The objective of this study was to describe how the ratio of the vertical velocity to the sweeping velocity magnitude changes along the full length and depth of a guide wall under a wide range of bypass flow percentages within a power canal. This paper focused on two guide wall configurations, each set at an angle of 45 ° to the approaching flow field and at a depth of 10 and 20 ft (3.05 and 6.10 m). The hydraulic conditions upstream of each guide wall configuration were shown to be impacted by a change in the bypass flow percentage, not only near the bypass but also at upstream sections of the guide wall. Furthermore, the effect of changing the bypass flow percentage was similar for both guide wall depths. In both cases, the effect of increasing the bypass flow percentage was magnified closer to the bypass and deeper in the water column along the guide wall.

  10. Does extubation result in haemodynamic instability in patients following coronary artery bypass grafts?

    Science.gov (United States)

    Walthall, H; Ray, S; Robson, D

    2001-10-01

    Coronary heart disease and its management continue to be at the centre of Government health policy. The present political climate demands clinical effectiveness and best practice should be established, while maintaining the philosophy of cost-effectiveness and resource management. These directives have led practitioners to question the care of patients following coronary artery bypass surgery, in particular the role of mechanical ventilation and the subsequent act of extubation. A retrospective study of 89 patients who had coronary artery bypass grafts (emergency and elective) was undertaken, to establish if extubation had a significant effect on the haemodynamic status of patients with variable degrees of left ventricular function (19% with poor left ventricular function). The study found that extubation was achieved within a mean time of 4.97 hours following return from surgery. Extubation resulted in a significant increase in heart rate (P = 0.001), as well as a respiratory acidosis (pCO2: P = 0.000; pH: P = 0.000). However, the stability of the patient was not compromised, with neither mean arterial blood pressure (P = 0.825) nor oxygenation levels (P = 0.267) being significantly altered by extubation. On multivariate analysis, the act of extubation had no significant effect on any of the dependent variables. These results suggest that it is not extubation alone that has an impact on the haemodynamic stability of patients following coronary artery bypass grafts, but that this is indeed multifactorial. Therefore extubation is 'safe' practice for patients with varying degrees of left ventricular function following coronary artery bypass grafts. Limitations of the study are acknowledged.

  11. Changes in the vessels following aorto-coronary bypass operation

    International Nuclear Information System (INIS)

    Goebel, N.; Pfluger, N.; Speiser, K.; Turina, M.; Rothlin, M.; Zurich Univ.; Zurich Univ.

    1983-01-01

    In a prospective study (238 men, mean age 53 years) the changes of the native vessels were studied 3 months after a-c-bypass operation and 5 months after preop. angiography. Progression was defined as increase of stenoses of at least 20% or new total occlusion. Progression was significantly more frequent in vessels with than without bypass and was located proximally to the anastomoses in most cases, less frequently at the anastomoses and very rarely distally to the anastomoses. Proximal progression was significantly more frequent with patent than with occluded bypasses. Stenoses at the anastomoses were significantly more frequent with occluded than with patent bypasses. Stenoses of higher degrees hat a stonger tendency for progression than slighter stenoses. Regression was rare and nearly always caused by surgery. (orig.) [de

  12. Coronary Artery Bypass Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... Living With Related Issues Specifics See, Play and Learn Images Videos and Tutorials Research Clinical Trials Journal Articles Resources ... bypass surgery - slideshow (Medical Encyclopedia) Also in ... is better to reduce postoperative stroke... Article: Blood transfusion and ...

  13. 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.

  14. 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.

  15. Prolonged successful therapy for hyperinsulinaemic hypoglycaemia after gastric bypass

    DEFF Research Database (Denmark)

    Myint, K S; Greenfield, J R; Farooqi, I S

    2012-01-01

    Spontaneous hyperinsulinaemic hypoglycaemia following gastric bypass surgery (GBS) is increasingly recognised. However, its pathophysiology remains unclear. Some patients require pancreatectomy. Medical therapy with calcium channel blockers, acarbose and diazoxide has been reported to be beneficial...

  16. Protection of semiconductor converters for controlled bypass reactors

    International Nuclear Information System (INIS)

    Dolgopolov, A. G.; Akhmetzhanov, N. G.; Karmanov, V. F.

    2010-01-01

    Possible ways of protecting thyristor converters in systems for magnetizing 110 - 500 kV controlled bypass reactors during switching and automatic reclosing are examined based on experience with the development of equipment, line tests, and mathematical modelling.

  17. [Psychoprophylaxis in patients after coronary artery bypass graft operations].

    Science.gov (United States)

    Rymaszewska, Joanna; Chładzińska-Kiejna, Sylwia; Górna, Renata; Kustrzycki, Wojciech

    2004-05-01

    The paper presented problems of quality of life and psychosocial functioning of patients following coronary artery bypass grafting operations. Possibilities of psychoprophylactic effects towards these patients and its efficacy were described.

  18. Crohn’s disease after gastric bypass surgery

    OpenAIRE

    Janczewska, Izabella; Nekzada, Qayium; Kapraali, Marjo

    2011-01-01

    Bariatric surgery for the treatment of severe obesity has increased dramatically in recent years in the USA and parts of Western Europe. The most commonly used technique is the Roux-en Y gastric bypass (RYGBP). Several nutritional and gastrointestinal complications after bariatric surgery have been described during the last 10 years. The authors present two patients with diarrhoea and malnutrition; one after RYGBP and the other after jejunoileal bypass surgery. These patients were subsequentl...

  19. Transfusion requirements in elective cardiopulmonary bypass surgery patients

    DEFF Research Database (Denmark)

    Sivapalan, Praleene; Bäck, Anne Caroline; Ostrowski, Sisse Rye

    2017-01-01

    Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA......) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures. PMA and MEA...

  20. Severe hypoglycaemia post-gastric bypass requiring partial pancreatectomy

    DEFF Research Database (Denmark)

    Patti, M E; McMahon, G; Mun, E C

    2005-01-01

    AIMS/HYPOTHESIS: Postprandial hypoglycaemia following gastric bypass for obesity is considered a late manifestation of the dumping syndrome and can usually be managed with dietary modification. We investigated three patients with severe postprandial hypoglycaemia and hyperinsulinaemia unresponsive...... was assessed in all three patients. RESULTS: All three patients had evidence of severe postprandial hyperinsulinaemia and hypoglycaemia. In one patient, reversal of gastric bypass was ineffective in reversing hypoglycaemia. All three patients ultimately required partial pancreatectomy for control...

  1. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine

    OpenAIRE

    Passaroni, Andréia Cristina; Silva, Marcos Augusto de Moraes; Yoshida, Winston Bonetti

    2015-01-01

    AbstractObjective:To provide a brief review of the development of cardiopulmonary bypass.Methods: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.Results:The advancement of extracorporeal circulation techniques has played an essential role in minimizing the complications of cardiopulmonary bypass, which can range from vari...

  2. Method of treating emissions of a hybrid vehicle with a hydrocarbon absorber and a catalyst bypass system

    Science.gov (United States)

    Roos, Bryan Nathaniel; Gonze, Eugene V; Santoso, Halim G; Spohn, Brian L

    2014-01-14

    A method of treating emissions from an internal combustion engine of a hybrid vehicle includes directing a flow of air created by the internal combustion engine when the internal combustion engine is spinning but not being fueled through a hydrocarbon absorber to collect hydrocarbons within the flow of air. When the hydrocarbon absorber is full and unable to collect additional hydrocarbons, the flow of air is directed through an electrically heated catalyst to treat the flow of air and remove the hydrocarbons. When the hydrocarbon absorber is not full and able to collect additional hydrocarbons, the flow of air is directed through a bypass path that bypasses the electrically heated catalyst to conserve the thermal energy stored within the electrically heated catalyst.

  3. Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.

    Science.gov (United States)

    Holinski, Sebastian; Claus, Benjamin; Alaaraj, Nour; Dohmen, Pascal Maria; Kirilova, Kremena; Neumann, Konrad; Uebelhack, Ralf; Konertz, Wolfgang

    2008-11-01

    Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass. We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass. Patients scheduled for elective, primary and isolated coronary bypass surgery were randomised either to piracetam or placebo group. The study was performed in a double blind fashion. Patients received either 12 g piracetam or placebo at the beginning of the operation. Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer's Disease Assessment Scale were performed preoperatively and on the third postoperative day. To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis. A total number of 120 patients were enrolled into the study. Preoperative overall cognitive function were not significantly different between the groups. The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups (placebo-pre: -0.06+/-0.99 vs placebo-post: -1.38+/-1.11; ppiracetam-pre: 0.06+/-1.02 vs piracetam-post: -0.65+/-0.93; ppiracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function (pPiracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass. It reduces an early postoperative substantial decline of neuropsychological abilities.

  4. Prediction of coronary artery bypass graft flow

    International Nuclear Information System (INIS)

    Tamiya, Eiji; Hada, Yoshiyuki; Asano, Ken-ichi; Iio, Masahiro.

    1991-01-01

    To predict the coronary artery bypass graft (CABG) flow based on the time density curve (TDC) obtained from the digital subtraction aortograms (DSA), we developed a pulsatile CABG model (perfusion pressure 60,130 mmHg, pulse rate 53,126/min, cardiac output 3-7 l/min, diameter of the graft 2.1∼6.0 mm). After positioning the regions of interest (ROI), we injected contrast medium(5∼40 ml/sec, 5∼40 ml) into the outlet conduit. Concerning the TDCs, we calculated appearance time (Ta), peak densities (Dp), peak time (Tp), disappearance time (Td), integral of TDC, ΔTp (difference of Tp between two ROI) and ΔTa (difference of Ta between two ROI). Perfusion pressure, graft flow and output curve were similar to those of patients with CABG. Ta, Tp, Td, and ΔTp were affected by both the injection rate and the volume of the contrast medium; while Dp and the TDC integral were only affected by the latter parameter. Under the same conditions of contrast medium injection, the TDC depended strongly on graft flow, diameter of the graft, output and pulse rate. 21.6+0.92π·d 2 /4·Δ1/ΔTp·60 provided the most accurate estimation of CABG flow (r=0.865, p<0.01). We conclude that densitometric analysis of DSA may be useful in the prediction of CABG flow. (author)

  5. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

    Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

  6. Right atrial bypass model in the dog.

    Science.gov (United States)

    Breen, P H; Isserles, S A

    1995-02-01

    In gas exchange studies addressing the storage and transport of CO2 in dogs, a model in which cardiac output (QT) can be precisely controlled and measured would be beneficial. We identified problems with described extracorporeal circuits and implemented right atrial bypass (RAB) in dogs. In 6 anesthetized (chloralose and urethane), heparinized dogs (mean +/- SD, 24 +/- 4 kg) with open thorax, cannulas were inserted in both vena cavas to drain venous blood return to a reservoir (anaerobic bag or bubble oxygenator). A roller pump then drove blood through a heat exchanger back to the right atrial appendage. After 1.8 +/- 1.4 hour of RAB, physiologic variables remained within reference limits for dogs (QT, 1.5 +/- 0.3 L/min; blood pressure, 92 +/- 25 mm of Hg; arterial PCO2, 35 +/- 4 mm of Hg; PO2, 513 +/- 39 mm of Hg; pH, 7.39 +/- 0.08; and tissue CO2 production, 126 +/- 56 ml/min). To permit study of gas exchange, venous return (and thus, QT) and venous PCO2 and PO2 could be accurately regulated and measured over a wide range. Maintenance of native pulsatile lung perfusion and cardiogenic oscillations minimizes mismatching of pulmonary ventilation and perfusion and facilitates studies addressing pulmonary gas exchange. This RAB model is designed so that investigators can establish the preparation in a few hours.

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

    International Nuclear Information System (INIS)

    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

  8. Pressure vessel fracture studies pertaining to a PWR LOCA-ECC thermal shock: experiments TSE-3 and TSE-4 and update of TSE-1 and TSE-2 analysis

    International Nuclear Information System (INIS)

    Cheverton, R.D.; Bolt, S.E.

    1977-01-01

    The LOCA-ECC Thermal Shock Program was established to investigate the potential for flaw propagation in pressurized-water reactor (PWR) vessels during injection of emergency core coolant following a loss-of-coolant accident. Studies thus far have included fracture mechanics analyses of typical PWRs, the design and construction of a thermal shock test facility, determination of material properties for test specimens, and four thermal shock experiments with 0.53-m-OD (21-in.) by 0.15-m-wall (6-in.) cylindrical test specimens. In the first experiment, initiation was not expected and did not occur, although there was a small amount of subcritical crack growth. In the second experiment, initiation of a semicircular flaw took place as expected; the final length along the surface was about four times the initial length, but there was no radial growth. The third and fourth experiments were similar, and the long axial flaw initiated in good agreement with predictions

  9. Systematic evaluation program review of NRC Safety Topic VI-7.3 associated with the electrical, instrumentation and control portions of the ECCS actuation system for the Dresden II Nuclear Power Plant

    International Nuclear Information System (INIS)

    St Leger-Barter, G.

    1980-11-01

    This report documents the technical evaluation and review of NRC Safety Topic VI-7.A.3, associated with the electrical, instrumentation, and control portions of the classification of the ECCS actuation system for the Dresden II nuclear power plant, using current licensing criteria

  10. Post-test analysis for the MIDAS DVI tests using MARS

    International Nuclear Information System (INIS)

    Bae, K. H.; Lee, Y. J.; Kwon, T. S.; Lee, W. J.; Kim, H. C.

    2002-01-01

    Various DVI tests have been performed at MIDAS test facility which is a scaled facility of APR1400 applying a modified linear scale ratio. The evaluation results for the various void height tests and direct bypass tests using a multi-dimensional best-estimate analysis code MARS, show that; (a) MARS code has an advanced modeling capability of well predicting major multi-dimensional thermal-hydraulic phenomena occurring in the downcomer, (b) MARS code under-predicts the steam condensation rates, which in turn causes to over-predict the ECC bypass rates. However, the trend of decrease in steam condensation rate and increase in ECC bypass rate in accordance with the increase in steam flow rate, and the calculation results of the ECC bypass rates under the EM analysis conditions generally agree with the test data

  11. Bowel habits after gastric bypass versus the duodenal switch operation.

    Science.gov (United States)

    Wasserberg, Nir; Hamoui, Nahid; Petrone, Patrizio; Crookes, Peter F; Kaufman, Howard S

    2008-12-01

    One of the perceived disadvantages of the biliopancreatic diversion with duodenal switch operation is diarrhea. The aim of this study was to compare the bowel habits of patients after duodenal switch operation or Roux-en-Y gastric bypass. A prospective comparative case series design was used. Forty-six patients who underwent duodenal switch (n=28) or gastric bypass (n=18) were asked to complete a daily diary for 14 days after losing least 50% of their excess body weight. Data were collected on number of bowel episodes, incontinence, urgency, stool consistency, and awakening from sleep to defecate. Background variables were recorded from the medical files. The duodenal switch group was heavier (body mass index 53.5 vs 47.0 kg/m(2), p=0.03) and older (47.5 vs 41.0 years, p=NS) than the gastric bypass group. Median time to 50% excess body weight loss was 22 months in the duodenal switch group compared to 10.0 months in the gastric bypass group (p=0.001). Patients after duodenal switch surgery reported a median of 23.5 bowel episodes over the 14-day study period compared to 16.5 in the gastric bypass group (p=NS). There was no between-group differences in any of the other bowel parameters studied. Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.

  12. Annular MHD Physics for Turbojet Energy Bypass

    Science.gov (United States)

    Schneider, Steven J.

    2011-01-01

    The use of annular Hall type MHD generator/accelerator ducts for turbojet energy bypass is evaluated assuming weakly ionized flows obtained from pulsed nanosecond discharges. The equations for a 1-D, axisymmetric MHD generator/accelerator are derived and numerically integrated to determine the generator/accelerator performance characteristics. The concept offers a shockless means of interacting with high speed inlet flows and potentially offers variable inlet geometry performance without the complexity of moving parts simply by varying the generator loading parameter. The cycle analysis conducted iteratively with a spike inlet and turbojet flying at M = 7 at 30 km altitude is estimated to have a positive thrust per unit mass flow of 185 N-s/kg. The turbojet allowable combustor temperature is set at an aggressive 2200 deg K. The annular MHD Hall generator/accelerator is L = 3 m in length with a B(sub r) = 5 Tesla magnetic field and a conductivity of sigma = 5 mho/m for the generator and sigma= 1.0 mho/m for the accelerator. The calculated isentropic efficiency for the generator is eta(sub sg) = 84 percent at an enthalpy extraction ratio, eta(sub Ng) = 0.63. The calculated isentropic efficiency for the accelerator is eta(sub sa) = 81 percent at an enthalpy addition ratio, eta(sub Na) = 0.62. An assessment of the ionization fraction necessary to achieve a conductivity of sigma = 1.0 mho/m is n(sub e)/n = 1.90 X 10(exp -6), and for sigma = 5.0 mho/m is n(sub e)/n = 9.52 X 10(exp -6).

  13. Natural Product Screening Reveals Naphthoquinone Complex I Bypass Factors.

    Directory of Open Access Journals (Sweden)

    Scott B Vafai

    Full Text Available Deficiency of mitochondrial complex I is encountered in both rare and common diseases, but we have limited therapeutic options to treat this lesion to the oxidative phosphorylation system (OXPHOS. Idebenone and menadione are redox-active molecules capable of rescuing OXPHOS activity by engaging complex I-independent pathways of entry, often referred to as "complex I bypass." In the present study, we created a cellular model of complex I deficiency by using CRISPR genome editing to knock out Ndufa9 in mouse myoblasts, and utilized this cell line to develop a high-throughput screening platform for novel complex I bypass factors. We screened a library of ~40,000 natural product extracts and performed bioassay-guided fractionation on a subset of the top scoring hits. We isolated four plant-derived 1,4-naphthoquinone complex I bypass factors with structural similarity to menadione: chimaphilin and 3-chloro-chimaphilin from Chimaphila umbellata and dehydro-α-lapachone and dehydroiso-α-lapachone from Stereospermum euphoroides. We also tested a small number of structurally related naphthoquinones from commercial sources and identified two additional compounds with complex I bypass activity: 2-methoxy-1,4-naphthoquinone and 2-methoxy-3-methyl-1,4,-naphthoquinone. The six novel complex I bypass factors reported here expand this class of molecules and will be useful as tool compounds for investigating complex I disease biology.

  14. An Experimental Design of Bypass Magneto-Rheological (MR) damper

    Science.gov (United States)

    Rashid, MM; Aziz, Mohammad Abdul; Raisuddin Khan, Md.

    2017-11-01

    The magnetorheological (MR) fluid bypass damper fluid flow through a bypass by utilizing an external channel which allows the controllability of MR fluid in the channel. The Bypass MR damper (BMRD) contains a rectangular bypass flow channel, current controlled movable piston shaft arrangement and MR fluid. The static piston coil case is winding by a coil which is used inside the piston head arrangement. The current controlled coil case provides a magnetic flux through the BMRD cylinder for controllability. The high strength of alloy steel materials are used for making piston shaft which allows magnetic flux propagation throughout the BMRD cylinder. Using the above design materials, a Bypass MR damper is designed and tested. An excitation of current is applied during the experiment which characterizes the BMRD controllability. It is shown that the BMRD with external flow channel allows a high controllable damping force using an excitation current. The experimental result of damping force-displacement characteristics with current excitation and without current excitation are compared in this research. The BMRD model is validated by the experimental result at various frequencies and applied excitation current.

  15. The influence of core bypass flow during SBLOCA

    International Nuclear Information System (INIS)

    Maselj, A.; Jurkovic, M.

    1996-01-01

    Many parameters affect the behaviour of a NPP during a Small Break Loss of Coolant Accident (SBLOCA). The bypass flow between the core side and the downcomer is one of them. Different PWRs have different values of core bypass flow. In spite of the complexity of the real situation in the primary system during SBLOCA, some fundamental details of the phenomena can be explained with simplified mathematical models, which relate on basic parameters of the primary coolant. These models define the conditions for loop seal clearance and final results are confirmed with measured values. The analysis presented in the paper refers to Bethsy Test 9.1.b SB LOCA scenario, with variation of core bypass flow. Basic RELAP5 input model calculation results show very good agreement with the experimental data. The core liquid level depression before loop seal clearance is lower in case of smaller core bypass flow. This affects the fuel clad temperature because of different heat transfer mechanisms. Time of loop seal clearance is delayed with larger core bypass flow and consequently lower differential pressure between downcomer and core. (author)

  16. The in situ side-to-side bypass technique: a comprehensive review of the technical characteristics, current anastomosis approaches and surgical experience.

    Science.gov (United States)

    Wang, Long; Cai, Li; Qian, Hai; Lawton, Michael T; Shi, Xiang'en

    2018-05-02

    In situ side-to-side (STS) revascularization is an intracranial-intracranial (IC-IC) bypass technique that is increasingly used to treat complex aneurysms and cerebral ischemia. This sophisticated technique involves connecting two proximal parallel vessels to create an artificial conduit for blood flow. This study aims to provide a detailed description of the configuration of the STS bypass technique and extensive information regarding its technical characteristics, current anastomosis approaches and surgical significance. A literature search was performed using the PubMed, Medline, ScienceDirect, Embase, Wiley Online Library, Cambridge Journals, SAGE Journals, Oxford Journals, Research Gate, and Google Scholar databases. The terms "intracranial-intracranial bypass", "in situ bypass", "communicating bypass" and "STS anastomosis" were searched to identify pertinent articles. Articles involving in situ STS anastomosis combined with other bypass methods were excluded. Computer tablet-drawn illustrations of this technique are provided to enhance comprehension. In total, seventy articles that met our search and inclusion criteria were identified. Overall, the radiographical and clinical outcomes of one-hundred and thirty-two (125 aneurysm and 7 cerebral ischemia) patients who underwent in situ STS revascularization were analyzed. IC-IC bypass in the STS fashion can be a safe and effective strategy for the management of complex intracranial aneurysms and cerebral ischemia and is particularly attractive in rescue, anticipated and troubleshooting cases. Despite its extreme rarity, a de novo aneurysm may be observed following STS anastomosis; thus, long-term follow-up is mandatory. Vascular neurosurgeons should consider including this procedure in their treatment armamentarium. Copyright © 2018. Published by Elsevier Inc.

  17. Rankine cycle load limiting through use of a recuperator bypass

    Science.gov (United States)

    Ernst, Timothy C.

    2011-08-16

    A system for converting heat from an engine into work includes a boiler coupled to a heat source for transferring heat to a working fluid, a turbine that transforms the heat into work, a condenser that transforms the working fluid into liquid, a recuperator with one flow path that routes working fluid from the turbine to the condenser, and another flow path that routes liquid working fluid from the condenser to the boiler, the recuperator being configured to transfer heat to the liquid working fluid, and a bypass valve in parallel with the second flow path. The bypass valve is movable between a closed position, permitting flow through the second flow path and an opened position, under high engine load conditions, bypassing the second flow path.

  18. Decline in health-related quality of life 6 months after coronary artery bypass graft surgery the influence of anxiety, depression, and personality traits

    NARCIS (Netherlands)

    Middel, B.; El Baz, N.; Pedersen, S.S.; van Dijk, J.P.; Wynia, K.; Reijneveld, S.A.

    2014-01-01

    Background: Although coronary artery bypass graft (CABG) is known to improve health-related quality of life (HRQoL), this improvement does not seem to be realized in all patients who had undergone CABG surgery. Objective: The aim of this study was to test the direct and indirect influence of

  19. Decline in Health-Related Quality of Life 6 Months After Coronary Artery Bypass Graft Surgery : The Influence of Anxiety, Depression, and Personality Traits

    NARCIS (Netherlands)

    Middel, Berrie; El Baz, Noha; Pedersen, Susanne S; van Dijk, Jitse P; Wynia, Klaske; Reijneveld, Sijmen A

    2014-01-01

    Background: Although coronary artery bypass graft (CABG) is known to improve health-related quality of life (HRQoL), this improvement does not seem to be realized in all patients who had undergone CABG surgery. Objective: The aim of this study was to test the direct and indirect influence of

  20. The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

    DEFF Research Database (Denmark)

    Taqi, Esmaeel; Wallace, Laurie E; de Heuvel, Elaine

    2010-01-01

    The signals that govern the upregulation of nutrient absorption (adaptation) after intestinal resection are not well understood. A Gastric Roux-en-Y bypass (GRYB) model was used to isolate the relative contributions of direct mucosal stimulation by nutrients, biliary-pancreatic secretions......, and systemic enteric hormones on intestinal adaptation in short bowel syndrome....

  1. Exercise thallium-201 scintigraphy in evaluating aortocoronary bypass surgery

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Haaz, W.; Segal, B.L.; Kane, S.A.

    1981-01-01

    Thirty patients with recurrent symptoms after aortocoronary bypass graft surgery underwent angiography as well as exercise thallium 201 imaging. Exercise imaging has been shown to be highly specific (100 percent in our study) in evaluating patients after bypass surgery. Patients with complete revascularization have normal thallium 201 images. Similarly, exercise-induced defects are seen only in the presence of incomplete revascularization. There are patients, however, with incomplete revascularization with normal exercise images, but these generally limited to the right coronary artery or the diagonal vessels or their grafts

  2. Role of ternary fission in synthesis of bypassed nuclei

    International Nuclear Information System (INIS)

    Kramarovskij, Ya.M.; Chechev, V.P.

    1983-01-01

    A possible influence of ternary fission with escape of neutron-enriched light charged particles on the synthesis of bypassed nuclides is considered. It is shown that this concept cannot give explanation of bypassed isotope concentrations, but it can make some contribution, if the probability of ternary fission for superheavy nuclei grows sharply with Z 2 /A parameter. The account of β-delayed fission contributes to the shift of ternary fission fragments into the region of neutron-deficient isotopes. Consistent consideration of the ternary fission role in the nucleosynthesis is possible only with an important accumulation of experimental and theoretical data on this process, particularly for the nuclei with Z > 100

  3. Construct exploit constraint in crash analysis by bypassing canary

    Science.gov (United States)

    Huang, Ning; Huang, Shuguang; Huang, Hui; Chang, Chao

    2017-08-01

    Selective symbolic execution is a common program testing technology. Developed on the basis of it, some crash analysis systems are often used to test the fragility of the program by constructing exploit constraints, such as CRAX. From the study of crash analysis based on symbolic execution, this paper find that this technology cannot bypass the canary stack protection mechanisms. This paper makes the improvement uses the API hook in Linux. Experimental results show that the use of API hook can effectively solve the problem that crash analysis cannot bypass the canary protection.

  4. Development of an economical and ecological optimized multi slot fish bypass

    International Nuclear Information System (INIS)

    Tauber, M.; Mader, H.

    2009-01-01

    The European Union's Water Framework Directive (WFD), which came into force in 2000, represents a new framework governing water policies. The ecological objectives of the directive are sometimes in conflict with the historical use of waterbodies for hydropower generation. This paper discussed the mitigation of negative economical effects caused by outfitting hydropower plants with fish migration facilities claimed by the WFD. In particular, it reviewed the new modified version of the Vertical Slot Fishpass which reduces water discharge while maintaining or even enhancing the biological migration of aquatic species. Reducing the flow rate in the fish bypass results in more available water for hydropower generation, which is economically advantageous for operators. The available water resource is simply used more efficiently. The bypass was modified by adding additional slot baffles and guide walls in order to induce intended losses at roughness obstacles and to obtain isolated roughness current in the multi slot area. A Froude similarity model was used to obtain the results of the first phase of this project. Different arrangements of the slot baffles and locations were measured. The results of all trials revealed that the newly developed multi slot variants have clear advantages over conventional vertical slot fish passages. Discharge was reduced by up to 34 per cent while still maintaining the same water levels in the pools. As such, the general flow velocities were also reduced by about 10 per cent, thereby achieving the primary objective of the project. 7 refs., 18 figs

  5. Outcomes of lower extremity bypass performed for acute limb ischemia.

    Science.gov (United States)

    Baril, Donald T; Patel, Virendra I; Judelson, Dejah R; Goodney, Philip P; McPhee, James T; Hevelone, Nathanael D; Cronenwett, Jack L; Schanzer, Andres

    2013-10-01

    Acute limb ischemia remains one of the most challenging emergencies in vascular surgery. Historically, outcomes following interventions for acute limb ischemia have been associated with high rates of morbidity and mortality. The purpose of this study was to determine contemporary outcomes following lower extremity bypass performed for acute limb ischemia. All patients undergoing infrainguinal lower extremity bypass between 2003 and 2011 within hospitals comprising the Vascular Study Group of New England were identified. Patients were stratified according to whether or not the indication for lower extremity bypass was acute limb ischemia. Primary end points included bypass graft occlusion, major amputation, and mortality at 1 year postoperatively as determined by Kaplan-Meier life table analysis. Multivariable Cox proportional hazards models were constructed to evaluate independent predictors of mortality and major amputation at 1 year. Of 5712 lower extremity bypass procedures, 323 (5.7%) were performed for acute limb ischemia. Patients undergoing lower extremity bypass for acute limb ischemia were similar in age (66 vs 67; P = .084) and sex (68% male vs 69% male; P = .617) compared with chronic ischemia patients, but were less likely to be on aspirin (63% vs 75%; P < .0001) or a statin (55% vs 68%; P < .0001). Patients with acute limb ischemia were more likely to be current smokers (49% vs 39%; P < .0001), to have had a prior ipsilateral bypass (33% vs 24%; P = .004) or a prior ipsilateral percutaneous intervention (41% vs 29%; P = .001). Bypasses performed for acute limb ischemia were longer in duration (270 vs 244 minutes; P = .007), had greater blood loss (363 vs 272 mL; P < .0001), and more commonly utilized prosthetic conduits (41% vs 33%; P = .003). Acute limb ischemia patients experienced increased in-hospital major adverse events (20% vs 12%; P < .0001) including myocardial infarction, congestive heart failure exacerbation, deterioration in renal function

  6. Multi-slice CT angiography in evaluation of extracranial-intracranial bypass

    Energy Technology Data Exchange (ETDEWEB)

    Teksam, Mehmet E-mail: mehmetteksam@yahoo.com; McKinney, Alexander; Truwit, Charles L

    2004-12-01

    Multi-slice CT (MSCT) scanners provided significant improvement in vascular applications. In this study, our purpose was to determine the clinical utility of MSCTA in evaluation of extracranial-intracranial (EC-IC) bypass patency. Eleven (4 men and 7 women; mean age, 46 years; age range, 19-68 years) consecutive patients who underwent MSCTA and DSA after EC-IC bypass surgery were evaluated retrospectively. All patients underwent DSA within 3 weeks of MSCTA. The indications for EC-IC bypass were severe stenosis or occlusion of intracranial arteries in seven patients and therapeutic occlusion of intracranial artery for unclippable giant aneurysm in four patients. Ten patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and one patient underwent occipital artery-posterior cerebral artery (PCA) bypass. Eight STA-MCA bypasses in six patients were patent on MSCTA which were confirmed on DSA. Two MSCTA bypasses and one occipital artery-posterior cerebral artery (PCA) bypass were occluded in three patients on MSCTA and DSA. In one patient, minimal stenosis of the STA-MCA bypass was identified on MSCTA and DSA. In 1 patient, STA-MCA bypass was not well seen on MSCTA and suspected for occlusion. DSA identified the occlusion of bypass on this patient. MSCTA seems to be a very promising noninvasive technique in evaluation of EC-IC bypass.

  7. Multi-slice CT angiography in evaluation of extracranial-intracranial bypass

    International Nuclear Information System (INIS)

    Teksam, Mehmet; McKinney, Alexander; Truwit, Charles L.

    2004-01-01

    Multi-slice CT (MSCT) scanners provided significant improvement in vascular applications. In this study, our purpose was to determine the clinical utility of MSCTA in evaluation of extracranial-intracranial (EC-IC) bypass patency. Eleven (4 men and 7 women; mean age, 46 years; age range, 19-68 years) consecutive patients who underwent MSCTA and DSA after EC-IC bypass surgery were evaluated retrospectively. All patients underwent DSA within 3 weeks of MSCTA. The indications for EC-IC bypass were severe stenosis or occlusion of intracranial arteries in seven patients and therapeutic occlusion of intracranial artery for unclippable giant aneurysm in four patients. Ten patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and one patient underwent occipital artery-posterior cerebral artery (PCA) bypass. Eight STA-MCA bypasses in six patients were patent on MSCTA which were confirmed on DSA. Two MSCTA bypasses and one occipital artery-posterior cerebral artery (PCA) bypass were occluded in three patients on MSCTA and DSA. In one patient, minimal stenosis of the STA-MCA bypass was identified on MSCTA and DSA. In 1 patient, STA-MCA bypass was not well seen on MSCTA and suspected for occlusion. DSA identified the occlusion of bypass on this patient. MSCTA seems to be a very promising noninvasive technique in evaluation of EC-IC bypass

  8. 21 CFR 870.4360 - Nonroller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonroller-type cardiopulmonary bypass blood pump... Nonroller-type cardiopulmonary bypass blood pump. (a) Identification. A nonroller-type cardiopulmonary bypass blood pump is a device that uses a method other than revolving rollers to pump the blood through...

  9. 21 CFR 870.4370 - Roller-type cardiopulmonary bypass blood pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Roller-type cardiopulmonary bypass blood pump. 870... Roller-type cardiopulmonary bypass blood pump. (a) Identification. A roller-type cardiopulmonary bypass blood pump is a device that uses a revolving roller mechanism to pump the blood through the...

  10. 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 blood filter is a device used as part of a gas exchange (oxygenator) system to filter nonbiologic...

  11. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class II...

  12. On-pump versus off-pump coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Houlind, Kim Christian

    2013-01-01

    Off pump coronary artery bypass surgery has been purported to be safer than conventional coronary artery bypass surgery performed using cardiopulmonary bypass. This theory was supported by a number of early series, but failed to be confirmed by a number of small, randomized controlled trials...

  13. Esophageal bypass after failed chemoradiotherapy for unresectable esophageal cancer

    International Nuclear Information System (INIS)

    Matono, Satoru; Tanaka, Toshiaki; Mori, Naoki; Nagano, Takeshi; Fujita, Hiromasa; Shirouzu, Kazuo

    2013-01-01

    Esophageal stenosis and/or fistula often occur after chemoradiotherapy (CRT) for unresectable esophageal cancer. In such patients, an esophageal stent can help achieve oral intake. However an esophageal stent cannot be inserted where there is complete stenosis or where the tumor is located. In such cases, esophageal bypass surgery may be necessary. Here, we investigated the clinical characteristics and outcomes in patients who underwent esophageal bypass surgery in our institution. We reviewed 10 cases of esophageal bypass surgery (gastric tube in 8 cases, colon in 2 cases) after CRT for unresectable esophageal cancer, between 2001 and 2009. There were 5 of stenosis-only cases, 4 fistula-only cases, and 1 case of stenosis and fistula. There were postoperative complications in 5 cases (50%), and all these were treated conservatively and healed. The median survival from surgery to peroral intake was 20 days (range 9-90 days), and the median survival after starting peroral intake was 130 days (range 48-293 days). Esophageal bypass surgery can achieve good performance status and improve peroral intake. (author)

  14. Myocardial injury and protection related to cardiopulmonary bypass

    NARCIS (Netherlands)

    de Hert, Stefan; Moerman, Anneliese

    2015-01-01

    During cardiac surgery with cardiopulmonary bypass, the heart is isolated from the circulation. This inevitably induces myocardial ischemia. In addition to this ischemic insult, an additional hit will occur upon reperfusion, which may worsen the extent of tissue damage and organ dysfunction. Over

  15. Gastrointestinal motility during cardiopulmonary bypass : A sonomicrometric study

    NARCIS (Netherlands)

    Gu, YJ; de Kroon, TL; Elstrodt, JM; Rakhorst, G

    Cardiopulmonary bypass (CPB) is known to impair the integrity of the gastrointestinal tract. However, little is known about the movement behavior of the gastrointestinal tract during CPB. This study was aimed to assess the gastrointestinal motility with sonomicrometry, a distance measurement using

  16. PREVENTION OF BLOOD ACTIVATION DURING AND COMPLICATIONS AFTER CARDIOPULMONARY BYPASS

    NARCIS (Netherlands)

    VANOEVEREN, W; WILDEVUUR, CRH

    1991-01-01

    The cardiopulmonary bypass (CPB) circuit for open heart surgery initiates a whole body inflammatory reaction (WBIR) resulting in impaired hemostasis and organ dysfunction. Impaired hemostasis appeared to be related to the activation of the contact system (factor XII), which can be inhibited by

  17. Emergency bypass post percutaneous atrial ablation: a case report.

    LENUS (Irish Health Repository)

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  18. Simulation of a severe accident at a typical PWR due to break of a hot leg ECCS line using MELCOR code

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Min; Sabundjian, Gaianê, E-mail: smlee@ipen.br, E-mail: gdjian@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2017-11-01

    The aim of this work was to simulate a severe accident at a typical PWR caused by break in Emergency Core Cooling System (ECCS) line of a hot leg using the MELCOR code. The nodalization of this typical PWR was elaborated by the Global Research for Safety (GRS) and provided to the CNEN for analysis of the severe accidents at the Angra 2, which is similar to that PWR. Although both of them are not identical the results obtained for that typical PWR may be valuable because of the lack of officially published calculation for Angra 2. Relevant parameters such as pressure, temperature and water level in various control volumes after the break in the hot leg were calculated as well as degree of core degradation and hydrogen concentration in containment. The result obtained in this work could be considered satisfactory in the sense that the physical phenomena reproduced by the simulation were in general very reasonable, and most of the events occurred within acceptable time intervals. However, the uncertainty analysis was not carried out in this work. Furthermore, this scenario could be used as a base for the study of the effectiveness of some preventive or/and mitigating measures of Severe Accident Management (SAMG) by adding associated conditions for each measure in its input. (author)

  19. Simulation of a severe accident at a typical PWR due to break of a hot leg ECCS line using MELCOR code

    International Nuclear Information System (INIS)

    Lee, Seung Min; Sabundjian, Gaianê

    2017-01-01

    The aim of this work was to simulate a severe accident at a typical PWR caused by break in Emergency Core Cooling System (ECCS) line of a hot leg using the MELCOR code. The nodalization of this typical PWR was elaborated by the Global Research for Safety (GRS) and provided to the CNEN for analysis of the severe accidents at the Angra 2, which is similar to that PWR. Although both of them are not identical the results obtained for that typical PWR may be valuable because of the lack of officially published calculation for Angra 2. Relevant parameters such as pressure, temperature and water level in various control volumes after the break in the hot leg were calculated as well as degree of core degradation and hydrogen concentration in containment. The result obtained in this work could be considered satisfactory in the sense that the physical phenomena reproduced by the simulation were in general very reasonable, and most of the events occurred within acceptable time intervals. However, the uncertainty analysis was not carried out in this work. Furthermore, this scenario could be used as a base for the study of the effectiveness of some preventive or/and mitigating measures of Severe Accident Management (SAMG) by adding associated conditions for each measure in its input. (author)

  20. Correlated electron capture in the impact parameter and final projectile charge-state dependence of ECC cusp production in 0.53 MeV u-1 F8+ + Ne

    International Nuclear Information System (INIS)

    Skutlartz, A.; Hagmann, S.; Schmidt-Boecking, H.

    1988-01-01

    The impact parameter dependence of ECC cusp electron production in collisions of fast, highly charged ions with atoms is investigated by measuring the scattered projectiles in coincidence with cusp electrons emitted at 0 0 with respect to the beam axis. The absolute probabilities for ECC cusp production show a maximum at b ≅ 0.10 au, decrease strongly for smaller impact parameters and more gently toward larger impact parameters. In addition the final charge state of the scattered projectile is also determined simultaneously for each collision event. The probabilities, as a function of the projectile final charge state, are large for the case where at least one or more electrons are simultaneously captured into bound states of the projectile, but are surprisingly small for collisions in which a projectile did not capture an electron into a bound state. (author)

  1. Is phonology bypassed in normal or dyslexic development?

    Science.gov (United States)

    Pennington, B F; Lefly, D L; Van Orden, G C; Bookman, M O; Smith, S D

    1987-01-01

    A pervasive assumption in most accounts of normal reading and spelling development is that phonological coding is important early in development but is subsequently superseded by faster, orthographic coding which bypasses phonology. We call this assumption, which derives from dual process theory, the developmental bypass hypothesis. The present study tests four specific predictions of the developmental bypass hypothesis by comparing dyslexics and nondyslexics from the same families in a cross-sectional design. The four predictions are: 1) That phonological coding skill develops early in normal readers and soon reaches asymptote, whereas orthographic coding skill has a protracted course of development; 2) that the correlation of adult reading or spelling performance with phonological coding skill is considerably less than the correlation with orthographic coding skill; 3) that dyslexics who are mainly deficient in phonological coding skill should be able to bypass this deficit and eventually close the gap in reading and spelling performance; and 4) that the greatest differences between dyslexics and developmental controls on measures of phonological coding skill should be observed early rather than late in development.None of the four predictions of the developmental bypass hypothesis were upheld. Phonological coding skill continued to develop in nondyslexics until adulthood. It accounted for a substantial (32-53 percent) portion of the variance in reading and spelling performance in adult nondyslexics, whereas orthographic coding skill did not account for a statistically reliable portion of this variance. The dyslexics differed little across age in phonological coding skill, but made linear progress in orthographic coding skill, surpassing spelling-age (SA) controls by adulthood. Nonetheless, they didnot close the gap in reading and spelling performance. Finally, dyslexics were significantly worse than SA (and Reading Age [RA]) controls in phonological coding skill

  2. Platelet hyperreactivity in response to on- and off-pump coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Bochsen, Louise; Rosengaard, Lisbeth Bredahl; Nielsen, Allan Bybeck

    2009-01-01

    Hypercoagulability has been reported after off-pump coronary artery bypass grafting (OPCAB) compared with patients undergoing standard coronary artery bypass grafting (CABG) with cardiopulmonary bypass. The aim of this study was to evaluate the changes in platelet reactivity in response to cardiac...... and this study identified 23% of patients needing coronary bypass surgery to be at high risk for recurrent ischemic events at 1 month after surgery, based on the MA. These results suggest that a more aggressive antithrombotic treatment might be warranted for patients undergoing coronary artery bypass grafting...

  3. Impact of top end anastomosis design on patency and flow stability in coronary artery bypass grafting.

    Science.gov (United States)

    Koyama, Sachi; Kitamura, Tadashi; Itatani, Keiichi; Yamamoto, Tadashi; Miyazaki, Shohei; Oka, Norihiko; Nakashima, Kouki; Horai, Tetsuya; Ono, Minoru; Miyaji, Kagami

    2016-05-01

    For coronary artery bypass grafting (CABG), free grafts such as a saphenous vein or radial artery are often used for grafts to the lateral and posterior walls. However, the relationship between top-end anastomosis design and long-term patency remains unknown. Because coronary artery blood flow is dominant during diastole, top-end anastomosis may work better if the graft is directed towards the apex, whereas the shortest graft pathway appears to be most efficient. Using computational fluid dynamic models, we evaluated the hemodynamic variables that were affected by the angle of the top-end anastomosis. We created three-dimensional geometries of the aortic root with coronary arteries that involved 75 % stenosis in the obtuse marginal and postero-lateral branches. Two bypass models under vasodilator administration were created: in a"Model A", the top-end anastomosis is parallel to the long axis of the ascending aorta and the graft passed over the conus directed towards the apex; in a "Model B", the top-end anastomosis is directed toward the shortest pathway, and form near the right angles to the long axis of the ascending aorta. Wall shear stress (WSS) and its fluctuation, an oscillatory shear index (OSI) were evaluated to predict fibrosis progression at the anastomosis site and graft flow. Graft flow was 197.3 ml/min and 207.3 ml/min in the "Model A" and "Model B", respectively. The minimal WSS value inside the graft with the "Model A" and "Model B" was 0.53 Pa and 4.09 Pa, respectively, and the OSI value was 0.46 and 0.04, respectively. The top-end anastomosis of a free graft should be directed vertically towards the aorta to achieve the shortest graft pathway to maintain a high graft flow rate and to avoid the risks of endothelial fibrosis and plaque progression over the long-term after CABG.

  4. Evaluation of Factors Influencing Liver Function Test in On-Pump Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Shahrbano Shahbazi

    2013-12-01

    Full Text Available Background: Liver dysfunction during on-pump coronary artery bypass graft surgery (CABG is a rare complication but is associated with significant morbidity and mortality. The ability to identify high-risk patients may be helpful in planning appropriate management strategies. We aimed to evaluate the factors influencing liver function tests during on-pump CABG. Methods: In 146 patients scheduled for on-pump CABG, the liver function test was done preoperatively and on the first postoperative day. Some preoperative and intraoperative risk factors were checked and then the postoperative liver function tests were compared with the preoperative ones. Probable relationships between these changes and the preoperative and intraoperative risk factors were studied. Results: A medical history of diabetes had a significant relationship with the changes in direct bilirubin. Preoperative central venous pressure had a significant relationship with the changes in aspartate aminotransferase and alanine aminotransferase. Use of intra-aortic balloon pump and duration of aortic cross-clamp were significantly related to the changes in the liver function tests except for alanine aminotransferase and alkaline phosphatase. Conclusion: It seems that the techniques for the reduction of cardiopulmonary bypass and aortic cross-clamp duration may be useful to protect liver function. We recommend that a larger population of patients be studied to confirm these findings.

  5. Medical image of the week: Dobhoff tube placement with Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Ali H

    2018-04-01

    Full Text Available No abstract available. Article truncated after 150 words. Roux-en-Y gastric bypass is one of the most commonly performed bariatric operations in the United States. It involves partitioning a small gastric pouch off the proximal stomach and attaching that pouch directly to the intestine, thereby bypassing the large remainder of the stomach (1,2. Placing a Dobhoff tube (DHT and confirming its placement can be challenging due to the change in anatomy after the procedure. Here, we have a 65-year-old woman who presented to the hospital with acute encephalopathy and acute hypoxic respiratory failure due to multifocal pneumonia requiring intubation and prolonged ICU stay. A DHT was inserted after intubation for feeding purposes. An abdominal X-ray was obtained to confirm placement of the DHT (Figure 1. Normally the DHT tip should be placed in the 2nd to 3rd portion of the duodenum and would create a C-shaped tracing on the X-ray. However, in our patient who had history of Roux-en-Y …

  6. Factors associated with mortality in patients undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Cintia Koerich

    Full Text Available ABSTRACT Objective: to investigate the factors associated with mortality in patients undergoing coronary artery bypass grafting in a cardiovascular referral hospital in Santa Catarina. Method: quantitative, exploratory, descriptive and retrospective study. The medical records of 1447 patients, from 2005 to 2013, were analyzed for statistically related variables, these being: profile, hospitalization diagnosis, risk factors for coronary artery disease, complications recorded during the hospitalization, length of hospitalization and cause of death. Results: the mortality rate was 5.3% during the study period. Death was more common in females and those of black skin color, with a mean age of 65 years. Acute myocardial infarction was the most common hospitalization diagnosis. The majority of the complications recorded during hospitalization were characterized by changes in the cardiovascular system, with longer hospitalization periods being directly related to death from septic shock. Conclusion: the data provide subsidies for nursing work with preventive measures and early detection of complications associated with coronary artery bypass grafting. This reinforces the importance of using the data as quality indicators, aiming to guarantee care guided by reliable information to guide managers in planning patient care and high complexity health services.

  7. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  8. Interaction of Liquid Film Flow of Direct Vessel Injection Under the Cross Directional Gas Flow

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han-sol; Lee, Jae-young [Handong Global University, Pohang (Korea, Republic of); Euh, Dong-Jin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    In order to obtain a proper scaling law of the flow, local information of the flow was investigated experimentally and also numerically. A series of experiments were conducted in the 1/20 modified linear scaled plate type test rig to analyze a liquid film from ECC water injection through the DVI nozzle to the downcomer wall. The present study investigates liquid film flow generated in a downcomer of direct vessel injection (DVI) system which is employed as an emergency core cooling (ECC) system during a loss of coolant accident in the Korea nuclear power plant APR1400. During the late reflooding, complicated multi-phase flow phenomena including the wavy film flow, film breakup, entrainment, liquid film shift due to interfacial drag and gas jet impingement occur. A confocal chromatic sensor was used to measure the local instantaneous liquid film thickness and a hydraulic jump in the film flow and boundaries of the film flow. It was found that CFD analysis results without surface tension model showed some difference with the data in surface tension dominated flow region. For the interaction between a liquid film and gas shear flow, CFD results make a good agreement with the real liquid film dynamics in the case of low film Reynolds number or low Weber number flow. In the 1/20 scaled plate type experiment and simulation, the deformed spreading profile results seem to accord with each other at the relatively low We and Re regime.

  9. Análisis de predictores independientes del flujo del bypass coronario en pacientes intervenidos de revascularización miocárdica aislada

    Directory of Open Access Journals (Sweden)

    Stefano Urso

    2017-11-01

    ni analizado como variable continua ni como variable dicotómica. Abstract: Introduction and objective: The transit time flowmeter allows knowing two parameters: the mean bypass flow and pulsatility index. These two parameters, when altered, can suggest a bypass stenosis. Factors other than the permeability of the anastomosis, as the quality of coronary bed, may alter the flow of bypass and complicates its interpretation. The aim of our study is to analyze the independent predictors of the mean flow of aorto-coronary bypasses. Methods: We collected a retrospective series of 90 consecutive patients who underwent isolated coronary artery bypass grafting by the same surgeon from January 2014 to August 2016. From this series, we have built an electronic database where each record corresponds to one graft and the correspondent single or multiple bypasses. Therefore, we built a database including 185 grafts. Of these, 8 grafts were not analyzed because the flow had not been correctly measured. Therefore, the flow and pulsatility index values of 177 grafts were available for our statistical analysis. Results: Multiple linear regression analysis detected two independent predictors of bypass flow: sequential saphenous vein graft (partial r value: 0.32; P<.0001 and arterial graft (partial r-value: –0.23; P=.0021. Therefore, our model showed a direct correlation between use of saphenous graft with sequential technique and bypass flow and an inverse correlation between arterial graft use and bypass flow. Conclusions: The predictors of aorto-coronary bypass flow are the use of an arterial graft (negative coefficient and the use of a sequential venous graft (positive coefficient. Our statistical model has not identified as a predictor the SYNTAX score nor analyzed as a continuous variable nor as a dichotomous variable. Palabras clave: Cirugía coronaria, SYNTAX score, Flujo Bypass, Keywords: Coronary surgery, SYNTAX score, Bypass flow

  10. Performance of a remote steering antenna for ECRH/ECCS applications using 4-wall corrugated square waveguide

    International Nuclear Information System (INIS)

    Kasparek, W.; Gantenbein, G.; Plaum, B.; Wacker, R.; Filipovic, E.; Chirkov, A.V.; Denisov, G.G.; Kuzikov, S.V.; Ohkubo, K.; Hollmann, F.; Wagner, D.

    2003-01-01

    For the upper ECW launcher on ITER, the use of a 'remote steering antenna' based on the imaging properties of rectangular waveguides is planned. To characterise launchers of this type, low-power experiments on a 4-side corrugated square waveguide with a scanning mirror at the input of the waveguide were performed in the frequency range of 140 to 160 GHz. It is shown, that elliptical polarisation needed for ECCD can be transmitted without depolarization. The usable steering range of the antenna is at least -10 angle < φ ≤ + 10 angle. Experiments with the scanning plane in the diagonal of the square waveguide led to a negligible increase the scanning range, and lobes in the upward and downward direction are detected at larger scanning angles. Mitre bends can be integrated into the waveguide without prohibitive extra loss, which is demonstrated by far-field measurements. Detailed calorimetric measurements for this set up confirm this statement for the polarisation perpendicular to the scanning plane, whereas extra loss is measured for the parallel polarisation. Results are discussed and are compared to theory. (authors)

  11. EARLY POSTOPERATIVE COMPLICATIONS IN ROUX-EN-Y GASTRIC BYPASS.

    Science.gov (United States)

    Stoll, Aluisio; Rosin, Leandro; Dias, Mariana Fernandes; Marquiotti, Bruna; Gugelmin, Giovana; Stoll, Gabriela Fanezzi

    Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. To quantify the main early postoperative complications in patients submitted to the gastric bypass. Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death. Bypass gástrico em Y-de-Roux é uma das operações bariátricas mais comuns e leva a perdas consideráveis de peso já nos primeiros meses. Quantificar as principais complicações pós-operatórias precoces em pacientes submetidos ao bypass gástrico. Coorte retrospectiva observacional. Amostra de 1051 pacientes portadores de obesidade grau II associada à comorbidades ou grau III submetidos ao bypass gástrico com acompanhamento de 30 dias a partir da data da operação. A idade média dos pacientes foi de 36 anos com predominância de mulheres (81,1%). O índice de massa corporal pré-operatório médio foi de 43 kg/m². A principal complicação foi fístula (2,3%), seguida de obstrução intestinal (0,5%) e tromboembolismo pulmonar (0,5%). Óbito ocorreu em 0,6% dos casos. No período de 30 dias de pós-operatório a taxa geral de complicações foi de 3,8%; a de reoperação de 2,6% e óbito em 0,6%. A fístula foi a principal complicação e a principal causa de internamento em

  12. Brain machine interface and limb reanimation technologies: restoring function after spinal cord injury through development of a bypass system.

    Science.gov (United States)

    Lobel, Darlene A; Lee, Kendall H

    2014-05-01

    Functional restoration of limb movement after traumatic spinal cord injury (SCI) remains the ultimate goal in SCI treatment and directs the focus of current research strategies. To date, most investigations in the treatment of SCI focus on repairing the injury site. Although offering some promise, these efforts have met with significant roadblocks because treatment measures that are successful in animal trials do not yield similar results in human trials. In contrast to biologic therapies, there are now emerging neural interface technologies, such as brain machine interface (BMI) and limb reanimation through electrical stimulators, to create a bypass around the site of the SCI. The BMI systems analyze brain signals to allow control of devices that are used to assist SCI patients. Such devices may include a computer, robotic arm, or exoskeleton. Limb reanimation technologies, which include functional electrical stimulation, epidural stimulation, and intraspinal microstimulation systems, activate neuronal pathways below the level of the SCI. We present a concise review of recent advances in the BMI and limb reanimation technologies that provides the foundation for the development of a bypass system to improve functional outcome after traumatic SCI. We also discuss challenges to the practical implementation of such a bypass system in both these developing fields. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  13. Effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery: A meta-analysis

    Science.gov (United States)

    FANG, YU; QIU, ZHANDONG; HU, WENTAO; YANG, JIA; YI, XIYAN; HUANG, LIANGJIANG; ZHANG, SUMING

    2014-01-01

    Cognitive impairments are observed in numerous patients following coronary bypass surgery, and piracetam are nootropic compounds that modulate cerebral functions by directly enhancing cognitive processes. The present meta-analysis was conducted to evaluate the protective effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery. The relevant studies were identified by searching Medline, EMBASE, PubMed and the Cochrane Library up to June 2013 and the pertinent bibliographies from the retrieved studies were reviewed. Data were selected from the studies according to predefined criteria. The meta-analysis included two randomized control trials involving 184 patients and including the Syndrom-Kurz test (SKT). Findings of the meta-analysis showed that following treatment the change from baseline observed in five SKT subtest scores, conducted with piracetam patients, indicated a significant advantage over those patients that were in the placebo group. The subtests included immediate pictured object recall, weighted mean difference (WMD)=0.91, 95% confidence interval (CI) 0.51–1.31, Ppiracetam may have been effective in improving the short-term cognitive performance of patients undergoing coronary bypass surgery. High quality, well-controlled and longer randomized trials are required to corroborate this result. PMID:24396419

  14. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

    Science.gov (United States)

    Marr, Brendan; Yenumula, Panduranga

    2012-01-01

    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  15. Renovation work on the Geneva motorway bypass

    CERN Multimedia

    2006-01-01

    The motorway maintenance work currently in progress includes repair work on the Vernier bridge. Temporary traffic restrictions will be in place during summer 2006. From 12 June 2006, for a period of 11 weeks Traffic arriving from the route de Vernier (in the direction of the city centre) will not be able to turn left onto the Vernier bridge to join the motorway but will be deviated via the route de Pré-Bois. From 3 July 2006, for a period of 8 weeks Traffic arriving from the Vernier motorway tunnel (in the direction of Lausanne) and exiting onto the route de Vernier will not be able to turn left. Vehicles will be deviated via the road that runs parallel to the motorway, then via the route de Meyrin and the route de Pré-Bois. Users are invited to follow the road signs in place. For further information: Tel. 163 or www.autoroute-aeroport.ch State of Geneva Department of Construction and Information Technology Civil Engineering Department

  16. Renovation work on the Geneva motorway bypass

    CERN Document Server

    2006-01-01

    The motorway maintenance work currently in progress includes repair work on the Vernier bridge. Temporary traffic restrictions will be in place during summer 2006. From 12 June 2006, for a period of 11 weeks Traffic arriving from the route de Vernier (in the direction of the city centre) will not be able to turn left onto the Vernier bridge to join the motorway but will be deviated via the route de Pré-Bois. From 3 July 2006, for a period of 8 weeks Traffic arriving from the Vernier motorway tunnel (in the direction of Lausanne) and exiting onto the route de Vernier will not be able to turn left. Vehicles will be deviated via the road that runs parallel to the motorway, then via the route de Meyrin and the route de Pré-Bois. Users are invited to follow the road signs in place. For further information: Tel. 163 or www.autoroute-aeroport.ch State of GenevaDepartment of Construction and Information Technology Civil Engineering Department

  17. Management of broken instrument by file bypass technique

    Directory of Open Access Journals (Sweden)

    Sultana Parveen

    2017-02-01

    Full Text Available Different devices and techniques have been developed to retrieve fractured instruments during the endodontic procedures. This case report describes the management of a broken instrument, which was accidentally broken during cleaning and shaping of the root canal in right 2nd molar tooth. A # 25 stainless steel K-file was separated in mesiobuccal canal of the treated tooth. At first, a radiograph was taken to confirm the level of separation of the instrument. The instrument was found to be separated at the apical 3rd of the mesial canal and then file bypass technique was performed. Calcium hydroxide dressing was given for 7 days followed by obturation with guttapercha cone and zinc oxide eugenol sealer in lateral condensation technique. It can be concluded that bypass technique can be considered as simple and effective technique for the management of broken instrument into the root canal.

  18. Decrease of total antioxidant capacity during coronary artery bypass surgery.

    Science.gov (United States)

    Kunt, Alper Sami; Selek, Sahbettin; Celik, Hakim; Demir, Deniz; Erel, Ozcan; Andac, Mehmet Halit

    2006-09-01

    Cardiac surgery induces an oxidative stress, which may lead to impairment of cardiac function. In this study, we aimed to measure the changes of oxidative and antioxidative status of patients undergoing coronary artery bypass surgery (CABG). We studied 79 patients who underwent CABG with and without cardiopulmonary bypass (CPB). Of the 79 patients, 39 had CPB and 40 did not. Blood samples were drawn before, during, and after the surgery. Antioxidant status was evaluated by measuring total antioxidant capacity (TAC), and oxidative status was evaluated by measuring total peroxide (TP) levels and oxidative stress index (OSI). TP and OSI levels increased, while TAC decreased progressively after the beginning of surgery, for all patients. There were negative correlations between TAC levels and aortic cross-clamping period and anastomosis time ( r = -0.553, p antioxidant vitamins such as vitamins C and E may be beneficial for patients undergoing CABG.

  19. Aorto-aortic intrathoracic bypass in surgical treatment of aortic

    International Nuclear Information System (INIS)

    Gutierrez Perez, F.; Duran Reyes, A.; Bigalli, D.; Filgueira Berobide, J.

    1998-01-01

    The prevalence of coarctation of the aorta is 6.5 percent of all congenital heart defects, according to national and international data. There is a restenosis rate of patients after surgery. Factors that influence this evolution depends on the age at which patients underwent surgery for the first time the anatomy of the aortic arch and type of surgical technique. Several procedures can be used to correct the coarctation, which include surgery and balloon catheter dilation. We present here a case of a patient of 22 years old, with a recurrent coarctation of the aorta studied by echocardiography and magnetic resonance imaging. The patient underwent surgery a third time. We used an anterior approach (median sternotomy) and performed an aortic bypass graft, intrathoracic, under cardiopulmonary bypass. Evolved favorably and was discharged on the sixth day of post operative day (Author) [es

  20. Pharmacological Bypass of Cockayne Syndrome B Function in Neuronal Differentiation

    Directory of Open Access Journals (Sweden)

    Yuming Wang

    2016-03-01

    Full Text Available Cockayne syndrome (CS is a severe neurodevelopmental disorder characterized by growth abnormalities, premature aging, and photosensitivity. Mutation of Cockayne syndrome B (CSB affects neuronal gene expression and differentiation, so we attempted to bypass its function by expressing downstream target genes. Intriguingly, ectopic expression of Synaptotagmin 9 (SYT9, a key component of the machinery controlling neurotrophin release, bypasses the need for CSB in neuritogenesis. Importantly, brain-derived neurotrophic factor (BDNF, a neurotrophin implicated in neuronal differentiation and synaptic modulation, and pharmacological mimics such as 7,8-dihydroxyflavone and amitriptyline can compensate for CSB deficiency in cell models of neuronal differentiation as well. SYT9 and BDNF are downregulated in CS patient brain tissue, further indicating that sub-optimal neurotrophin signaling underlies neurological defects in CS. In addition to shedding light on cellular mechanisms underlying CS and pointing to future avenues for pharmacological intervention, these data suggest an important role for SYT9 in neuronal differentiation.

  1. Distinctive striatal dopamine signaling after dieting and gastric bypass.

    Science.gov (United States)

    Hankir, Mohammed K; Ashrafian, Hutan; Hesse, Swen; Horstmann, Annette; Fenske, Wiebke K

    2015-05-01

    Highly palatable and/or calorically dense foods, such as those rich in fat, engage the striatum to govern and set complex behaviors. Striatal dopamine signaling has been implicated in hedonic feeding and the development of obesity. Dieting and bariatric surgery have markedly different outcomes on weight loss, yet how these interventions affect central homeostatic and food reward processing remains poorly understood. Here, we propose that dieting and gastric bypass produce distinct changes in peripheral factors with known roles in regulating energy homeostasis, resulting in differential modulation of nigrostriatal and mesolimbic dopaminergic reward circuits. Enhancement of intestinal fat metabolism after gastric bypass may also modify striatal dopamine signaling contributing to its unique long-term effects on feeding behavior and body weight in obese individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. In situ saphenous vein bypass surgery in diabetic patients

    DEFF Research Database (Denmark)

    Jensen, L P; Schroeder, T V; Lorentzen, J E

    1992-01-01

    .005). Indication for surgery was gangrene or ulceration in 57% of diabetics, as opposed to 36% in non-diabetic patients (p = 0.0002). A femoro-popliteal bypass was performed in 18% of patients, whereas 82% received an infrapopliteal procedure, of which 42% were to the distal third of the calf or foot. Diabetic......From 1986 through to 1990 a total of 483 consecutive in situ infra-inguinal vein bypass procedures were performed in 444 patients, of whom 112 (25%) were diabetics (57 insulin dependent diabetes mellitus and 55 non-insulin-dependent diabetes mellitus). Based on a prospective vascular data registry...... this material was analysed to determine the influence of diabetes on the outcome. Preoperative risk factors were equally distributed among diabetic and non-diabetic patients, except for smoking habits (diabetics: 48%; non-diabetics: 64%, p = 0.002) and cardiac disease (diabetics: 45%; non-diabetics: 29%, p = 0...

  3. Study of bypass diodes configuration on PV modules

    Energy Technology Data Exchange (ETDEWEB)

    Silvestre, S.; Boronat, A.; Chouder, A. [Electronics Engineering Department - UPC., C/Jordi Girona 1-3, Modul C4 Campus Nord UPC., 08034 Barcelona (Spain)

    2009-09-15

    A procedure of simulation and modelling solar cells and PV modules, working partially shadowed in Pspice environment, is presented. Simulation results have been contrasted with real measured data from a commercial PV module of 209 Wp from Siliken. Some cases of study are presented as application examples of this simulation methodology, showing its potential on the design of bypass diodes configuration to include in a PV module and also on the study of PV generators working in partial shading conditions. (author)

  4. Microsurgical Bypass Training Rat Model: Part 2-Anastomosis Configurations.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Yousef, Sonia; Mokhtari, Pooneh; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal preclinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery. Thirteen male Sprague-Dawley rats underwent inhalant anesthesia. The abdominal aorta and the CIAs were exposed. The distances between the major branches of the aorta were measured to find the optimal location for an end-to-end anastomosis. Also, the feasibility of performing side-to-side and end-to-side anastomoses between the CIAs was assessed. All bypass configurations could be performed between the left renal artery and the CIA bifurcation. The longest segments of the aorta without major branches were 1) between the left renal and left iliolumbar arteries (16.9 mm ± 4.6), and 2) between the right iliolumbar artery and the aortic bifurcation (9.7 mm ± 4.7). The CIAs could be juxtaposed for an average length of 7.6 mm ± 1.3, for a side-to-side anastomosis. The left CIA could be successfully reimplanted on to the right CIA at an average distance of 9.1 mm ± 1.6 from the aortic bifurcation. Our results show that rat's abdominal aorta and CIAs may be effectively used for all the anastomosis configurations used in cerebral revascularization procedures. We also provide technical nuances and anatomic descriptions to plan for practicing each bypass configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Constitutive modeling of coronary artery bypass graft with incorporated torsion

    Czech Academy of Sciences Publication Activity Database

    Horný, L.; Chlup, Hynek; Žitný, R.; Adámek, T.

    2009-01-01

    Roč. 49, č. 2 (2009), s. 273-277 ISSN 0543-5846 R&D Projects: GA ČR(CZ) GA106/08/0557 Institutional research plan: CEZ:AV0Z20760514 Keywords : coronary artery bypass graft * constitutive model * digital image correlation Subject RIV: BJ - Thermodynamics Impact factor: 0.439, year: 2009 http://web.tuke.sk/sjf-kamam/mmams2009/contents.pdf

  6. Disseminated intravascular and intracardiac thrombosis after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Deepak K Tempe

    2017-01-01

    Full Text Available Massive intracardiac and intravascular thrombosis is a rare complication following cardiopulmonary bypass (CPB. Most of the cases of the disseminated thrombosis have been reported in patients undergoing complex cardiac surgeries and those receiving antifibrinolytic agents during CPB. We report the occurrence of disseminated intravascular and intracardiac thrombosis after CPB in a patient undergoing mitral valve replacement in which no antifibrinolytic agent was used. The possible pathophysiology and management of the patient is discussed.

  7. Evaluation of coronary artery bypass grafts with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Okamura, Yoshitaka; Yamada, Yasuyuki; Mochizuki, Yoshihiko; Iida, Hiroshi; Mori, Hideaki; Sugita, You-ichi; Shimada, Kou-ichirou

    1997-01-01

    Currently, the efficacy of magnetic resonance imaging (MRI) for evaluating coronary artery disease has been reported. In this study, we have evaluated the usefulness and the problems of MRI for evaluating the patency of coronary artery bypass grafts. Thirty-five patients who received coronary artery bypass grafting (CABG) were evaluated by using MRI for determining the graft patency compared with conventional coronary angiography. There were 30 men and 5 women. The mean age was 61.2 years (range 45 to 75). The 35 patients had a total of 92 grafts (28 internal thoracic artery, 7 gastroepiploic artery and 57 saphenous vein grafts). Magnetic resonance coronary angiogram (MRCA) was performed with SIGNA HORIZON 1.5 T (GE Inc.) by using 2D-FASTCARD sequence. All patients underwent imaging in the transverse and coronal planes, most had imaging in the sagittal plane, and a few had in the oblique plane. By using MRCA, 82 of 90 grafts were diagnosed correctly as patent, and 1 of 2 grafts were diagnosed correctly as occluded. Thirty-four of 40 LAD grafts (85%), 20 of 22 RCA grafts (91%) and 29 of 30 Cx grafts (97%) were correctly evaluated. The efficacy of MRCA for evaluating the patency of coronary artery bypass grafts was recognized. But the sternal wire (stainless steel) and hemoclip interfere with the interpretation and reduce the sensitivity. Higher sensitivity may be obtained by changing the material of the sternal wires and hemoclips at coronary surgery. (author)

  8. 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.

  9. Modulation method of scroll compressor based on suction gas bypass

    International Nuclear Information System (INIS)

    Wang Baolong; Han Linjun; Shi Wenxing; Li Xianting

    2012-01-01

    The air conditioners and heat pumps tend to work in much mild environments and part load situations rather than provide the rated full capacity under severe rated testing conditions. Both the capacity and inner compression ratio of the compressor should be regulated according to the working condition for higher energy efficiency and occupants’ comfort. A potential modulating technology of the scroll compressor, suction gas bypass, is investigated in this paper. The principle and operation method are illuminated and the adaptability is validated by experiments and simulations. As a conclusion, an appropriate suction gas bypass can reduce the inner compression loss of the scroll compressor under over compression conditions, enhance the system COP and also largely decrease the heating/cooling capacity of the refrigeration/heat pump system. - Highlights: ► Suction gas bypass (SGB) is an effective regulating method of scroll compressor. ► SGB reduces the inner compression loss under over compression conditions. ► SGB largely decreases the heating/cooling capacity of the refrigeration system.

  10. Carotid disease in diabetic patients undergoing coronary artery bypass grafting

    International Nuclear Information System (INIS)

    Shahid, M.; Abid, A.R.; Dar, M.A.; Noeman, A.; Amin, S.; Azhar, M.

    2012-01-01

    Objective: To compare the severity of carotid artery disease in diabetic and non-diabetic patients undergoing coronary artery bypass grafting. Methods: From January to June 2008, 379 patients undergoing elective coronary artery bypass surgery were preoperatively evaluated for the presence of carotid stenoses by duplex scanning. Patients were divided into two groups, Group I, 156 (41.2%) diabetic patients and Group II, 223 (58.8%) non-diabetic patients. Results: There were 314 (82.8%) males and 65 (17.2%) females with a mean age of 57.2+-9.1 years. In diabetic group there were 125 (80.1%) males and 31 (19.9%) females with a mean age of 56.3+-8.9 years. Left main stem stenosis was present in 59 (37.8%) diabetics and 45 (20.2%) non-diabetics (p 70% stenosis was present in 20 (5.3%) with 13 (8.3%) diabetics and 7 (3.1%) non-diabetics (p<0.025). Stenosis of 50-70% was observed in 30 (7.9%) of which 17 (10.9%) were diabetics and 13 (5.8%) were non-diabetics. Conclusion: Presence of diabetes mellitus is associated with diffuse coronary artery disease and significant carotid artery disease in patients undergoing coronary artery bypass grafting. (author)

  11. Ruptured peroneal aneurysm after infrapopliteal prosthetic bypass with Taylor patch

    Directory of Open Access Journals (Sweden)

    Florian Enzmann

    Full Text Available Introduction: A 45-year-old mailman underwent an implantation of a femoro-peroneal polytetrafluoroethylene (PTFE bypass with a distal Taylor patch six years prior to admission after two failed autologous reconstructions and extensive fasciotomy. The initial pathology was an acute ischemia due to popliteal entrapment with subsequent popliteal thrombectomy. Report: The patient was examined because of pain, reduction of walking distance and development of a palpable mass at the medial fasciotomy site. A 6-cm pseudoaneurysm with complete disruption of the suture line of the vein patch was discovered and resected. Arterial continuity with a vein interposition graft was established using non-reversed cephalic vein. Conclusion: The etiology of the aneurysm is not entirely clear. One may argue that the fourth revascularization could have been performed with an arm vein instead of a prosthetic graft with the probability of a better long term patency in a young patient. 15 months after the procedure the bypass is patent and the patient is without any symptoms. This complication of a Taylor patch has not been reported before. Keywords: Taylor patch, Pseudoaneurysm, Infrapopliteal bypass

  12. Simultaneous nephrectomy and coronary artery bypass grafting through extended sternotomy

    Directory of Open Access Journals (Sweden)

    Budrikis Algimantas

    2012-08-01

    Full Text Available Abstract Background The advances in surgical techniques, resuscitation and anesthesiology support over the last years have allowed simultaneous thoracic and abdominal operations to be made for cancer and concomitant severe heart vessel disease relieving the patient from several diseases simultaneously and achieving long lasting remission or cure. Clinical case A simultaneous nephrectomy and coronary artery bypass grafting procedure through extended sternotomy is reported. A 63-year-old man with severe coronary artery disease was found to have renal carcinoma. Diagnosis Postoperative pathological investigation of the tumor revealed the presence of renal cell carcinoma pT3a N0 M0, G2. Coronarography revealed advanced three-vessel coronary artery disease. Treatment We successfully performed a simultaneous curative surgery for renal carcinoma and coronary artery bypass graft surgery under cardiopulmonary bypass using a novel technique of extended sternotomy. Simultaneous surgery thus appears to be a beneficial and safe approach for the treatment of coronary artery disease and resectable renal cancer in carefully selected patients.

  13. Flow Simulation of Supersonic Inlet with Bypass Annular Duct

    Science.gov (United States)

    Kim, HyoungJin; Kumano, Takayasu; Liou, Meng-Sing; Povinelli, Louis A.; Conners, Timothy R.

    2011-01-01

    A relaxed isentropic compression supersonic inlet is a new concept that produces smaller cowl drag than a conventional inlet, but incurs lower total pressure recovery and increased flow distortion in the (radially) outer flowpath. A supersonic inlet comprising a bypass annulus to the relaxed isentropic compression inlet dumps out airflow of low quality through the bypass duct. A reliable computational fluid dynamics solution can provide considerable useful information to ascertain quantitatively relative merits of the concept, and further provide a basis for optimizing the design. For a fast and reliable performance evaluation of the inlet performance, an equivalent axisymmetric model whose area changes accounts for geometric and physical (blockage) effects resulting from the original complex three-dimensional configuration is proposed. In addition, full three-dimensional calculations are conducted for studying flow phenomena and verifying the validity of the equivalent model. The inlet-engine coupling is carried out by embedding numerical propulsion system simulation engine data into the flow solver for interactive boundary conditions at the engine fan face and exhaust plane. It was found that the blockage resulting from complex three-dimensional geometries in the bypass duct causes significant degradation of inlet performance by pushing the terminal normal shock upstream.

  14. Breast cancer biomarkers predict weight loss after gastric bypass surgery

    Directory of Open Access Journals (Sweden)

    Sauter Edward R

    2012-01-01

    Full Text Available Abstract Background Obesity has long been associated with postmenopausal breast cancer risk and more recently with premenopausal breast cancer risk. We previously observed that nipple aspirate fluid (n levels of prostate specific antigen (PSA were associated with obesity. Serum (s levels of adiponectin are lower in women with higher body mass index (BMI and with breast cancer. We conducted a prospective study of obese women who underwent gastric bypass surgery to determine: 1 change in n- and s-adiponectin and nPSA after surgery and 2 if biomarker change is related to change in BMI. Samples (30-s, 28-n and BMI were obtained from women 0, 3, 6 and 12 months after surgery. Findings There was a significant increase after surgery in pre- but not postmenopausal women at all time points in s-adiponectin and at 3 and 6 months in n-adiponectin. Low n-PSA and high s-adiponectin values were highly correlated with decrease in BMI from baseline. Conclusions Adiponectin increases locally in the breast and systemically in premenopausal women after gastric bypass. s-adiponectin in pre- and nPSA in postmenopausal women correlated with greater weight loss. This study provides preliminary evidence for biologic markers to predict weight loss after gastric bypass surgery.

  15. Assessing Patient bypass Behavior Using Taxi Trip Origin–Destination (OD Data

    Directory of Open Access Journals (Sweden)

    Gege Yang

    2016-09-01

    Full Text Available Many patients prefer to use the best hospitals even if there are one or more other hospitals closer to their homes; this behavior is called “hospital bypass behavior”. Because this behavior can be problematic in urban areas, it is important that it be reduced. In this paper, the taxi GPS data of Beijing and Suzhou were used to measure hospital bypass behavior. The “bypass behavior index” (BBI represents the bypass behavior for each hospital. The results indicated that the mean hospital bypass trip distance value ranges from 5.988 km to 9.754 km in Beijing and from 4.168 km to 10.283 km in Suzhou. In general, the bypass shares of both areas show a gradually increasing trend. The following hospitals exhibited significant patient bypass behavior: the 301 Hospital, Beijing Children’s Hospital, the Second Affiliated Hospital of Soochow University and the Suzhou Hospital of Traditional Chinese Medicine. The hospitals’ reputation, transport accessibility and spatial distribution were found to be the main factors affecting patient bypass behavior. Although the hospital bypass phenomena generally appeared to be more pronounced in Beijing, the bypass trip distances between hospitals were found to be more significant in Suzhou.

  16. Graft type for femoro-popliteal bypass surgery.

    Science.gov (United States)

    Ambler, Graeme K; Twine, Christopher P

    2018-02-11

    Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves grafts using autologous vein, polytetrafluoroethylene (PTFE) or Dacron as a bypass conduit. This is the second update of a Cochrane review first published in 1999 and last updated in 2010. To assess the effects of bypass graft type in the treatment of stenosis or occlusion of the femoro-popliteal arterial segment, for above- and below-knee femoro-popliteal bypass grafts. For this update, the Cochrane Vascular Information Specialist searched the Vascular Specialised Register (13 March 2017) and CENTRAL (2017, Issue 2). Trial registries were also searched. We included randomised trials comparing at least two different types of femoro-popliteal grafts for arterial reconstruction in patients with femoro-popliteal ischaemia. Randomised controlled trials comparing bypass grafting to angioplasty or to other interventions were not included. Both review authors (GKA and CPT) independently screened studies, extracted data, assessed trials for risk of bias and graded the quality of the evidence using GRADE criteria. We included nineteen randomised controlled trials, with a total of 3123 patients (2547 above-knee, 576 below-knee bypass surgery). In total, nine graft types were compared (autologous vein, polytetrafluoroethylene (PTFE) with and without vein cuff, human umbilical vein (HUV), polyurethane (PUR), Dacron and heparin bonded Dacron (HBD); FUSION BIOLINE and Dacron with external support). Studies differed in which graft types they compared and follow-up ranged from six months to 10 years.Above-knee bypassFor above-knee bypass, there was moderate-quality evidence that autologous vein grafts improve primary patency compared to prosthetic grafts by 60 months (Peto odds ratio (OR) 0.47, 95% confidence interval (CI

  17. Frequent change of procedure during coronary artery bypass surgery suggests insufficient preoperative diagnostic strategy

    DEFF Research Database (Denmark)

    Eckardt, Rozy; Kjeldsen, Bo Juel; Thayssen, Per

    2007-01-01

    We sought to evaluate how often and in what way surgeons change peroperatively their preoperative coronary artery bypass grafting strategy and to what degree these changes affect postoperative graft patency. A series of 109 patients with stable angina pectoris and at least one occluded coronary...... a discrepancy in 22% of the patients, resulting in a lower or higher number of grafts than pre-operatively estimated. The difference in shift rates between the three sites, left anterior descending, left circumflex, and right coronary artery, was significant (P=0.014). Patency rates were highest when only...... preoperatively planned grafts were inserted. When shifts occurred, no matter in which direction, it resulted in a decreased patency rate of the inserted grafts. This finding was significant for LAD (P=0.037). Our findings might indicate the necessity of future studies with the use of scintigraphy or fractional...

  18. A Case of Severe Accidental Hypothermia Successfully Treated with Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Erfun M. Hatam

    2017-01-01

    Full Text Available After missing for seven days, a 34-year-old female was found with a rectal temperature of 19.8oC. Instead of attempting aggressive rewarming in the emergency department she was directly transferred to the operating room for extracorporeal rewarming. She received cardiopulmonary bypass (CPB for 66 minutes at an initial warming rate of 12oC/ hour and warmed to 36.2oC. Her postoperative course was complicated by sepsis, which eventually led to bilateral below-knee amputations after refusing antibiotics. She was discharged 22 days after admission, with full neurologic recovery. This remarkable case highlights the emerging role of CPB as the definitive therapy for severe accidental hypothermia.

  19. Passage of downstream migrant American eels through an airlift-assisted deep bypass

    Science.gov (United States)

    Haro, Alexander J.; Watten, Barnaby J.; Noreika, John

    2016-01-01

    Traditional downstream guidance and bypass facilities for anadromous fishes (i.e., surface bypasses, surface guidance structures, and behavioral barriers) have frequently been ineffective for anguillid eels. Because eels typically spend the majority of their time near the bottom in the vicinity of intake structures, deep bypass structures with entrances near the bottom hold promise for increased effectiveness, thereby aiding in the recovery of this important species. A new design of a deep bypass system that uses airlift technology (the Conte Airlift Bypass) to induce flow in a bypass pipe was tested in a simulated intake entrance environment under controlled laboratory conditions. Water velocities of 0.9–1.5 m s−1 could be generated at the bypass entrance (opening with 0.073 m2 area), with corresponding flows through the bypass pipe of 0.07–0.11 m3 s−1. Gas saturation and hydrostatic pressure within the bypass pipe did not vary appreciably from a control (no air) condition under tested airflows. Migratory silver-phase American eels (Anguilla rostrata) tested during dark conditions readily located, entered, and passed through the bypass; initial avoidance rates (eels approaching but not entering the bypass entrance) were lower at higher entrance velocities. Eels that investigated the bypass pipe entrance tended to enter headfirst, but those that then exited the pipe upstream did so more frequently at lower entrance velocities. Eels appeared to swim against the flow while being transported downstream through the pipe; median transit times through the bypass for each test velocity ranged from 5.8 to 12.2 s, with transit time decreasing with increasing entrance velocity. Eels did not show strong avoidance of the vertical section of the pipe which contained injected air. No mortality or injury of bypassed eels was observed, and individual eels repeatedly passed through the bypass at rates of up to 40 passes per hour, suggesting that individuals do not

  20. 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.

  1. DNA polymerase eta participates in the mutagenic bypass of adducts induced by benzo[a]pyrene diol epoxide in mammalian cells.

    Directory of Open Access Journals (Sweden)

    Alden C Klarer

    Full Text Available Y-family DNA-polymerases have larger active sites that can accommodate bulky DNA adducts allowing them to bypass these lesions during replication. One member, polymerase eta (pol eta, is specialized for the bypass of UV-induced thymidine-thymidine dimers, correctly inserting two adenines. Loss of pol eta function is the molecular basis for xeroderma pigmentosum (XP variant where the accumulation of mutations results in a dramatic increase in UV-induced skin cancers. Less is known about the role of pol eta in the bypass of other DNA adducts. A commonly encountered DNA adduct is that caused by benzo[a]pyrene diol epoxide (BPDE, the ultimate carcinogenic metabolite of the environmental chemical benzo[a]pyrene. Here, treatment of pol eta-deficient fibroblasts from humans and mice with BPDE resulted in a significant decrease in Hprt gene mutations. These studies in mammalian cells support a number of in vitro reports that purified pol eta has error-prone activity on plasmids with site-directed BPDE adducts. Sequencing the Hprt gene from this work shows that the majority of mutations are G>T transversions. These data suggest that pol eta has error-prone activity when bypassing BPDE-adducts. Understanding the basis of environmental carcinogen-derived mutations may enable prevention strategies to reduce such mutations with the intent to reduce the number of environmentally relevant cancers.

  2. A study on bypass flow gap distribution in a prismatic VHTR core

    International Nuclear Information System (INIS)

    Kim, M. H.; Jo, C. K.; Lim, H. S.

    2010-01-01

    Core bypass flow in VHTR is one of the key issues for core thermal margins and efficiency. The bypass flow in the prismatic core varies during core cycles due to the irradiation shrinkage and thermal expansion of the graphite blocks. A procedure to evaluate the local gap size variation between graphite blocks was developed and applied to a prismatic core VHTR. The influence of the core restraint mechanism on the bypass flow gap was evaluated. The predicted gap size is as much as 8 mm when the graphite block is exposed to its allowable limit of irradiation fluence. The analysis for the core bypass flow and hot spot was carried out based on the calculated gap distributions. The results indicate that the bypass flow and the location of core hot spots are closely related and a measure to reduce the bypass flow is necessary. (authors)

  3. Alternative energy sources: ECC report

    International Nuclear Information System (INIS)

    Renwick, Lord; Stoddart, Lord; Lauderdale, Earl of

    1988-01-01

    The European Communities Committee Report on Alternative Energy Resources was debated. Six alternative energy sources were first described - wind power, biomass, geothermal energy, solar energy, wave and tidal power. Combined heat and power was also mentioned. General questions concerning alternative energy sources were then considered. In particular, their potential contribution to the energy demand was assessed. The evidence presented to the committee suggested that they would only make a small contribution in the near future and could not be considered as a substitute for coal and nuclear power. However, by the year 2030 it would be possible for 18% of the national electricity demand to be met by alternative energy sources. The economic and environmental issues were assessed briefly and the report's conclusions were summarized. An independent review of wave power was called for in view of conflicting evidence presented to the committee. The debate which followed lasted three hours and is reported verbatim. Other issues raised included energy conservation, public attitudes to energy, the environment, government and private funding of research and development of nuclear power, including fusion. (U.K.)

  4. Post-test analysis for the APR1400 LBLOCA DVI performance test using MARS

    International Nuclear Information System (INIS)

    Bae, Kyoo Hwan; Lee, Y. J.; Kim, H. C.; Bae, Y. Y.; Park, J. K.; Lee, W.

    2002-03-01

    Post-test analyses using a multi-dimensional best-estimate analysis code, MARS, are performed for the APR1400 LBLOCA DVI (Direct Vessel Injection) performance tests. This report describes the code evaluation results for the test data of various void height tests and direct bypass tests that have been performed at MIDAS test facility. MIDAS is a scaled test facility of APR1400 with the objective of identifying multi-dimensional thermal-hydraulic phenomena in the downcomer during the reflood conditions of a large break LOCA. A modified linear scale ratio was applied in its construction and test conditions. The major thermal-hydraulic parameters such as ECC bypass fraction, steam condensation fraction, and temperature distributions in downcomer are compared and evaluated. The evaluation results of MARS code for the various test cases show that: (a) MARS code has an advanced modeling capability of well predicting major multi-dimensional thermal-hydraulic phenomena occurring in the downcomer, (b) MARS code under-predicts the steam condensation rates, which in turn causes to over-predict the ECC bypass rates. However, the trend of decrease in steam condensation rate and increase in ECC bypass rate in accordance with the increase in steam flow rate, and the calculation results of the ECC bypass rates under the EM analysis conditions generally agree with the test data

  5. Rural Bypass of Critical Access Hospitals in Iowa: Do Visiting Surgical Specialists Make a Difference?

    Science.gov (United States)

    Weigel, Paula A M; Ullrich, Fred; Ward, Marcia M

    2018-02-01

    Rural bypass for elective surgical procedures is a challenge for critical access hospitals, yet there are opportunities for rural hospitals to improve local retention of surgical candidates through alternative approaches to developing surgery lines of business. In this study we examine the effect of visiting surgical specialists on the odds of rural bypass. Discharge data from the 2011 State Inpatient Databases and State Ambulatory Surgery Databases for Iowa were linked to outreach data from the Office of Statewide Clinical Education Programs and Iowa Physician Information System to model the effect of surgeon specialist supply on rural patients' decision to bypass rural critical access hospitals. Patients in rural communities with a local general surgeon were more likely to be retained in a community than to bypass. Those in communities with visiting general surgeons were more likely to bypass, as were those in communities with visiting urologists and obstetricians. Patients in communities with visiting ophthalmologists and orthopedic surgeons were at higher odds of being retained for their elective surgeries. In addition to known patient and local hospital factors that have an influence on bypass behavior among rural patients seeking elective surgery, availability of surgeon specialists also plays an important role in whether patients bypass or not. Visiting ophthalmologists and orthopedic surgeons were associated with less bypass, as was having local general surgeons. Visiting general surgeons, urologists, and obstetricians were associated with greater odds of bypass. © 2016 National Rural Health Association.

  6. The Effects of Normothermic and Hypothermic Cardiopulmonary Bypass Upon Defibrillation Energy Requirements and Transmyocardial Impedance

    National Research Council Canada - National Science Library

    Martin, David

    1993-01-01

    .... To evaluate these questions we studied the effect of controlled hypothermia upon defibrillation energy requirements and transcardiac impedance in a canine model of cardiopulmonary bypass in which 26...

  7. Tidlige erfaringer med duplexovervågning af femoropopliteale og -krurale vene-bypass

    DEFF Research Database (Denmark)

    Nielsen, Tina G; von Jessen, Frants; Schroeder, T V

    1993-01-01

    Identification and correction of graft stenoses in femoropopliteal and -crural vein bypasses can prevent reconstruction failure. Sixty six consecutive vein bypasses entered a postoperative surveillance protocol, which implied clinical assessment, measurement of ankle blood pressure and duplex...... could not be reestablished. Of the 34 bypasses with normal duplex-scans only 2 (6%) thrombosed (p blood pressure measurement could reliably predict graft failure. This study indicates that duplex......-scanning effectively identifies grafts at risk and can be expected to improve long-term patency of infrainguinal vein bypasses....

  8. 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

  9. Evaluation of aortocoronary bypass graft patency by reconstructed CT image

    International Nuclear Information System (INIS)

    Kawakita, Seizaburo; Koide, Takashi; Saito, Yoshio; Yamamoto, Tadao; Iwasaki, Tadaaki

    1982-01-01

    Ten patients were examined in the period of three months from January to March 1981. The patients were operated from 1 month to 7 years before CT. A bypass to the left anterior descending artery (LAD) was grafted in 10 cases, 2 to the right coronary artery (RCA), 4 to an obtuse marginal artery (OM), and 1 to a diagonal artery. Image reconstruction was performed in 10 cases by using an image analytical computer Evaluskop. Appropriate planes for reconstruction were selected by trial and error methods upon observation of CT images. When gained picture of a graft course coincided with surgical records or angiography, the work of building images was concluded. On cross section, grafts to LAD were visualized in all 10 cases: 9 in the entire course and 1 in a proximal part of the graft. Two to RCA, 4 to OM and 1 to a diagonal were also successfully visualized. Reconstruction of graft images succeeded in 9 grafts of 6 cases. The course of a graft could be pursued from the proximal to the distal end adjacent to the cardiac chamber. The picture of a bypass to LAD was visualized in 6 of 10 grafts. Two bypass to RCA could be depicted, and 1 to OM was also found. However 3 to OM and 1 to a diagonal failed to be visualized throughout their courses in reconstructed images. I think that the causes of faillure mainly depended upon the course of the graft. When a graft was running arc-like surrounding the heart chamber, it was very difficult to depict its entire length in reconstructed images, though the graft could be detected in cross sections. These preliminary studies indicated that reconstruction of CT images had some benefits for the pursuit of graft courses. (J.P.N.)

  10. Patient-controlled analgesia after coronary bypass: Remifentanil or sufentanil?

    Science.gov (United States)

    Alavi, Seyed Mostafa; Ghoreishi, Seyed Mohammadmehran; Chitsazan, Mitra; Ghandi, Iman; Fard, Alireza Jahangiri; Hosseini, Seyed Saeed; Mahjoobifard, Maziar; Fani, Kamal

    2014-07-01

    adequate pain control after cardiac surgery is mandatory to reduce its remarkable morbidity. In this study, we aimed to compare the efficacy of patient-controlled analgesia with remifentanil or sufentanil for pain management after coronary artery bypass grafting. 249 patients who underwent coronary artery bypass were randomly assigned to receive patient-controlled analgesia with remifentanil or sufentanil during the first 24 h postoperatively. Pain intensity during patient-controlled analgesia was assessed using 4 different pain rating scales. patients given remifentanil had lower Visual Analog Scale scores at 24 h compared to those given sufentanil (p = 0.002). The Numeric Rating Scale at 24 h was also significantly lower in patients using remifentanil (p = 0.004). The Faces Pain Scale scores at 4, 18, and 24 h were significantly lower in patients using remifentanil compared to those using sufentanil (p = 0.045, 0.036, and 0.011, respectively). No significant differences between groups were seen in the pain intensity assessed by the Behavior Rating Scale at any time point during the first 24 h postoperatively. our study showed that both remifentanil and sufentanil patient-controlled analgesia can provide acceptable analgesia after coronary artery bypass. The difference between their efficacies was inconspicuous until 24 h postoperatively. Remifentanil seems to result in better pain relief at 24 h postoperatively. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Deoxypyrimidine monophosphate bypass therapy for thymidine kinase 2 deficiency

    OpenAIRE

    Garone, Caterina; Garc??a-D??az, Beatriz; Emmanuele, Valentina; L??pez Garc??a, Luis Carlos; Tadesse, Saba; Akman, Hasan O.; Tanji, Kurenai; Quinzii, Catarina M.; Hirano, Michio

    2014-01-01

    Autosomal recessive mutations in the thymidine kinase 2 gene (TK2) cause mitochondrial DNA depletion, multiple deletions, or both due to loss of TK2 enzyme activity and ensuing unbalanced deoxynucleotide triphosphate (dNTP) pools. To bypass Tk2 deficiency, we administered deoxycytidine and deoxythymidine monophosphates (dCMP+dTMP) to the Tk2 H126N (Tk2 −/− ) knock-in mouse model from postnatal day 4, when mutant mice are phenotypically normal, but biochemically affected. Assessment of 13-day-...

  12. 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......, a massive constipation of the small bowel was most likely a contributing factor. In the second case, the cause was a kink of the entero-entero anastomosis leading to obstruction and finally perforation of the biliary limp. Late perforations are among the rarely reported complications associated with gastric...

  13. 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.

  14. 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.

  15. Return to the workforce following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Butt, Jawad H; Rørth, Rasmus; Kragholm, Kristian

    2018-01-01

    Background Returning to the workforce after coronary artery bypass grafting (CABG) holds important socioeconomic consequences not only for patients, but the society as well. Yet data on this issue are limited. We examined return to the workforce and associated factors in patients of working age.......0%) patients had returned to the workforce, 614 (10.2%) were on paid sick leave, 267 (4.4%) received disability pension, 250 (4.1%) were on early retirement, 57 (0.9%) had died, and 16 (0.3%) had emigrated. Factors associated with return to the workforce were identified using multivariable logistic regression...

  16. Incidental invasive thymoma during coronary artery bypass surgery

    International Nuclear Information System (INIS)

    Al-Smady, Moaath M.; Hammdan, Farouq F.; Abu-Abeeleh, Mahmood M.; Massad, Islam M.

    2009-01-01

    We encountered 2 incidental cases of invasive thymomas at Jordan University Hospital, Amman, Jordan: during the routine coronary artery bypass graft surgery between 2005 and 2008 with an incidence of 0.6%. Both patients presented with angina pain. None of the 2 patients had pressure symptoms (cough, shortness of breath or superior vena cava syndrome) or Myasthenia Gravis symptoms. Total thyectomy with dissection of perithymic fat was performed on both cases. No radiotherapy was given. No recurrence of the tumor was seen in 2 years follow-up. These cases are presented to emphasize the occurrence of this tumor. (author)

  17. Reconstructive surgery after jejunoileal bypass or gastric partition operations.

    Science.gov (United States)

    Bingham, H G

    1982-05-01

    Twenty-five morbidly obese patients had plastic operations to remove redundant tissue after either jejunoileal bypass or gastric partition. The average weight loss in this group of patients was 79.9 kg (176 lb) and the average age was 32 years. Abdominoplasty was the most common operation, and, although there was no mortality, postoperative complications were common and usually related to wound healing. The average hospital stay was ten days. Most of these patients were pleased with their results and lived happier and more productive lives.

  18. Cine CT in the evaluation of coronary bypass graft patency

    International Nuclear Information System (INIS)

    Stanford, W.; Rooholamini, M.; Rumberger, J.; Marcus, M.; Hiratzka, L.

    1986-01-01

    Cine CT produces axial images over an 8-cm section of the aorta in 50 msec. This characteristic makes the technique useful for evaluating coronary bypass graft (CBG) patency. With the use of 40 ml of 67% iothalamate sodium injected via an antecubital vein, 28 patients with 68 CBGs underwent cine CT. Ten patients with 21 CBGs also underwent cardiac catheterization. In the latter group the overall accuracy of cine CT compared to cardiac catheterization was 95.2% (20/21). The sensitivity was 94.1% (16/17), and the specificity was 100% (4/4). This figure compares favorably with the 92% sensitivity achieved with conventional CT

  19. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support.

    Science.gov (United States)

    2006-05-01

    This publication presents the 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of the pediatric patient and the 2005 American Academy of Pediatrics/AHA guidelines for CPR and ECC of the neonate. The guidelines are based on the evidence evaluation from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, hosted by the American Heart Association in Dallas, Texas, January 23-30, 2005. The "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" contain recommendations designed to improve survival from sudden cardiac arrest and acute life-threatening cardiopulmonary problems. The evidence evaluation process that was the basis for these guidelines was accomplished in collaboration with the International Liaison Committee on Resuscitation (ILCOR). The ILCOR process is described in more detail in the "International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations." The recommendations in the "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" confirm the safety and effectiveness of many approaches, acknowledge that other approaches may not be optimal, and recommend new treatments that have undergone evidence evaluation. These new recommendations do not imply that care involving the use of earlier guidelines is unsafe. In addition, it is important to note that these guidelines will not apply to all rescuers and all victims in all situations. The leader of a resuscitation attempt may need to adapt application of the guidelines to unique circumstances. The following are the major pediatric advanced life support changes in the 2005 guidelines: There is further caution about the use of endotracheal tubes. Laryngeal mask airways are acceptable when used by experienced

  20. Enhanced glucose metabolism in cultured human skeletal muscle after Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Nascimento, Emmani B M; Riedl, Isabelle; Jiang, Lake Qunfeng; Kulkarni, Sameer S; Näslund, Erik; Krook, Anna

    2015-01-01

    Roux-en-Y gastric bypass (RYGB) surgery rapidly increases whole body insulin sensitivity, with changes in several organs including skeletal muscle. Objectives were to determine whether improvements in insulin action in skeletal muscle may occur directly at the level of the myocyte or secondarily from changes in systemic factors associated with weight loss. Myotubes were derived before and after RYGB surgery. The setting was Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. Eight patients (body mass index (BMI) 41.8 kg/m(2); age 41 yr) underwent RYGB surgery. Before and 6 months after RYGB surgery, skeletal muscle biopsies were collected from vastus lateralis muscle. Satellite cells derived from skeletal muscle biopsies were propagated in vitro as myoblasts and differentiated into myotubes. Expression of myogenic markers is increased in myoblasts derived from biopsies taken 6 months after bypass surgery, compared with their respective presurgery condition. Furthermore, glycogen synthesis, tyrosine phosphorylation of insulin receptor (IRS)-1-Tyr612 and Interleukin (IL)-8 secretion were increased, while fatty acid oxidation and circulating IL8 levels remain unaltered. Myotubes derived from muscle biopsies obtained after RYGB surgery displayed increased insulin-stimulated phosphorylation of protein kinase B (PKB)-Thr308 and proline-rich Akt substrate of 40 kDa (PRAS40)-Thr246. RYGB surgery is accompanied by enhanced glucose metabolism and insulin signaling, altered IL8 secretion and changes in mRNA levels and myogenic markers in cultured skeletal muscle cells. Thus, RYGB surgery involves intrinsic reprogramming of skeletal muscle to increase peripheral insulin sensitivity and glucose metabolism. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Outcome in adult patients with hemorrhagic moyamoya disease after combined extracranial-intracranial bypass.

    Science.gov (United States)

    Jiang, Hanqiang; Ni, Wei; Xu, Bin; Lei, Yu; Tian, Yanlong; Xu, Feng; Gu, Yuxiang; Mao, Ying

    2014-11-01

    The outcome of patients with hemorrhagic moyamoya disease (MMD) after cerebral revascularization is uncertain. The purpose of this study was to delineate the efficacy of this surgical method in the treatment of hemorrhagic MMD. Between January 2007 and August 2011, a consecutive cohort of 113 patients with hemorrhagic MMD was enrolled into this prospective single-center cohort study. The surgical method was combined direct and indirect bypass. The cumulative probability of the primary end point (all stroke and deaths from surgery through 30 days after surgery and ipsilateral recurrent hemorrhage afterward) was analyzed. The angiographic outcome was measured by the following parameters: bypass patency, reduction of basal MMD vessels, improved degree of dilation, and branch extension of the anterior choroidal and posterior communicating arteries (AChA-PCoA). Of the 113 enrolled cases, CT scans revealed pure intraventricular hemorrhage (IVH) in 63 cases (55.7%), pure intracranial hemorrhage (ICH) in 14 cases (12.4%), and ICH with IVH in 36 cases (31.9%). In 74 of 113 hemorrhagic hemispheres (65.5%), the AChA-PCoA was extremely dilated with extensive branches beyond the choroidal fissure. A total of 114 surgeries were performed. No patient suffered ischemic or hemorrhagic stroke through 30 days after surgery. Ipsilateral rebleeding occurred in 5 patients, 4 of whom died of the rebleeding event. The cumulative probability of the primary end point was 0% at 1 year and 1.9% at 2 years. The annual rebleeding rate was 1.87%/person/year. The improvement in AChA-PCoA extension was observed in 75 of 107 operated hemispheres (70.1%), which was higher than that in 7 of 105 unoperated hemispheres (35.2%). Revascularization may provide a benefit over conservative therapy for hemorrhagic MMD patients. The improvement of dilation and branch extension of AChA-PCoA might be correlated with the low rebleeding rate.

  2. Red Blood Cell Transfusions Impact Pneumonia Rates After Coronary Artery Bypass Grafting Surgery

    Science.gov (United States)

    Likosky, Donald S.; Paone, Gaetano; Zhang, Min; Rogers, Mary A.M.; Harrington, Steven D.; Theurer, Patricia F.; DeLucia, Alphonse; Fishstrom, Astrid; Camaj, Anton; Prager, Richard L.

    2016-01-01

    Background Pneumonia, a known complication of coronary artery bypass (CABG) surgery, significantly increases a patient’s risk of morbidity and mortality. While not well characterized, red blood cell transfusions (RBC) may increase a patient’s risk of pneumonia. We describe the relationship between RBC transfusion and post-operative pneumonia after CABG surgery. Methods A total of 16,182 consecutive patients underwent isolated CABG surgery between 2011 and 2013 at one of 33 hospitals in the state of Michigan. We used multivariable logistic regression to estimate the odds of pneumonia associated with the use or number (0, 1, 2, 3, 4, 5, >6) of RBC units. We adjusted for predicted risk of mortality, pre-operative hematocrit, history of pneumonia, cardiopulmonary bypass duration and medical center. We confirmed the strength and direction of these relationships among selected clinical subgroups in a secondary analysis. Results 576 (3.6%) patients developed pneumonia and 6,451 (39.9%) received RBC transfusions. There was a significant association between any RBC transfusion and pneumonia (ORadj 3.4, p<0.001). There was a dose-response between number of units and odds of pneumonia, ptrend<0.001. Patients receiving only 2 units of RBCs had twofold (ORadj 2.1, p<0.001) increased odds of pneumonia. These findings were consistent across clinical subgroups. Conclusions We found a significant, volume-dependent association between an increasing number of RBCs and odds of pneumonia, which persisted after adjusting for pre-operative patient characteristics. Clinical teams should explore opportunities for preventing a patient’s risk of RBC transfusions, including reducing hemodilution or adopting a lower transfusion threshold in a stable patient. PMID:26209489

  3. Fuel temperature prediction using a variable bypass gap size in the prismatic VHTR

    International Nuclear Information System (INIS)

    Lee, Sung Nam; Tak, Nam-il; Kim, Min Hwan

    2016-01-01

    Highlights: • The bypass flow of the prismatic very high temperature reactor is analyzed. • The bypass gap sizes are calculated considering the effect of the neutron fluences and thermal expansion. • The fuel hot spot temperature and temperature profiles are calculated using the variable gap size. • The BOC, MOC and EOC condition at the cycle 07 and 14 are applied. - Abstract: The temperature gradient and hot spot temperatures were calculated in the prismatic very high temperature reactor as a function of the variable bypass gap size. Many previous studies have predicted the temperature of the reactor core based on a fixed bypass gap size. The graphite matrix of the assemblies in the reactor core undergoes a dimensional change during the operation due to thermal expansion and neutron fluence. The expansion and shrinkage of the bypass gaps change the coolant flow fractions into the coolant channels, the control rod holes, and the bypass gaps. Therefore, the temperature of the assemblies may differ compared to those for the fixed bypass gap case. The temperature gradient and the hot spot temperatures are important for the design of reactor structures to ensure their safety and efficiency. In the present study, the temperature variation of the PMR200 is studied at the beginning (BOC), middle (MOC), and end (EOC) of cycles 07 and 14. CORONA code which has been developed in KAERI is applied to solve the thermal-hydraulics of the reactor core of the PMR200. CORONA solves a fluid region using a one-dimensional formulation and a solid region using a three-dimensional formulation to enhance the computational speed and still obtain a reasonable accuracy. The maximum temperatures in the fuel assemblies using the variable bypass gaps did not differ much from the corresponding temperatures using the fixed bypass gaps. However, the maximum temperatures in the reflector assemblies using the variable bypass gaps differ significantly from the corresponding temperatures

  4. Results of The Comparative Study of 200 Cases: One Anastomosis Gastric Bypass vs Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Navarrete, Salvador; Leyba, José Luis; Ll, Salvador Navarrete; Borjas, Guillermo; Tapia, José León; Alcázar, Ruben

    2018-05-01

    Obesity has experienced worldwide increase and surgery has become the treatment that has achieved the best results. Several techniques have been described; the most popular are vertical gastrectomy (GV) and the Roux-en-Y gastric bypass (RYGB). However, mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) has gained popularity due to its simplicity and good results. To comparatively evaluate the results of MGB/OAGB with those of RYGB with 1-year follow-up. The paper presents a comparative case and control study of 100 patients that underwent MGB/OAGB surgery and another 100 with RYGB surgery, operated between 2008 and 2016. Patients were not submitted to revision surgery and had the following pre-operative variables: age 40.46 ± 12.4 vs. 39.43 ± 10.33 years; sex 64 and 54 women, 36 and 46 men; BMI 44.8 ± 12.06 and 45.29 ± 8.82 kg/m 2 ; 50 and 54 cases with comorbidities, respectively, these being non-significant differences. The surgical time was 69.01 ± 4.62 (OAGB) vs. 88.98 ± 3.44 min; the time of hospitalization was 2 days, reaching a BMI of 27.7 ± 7.85 and 29 ± 4.52 kg/m 2 , with an excess weight loss 1 year after surgery of 89.4 vs. 85.9%, respectively. The morbidity rates are 9% for OAGB and 11% for the RYGB. There was a comorbidity resolution of 84.4 and 83.7% respectively, without mortality. The results show the benefits of both techniques, OAGB being the easiest to perform and with less surgical time.

  5. A new step in cement plant bypass technology; Une nouvelle avancee pour les by-pass en cimenterie

    Energy Technology Data Exchange (ETDEWEB)

    Civiel, G. [Technip, 92 - Rueil-Malmaison (France)

    2001-12-01

    The demand of valorizing more and more waste fuel in cement industry results in an increase of volatile element quantities in kiln system, particularly chlorine. In 'Ciment, Betons, Platres, Chaux' no 849 May-June 2001, we made reference to the two new approaches developed by TECHNIP CL to solve the problem of the volatile elements in clinker burning lines: the raw meal curtain and the Taiheyo by-pass. The following article is focused on the second system. (author)

  6. 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; Kjeldsen, Bo Juul; 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......-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...

  7. The effects of conventional extracorporeal circulation versus miniaturized extracorporeal circulation on microcirculation during cardiopulmonary bypass-assisted coronary artery bypass graft surgery

    NARCIS (Netherlands)

    Yuruk, Koray; Bezemer, Rick; Euser, Mariska; Milstein, Dan M. J.; de Geus, Hilde H. R.; Scholten, Evert W.; de Mol, Bas A. J. M.; Ince, Can

    2012-01-01

    OBJECTIVES: To reduce the complications associated with cardiopulmonary bypass (CPB) during cardiac surgery, many modifications have been made to conventional extracorporeal circulation systems. This trend has led to the development of miniaturized extracorporeal circulation systems. Cardiac surgery

  8. The problem of calcified ascending aorta during aortocoronary bypass

    Directory of Open Access Journals (Sweden)

    Nežić Duško G.

    2004-01-01

    Full Text Available Heavily calcified ascending aorta significantly increased morbidity and lethality during open-heart surgery. Cannulation and clamping (partial or total of severely atherosclerotic ascending aorta can easily cause damage and rupture of aortic wall, with consequential distal (often fatal embolization with atheromatous debris (brain, myocardium. From June 1998. until June 2000, 11 of 2 136 (0.5% patients who underwent coronary artery bypass grafting were with the severe atheromatous ascending aorta. The site of cannulation was in the aortic arch in three patients (aorta was occluded with Foley catheter in one case, and single clamp technique was used in the other two cases. The femoral artery was the cannulation site in other five cases. Profound hypothermia, ventricular fibrillation, and circulatory arrest, with no cross-clamping or cardioplegia, were used in three patients. Two patients were operated on with extracorporeal circulation, one in normothermia, on the beating heart, the other in moderate hypothermia, on fibrillating heart. In three patients myocardial revascularization was performed on the beating heart, in normothermia, without extracorporeal circulation. Postoperative course was uneventful in all 11 patients. Neither atheroembolism in the peripheral organs, nor atheroembolism of the extramities occurred. The proposed surgical approaches have the potential to reduce the prevalence of stroke and systemic embolization associated with coronary artery bypass grafting in patients with heavily calcified ascending aorta. This result was achieved due to the applied modifications of standard cardiosurgical technique.

  9. Plasma magnesium concentration in patients undergoing coronary artery bypass grafting.

    Science.gov (United States)

    Kotlinska-Hasiec, Edyta; Makara-Studzinska, Marta; Czajkowski, Marek; Rzecki, Ziemowit; Olszewski, Krzysztof; Stadnik, Adam; Pilat, Jacek; Rybojad, Beata; Dabrowski, Wojciech

    2017-05-11

    [b]Introduction[/b]. Magnesium (Mg) plays a crucial role in cell physiology and its deficiency may cause many disorders which often require intensive treatment. The aim of this study was to analyse some factors affecting preoperative plasma Mg concentration in patients undergoing coronary artery bypass grafting (CABG). [b]Materials and method[/b]. Adult patients scheduled for elective CABG with cardio-pulmonary bypass (CPB) under general anaesthesia were studied. Plasma Mg concentration was analysed before surgery in accordance with age, domicile, profession, tobacco smoking and preoperative Mg supplementation. Blood samples were obtained from the radial artery just before the administration of anaesthesia. [b]Results. [/b]150 patients were studied. Mean preoperative plasma Mg concentration was 0.93 ± 0.17 mmol/L; mean concentration in patients - 1.02 ± 0.16; preoperative Mg supplementation was significantly higher than in patients without such supplementation. Moreover, intellectual workers supplemented Mg more frequently and had higher plasma Mg concentration than physical workers. Plasma Mg concentration decreases in elderly patients. Patients living in cities, on average, had the highest plasma Mg concentration. Smokers had significantly lower plasma Mg concentration than non-smokers. [b]Conclusions. [/b]1. Preoperative magnesium supplementation increases its plasma concentration. 2. Intellectual workers frequently supplement magnesium. 3. Smoking cigarettes decreases plasma magnesium concentration.

  10. Proliferative and morphologic changes in rat colon following bypass surgery.

    Science.gov (United States)

    Barkla, D H; Tutton, P J

    1985-06-01

    In this study the proliferative and morphologic changes that occur in the colon of normal and dimethylhydrazine-treated rats following surgical bypass of the middle third of the colon are reported. Proliferative changes were measured by estimating accumulated mitotic indexes following vinblastine treatment and morphologic changes were observed with the use of light microscopy and scanning electron microscopy. Data were collected on Days 0, 7, 14, 30, and 72 after surgery. The results show that surgical bypass produces contrasting effects in the segments proximal to and distal to the suture line. In the proximal segment there was morphologic evidence of hyperplasia, although proliferative activity was unchanged except for an increase at 7 days in normal rats. In the distal segment there was a long-lived increase in the mitotic index, although morphologic changes were not seen. The results for DMH-treated rats were similar to those in normal rats. Groups of isolated dysplastic epithelial cells were often seen in the submucosa adjacent to sutures up to 72 days after surgery. Increased lymphoid infiltration was seen in segments proximal to but not distal to the suture line. It is hypothesized that the different responses of the proximal and distal segments may be related to the different embryologic origins of those segments. It is also hypothesized that the seeding of the submucosa with epithelial cells during suturing may be a factor in tumor recurrence.

  11. Impact of gender on outcome after coronary artery bypass surgery.

    Science.gov (United States)

    Ennker, Ina C; Albert, Alexander; Pietrowski, Detlef; Bauer, Kerstin; Ennker, Juergen; Florath, Ines

    2009-06-01

    Following recent studies concerning the increased risk of coronary artery bypass surgery for women, the impact of sex is still a controversial issue. Between 1996 and 2006, 9,527 men and 3,079 women underwent isolated coronary artery bypass in our institute. To adjust for dissimilarities in preoperative risk profiles, propensity score-based matching was applied. Before adjustment, clinical outcomes in terms of operative mortality, arrhythmias, intensive care unit stay, and maximum creatine kinase-MB levels were significantly different for men and women. After balancing the preoperative characteristics, including height, no significant differences in clinical outcomes were observed. However, there was decreased use of internal mammary artery, less total arterial revascularization, and increasing creatine kinase-MB levels with decreasing height. This study supports the theory that female sex per se does not increase operative risk, but shorter height, which is more common in women, affects the outcome, probably due to technical difficulties in shorter patients with smaller internal mammary arteries and coronary vessels. Thus women may especially benefit from sequential arterial grafting.

  12. Anesthesia for off-pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

    Full Text Available The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

  13. Myocardial contractile function in survived neonatal piglets after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Popov Aron-Frederik

    2010-11-01

    Full Text Available Abstract Background Hemodynamic function may be depressed in the early postoperative stages after cardiac surgery. The aim of this study was the analysis of the myocardial contractility in neonates after cardiopulmonary bypass (CPB and mild hypothermia. Methods Three indices of left ventricular myocardial contractile function (dP/dt, (dP/dt/P, and wall thickening were studied up to 6 hours after CPB in neonatal piglets (CPB group; n = 4. The contractility data were analysed and then compared to the data of newborn piglets who also underwent median thoracotomy and instrumentation for the same time intervals but without CPB (non-CPB group; n = 3. Results Left ventricular dP/dtmax and (dP/dtmax/P remained stable in CPB group, while dP/dtmax decreased in non-CPB group 5 hours postoperatively (1761 ± 205 mmHg/s at baseline vs. 1170 ± 205 mmHg/s after 5 h; p max and (dP/dtmax/P there were no statistically significant differences between the two groups. Comparably, although myocardial thickening decreased in the non-CPB group the differences between the two groups were not statistically significant. Conclusions The myocardial contractile function in survived neonatal piglets remained stable 6 hours after cardiopulmonary bypass and mild hypothermia probably due to regional hypercontractility.

  14. Surgical revascularization of posterior coronary arteries without cardiopulomonary bypass

    Directory of Open Access Journals (Sweden)

    Lobo Filho J. Glauco

    1999-01-01

    Full Text Available OBJECTIVE: To assess the results observed during the early postoperative period in patients who had the posterior coronary arteries revascularized without cardiopulmonary bypass (CPB, in regard to the following parameters: age, sex,bypass grafts types, morbidity and mortality. METHODS: From January 1995 to June 1998, 673 patients underwent myocardial revascularization (MR. Of this total, 607 (90.20% MR procedures were performed without CPB. The posterior coronary arteries (PCA were revascularized in 298 (44.27% patients, 280 (93.95% without CPB. The age of the patients ranged from 37 to 88 years (mean, 61 years. The male gender predominated, with 198 men (70.7%. The revascularization of the posterior coronary arteries had the following distribution: diagonalis artery (31 patients, 10%; marginal branches of the circumflex artery (243 patients, 78.7%; posterior ventricular artery (4 patients, 1.3%; and posterior descending artery (31 patients, 10%. RESULTS: Procedure-related complications without death occurred in 7 cases, giving a morbidity of 2.5%. There were 11 deaths in the early postoperative period (mortality of 3.9%. CONCLUSION: Similarly to the anterior coronary arteries, the posterior coronary arteries may benefit from myocardial revascularization without CPB.

  15. Evaluation of olfactory memory after coronary artery bypass grafting.

    Science.gov (United States)

    Erdem, Kemalettin; Yurttas, Veysel; Bilgi, Murat; Demırhan, Abdullah; Apuhan, Tayfun; Bugra, Onursal; Daglar, Bahadir

    2014-12-01

    This study determined whether coronary artery bypass grafting (CABG) surgery has any effect on olfactory function, employing the Brief Smell Identification Test (B-SIT). All the participants were informed preoperatively about the B-SIT test and the mode of its application. The test was performed by each patient preoperatively (d0) as well as 1 (d1) and 3 (d3) days following the surgery. C-reactive protein (CRP) levels were recorded at the same time as the smell test. This prospective study included 45 patients. The mean age was 67 ± 7.55, and the group was 29% male. The mean durations of cross clamping and cardiopulmonary bypass were 54 ± 32 min and 62.5 ± 37.0 min, respectively. Eleven different odors were tested. Significant differences were observed for several odors: leather between d0 and d3, pine between d0 and d3, onion between d0 and d1, onion between d0 and d3, and soap between d0 and d1. The postoperative CRP levels were significantly higher than the preoperative levels. The correlation analysis determined that the postoperative CRP levels were negatively correlated with the B-SIT score (r = -0.48, p = 0.001). Our findings suggest that patients after CABG are prone to develop olfactory dysfunction in the early postoperative period and that olfactory dysfunction is associated with postoperative CRP levels.

  16. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Perko, Mario J; Lund, Jens T

    2010-01-01

    Off-pump coronary artery bypass grafting compared with coronary revascularization with cardiopulmonary bypass seems safe and results in about the same outcome in low-risk patients. Observational studies indicate that off-pump surgery may provide more benefit in high-risk patients. Our objective...... was to compare 30-day outcomes in high-risk patients randomized to coronary artery bypass grafting without or with cardiopulmonary bypass....

  17. Myocardial metabolism during anaesthesia with propofol--low dose fentanyl for coronary artery bypass surgery

    NARCIS (Netherlands)

    Vermeyen, K. M.; de Hert, S. G.; Erpels, F. A.; Adriaensen, H. F.

    1991-01-01

    We have studied the haemodynamic and myocardial effects of propofol-fentanyl anaesthesia in 12 patients undergoing coronary artery bypass surgery during the pre-bypass period. The induction dose of propofol was 1.5 mg kg-1 and mean infusion rate during maintenance was 4.48 mg kg-1 h-1 (range

  18. 40 CFR 63.1569 - What are my requirements for HAP emissions from bypass lines?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are my requirements for HAP emissions from bypass lines? 63.1569 Section 63.1569 Protection of Environment ENVIRONMENTAL PROTECTION... HAP emissions from bypass lines? (a) What work practice standards must I meet? (1) You must meet each...

  19. 40 CFR 63.307 - Standards for bypass/bleeder stacks.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Standards for bypass/bleeder stacks. 63.307 Section 63.307 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Standards for Coke Oven Batteries § 63.307 Standards for bypass/bleeder stacks. (a)(1) Except as otherwise...

  20. Effective void fraction for a BWR assembly with boiling in the bypass region

    International Nuclear Information System (INIS)

    Galperin, A.; Segev, M.; Knoglinger, E.

    1991-09-01

    Average BWR assembly cross-sections for nominal conditions, namely for zero bypass void, can be utilised in the analysis of transient conditions with boiling in the bypass. A model is developed to yield an effective channel void for such conditions. The use of this void in conjunction with the 'nominal conditions' cross section library approximately preserves the assembly K-infinity corresponding to the true channel and bypass voids. The effective void is an augmentation of the actual channel void. The augment is proportional to the bypass-to-channel volume ratio, to the bypass void, and to a weight W which is introduced to quantify the fact that a water molecule in the bypass has a different assembly criticality worth than one in the channel. The formula developed is superior to the practice of choosing W=1, namely a simple, non-weighted, transfer of water from channel to bypass. The use of this approximate effective channel void reproduces actual K-infinity values of assemblies to better than 5 mk, whereas the use of a simple model sometimes misspredicts the assembly K-infinity by 40 mK. The effective void model cannot handle cases in which both channel and bypass void value are high, simply because then the effective void α ch eff becomes meaningless. A method to treat the α eff >1 domain is developed by which corrections to cross sections are provided. Such corrections are synthesised as functions of the assembly parameters. (author) figs., tabs., refs

  1. 21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

    Science.gov (United States)

    2010-04-01

    ... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange (oxygenator...

  2. Local immobilization of the left anterior descending artery for minimally invasive coronary bypass grafting

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    We describe a device for coronary artery stabilization during minimally invasive coronary artery bypass grafting performed without cardiopulmonary bypass via a small (8 to 10 cm) left anterolateral thoracotomy. This device facilitates the anastomosis of the left internal mammary artery to the left

  3. Economic consequences of extra by-passes in district heating networks. Investment-, running- and maintenance costs

    International Nuclear Information System (INIS)

    Herbert, P.

    1995-02-01

    For various reasons, extra by-passes are installed in district heating networks to ensure a high flow temperature when the water circulation is insufficient. By 'extra by-pass' we here mean a connection between the distribution pipe and the return pipe. This study mainly deals with extra by-passes to prevent freezing. The estimation of the extra by-pass costs is based on the district heating rates. Our assumption is that an extra by-pass can be regarded as a substation in the district heating network, with regard to the demand for the water flow, heat and power. The reason is the difficulty to obtain available facts to estimate the real costs concerning extra by-passes. Therefore, the method can not claim that the information about the costs is exact but gives an indication of the size of them. The valves in an extra by-pass can be set more or less open. We assume that manual valves in extra by-passes are wide open. Thermostatic valves are, however, assumed to be adjusted in order to cause a very small water flow. 2 refs, 16 figs, 9 tabs, 6 appendices

  4. Fluoropolymer-coated dacron versus PTFE grafts for femorofemoral crossover bypass: randomised trial

    DEFF Research Database (Denmark)

    Eiberg, JP; Røder, Ole Christian; Stahl-Madsen, M

    2006-01-01

    To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery.......To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery....

  5. Long-term internal thoracic artery bypass graft patency and geometry assessed by multidetector computed tomography

    DEFF Research Database (Denmark)

    Zacho, Mette; Damgaard, Sune; Lilleoer, Nikolaj Thomas

    2012-01-01

    The left internal thoracic artery (LITA) undergoes vascular remodelling when used for coronary artery bypass grafting. In this study we tested the hypothesis that the extent of the LITA remodelling late after coronary artery bypass grafting assessed by multidetector computed tomography is related...

  6. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ..., or tubing. 870.4210 Section 870.4210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to...

  7. Assessment of coronary artery bypass graft patency by multidetector computed tomography and electron-beam tomography

    NARCIS (Netherlands)

    Piers, LH; Dorgelo, J; Tio, RA; Jessurun, GAJ; Oudkerk, M; Zijlstra, F

    This case report describes the use of retrospectively ECG-gated 16-slice multidetector computed tomography (MDCT) and electron-beam tomography (EBT) for assessing bypass graft patency in two patients with recurrent angina after coronary artery bypass graft surgery. The results of each tomographic

  8. Off-pump Coronary Artery Bypass Graft in a High Risk Patient ...

    African Journals Online (AJOL)

    On-pump coronary artery bypass graft (CABG) entails the use of cardiopulmonary bypass (CPB). The procedure is safe but it's not without complications like neurocognitive deficits, cerebrovascular accidents, myocardial ischemic injury and activation of inflammatory pathways that contribute to pulmonary, renal, hematologic ...

  9. Fatal air embolism during cardiopulmonary bypass : analysis of an incident and prevention measures

    NARCIS (Netherlands)

    van der Zee, Michiel P.; Koene, Bart M.; Mariani, Massimo A.

    Air embolism is a life-threatening complication during cardiopulmonary bypass. We present a case of a patient who suffered an air embolism during coronary bypass surgery, despite standard safety features and procedures. The patient died 3 days after surgery due to massive cerebral oedema. This case

  10. The impact of heparin-coated circuits on hemodynamics during and after cardiopulmonary bypass

    NARCIS (Netherlands)

    de Vroege, R; Huybregts, R; van Oeveren, W; van Klarenbosch, J; Linley, G; Mutlu, J; Jansen, E; Hack, E; Eijsman, L; Wildevuur, C

    This study was performed to investigate if heparin-coated extracorporeal circuits can reduce the systemic inflammatory reaction with the subsequent release of vasoactive substances during and after cardiopulmonary bypass. Fifty-one patients scheduled for coronary artery bypass grafting were perfused

  11. Coronary artery bypass grafting on the beating heart using the Octopus method

    NARCIS (Netherlands)

    Thijssens, K. M.; Rodrigus, I. E.; Amsel, B. J.; de Hert, S. G.; Moulijn, A. C.

    2000-01-01

    STUDY OBJECTIVE: To study the usefulness and effectiveness of off-pump coronary bypass grafting with the Octopus heart stabilizing device. METHOD: The files of thirty-one patients undergoing coronary artery bypass with the aid of the Octopus heart stabilizing device between April 1996 and October

  12. Video-assisted minimally invasive coronary operations without cardiopulmonary bypass : A multicenter study

    NARCIS (Netherlands)

    Benetti, F; Mariani, MA; Sani, G; Boonstra, PW; Grandjean, JG; Giomarelli, P; Toscano, M

    1996-01-01

    Objective: The need to avoid the risks associated with cardiopulmonary bypass has led to the interest in coronary operations without cardiopulmonary bypass, Patients and methods: From April 1994 to September 1995, 44 patients (mean age 63.3 +/- 10.0 years, range 43 to 83 years) were selected for

  13. Evaluation of Core Bypass Flow in the Prismatic VHTR with a Multi-block Experiment

    International Nuclear Information System (INIS)

    Lee, Jeong Hun; Yoon, Su Jong; Park, Goon Cherl; Kim, Min Hwan

    2010-01-01

    The core of Prismatic Modular Reactor (PMR) consists of assemblies of hexagonal graphite fuel and reflector elements. The core bypass flow of Very High Temperature Reactor (VHTR) is defined as the core flow that does not pass through the coolant channels but passes through the bypass gap between fuel elements. The increase in bypass flow makes the decrease in effective coolant flow. Since the core bypass flow has a negative impact on safety and efficiency of VHTR, core bypass phenomena have to be investigated to improve the core thermal margin of VHTR. For this purpose, the international project, I-NERI project, has been carried out since 2008. I-NERI project is collaborative project that KAERI and SNU of Korea side and INL, ANL and TAMU of U.S side are involved. In order to evaluate the core bypass flow, the multicolumn and multi-layer experimental facility is designed by SNU. In this experiment, the effect of cross-flow and local variation of bypass gap on the bypass flow distribution is investigated. Furthermore, the experimental data will be used for validation of CFD code or thermal hydraulic analysis codes such as GAMMA or GAS-NET

  14. Predictions of the Bypass Flows in the HTR-PM Reactor Core

    International Nuclear Information System (INIS)

    Sun Jun; Chen Zhipeng; Zheng Yanhua; Shi Lei; Li Fu

    2014-01-01

    In the HTR-PM reactor core, the basic structure materials are large amount of graphite reflectors and carbon bricks. Small gaps among those graphite and carbon bricks are widespread in the reactor core so that the cold helium flow may be bypassed and not completely heated. The bypass flows in relative lower temperature would change the flow and temperature distributions in the reactor core, therefore, the accurate prediction of bypass flows need to be carried out carefully to evaluate the influence to the reactor safety. Based on the characteristics of the bypass flow problem, hybrid method of the flow network and the CFD tools was employed to represent the connections and calculate flow distributions of all the main flow and bypass flow paths. In this paper, the hybrid method was described and applied to specific bypass flow problem in the HTR-PM. Various bypass flow paths in the HTR-PM were reviewed, figured out, and modeled by the flow network and the CFD methods, including the axial vertical gaps in the side reflectors, control rod channels, absorber sphere channels and radial gap flow through keys around the hot helium plenum. The bypass flow distributions and its flow rate ratio to the total flow rate in the primary loop were also calculated, discussed and evaluated. (author)

  15. Predictors of inotrope use in patients undergoing concomitant coronary artery bypass graft (CABG and aortic valve replacement (AVR surgeries at separation from cardiopulmonary bypass (CPB

    Directory of Open Access Journals (Sweden)

    Nelson William B

    2009-06-01

    Full Text Available Abstract Background Left ventricular dysfunction is common after coronary artery bypass graft and valve replacement surgeries and is often treated with inotropic drugs to maintain adequate hemodynamic status. In this study, we aimed to identify the demographic, clinical, laboratory, echocardiographic and hemodynamic factors that are associated with use of inotropic drugs in patients undergoing concomitant coronary artery bypass graft and aortic valve replacement surgery. Methods The study included 97 patients who had undergone concomitant coronary artery bypass graft and aortic valve replacement at Regions Hospital, University of Minnesota Medical School from January 2006 to December 2008. All data were collected retrospectively after reviewing electronic medical records. Inotropic support was defined as the use of dopamine [greater than or equal to] 5 ug/kg/min; any dose of epinephrine, norepinephrine, dobutamine, and milrinone at the separation from cardiopulmonary bypass. Results Inotropic support was used in a total of 50 patients (52% at the separation from cardiopulmonary bypass. Average age of the patients requiring inotropic support was 72.2 +/- 8.8 years. The study identified four significant, independent predictors of inotrope use: (1 Cardiac index [less than or equal to]2.5 L/min/m2, (2 LVEDP [greater than or equal to] 20 mm Hg, (3 LVEF [less than or equal to]40%, and (4 CKD stage 3 to 5. Conclusion We identified four independent risk factors for postoperative use of inotropic support in patients undergoing concomitant coronary artery bypass graft and arotic valve replacement surgery at the separation from cardiopulmonary bypass. The study results will be helpful to prospectively identify patients who will likely to require inotropic support at the separation from cardiopulmonary bypass.

  16. Temporary diabetes insipidus in 2 men after on-pump coronary artery bypass grafting.

    Science.gov (United States)

    Uyar, Ihsan Sami; Sahin, Veysel; Akpinar, Besir; Yurtman, Volkan; Abacilar, Feyzi; Okur, Faik Fevzi; Ates, Mehmet

    2013-01-01

    Many complications have been reported after cardiopulmonary bypass. A common physiologic change during the early postoperative period after cardiopulmonary bypass is increased diuresis. In patients whose urine output is increased, postoperative diabetes insipidus can develop, although reports of this are rare. We present the cases of 2 patients who underwent on-pump coronary artery bypass grafting (with cardiopulmonary bypass). Each was diagnosed with diabetes insipidus postoperatively: a 54-year-old man on the 3rd day, and a 66-year-old man on the 4th day. Each patient recovered from the condition after 6 hours of intranasal therapy with synthetic vasopressin (antidiuretic hormone). The diagnosis of diabetes insipidus should be considered in patients who produce excessive urine early after cardiac surgery in which cardiopulmonary bypass has been used.

  17. Active bypass flow control for a seal in a gas turbine engine

    Science.gov (United States)

    Ebert, Todd A.; Kimmel, Keith D.

    2017-01-10

    An active bypass flow control system for controlling bypass compressed air based upon leakage flow of compressed air flowing past an outer balance seal between a stator and rotor of a first stage of a gas turbine in a gas turbine engine is disclosed. The active bypass flow control system is an adjustable system in which one or more metering devices may be used to control the flow of bypass compressed air as the flow of compressed air past the outer balance seal changes over time as the outer balance seal between the rim cavity and the cooling cavity wears. In at least one embodiment, the metering device may include a valve formed from one or more pins movable between open and closed positions in which the one pin at least partially bisects the bypass channel to regulate flow.

  18. Rankine cycle condenser pressure control using an energy conversion device bypass valve

    Science.gov (United States)

    Ernst, Timothy C; Nelson, Christopher R; Zigan, James A

    2014-04-01

    The disclosure provides a waste heat recovery system and method in which pressure in a Rankine cycle (RC) system of the WHR system is regulated by diverting working fluid from entering an inlet of an energy conversion device of the RC system. In the system, an inlet of a controllable bypass valve is fluidly coupled to a working fluid path upstream of an energy conversion device of the RC system, and an outlet of the bypass valve is fluidly coupled to the working fluid path upstream of the condenser of the RC system such that working fluid passing through the bypass valve bypasses the energy conversion device and increases the pressure in a condenser. A controller determines the temperature and pressure of the working fluid and controls the bypass valve to regulate pressure in the condenser.

  19. On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in Elderly Patients

    DEFF Research Database (Denmark)

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

    2012-01-01

    BACKGROUND: Conventional coronary artery bypass grafting performed with the use of cardiopulmonary bypass is a well-validated treatment for patients with ischemic heart disease. Off-pump coronary artery bypass grafting (OPCAB) has been suggested to reduce the number of perioperative complications......, especially in elderly patients. METHODS AND RESULTS: In a multicenter, randomized trial, we assigned 900 patients >70 years of age to conventional coronary artery bypass grafting or OPCAB surgery. After 30 days, a blinded end-point committee assessed whether a combined end point of death, stroke...... experiencing the combined end point within 30 days was 10.2% for conventional coronary artery bypass grafting and 10.7% for OPCAB. Implied risk difference of 0.4% (with a 95% confidence interval, -3.6 to 4.4) showed nonsignificance in a standard test for equality (P=0.83) and for noninferiority...

  20. Blood utilization in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass.

    Science.gov (United States)

    Wesley, Mark C; Yuki, Koichi; Daaboul, Dima G; Dinardo, James A

    2011-07-01

    Neonates and infants undergoing cardiac surgery with cardiopulmonary bypass are exposed to multiple blood products from different donors. The volume of the bypass circuit is often as large as the patient's total blood volume and asanguineous bypass primes are unusual. As a result, blood products are required for the cardiopulmonary bypass prime and are often used to treat the postbypass dilutional coagulopathy. We review clot formation and strength, cardiopulmonary bypass prime considerations, assessment of postbypass coagulopathy, component therapy use, ultrafiltration techniques, and use of antifibrinolytic medications. A combined approach including techniques to minimize the prime volume, utilization of ultrafiltration, administration of antifibrinolytics during surgery, and the proper treatment of the dilutional coagulopathy can limit the transfusion requirements.

  1. The experience of totally endoscopic coronary bypass grafting with the robotic system «Da Vinci» in Russia

    Science.gov (United States)

    Efendiev, V. U.; Alsov, S. A.; Ruzmatov, T. M.; Mikheenko, I. L.; Chernyavsky, A. M.; Malakhov, E. S.

    2015-11-01

    A new technology - a thoracoscopic coronary bypass grafting with the use of Da Vinci robotic system in Russia is represented by the experience of NRICP. The technology was introduced in Russia in 2011. Overall, one hundred endoscopic coronary artery bypass procedures were performed. We have compared and analyzed results of coronary artery stenting vs minimally invasive coronary artery bypass grafting. According to the results, totally endoscopic coronary artery bypass grafting has several advantages over alternative treatment strategies.

  2. Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Jensen, Birte Ostergaard; Hughes, Pia; Rasmussen, Lars S

    2006-01-01

    It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed.......It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). However, evidence for this statement is preliminary, and additional insight is needed....

  3. Direct, High‑flow Bypass for a Pediatric Giant, Fusiform Aneurysm of ...

    African Journals Online (AJOL)

    tunneled through an endotracheal tube from proximal to distal in anticipation of ... Figure 1: AP and lateral view, respectively, of the giant fusiform aneurysm interrupted and .... compression are assiduously avoided. With continued technical ...

  4. Keys to Achieving Target First Medical Contact to Balloon Times and Bypassing Emergency Department More Important Than Distance

    Directory of Open Access Journals (Sweden)

    Saad Ezad

    2018-01-01

    Full Text Available Background. Australian guidelines advocate primary percutaneous coronary intervention (PPCI as the reperfusion strategy of choice for ST elevation myocardial infarction (STEMI in patients in whom it can be performed within 90 minutes of first medical contact; otherwise, fibrinolytic therapy is preferred. In a large health district, the reperfusion strategy is often chosen in the prehospital setting. We sought to identify a distance from a PCI centre, which made it unlikely first medical contact to balloon time (FMCTB of less than 90 minutes could be achieved in the Hunter New England health district and to identify causes of delay in patients who were triaged to a PPCI strategy. Methods and Results. We studied 116 patients presenting via the ambulance service with STEMI from January 2016 to December 2016. In patients who were taken directly to the cardiac catheterisation lab, a maximum distance of 50 km from hospital resulted in 75% of patients receiving PCI within 90 minutes and approximately 95% of patients receiving PCI within 120 minutes. Patients who bypassed the emergency department (ED were significantly more likely to have FMCTB of less than 90 minutes (p<0.001 despite having a longer travel distance (28.5 km versus 17.4 km, p<0.001. Patients transiting via the ED were significantly more likely to present out of hours (60 versus 24.2% p<0.001. Conclusions. Patients who do not bypass the ED have a longer FMCTB across all spectrum of distances from the PCI centre; therefore, bypassing the ED is key to achieving target FMCTB times. Using a cutoff distance of 50 km may reduce human error in estimating travel time to our PCI centre and thereby identifying patients who should receive prehospital thrombolysis.

  5. Transcatheter aortic valve implantation and off-pump coronary artery bypass surgery: an effective hybrid procedure in selected patients.

    Science.gov (United States)

    Mayr, Benedikt; Firschke, Christian; Erlebach, Magdalena; Bleiziffer, Sabine; Krane, Markus; Joner, Michael; Herold, Ulf; Nöbauer, Christian; Lange, Rüdiger; Deutsch, Marcus-André

    2018-02-26

    Simultaneous surgical off-pump coronary revascularization and transcatheter aortic valve implantation (TAVI) as a hybrid procedure may be a therapeutic option for patients with a TAVI indication who are not suitable for percutaneous coronary intervention and for patients who have an indication for combined surgical aortic valve implantation and coronary artery bypass grafting but present with a porcelain aorta. Early outcomes of these patients are analysed in this study. From February 2011 to April 2017, hybrid TAVI/off-pump coronary artery bypass (OPCAB) was performed in 12 (60%) patients, hybrid TAVI/minimally invasive direct coronary artery bypass in 6 (30%) patients and staged TAVI/OPCAB in 2 (10%) patients. Endpoints of this study were 30-day mortality, device success and postoperative adverse events as defined by the updated Valve Academic Research Consortium (VARC-2). The median age at the time of surgery was 77 years [interquartile range (IQR), 70-81] with a median logistic EuroSCORE and Society of Thoracic Surgeons' Predicted Risk score of 16.1% (IQR, 9.3-28.1) and 3.9% (IQR, 2.2-5.6), respectively. The median Synergy between PCI with Taxus and Cardiac Surgery score was 16.5 (IQR, 9.8-22.8). TAVI implantation routes were transaortic in 9 (45%) patients, transapical and transfemoral in 5 (25%) patients each and transsubclavian in 1 (5%) patient. Complete myocardial revascularization was achieved in 75% of patients. Device success rate was 100%. Paravalvular aortic regurgitation did not exceed mild in any patient. Stroke/transient ischaemic attack, vascular complications and myocardial infarction were not observed. Re-exploration for bleeding was required in 1 (5%) patient. Thirty-day mortality was 0%. Hybrid OPCAB/MIDCAB and TAVI prove to be a safe and effective alternative treatment option in selected higher risk patients.

  6. Duodenal-jejunal bypass liner implantation provokes rapid weight loss and improved glycemic control, accompanied by elevated fasting ghrelin levels

    NARCIS (Netherlands)

    Koehestanie, P.; Dogan, K.; Berends, F.; Janssen, I.; Wahab, P.J.; Groenen, M.; Müller, M.R.; Wit, de N.J.W.

    2014-01-01

    Background and study aims: Endoscopic implantation of a duodenal-jejunal bypass liner (DJBL) is a novel bariatric technique to induce weight loss and remission of type 2 diabetes mellitus. Placement of the DJBL mimics the bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. In this

  7. 75 FR 62919 - Notice of Final Federal Agency Actions on the Route 250 Bypass Interchange at McIntire Road...

    Science.gov (United States)

    2010-10-13

    ... on the Route 250 Bypass Interchange at McIntire Road Project in Virginia AGENCY: Federal Highway.... 139(l)(1). The actions relate to the Route 250 Bypass Interchange at McIntire Road project in the City... Virginia: Route 250 Bypass Interchange at McIntire Road. The project would involve construction of a grade...

  8. 78 FR 72567 - Airworthiness Directives; General Electric Company Turbofan Engines

    Science.gov (United States)

    2013-12-03

    ... Airworthiness Directives; General Electric Company Turbofan Engines AGENCY: Federal Aviation Administration (FAA... General Electric Company (GE) GE90-110B1 and -115B turbofan engines. This AD was prompted by multiple... turbofan engines with variable bypass valve (VBV) actuator fuel supply tube, part number (P/N) 2165M22P01...

  9. Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Croughwell, N.; Lyth, M.; Quill, T.J.; Newman, M.; Greeley, W.J.; Smith, L.R.; Reves, J.G.

    1990-01-01

    We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cerebral blood flow was measured using 133Xe clearance during nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the conditions of hypothermia and normothermia. In diabetic patients, the cerebral blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9 +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/- 2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less than or equal to 0.005). The oxygen consumption was calculated from jugular bulb effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from 0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus, despite temperature-mediated changes in oxygen consumption, diabetic patients did not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen saturation gradients and oxygen extraction across the brain were calculated from arterial and jugular bulb blood samples. The increase in arteriovenous oxygen difference between temperature conditions in diabetic patients and controls was significantly different (p = 0.01). These data reveal that diabetic patients lose cerebral autoregulation during cardiopulmonary bypass and compensate for an imbalance in adequate oxygen delivery by increasing oxygen extraction

  10. 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

    Full Text Available The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1. In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and

  11. Numerical and experimental investigation on labyrinth seal mechanism for bypass flow reduction in prismatic VHTR core

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Su-Jong, E-mail: paper80@snu.ac.r [Department of Nuclear Engineering, Seoul National University, San 56-1, Daehak-Dong, Kwanak-Gu, Seoul 151-742 (Korea, Republic of); Lee, Jeong-Hun [Department of Nuclear Engineering, Seoul National University, San 56-1, Daehak-Dong, Kwanak-Gu, Seoul 151-742 (Korea, Republic of); Lee, Sang-Moon [Department of Mechanical Engineering, Inha University, 253 Yonghyun-Dong, Nam-Gu, Incheon 402-751 (Korea, Republic of); Tak, Nam-il; Kim, Min-Hwan [Korea Atomic Energy Research Institute, 150-1 Deokjin-Dong, 1045 Daedeokdaero, Yuseong, Daejeon 305-353 (Korea, Republic of); Kim, Kwang-Yong [Department of Mechanical Engineering, Inha University, 253 Yonghyun-Dong, Nam-Gu, Incheon 402-751 (Korea, Republic of); Park, Goon-Cherl [Department of Nuclear Engineering, Seoul National University, San 56-1, Daehak-Dong, Kwanak-Gu, Seoul 151-742 (Korea, Republic of)

    2013-09-15

    Highlights: • Bypass flow reduction method was developed by applying labyrinth seal mechanism. • Grooves on side walls of replaceable reflector block were made. • Design of the grooved wall of the reflector block was optimized by the RSA method. • The flow resistance of the bypass gap rose from 18.04 to 26.24 by the optimization. • The bypass ratios at the inlet and outlet were reduced by 36.19% and 14.66%, respectively. -- Abstract: Core bypass flow in block type very high temperature reactor (VHTR) occurs due to the inevitable gaps between the hexagonal core blocks for the block installation and refueling. Since the core bypass flow affects the reactor safety and efficiency, it should be minimized to enhance the core thermal margin. In this regard, the core bypass flow reduction method applying the labyrinth seal mechanism was developed and optimized by using the single-objective shape optimization method. Response surface approximation (RSA) method was adopted as the optimization method. Side wall of the replaceable reflector block was redesigned and response surface approximate model was adopted to optimize the shape of the reflector wall. Computational fluid dynamics (CFD) analyses were carried out not only to assess the limitation of existing method of bypass flow reduction, but also to optimize the design of a newly developed reduction method. The experiment with Seoul National University (SNU) multi-block experimental facility was performed to demonstrate the performance of the reduction method. It was found that the effect of the existing bypass flow reduction method by sealing the bypass gap exit was restricted nearby the lower region of the core. However, the flow resistance factor of the bypass gap increased from 18.04 to 26.24 by the optimized reduction method. The results of the performance test showed that the bypass flow distribution was reduced throughout the entire core regions. The bypass flow ratios at the inlet and the outlet were

  12. Direct olive oil analysis

    Directory of Open Access Journals (Sweden)

    Peña, F.

    2002-03-01

    Full Text Available The practical impact of “direct analysis” is undeniable as it strong contributes to enhance the so-called productive analytical features such as expeditiousness, reduction of costs and minimisation of risks for the analysts and environment. The main objective is to establish a reliable bypass to the conventional preliminary operations of the analytical process. This paper offers a systematic approach in this context and emphasises the great field of action of direct methodologies in the routine analysis of olive oil. Two main types of methodologies are considered. On the one hand, the direct determination of volatile components is systematically considered. On the other hand, simple procedures to automatically implement the preliminary operations of the oil analysis using simple devices in which the sample is directly introduced with/without a simple dilution are present and discussed.El impacto práctico del análisis directo es tan innegable como que el contribuye decisivamente a mejorar las denominadas características analíticas relacionadas con la productividad como la rapidez, la reducción de costes y la minimización de riesgos para los analistas y el ambiente. El principal objetivo es establecer un adecuado "bypass" a las operaciones convencionales preliminares del proceso analítico. Este artículo ofrece una propuesta sistemática en este contexto y resalta el gran campo de acción de las metodologías directas en los análisis de rutina del aceite de oliva. Se analizan los dos tipos principales de metodologías. Por una lado, se analiza la determinación directa de los compuestos volátiles. Por el otro, se presentan y discuten los procedimientos simples para implementar automáticamente las operaciones preliminares del análisis del aceite usando sistemas simples en los que la muestra se introduce directamente con/sin un dilución simple.

  13. Photovoltaic power generation system free of bypass diodes

    Science.gov (United States)

    Lentine, Anthony L.; Okandan, Murat; Nielson, Gregory N.

    2015-07-28

    A photovoltaic power generation system that includes a solar panel that is free of bypass diodes is described herein. The solar panel includes a plurality of photovoltaic sub-modules, wherein at least two of photovoltaic sub-modules in the plurality of photovoltaic sub-modules are electrically connected in parallel. A photovoltaic sub-module includes a plurality of groups of electrically connected photovoltaic cells, wherein at least two of the groups are electrically connected in series. A photovoltaic group includes a plurality of strings of photovoltaic cells, wherein a string of photovoltaic cells comprises a plurality of photovoltaic cells electrically connected in series. The strings of photovoltaic cells are electrically connected in parallel, and the photovoltaic cells are microsystem-enabled photovoltaic cells.

  14. Study of transient turbine shot without bypass in a BWR

    International Nuclear Information System (INIS)

    Vallejo Q, J. A.; Martin del Campo M, C.; Fuentes M, L.; Francois L, J. L.

    2015-09-01

    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)

  15. Achalasia 5 years following Roux-en-y gastric bypass

    Directory of Open Access Journals (Sweden)

    Mehyar Hefazi Torghabeh

    2015-01-01

    Full Text Available Oesophageal achalasia is a rare, but serious condition in which the motility of the lower oesophageal sphincter (LES is inhibited. This disorder of idiopathic aetiology complicates the peristaltic function and relaxation of the LES that may cause symptoms such as dysphagia, epigastric pain, and regurgitation of an obstructed food. The following case describes achalasia in a patient 5 years following a laparoscopic Roux-en-Y gastric bypass (RYGB. The patient underwent a laparoscopic Heller myotomy without a fundoplication. Although achalasia seems to be a rare occurrence in obese patients, this is the third case documented in a patient who previously had an RYGB. The role of performing a fundoplication in these patients remains to be elucidated.

  16. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

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

    2014-01-01

    significantly more women with hypertension in pregnancy; relative risk (RR) 2.5 (95% confidence interval 1.3-5.0), gestational diabetes; RR = 6.9 (3.5-13.5), and acute abdominal pain during pregnancy; RR = 4.7 (2.9-7.8) compared with normal weight controls. Compared with women with similar body mass index......, they had a lower incidence of preeclampsia and emergency cesarean sections, and their children a lower incidence of asphyxia; RR = 0.4 (0.2-0.8). Their children were on average 212 g smaller than newborn of normal weight mothers, and 319 g smaller than newborn of adipose controls, and had significantly...... more admissions to neonatal intensive care unit compared with newborn of normal weight mothers; RR = 1.5 (1.1-2.0). CONCLUSIONS: Gastric bypass may reduce the risk of preeclampsia, emergency cesarean section, and perinatal asphyxia, compared with adipose women without surgery. Compared with normal...

  17. Photovoltaic power generation system with photovoltaic cells as bypass diodes

    Science.gov (United States)

    Lentine, Anthony L.; Nielson, Gregory N.; Tauke-Pedretti, Anna; Cruz-Campa, Jose Luis; Okandan, Murat

    2017-11-28

    A photovoltaic power generation system that includes a solar panel is described herein. The solar panel includes a photovoltaic sub-module, which includes a group of microsystem enabled photovoltaic cells. The group includes a first string of photovoltaic cells, a second string of photovoltaic cells, and a differing photovoltaic cell. Photovoltaic cells in the first string are electrically connected in series, and photovoltaic cells in the second string are electrically connected in series. Further, the first string of photovoltaic cells, the second string of photovoltaic cells, and the differing photovoltaic cell are electrically connected in parallel. Moreover, the differing photovoltaic cell is used as a bypass diode for the first string of photovoltaic cells and the second string of photovoltaic cells.

  18. Antiplatelet therapy at the time of coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Kremke, Michael; Jensen, Mariann Tang; Bak, Mikkel

    2013-01-01

    OBJECTIVES: The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events. METHODS: A matched...... Denmark Heart Registry. RESULTS: Of the 6350 patients enrolled, 1846 (29%) had been exposed to aspirin or clopidogrel within 5 days prior to CABG (the APT group). Matching with the remaining 4504 (71%) patients of the control group resulted in 1132 pairs of patients. Patients in the APT group had greater...... postoperative bleeding (OR: 2.08, 95% CI: 1.55-2.80). Overall, preoperative APT had no significant effect on postoperative 30-day mortality, incidence of myocardial infarction, stroke or need for dialysis. CONCLUSIONS: Preoperative APT is associated with increased bleeding and greater transfusion requirements...

  19. Bypass laparoscopic procedure for palliation of esophageal cancer.

    Science.gov (United States)

    Siosaki, Marcos Duarte; Lacerda, Croider Franco; Bertulucci, Paulo Anderson; da Costa Filho, José Orlando; de Oliveira, Antônio Talvane Torres

    2013-03-26

    Esophageal cancer is a devastating disease with rapidly increasing incidence in Western countries. Dysphagia is the most common complication, causing severe malnutrition and reduced quality of life. A 69-year-old male with persistent esophageal cancer after radiation therapy was subjected to palliative by-pass surgery using a laparoscopic approach. Due to the advanced stage at diagnosis, palliative treatment was a more realistic option. Dysphagia is a most distressing symptom of this disease, causing malnutrition and reducing quality of life. The goal of palliation is to improve swallowing. The most common methods applied are endoscopic stenting, radiation therapy (external or brachytherapy), chemotherapy, yttrium-aluminum-garnet laser rechanneling or endoscopic dilatation. Palliative surgery is rarely proposed due to morbidity and complications. This paper demonstrates an update in the technique proposed by Postlethwait in 1979 for palliation of esophageal cancer. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2013.

  20. 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.

  1. Does topical tranexamic acid reduce postcoronary artery bypass graft bleeding?

    Directory of Open Access Journals (Sweden)

    Amir Mirmohammadsadeghi

    2018-01-01

    Full Text Available Background: Postoperative bleeding is a common problem in cardiac surgery. We tried to evaluate the effect of topical tranexamic acid (TA on reducing postoperative bleeding of patients undergoing on-pump coronary artery bypass graft (CABG surgery. Materials and Methods: One hundred and twenty-six isolated primary CABG patients were included in this clinical trial. They were divided blindly into two groups; Group 1, patients receiving 1 g TA diluted in 100 ml normal saline poured into mediastinal cavity before closing the chest and Group 2, patients receiving 100 ml normal saline at the end of operation. First 24 and 48 h chest tube drainage, hemoglobin decrease and packed RBC transfusion needs were compared. Results: Both groups were the same in baseline characteristics including gender, age, body mass index, ejection fraction, clamp time, bypass time, and operation length. During the first 24 h postoperatively, mean chest tube drainage in intervention group was 567 ml compared to 564 ml in control group (P = 0.89. Mean total chest tube drainage was 780 ml in intervention group and 715 ml in control group (P = 0.27. There was no significant difference in both mean hemoglobin decrease (P = 0.26 and packed RBC transfusion (P = 0.7. Topical application of 1 g TA diluted in 100 ml normal saline does not reduce postoperative bleeding of isolated on-pump CABG surgery. Conclusion: We do not recommend topical usage of 1 g TA diluted in 100 ml normal saline for decreasing blood loss in on-pump CABG patients.

  2. STATISTICAL ANALYSIS OF DAMAGEABILITY OF THE BYPASS ENGINES COMPRESSOR BLADES

    Directory of Open Access Journals (Sweden)

    Boris A. Chichkov

    2018-01-01

    Full Text Available Aircraft gas turbine engines during the operation are exposed to damage of flowing parts. The elements of the engine design, appreciably determining operational characteristics are rotor blades. Character of typical damages for various types of engines depends on appointment and a geographical place of the aircraft operation on which one or another engine is installed. For example, the greatest problem for turboshaft engines operated in the dusty air conditions is erosive wear of a rotor blade airfoil. Among principal causes of flowing parts damages of bypass engine compressors are foreign object damages. Independently there are the damages caused by fatigue of a rotor blade material at dangerous blade mode. Pieces of the ice formed in the input unit, birds and the like can also be a source of danger. The foreign objects getting into the engine from runway are nuts, bolts, pieces of tire protectors, lock-wire, elements from earlier flying off aircraft, etc. The entry of foreign objects into the engine depends on both an operation mode (during the operation on the ground, on takeoff, on landing roll using the reverse and so on, and the aircraft engine position.Thus the foreign objects entered into the flowing path of bypass engine damage blade cascade of low and high pressure. Foreign objects entered into the flowing part of the engine with rotor blades result in dents on edges and blade shroud, deformations of edges, breakage, camber of peripheral parts and are distributed "nonlinear" on path length (steps. The article presents the results of the statistical analysis of three types engine compressors damageability over the period of more than three years. Damages are divided according to types of engines in whole and to their separate steps, depths and lengths, blades damage location. The results of the analysis make it possible to develop recommendations to carry out the optical-visual control procedures.

  3. Marked hypercapnia during cardiopulmonary bypass for myocardial revascularization. Case report.

    Science.gov (United States)

    Nascimento, Maurício Serrano; Bernardes, Cassiano Franco; de Medeiros, Roberta Louro

    2002-04-01

    Bypassing heart blood and returning it oxygenated to systemic circulation is achieved at the expenses of major cardiopulmonary physiologic changes. The aim of this report was to present an anesthetic complication during CPB and to warn for the need of interaction of the whole anesthetic-surgical team to prevent adverse perioperative events. A brown female patient, 56 years old, 95 kg, height 1.65 m, physical status ASA IV, with chronic renal failure under hemodialysis was admitted for myocardial revascularization. Monitoring consisted of ECG, invasive blood pressure, pulse oximetry, capnography, esophageal temperature, central venous pressure and anesthetic gases analysis. Patient was premedicated with intravenous midazolam (0.05 mg kg(-1)). Anesthesia was induced with fentanyl (16 microg kg(-1)), etomidate (0.3 mg kg(-1)) and pancuronium (0.1 mg kg(-1)), and was maintained with O2, isoflurane (0.5 - 1 MAC) and fentanyl continuous infusion. Blood gas analysis after induction has shown: pH: 7.41; PaO2: 288 mmHg; PaCO2: 38 mmHg; HCO3: 24 mmol L(-1); BE: 0 mmol L(-1); SatO2 100%. A second blood gases analysis, sampled soon after CPB, returned in 30 minutes, showing: pH 7.15; PaO2: 86 mmHg; PaCO2 224 mmHg; HCO3: 29 mmol L(-1); BE: -3 mmol L(-1); SatO2 99%. Thorough and urgent checking of anesthetic and perfusion equipment was performed and revealed that the gas blender was connected to the O2 line and to a CO2 cylinder, when it should be connected to the compressed air cylinder. Bypass circuit mechanical problems may occur in the intraoperative period, and demand prompt repairs. Technological advances in anesthesia equipment, monitoring and safety standards will lessen the possibility of cases such as this to be repeated, but will never replace anesthesiologists surveillance.

  4. Oral Triiodothyronine for Infants and Children Undergoing Cardiopulmonary Bypass.

    Science.gov (United States)

    Marwali, Eva M; Boom, Cindy E; Budiwardhana, Novik; Fakhri, Dicky; Roebiono, Poppy S; Santoso, Anwar; Sastroasmoro, Sudigdo; Slee, April; Portman, Michael A

    2017-08-01

    This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population. We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia. The primary end point, time to extubation, was compared with Cox regression. The modified intention-to-treat group included 101 placebo and 104 treated patients. The stratified log-rank test did not show a significant treatment difference (p = 0.061) for time to extubation, but after adjustment for age, the nutritional Z score, and Aristotle surgical complexity, the hazard ratio was 1.33 (95% confidence interval, 1.00 to 1.76; p = 0.049). The effect of T3 was stronger in the strata aged 5 months and younger (hazard ratio, 1.86; 95% confidence interval 1.02 to 3.39; p = 0.043). Median intubation time was 47.3 hours for the placebo and 32.1 hours for the T3 group in aged 5 months and younger. Adverse events rates, including arrhythmia, were similar between groups, although sepsis was more frequent with placebo. Oral T3 supplementation may shorten time to extubation in children undergoing congenital heart disease operations, particularly infants aged 5 months or younger. Administration is relatively safe, simple and inexpensive. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Noninvasive detection of coronary artery bypass graft patency by intravenous electron beam computed tomographic angiography.

    Science.gov (United States)

    Yamakami, Shoji; Toyama, Junji; Okamoto, Mitsuhiro; Matsushita, Toyoaki; Murakami, Yoshimasa; Ogata, Masaki; Ito, Shigenori; Fukutomi, Tatsuya; Okayama, Naotsuka; Itoh, Makoto

    2003-11-01

    This study evaluates the usefullness of intravenous electron beam computed tomographic angiography (EBA) for the detection of coronary artery bypass graft patency in 43 patients (33 men and 10 women, mean age, 65 years) who had coronary artery bypass graft surgery. EBA was performed a few days before selective bypass graft angiography (SGA). Forty axial cross-sections of angiographic images of the heart were acquired consecutively by an electrocardiographic trigger signal at 40% of the RR interval, which corresponds to the end-systolic phase. EBA data were reconstructed as a three-dimensional shaded surface display of the heart and bypass grafts. Detectability of the patency of bypass gratis was evaluated, taking selective angiographic images of the bypass grafts as a gold standard. One hundred and nine grafts (96%) out of 114 grafts were subjected to evaluation: 37 grafts were left internal mammary artery grafts (LIMA), 7 were right internal mammary artery grafts (RIMA), 6 were gastroepiploic artery grafts (GEA), 7 were free gastroepiploic artery grafts with venous drainage (free-GEA), 7 were radial artery grafts (RAG), and 45 were saphenous vein gratis (SVG). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBA were 98%, 100%, 100%, 91%, and 98%, respectively. EBA sampled at the end-systolic period was determined to be useful for the detection of coronary artery bypass graft patency and occlusion.

  6. The Application of Advanced Technique of Fan Frame Unit on High Bypass Ratio Aero Engine

    Directory of Open Access Journals (Sweden)

    Hou Peng

    2017-01-01

    Full Text Available High bypass ratio aero-engine was widely used on military and civil aviation domain, as the power of larger aircraft. Fan frame unit was the main bearing frame of high bypass ratio aero-engine, which composed of strut, HUB MID BOX and external bypass parts. Resin/composite was used on external bypass parts(acoustic liner, containment ring, fan outlet guide vane and fan case skin fillets, which not only reduced the weight and manufacturing cost, but also improved the noise absorption, containment and anti-fatigue ability of engine. The design of composite was becoming a key technique for high bypass ratio aero-engine. In special test of the core engine, nitrogen cooling system was designed to cool the cavity of spool. The nitrogen pipeline passed through the inner cavity of fan frame, then inserted into NO. 3 bearing seal, so nitrogen gas was sent into the cavity of core engine spool. On high bypass ratio aero-engine, the external bypass and fan frame inner cavity were the design platform for advanced technique, such as composite and pipeline system, and also provided guarantee for reliable operation of engine.

  7. Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    2002-03-01

    The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

  8. Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

    International Nuclear Information System (INIS)

    Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

    2002-01-01

    The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

  9. Outcome after VAC® therapy for infected bypass grafts in the lower limb.

    Science.gov (United States)

    Acosta, S; Monsen, C

    2012-09-01

    To assess the outcome of vacuum-assisted wound closure (VAC(®)) therapy for infected bypass grafts. A retrospective 7-year review of patient records from 2004 to 2011 of all patients receiving VAC(®) therapy for infected bypass grafts. Thirty-seven patients with 42 wounds and 45 infected bypass (28 synthetic) grafts received VAC(®) treatment. Two serious bleeding episodes from the suture lines occurred. The median VAC(®) therapy time was 20 days. The proportion of patent bypass grafts was 91% (41/45) at a median time of 3.5 months from the start of VAC(®) therapy. Five patients with seven bypasses had persistent infection or re-infection, and the total graft preservation rate was 76% (34/45). The median follow-up time was 15 months. The presence of two infected bypass grafts in one groin wound was associated with an increased major amputation rate (hazard ratio (HR) 7.4 [95% confidence interval (CI) 2.0-27.5]), and synthetic graft infection (HR 5.0 [95% CI 1.5-17.4]) and non-healed wound (HR 3.6 [95% CI 1.5-8.7]) were associated with mortality. VAC(®) therapy of infected bypass grafts was able to induce effective wound healing without compromising the early bypass function. Two infected synthetic bypasses in the wound were associated with the highest risk of adverse outcome. Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  10. A simple technique can reduce cardiopulmonary bypass use during lung transplantation

    Directory of Open Access Journals (Sweden)

    Marcos N. Samano

    2016-04-01

    Full Text Available Cardiopulmonary bypass causes an inflammatory response and consumption of coagulation factors, increasing the risk of bleeding and neurological and renal complications. Its use during lung transplantation may be due to pulmonary hypertension or associated cardiac defects or just for better exposure of the pulmonary hilum. We describe a simple technique, or open pericardium retraction, to improve hilar exposure by lifting the heart by upward retraction of the pericardial sac. This technique permits lung transplantation without cardiopulmonary bypass when bypass use is recommended only for better exposure.

  11. Severe scurvy after gastric bypass surgery and a poor postoperative diet

    DEFF Research Database (Denmark)

    Hansen, Esben P K; Metzsche, Carsten; Henningsen, Emil

    2012-01-01

    After bariatric gastric bypass surgery patients are at risk of developing micronutrient deficiencies. If gastric bypass surgery is followed by a vitamin deficient diet the patients have a risk of developing vitamin-C deficiency. When spontaneous ecchymosis is observed in the skin, in at......-risk patients, scurvy must be considered. When treated with large doses of vitamin-C the symptoms of scurvy rapidly improve even if the patient has developed multiple organ dysfunction syndrome. KEYWORDS: Scurvy; Gastric bypass surgery; Multiorgan dysfunction....

  12. 78. Coronary bypass using bilateral internal mammary arteries in an achondroplast

    Directory of Open Access Journals (Sweden)

    Mohamed Abdulwahab Alassal

    2015-10-01

    Full Text Available Coronary bypass grafting for ischemic heart disease in achondroplastic dwarfs is very rare. Shortage of veins and sometimes, inadequate vein quality can cause difficulties during surgery. Only two achondroplastic cases were reported in literature that underwent coronary bypass surgery, in which the left internal mammary artery and vein grafts were used. To the best of our knowledge using bilateral internal mammary arteries in such patients was not reported. We report here a 55 years old male achondroplastic dwarf who had triple vessels coronary disease that underwent successful coronary bypass surgery using bilateral mammary arteries. Anatomic and surgical challenges in achondroplasia are highlighted

  13. An animal model for instructing and the study of in situ arterial bypass.

    Science.gov (United States)

    Saifi, J; Chang, B B; Paty, P S; Kaufman, J; Leather, R P; Shah, D M

    1990-11-01

    A canine model that used the cephalic vein to bypass from the brachial to the ulnar artery was designed for use in instructing and evaluating surgical technique needed for constructing an in situ arterial bypass. This model was used for instructing vascular residents in the in situ vein bypass technique. The use of this model enabled the resident to become more adept with the instruments for valve incision and construction of small vessel anastomosis. The improvement in the resident's operative technique was reflected by a decrease in the number of technical complications (missed valves, missed arteriovenous fistulas, poorly constructed anastomoses) and improved patency rate.

  14. Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass

    Directory of Open Access Journals (Sweden)

    Joung Hun Byun

    2017-10-01

    Full Text Available Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs with lifestyle- limiting claudication (n=12 or chronic critical limb ischemia (n=6 underwent femoral–above-knee (AK polytetrafluoroethylene (PTFE bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. Results: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months, and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55 significantly increased to 0.8 (range, 0.5 to 1.0 at 12 months (p<0.01. The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. Conclusion: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.

  15. Avaliação da resistência a fadiga dos Engineered Cementitious Composites (ecc, reforçados com fibra de polipropileno e produzidos com adição de cinza de casca de arroz

    Directory of Open Access Journals (Sweden)

    Alceu Lopes de Freitas Júnior

    2017-07-01

    Full Text Available O Engineered Cementitious Composites - ECC – é um tipo especial de compósito cimentício de alto desempenho reforçado com fibra, cuja principal característica é a alta ductilidade. O traço de ECC é composto por cimento, material pozolânico, agregado miúdo e fibras. Este estudo avaliou a resistência à fadiga de traços de Engineered Cementitious Composites reforçados com fibras de polipropileno - PPECC – e cuja composição da matriz cimentícia tenha a incorporação de cinza de casca de arroz como material suplementar. Para isto, foram produzidos corpos de prova com substrato de concreto para pavimento e overlay com o traço de PPECC desenvolvido. Os corpos de prova foram submetidos aos ensaios de flexão a quatro pontos (estático e cíclico. Compararam-se os resultados obtidos no ensaio estático dos traços de PPECC com os resultados obtidos neste mesmo ensaio com corpos de prova produzidos somente por concreto para pavimento. Foram analisados os resultados dos ensaios cíclicos em diferentes intervalos de tensões. Com os resultados variação da tensão x números de ciclos, obtidos no ensaio cíclico, foi avaliado o comportamento à fadiga do compósito.

  16. Homogeneous shear turbulence – bypass concept via interplay of linear transient growth and nonlinear transverse cascade

    International Nuclear Information System (INIS)

    Mamatsashvili, George; Dong, Siwei; Jiménez, Javier; Khujadze, George; Chagelishvili, George; Foysi, Holger

    2016-01-01

    We performed direct numerical simulations of homogeneous shear turbulence to study the mechanism of the self-sustenance of subcritical turbulence in spectrally stable (constant) shear flows. For this purpose, we analyzed the turbulence dynamics in Fourier/wavenumber/spectral space based on the simulation data for the domain aspect ratio 1 : 1 : 1. Specifically, we examined the interplay of linear transient growth of Fourier harmonics and nonlinear processes. The transient growth of harmonics is strongly anisotropic in spectral space. This, in turn, leads to anisotropy of nonlinear processes in spectral space and, as a result, the main nonlinear process appears to be not a direct/inverse, but rather a transverse/angular redistribution of harmonics in Fourier space referred to as the nonlinear transverse cascade. It is demonstrated that the turbulence is sustained by the interplay of the linear transient, or nonmodal growth and the transverse cascade. This course of events reliably exemplifies the wellknown bypass scenario of subcritical turbulence in spectrally stable shear flows. These processes mainly operate at large length scales, comparable to the box size. Consequently, the central, small wavenumber area of Fourier space (the size of which is determined below) is crucial in the self-sustenance and is labeled the vital area. Outside the vital area, the transient growth and the transverse cascade are of secondary importance - Fourier harmonics are transferred to dissipative scales by the nonlinear direct cascade. The number of harmonics actively participating in the self-sustaining process (i.e., the harmonics whose energies grow more than 10% of the maximum spectral energy at least once during evolution) is quite large - it is equal to 36 for the considered box aspect ratio - and obviously cannot be described by low-order models. (paper)

  17. The regional economic impacts of bypasses : a longitudinal study incorporating spatial panel econometrics and multilevel modeling.

    Science.gov (United States)

    2011-09-01

    This paper will describe an integrated approach to documenting and quantifying the impacts of bypasses : on small communities, with a focus on what economic impacts, if any, occur, and how these impacts : change over time. Two similarly sized communi...

  18. Attenuated renal and intestinal injury after use of a mini-cardiopulmonary bypass system

    NARCIS (Netherlands)

    Huybregts, Rien A. J. M.; Morariu, Aurora M.; Rakhorst, Gerhard; Spiegelenberg, Stefan R.; Romijn, Hans W. A.; de Vroege, Roel; van Oeveren, Willem

    Background. Transient, subclinical myocardial, renal, intestinal, and hepatic tissue injury and impaired homeostasis is detectable even in low-risk patients undergoing conventional cardiopulmonary bypass (CPB). Small extracorporeal closed circuits with low priming volumes and optimized perfusion

  19. THE BASIC LAWS AND FEATURES OF CYTOKINE DYNAMICS IN PROCESS AND EARLY TERMS AFTER CARDIOPULMONARY BYPASS

    Directory of Open Access Journals (Sweden)

    S. I. Suskov

    2011-01-01

    Full Text Available The basic variants of cytokines reactions defining type of organ dysfunctions are revealed in the course of car- diopulmonary bypass and in the early postoperative period. Their character and expression, depends on gravity preoperative an immunodeficiency and initial degree of heart insufficiency. Diphasic dynamics of development of system inflammatory reaction is confirmed after cardiopulmonary bypass: increase of levels proinflammatory cytokines is in the first phase and anti-inflammatory cytokines with development immunodepression and cellular anergy in is the second phase. Also, key role IL-1Ra is revealed in restraint of hyperactivation of system inflam- matory reaction. Blood whey levels IL-6, IL-8, G-CSF, TNF-α and IL-1Ra should be defined to cardiopulmonary bypass, in 10–12 hours, 24 hours and 3 days after cardiopulmonary bypass and may be used as prognostic criteria of development of postoperative complications. 

  20. Preliminary Estimation of Local Bypass Flow Gap Sizes for a Prismatic VHTR Core

    International Nuclear Information System (INIS)

    Kim, Min Hwan; Jo, Chang Keun; Lee, Won Jae

    2009-01-01

    The Very High Temperature Reactor (VHTR) has been selected for the Nuclear Hydrogen Development and Demonstration (NHDD) project. In the VHTR design, core bypass flow has been one of key issues for core thermal margins and target temperature of the core outlet. The core bypass flow in the prismatic VHTR varies with the core life due to the irradiation shrinkage/ swelling and thermal expansion of the graphite blocks, which could be a significant proportion of the total core flow. Thus, accurate prediction of the bypass flow is of major importance in assuring the core thermal margin. To predict the bypass flow, first of all, local gap sizes between graphite blocks in the core should be determined. The objectives of this work are to develop a methodology for determining the gap sizes and to perform a preliminary evaluation for a reference reactor

  1. Clinical significance of 201Tl reverse redistribution in patients with aorto-coronary bypass surgery

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Tashiisa; Hayashida, Kohei; Kozuka, Takahira

    1987-01-01

    Detection of myocardial ischemia by the stress thallium scan has traditionally been performed using transient defect analysis on exercise, followed by redistribution studies. Worsening of the 201 Tl myocardial image from exercise to redistribution is referred to as reverse redistribution. In this study, we found reverse redistribution in 10 (21%) of 48 angina pectoris patients who had undergone aortocoronary bypass surgery. The clinical significance of this phenomenon in these patients was investigated in relation to angiographic and surgical findings. Reverse redistribution was found to occur in regions which were supplied by bypass grafts. These areas showed increased coronary blood flow and rapid thallium washout. Our results indicate that a perfusion defect in the bypass region of the redistribution image might be caused by relatively rapid washout in the bypass graft region compared to the adjacent normal myocardium. These results should be considered in the clinical interpretation of stress thallium scans. (orig.)

  2. Extracranial–intracranial bypass for Takayasu’s arteritis: A case report

    Directory of Open Access Journals (Sweden)

    Richard M. Young, M.D.

    2014-12-01

    Conclusion: STA–MCA bypass to enhance cerebral blood flow in the setting of stroke symptoms due to Takayasu’s arteritis can serve as a bridge before definitive cardiothoracic treatment of the great vessels.

  3. Decline in Health-Related Quality of Life 6 Months After Coronary Artery Bypass Graft Surgery

    DEFF Research Database (Denmark)

    El Baz, Noha; Pedersen, Susanne S.; van Dijk, Jitse P

    2013-01-01

    Although coronary artery bypass graft (CABG) is known to improve health-related quality of life (HRQoL), this improvement does not seem to be realized in all patients who had undergone CABG surgery....

  4. HYPOTHERMIC CARDIOPULMONARY BYPASS INFLUENCES THE CONCENTRATION-RESPONSE RELATIONSHIP AND THE BIODISPOSITION OF ROCURONIUM

    NARCIS (Netherlands)

    SMEULERS, NJ; WIERDA, JMKH; VANDENBROEK, L; HUET, RCGG; HENNIS, PJ

    In 10 patients scheduled for elective coronary artery bypass grafting under midazolam-sufentanil anaesthesia, the influence of hypothermia on the plasma concentration-response and biodisposition of rocuronium were investigated. Neuromuscular function was monitored mechanomyographically. plasma and

  5. Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury

    DEFF Research Database (Denmark)

    Kandler, K; Jensen, M E; Nilsson, J C

    2015-01-01

    BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is common and is associated with increased mortality. We wanted to investigate if the arterial pressure or the use of norepinephrine during cardiopulmonary bypass were associated with AKI. METHODS: A retrospective analysis of patients who...... underwent coronary artery bypass grafting with or without concomitant procedures was conducted. AKI was defined using the RIFLE criteria. Data on arterial pressure and use of norepinephrine during cardiopulmonary bypass were entered in a binary logistic regression model to control for possible perioperative...... and in higher amounts, during cardiopulmonary bypass, in patients who developed AKI. These differences in arterial pressures and use of norepinephrine between the groups were not found to be significant when entered in the binary logistic regression model. CONCLUSION: No independent relationship between...

  6. Off-Pump Versus On-Pump Coronary Artery Bypass Grafting

    DEFF Research Database (Denmark)

    Møller, Christian H; Steinbrüchel, Daniel A

    2014-01-01

    Coronary artery bypass grafting (CABG) remains the preferred treatment in patients with complex coronary artery disease. However, whether the procedure should be performed with or without the use of cardiopulmonary bypass, referred to as off-pump and on-pump CABG, is still up for debate....... Intuitively, avoidance of cardiopulmonary bypass seems beneficial as the systemic inflammatory response from extracorporeal circulation is omitted, but no single randomized trial has been able to prove off-pump CABG superior to on-pump CABG as regards the hard outcomes death, stroke or myocardial infarction....... In contrast, off-pump CABG is technically more challenging and may be associated with increased risk of incomplete revascularization. The purpose of the review is to summarize the current literature comparing outcomes of off-pump versus on-pump coronary artery bypass surgery....

  7. Increased neutrophil priming and sensitization before commencing cardiopulmonary bypass in cardiac surgical patients

    NARCIS (Netherlands)

    Gu, YJ; Schoen, P; Tigchelaar, [No Value; Loef, BG; Ebels, T; Rankin, AJ; van Oeveren, W

    2002-01-01

    Background. Neutrophil activation is implicated in postoperative complications in patients having cardiac surgery with cardiopulmonary bypass (CPB). This study was designed to determine the temporal fluctuations in the primability of neutrophils in the preoperative, intraoperative, and postoperative

  8. Is the use of albumin in colloid prime solution of cardiopulmonary bypass circuit justified?

    NARCIS (Netherlands)

    Boks, RH; van Herwerden, LA; Takkenberg, JJM; van Oeveren, W; Gu, YJ; Wijers, MJ; Bogers, AJJC

    Background. Albumin in the priming solution precoats the surface of the cardiopulmonary bypass circuit, supposedly causing delayed adsorption of fibrinogen and reduced activation and adhesion of platelets. This action may result in lower transoxygenator resistance. Because our institution uses a

  9. Active bypass flow control for a seal in a gas turbine engine

    Science.gov (United States)

    Ebert, Todd A.; Kimmel, Keith D.

    2017-03-14

    An active bypass flow control system for controlling bypass compressed air based upon leakage flow of compressed air flowing past an outer balance seal between a stator and rotor of a first stage of a gas turbine in a gas turbine engine is disclosed. The active bypass flow control system is an adjustable system in which one or more metering devices may be used to control the flow of bypass compressed air as the flow of compressed air past the outer balance seal changes over time as the outer balance seal between the rim cavity and the cooling cavity wears In at least one embodiment, the metering device may include an annular ring having at least one metering orifice extending therethrough, whereby alignment of the metering orifice with the outlet may be adjustable to change a cross-sectional area of an opening of aligned portions of the outlet and the metering orifice.

  10. 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.

  11. Impaired microcirculatory perfusion in a rat model of cardiopulmonary bypass : the role of hemodilution

    NARCIS (Netherlands)

    Koning, Nick J.; de lange, Fellery; Vonk, Alexander B. A.; Ahmed, Yunus; van den Brom, Charissa E.; Bogaards, Sylvia; van Meurs, Matijs; Jongman, Rianne M.; Schalkwijk, Casper G.; Begieneman, Mark P. V.; Niessen, Hans W.; Baufreton, Christophe; Boer, Christa

    2016-01-01

    Although hemodilution is attributed as the main cause of microcirculatory impairment during cardiopulmonary bypass (CPB), this relationship has never been investigated. We investigated the distinct effects of hemodilution with or without CPB on microvascular perfusion and subsequent renal tissue

  12. Posttraumatic growth in post-surgical coronary artery bypass graft patients

    Directory of Open Access Journals (Sweden)

    Catherine A Waight

    2015-02-01

    Full Text Available Recent research in posttraumatic growth has been applied to people with life-threatening illnesses to optimise recovery. There is a lack of research exploring posttraumatic growth in coronary artery bypass graft patients. This article describes the recovery experience of 14 coronary artery bypass graft patients (13 males and 1 female at their first outpatient review post-surgery. Grounded theory analysis was used to develop a model of distinct and shared pathways to growth depending on whether patients were symptomatic or asymptomatic pre-coronary artery bypass graft. Outcomes of posttraumatic growth in this sample included action-based healthy lifestyle growth and two forms of cognitive growth: appreciation of life and new possibilities. The model of posttraumatic growth developed in this study may be helpful in guiding future research into promoting posttraumatic growth and behaviour change in coronary artery bypass graft patients.

  13. Initial clinical experience with the trabecular micro-bypass stent in patients with glaucoma.

    Science.gov (United States)

    Spiegel, Detlev; Wetzel, Wolfgang; Haffner, David S; Hill, Richard A

    2007-01-01

    This study was undertaken to evaluate the efficiency of a trabecular micro-bypass stent designed to allow direct aqueous drainage from the anterior chamber into Schlemm's canal in patients with glaucoma. In this prospective case series of 6 patients with open-angle glaucoma, the microstent was inserted ab interno under local anesthesia in an ophthalmic operating room. Patients were seen postoperatively at 1 to 2 d, 1 wk, and 1, 2, 6, and 12 mo. All stents were successfully placed within Schlemm's canal. Mean intraocular pressure (IOP) at preoperative baseline was 20.2+/-6.3 mm Hg (range, 14-31 mm Hg). Mean IOP decreased during the immediate postoperative period to approximately 12 to 13 mm Hg and was stabilized at 14 to 15 mm Hg with reduction of medication throughout 1 y of follow-up. No major complications occurred. According to observations reported in this feasibility study, the microstent was effective in reducing IOP and in decreasing the number of glaucoma medications required to control IOP. Implantation procedures were safe, and stents remained in place throughout the follow-up period. None of the complications traditionally associated with filtering surgery were reported. Further research on this stent in a larger group of patients is needed to assess its role in glaucoma therapy.

  14. Differential Canalograms Detect Outflow Changes from Trabecular Micro-Bypass Stents and Ab Interno Trabeculectomy.

    Science.gov (United States)

    Parikh, Hardik A; Loewen, Ralitsa T; Roy, Pritha; Schuman, Joel S; Lathrop, Kira L; Loewen, Nils A

    2016-11-04

    Recently introduced microincisional glaucoma surgeries that enhance conventional outflow offer a favorable risk profile over traditional surgeries, but can be unpredictable. Two paramount challenges are the lack of an adequate training model for angle surgeries and the absence of an intraoperative quantification of surgical success. To address both, we developed an ex vivo training system and a differential, quantitative canalography method that uses slope-adjusted fluorescence intensities of two different chromophores to avoid quenching. We assessed outflow enhancement by trabecular micro-bypass (TMB) implantation or by ab interno trabeculectomy (AIT). In this porcine model, TMB resulted in an insignificant (p > 0.05) outflow increase of 13 ± 5%, 14 ± 8%, 9 ± 3%, and 24 ± 9% in the inferonasal, superonasal, superotemporal, and inferotemporal quadrant, respectively. AIT caused a 100 ± 50% (p = 0.002), 75 ± 28% (p = 0.002), 19 ± 8%, and 40 ± 21% increase in those quadrants. The direct gonioscopy and tactile feedback provided a surgical experience that was very similar to that in human patients. Despite the more narrow and discontinuous circumferential drainage elements in the pig with potential for underperformance or partial stent obstruction, unequivocal patterns of focal outflow enhancement by TMB were seen in this training model. AIT achieved extensive access to outflow pathways beyond the surgical site itself.

  15. Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery

    Directory of Open Access Journals (Sweden)

    Kanko Muhip

    2012-01-01

    Full Text Available Abstract Background Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops. Methods and Results 30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD of IMA (0.67677 ± 0.09985 were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894 and postoperative (0.70477 ± 0.07523 measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA. Conclusions IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.

  16. DNA Repair Mechanisms and the Bypass of DNA Damage in Saccharomyces cerevisiae

    Science.gov (United States)

    Boiteux, Serge; Jinks-Robertson, Sue

    2013-01-01

    DNA repair mechanisms are critical for maintaining the integrity of genomic DNA, and their loss is associated with cancer predisposition syndromes. Studies in Saccharomyces cerevisiae have played a central role in elucidating the highly conserved mechanisms that promote eukaryotic genome stability. This review will focus on repair mechanisms that involve excision of a single strand from duplex DNA with the intact, complementary strand serving as a template to fill the resulting gap. These mechanisms are of two general types: those that remove damage from DNA and those that repair errors made during DNA synthesis. The major DNA-damage repair pathways are base excision repair and nucleotide excision repair, which, in the most simple terms, are distinguished by the extent of single-strand DNA removed together with the lesion. Mistakes made by DNA polymerases are corrected by the mismatch repair pathway, which also corrects mismatches generated when single strands of non-identical duplexes are exchanged during homologous recombination. In addition to the true repair pathways, the postreplication repair pathway allows lesions or structural aberrations that block replicative DNA polymerases to be tolerated. There are two bypass mechanisms: an error-free mechanism that involves a switch to an undamaged template for synthesis past the lesion and an error-prone mechanism that utilizes specialized translesion synthesis DNA polymerases to directly synthesize DNA across the lesion. A high level of functional redundancy exists among the pathways that deal with lesions, which minimizes the detrimental effects of endogenous and exogenous DNA damage. PMID:23547164

  17. Evidence-based algorithm for heparin dosing before cardiopulmonary bypass. Part 1: Development of the algorithm.

    Science.gov (United States)

    McKinney, Mark C; Riley, Jeffrey B

    2007-12-01

    The incidence of heparin resistance during adult cardiac surgery with cardiopulmonary bypass has been reported at 15%-20%. The consistent use of a clinical decision-making algorithm may increase the consistency of patient care and likely reduce the total required heparin dose and other problems associated with heparin dosing. After a directed survey of practicing perfusionists regarding treatment of heparin resistance and a literature search for high-level evidence regarding the diagnosis and treatment of heparin resistance, an evidence-based decision-making algorithm was constructed. The face validity of the algorithm decisive steps and logic was confirmed by a second survey of practicing perfusionists. The algorithm begins with review of the patient history to identify predictors for heparin resistance. The definition for heparin resistance contained in the algorithm is an activated clotting time 450 IU/kg heparin loading dose. Based on the literature, the treatment for heparin resistance used in the algorithm is anti-thrombin III supplement. The algorithm seems to be valid and is supported by high-level evidence and clinician opinion. The next step is a human randomized clinical trial to test the clinical procedure guideline algorithm vs. current standard clinical practice.

  18. Patient Specific Multiscale Simulations of Blood Flow in Coronary Artery Bypass Surgery

    Science.gov (United States)

    Bangalore Ramachandra, Abhay; Sankaran, Sethuraman; Kahn, Andrew M.; Marsden, Alison L.

    2013-11-01

    Coronary artery bypass surgery is performed to revascularize blocked coronary arteries in roughly 400,000 patients per year in the US.While arterial grafts offer superior patency, vein grafts are used in more than 70% of procedures, as most patients require multiple grafts. Vein graft failure (approx. 50% within 10 years) remains a major clinical issue. Mounting evidence suggests that hemodynamics plays a key role as a mechano-biological stimulus contributing to graft failure. However, quantifying relevant hemodynamic quantities (e.g. wall shear stress) invivo is not possible directly using clinical imaging techniques. We numerically compute graft hemodynamics in a cohort of 3-D patient specific models using a stabilized finite element method. The 3D flow domain is coupled to a 0D lumped parameter circulatory model. Boundary conditions are tuned to match patient specific blood pressures, stroke volumes & heart rates. Results reproduce clinically observed coronary flow waveforms. We quantify differences in multiple hemodynamic quantities between arterial & venous grafts & discuss possible correlations between graft hemodynamics & clinically observed graft failure.Such correlations will provide further insight into mechanisms of graft failure and may lead to improved clinical outcomes.

  19. Synthetic niches for differentiation of human embryonic stem cells bypassing embryoid body formation.

    Science.gov (United States)

    Liu, Yarong; Fox, Victoria; Lei, Yuning; Hu, Biliang; Joo, Kye-Il; Wang, Pin

    2014-07-01

    The unique self-renewal and pluripotency features of human embryonic stem cells (hESCs) offer the potential for unlimited development of novel cell therapies. Currently, hESCs are cultured and differentiated using methods, such as monolayer culture and embryoid body (EB) formation. As such, achieving efficient differentiation into higher order structures remains a challenge, as well as maintaining cell viability during differentiation into homogeneous cell populations. Here, we describe the application of highly porous polymer scaffolds as synthetic stem cell niches. Bypassing the EB formation step, these scaffolds are capable of three-dimensional culture of undifferentiated hESCs and subsequent directed differentiation into three primary germ layers. H9 hESCs were successfully maintained and proliferated in biodegradable polymer scaffolds based on poly (lactic-co-glycolic acid) (PLGA). The results showed that cells within PLGA scaffolds retained characteristics of undifferentiated pluripotent stem cells. Moreover, the scaffolds allowed differentiation towards the lineage of interest by the addition of growth factors to the culture system. The in vivo transplantation study revealed that the scaffolds could provide a microenvironment that enabled hESCs to interact with their surroundings, thereby promoting cell differentiation. Therefore, this approach, which provides a unique culture/differentiation system for hESCs, will find its utility in various stem cell-based tissue-engineering applications. © 2013 Wiley Periodicals, Inc.

  20. Roux-en-Y gastric bypass increases intravenous ethanol self-administration in dietary obese rats.

    Directory of Open Access Journals (Sweden)

    James E Polston

    Full Text Available Roux-en-Y gastric bypass surgery (RYGB is an effective treatment for severe obesity. Clinical studies however have reported susceptibility to increased alcohol use after RYGB, and preclinical studies have shown increased alcohol intake in obese rats after RYGB. This could reflect a direct enhancement of alcohol's rewarding effects in the brain or an indirect effect due to increased alcohol absorption after RGYB. To rule out the contribution that changes in alcohol absorption have on its rewarding effects, here we assessed the effects of RYGB on intravenously (IV administered ethanol (1%. For this purpose, high fat (60% kcal from fat diet-induced obese male Sprague Dawley rats were tested ~2 months after RYGB or sham surgery (SHAM using both fixed and progressive ratio schedules of reinforcement to evaluate if RGYB modified the reinforcing effects of IV ethanol. Compared to SHAM, RYGB rats made significantly more active spout responses to earn IV ethanol during the fixed ratio schedule, and achieved higher breakpoints during the progressive ratio schedule. Although additional studies are needed, our results provide preliminary evidence that RYGB increases the rewarding effects of alcohol independent of its effects on alcohol absorption.

  1. 2010 Survey on cell phone use while performing cardiopulmonary bypass.

    Science.gov (United States)

    Smith, T; Darling, E; Searles, B

    2011-09-01

    Cell phone use in the U.S. has increased dramatically over the past decade and text messaging among adults is now mainstream. In professions such as perfusion, where clinical vigilance is essential to patient care, the potential distraction of cell phones may be especially problematic. However, the extent of this as an issue is currently unknown. Therefore, the purpose of this study was to (1) determine the frequency of cell phone use in the perfusion community, and (2) to identify concerns and opinions among perfusionists regarding cell phone use. In October 2010, a link to a 19-question survey (surveymonkey.com) was posted on the AmSECT (PerfList) and Perfusion.com (PerfMail) forums. There were 439 respondents. Demographic distribution is as follows; Chief Perfusionist (30.5%), Staff Perfusionist (62.0%), and Other (7.5%), with age ranges of 20-30 years (14.2%), 30-40 years (26.5%), 40-50 years (26.7%), 50-60 years (26.7%), >60 years (5.9%). The use of a cell phone during the performance of cardiopulmonary bypass (CPB) was reported by 55.6% of perfusionists. Sending text messages while performing CPB was acknowledged by 49.2%, with clear generational differences detected when cross-referenced with age groups. For smart phone features, perfusionists report having accessed e-mail (21%), used the internet (15.1%), or have checked/posted on social networking sites (3.1%) while performing CPB. Safety concerns were expressed by 78.3% who believe that cell phones can introduce a potentially significant safety risk to patients. Speaking on a cell phone and text messaging during CPB are regarded as "always an unsafe practice" by 42.3% and 51.7% of respondents, respectively. Personal distraction by cell phone use that negatively affected performance was admitted by 7.3%, whereas witnessing another perfusionist distracted with phone/text while on CPB was acknowledged by 33.7% of respondents. This survey suggests that the majority of perfusionists believe cell phones raise

  2. [Coronary bypass in treatment of high-risk patients].

    Science.gov (United States)

    Avdagić, Harun; Mujanović, Emir; Mesanović, Nihad; Sijereić-Avdagić, Selma; Pirić, Melika

    2009-01-01

    Although it is possible to find a number of comparative studies in the world literature discussing the results of coronary artery bypass surgery (CABG) with and without cardiopulmonary bypass (CPB), until now such analysis has not been made in Bosnia and Herzegovina. The main aim of this scientific work was to compare morbidity and mortality, need for blood transfusions, length of stay in the intensive care unit, total length of hospitalisation and number of complication in two groups of patients operated with these methods. Patients with EuroScore > or =5 with CABG operated in Cardiovascular Clinic Tuzla, from May 2000 to May 2005 divided in two groups, were included in this study. There were 100 patients in the first group operated with CPB and 100 patients in the second group operated without CPB. The average time spent on respirators was shorter in patients operated without CPB (3.7 vs.9.74 hours, p = 0.023) and the time spent in Intensive care shorter too (19 vs. 23 days, p = 0.008). Volume of postoperative bleeding was less in patients operated without CPB (574.9 vs. 988.9 ml, p = 0.038), as volume after blood transfusion (168.8 vs. 350.3 mi, p = 0.001). Intraoperative inotrope support was less in patients operated without CPB (8.0 vs. 19.0%, p = 0.038) as postoperative inotrope support (6.0 vs. 17.0%, p = 0.027). The most usual postoperative complication was atrial fibrillation and there was no difference between patients operated with CPB and without CPB (24% vs. 17%, p = 0.293). Mortality was not different in patients operated with or without CPB (2.0% vs. 6.0%, p = 0.140). The average time of total hospitalisation was also shorter in patients operated without CPB (8.0 vs. 9.5 days, p = 0.039. In conclusion CABG without CPB has many advantages compared to the conventional method. Mortality and morbidity are reduced and there is less need for transfusion. The time spent on mechanical ventilation is reduced and less time is spent in intensive care. The total

  3. 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)

  4. Hemodynamic effect of bypass geometry on intracranial aneurysm: A numerical investigation.

    Science.gov (United States)

    Kurşun, Burak; Uğur, Levent; Keskin, Gökhan

    2018-05-01

    Hemodynamic analyzes are used in the clinical investigation and treatment of cardiovascular diseases. In the present study, the effect of bypass geometry on intracranial aneurysm hemodynamics was investigated numerically. Pressure, wall shear stress (WSS) and velocity distribution causing the aneurysm to grow and rupture were investigated and the best conditions were tried to be determined in case of bypassing between basilar (BA) and left/right posterior arteries (LPCA/RPCA) for different values of parameters. The finite volume method was used for numerical solutions and calculations were performed with the ANSYS-Fluent software. The SIMPLE algorithm was used to solve the discretized conservation equations. Second Order Upwind method was preferred for finding intermediate point values in the computational domain. As the blood flow velocity changes with time, the blood viscosity value also changes. For this reason, the Carreu model was used in determining the viscosity depending on the velocity. Numerical study results showed that when bypassed, pressure and wall shear stresses reduced in the range of 40-70% in the aneurysm. Numerical results obtained are presented in graphs including the variation of pressure, wall shear stress and velocity streamlines in the aneurysm. Considering the numerical results for all parameter values, it is seen that the most important factors affecting the pressure and WSS values in bypassing are the bypass position on the basilar artery (L b ) and the diameter of the bypass vessel (d). Pressure and wall shear stress reduced in the range of 40-70% in the aneurysm in the case of bypass for all parameters. This demonstrates that pressure and WSS values can be greatly reduced in aneurysm treatment by bypassing in cases where clipping or coil embolization methods can not be applied. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. The incidence of ureteral obstruction secondary to aorto-femoral bypass surgery. A prospective study

    DEFF Research Database (Denmark)

    Henriksen, L O; Mejdahl, Steen; Petersen, F

    1988-01-01

    Hydronephrosis is reported to be an infrequent complication of aorto-femoral bypass operations. To define the true incidence of this complication, renography (131I-Hippuran) and renal scintigraphy (99 Technetium) were performed both pre- and postoperatively on 56 asymptomatic patients following...... successful aortic reconstruction. No patient developed signs of ureteral obstruction. It is concluded that hydronephrosis is a rare complication to aorto-femoral bypass surgery and postoperative control is only indicated in patients with symptoms from the urinary tract....

  6. Effect of STA-MCA bypass based on the motor activation SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-07-01

    The effect of STA-MCA bypass for ischemic cerebrovascular diseases (CVDs) on pure motor function using motor activation SPECT was evaluated and analyzed, and this effect with the resting cerebral blood flow and reserved capacity was compared. Motor activation SPECT were carried out on 22 cases with STA-MCA bypass for symptomatic ischemic CVDs. All motors activation SPECT using the finger opposition task on the affected side were performed before bypass, at 1 month, and 3 months after the bypass. Visual inspection was used to determine whether the result of the motor activation SPECT was as negative or positive. The activated region was detected anatomically precisely by superimposing the SPECT on the MRI. Before this study, the same examination was performed on normal controls. In controls, 91% showed the activated area on the sensorimotor cortex after the finger opposition tasks. Before bypass, the resting SPECT revealed reduction of cerebral blood flow (CBF) on the affected side in all cases. All cases also showed a disturbed response to acetazolamide (ACZ). Nine cases were positive in the motor activation SPECT. One month after bypass, the resting CBF increased in 11 cases. Seven showed preoperative positive motor activation. Fifteen cases were positive in the motor activation SPECT. Three months after bypass, 20 cases showed improvement in the resting CBF, and 19 cases were positive in the motor activation SPECT. Ten cases were negative in the preoperative motor activation SPECT. At one month after surgery, ACZ activation SPECT was performed in 12 cases. Five showed improvement of the response to ACZ. At 3 months after surgery, 8 of 12 cases treated with ACZ activation SPECT showed improved response to ACZ. In most of the cases, improved response to ACZ could be seen after response to motor activation improved. STA-MCA bypass is useful not only for resting CBF but also for pure motor function based on motor activation SPECT. (K.H.)

  7. A nutritional and metabolic assessment of a cardiopulmonary bypass technique without donor blood

    OpenAIRE

    東,良平

    1993-01-01

    A nutritional and metabolic assessment of a cardiopulmonary bypass technique without donor blood was made in 23 patients undergoing open heart surgery (non-donor blood group). For comparison, 14 patients receiving cardiopulmonary bypass with donor blood prime (donor blood group) were also evaluated. 1)Serum transferrin level showed significantly more rapid recovery in the non-donor blood group compared to the donor blood group on the 7th post operative day. 2)Total protein, serum albumin, arm...

  8. Effect of STA-MCA bypass based on the motor activation SPECT

    International Nuclear Information System (INIS)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

    1999-01-01

    The effect of STA-MCA bypass for ischemic cerebrovascular diseases (CVDs) on pure motor function using motor activation SPECT was evaluated and analyzed, and this effect with the resting cerebral blood flow and reserved capacity was compared. Motor activation SPECT were carried out on 22 cases with STA-MCA bypass for symptomatic ischemic CVDs. All motors activation SPECT using the finger opposition task on the affected side were performed before bypass, at 1 month, and 3 months after the bypass. Visual inspection was used to determine whether the result of the motor activation SPECT was as negative or positive. The activated region was detected anatomically precisely by superimposing the SPECT on the MRI. Before this study, the same examination was performed on normal controls. In controls, 91% showed the activated area on the sensorimotor cortex after the finger opposition tasks. Before bypass, the resting SPECT revealed reduction of cerebral blood flow (CBF) on the affected side in all cases. All cases also showed a disturbed response to acetazolamide (ACZ). Nine cases were positive in the motor activation SPECT. One month after bypass, the resting CBF increased in 11 cases. Seven showed preoperative positive motor activation. Fifteen cases were positive in the motor activation SPECT. Three months after bypass, 20 cases showed improvement in the resting CBF, and 19 cases were positive in the motor activation SPECT. Ten cases were negative in the preoperative motor activation SPECT. At one month after surgery, ACZ activation SPECT was performed in 12 cases. Five showed improvement of the response to ACZ. At 3 months after surgery, 8 of 12 cases treated with ACZ activation SPECT showed improved response to ACZ. In most of the cases, improved response to ACZ could be seen after response to motor activation improved. STA-MCA bypass is useful not only for resting CBF but also for pure motor function based on motor activation SPECT. (K.H.)

  9. Dangers of bypassing thermal overload relays in nuclear power plant motor operated valve circuits

    International Nuclear Information System (INIS)

    Baxter, F.D.

    1980-01-01

    Operation of motor operated valves is analyzed under various abnormal conditions such as frozen bearing, tight packing, mid-travel obstruction, torque switch failure, limit switch failure, and post-accident operation. Each condition has been reviewed to show that an adverse situation results if the thermal overload relays in the circuit are bypassed. In conclusion, there appears to be no technical basis for bypassing or oversizing the thermal overload relay provided it is selected correctly

  10. Pulmonary artery perfusion versus no pulmonary perfusion during cardiopulmonary bypass in patients with COPD

    DEFF Research Database (Denmark)

    Buggeskov, Katrine B; Sundskard, Martin M; Jonassen, Thomas

    2016-01-01

    INTRODUCTION: Absence of pulmonary perfusion during cardiopulmonary bypass (CPB) may be associated with reduced postoperative oxygenation. Effects of active pulmonary artery perfusion were explored in patients with chronic obstructive pulmonary disease (COPD) undergoing cardiac surgery. METHODS: 90...... perfusion with normothermic oxygenated blood during cardiopulmonary bypass appears to improve postoperative oxygenation in patients with COPD undergoing cardiac surgery. Pulmonary artery perfusion with hypothermic HTK solution does not seem to improve postoperative oxygenation. TRIAL REGISTRATION NUMBER...

  11. Correlation of femoral artery vs radial artery pressures with central pressure after cardiopulmonary bypass in children

    International Nuclear Information System (INIS)

    Yaseen, R.; Memon, H.

    2008-01-01

    To assess the effectiveness of femoral and radial arterial lines on the correlation of peripheral and central mean arterial blood pressure in children after discontinuation of cardiopulmonary bypass. Fifty children scheduled for cardiac surgery with cardiopulmonary bypass were included in the study. After approval from the hospital ethics committee and informed consent. 50 children undergoing cardiac surgical procedures with cardiopulmonary bypass were randomly assigned to two different groups. In Group- A (RAP, n-2) a radial arterial line and in Group-B (FAP, n-25) a femoral arterial line was used to monitor the blood pressure. Simultaneous mean peripheral arterial pressure and mean central aortic pressure were recorded before cardiopulmonary bypass and 5 mins after separation from the cardiopulmonary bypass. The correlation of mean peripheral arterial pressure (radial and femoral) versus mean aortic pressure were compared. The data was recorded as Mean +- SD and P-value. The ages of children ranged from 4-12 years and their weight from 14.1-28.5 kg. In all of them following cardiopulmonary bypass, aortic pressure correlates better with femoral arterial pressure (p<0.001). The radial arterial line readings under estimated central aortic pressure when compared to femoral arterial line readings. Aortic pressure readings correlate better with femoral arterial pressure than radial arterial pressure in children. (author)

  12. Autologous blood sequestration using a double venous reservoir bypass circuit and polymerized hemoglobin prime.

    Science.gov (United States)

    Neragi-Miandoab, Siyamek; Guerrero, J Luis; Vlahakes, Gus J

    2002-01-01

    Cardiac surgery often necessitates transfusion of homologous blood. Hemoglobin based oxygen carrying solutions (HBOCs) transport oxygen, suggesting use in cardiopulmonary bypass. HBOC was used in a novel oxygenator double-reservoir circuit that permits acute sequestration of a portion of the autologous blood volume during bypass. Two groups of seven mongrel dogs each were studied in an experimental bypass model using global myocardial ischemia and cardioplegia protection: HBOC group, initial venous return drained to a separate reservoir and hypothermic bypass was conducted with HBOC containing perfusate in a second bypass reservoir; Control group, crystalloid prime in a conventional circuit. Hemodynamics and metabolic and hematologic parameters were measured before and 60 min after aortic clamp removal and reinfusion of sequestered autologous blood. Blood gases, base excess, hematocrit, total hemoglobin, and platelet counts were measured. In the HBOC group, metabolic acidosis did not occur, and ventricular function was preserved. Net conservation of platelets was noted at study conclusion: control 33+/-13 x 10(3) per mm3 versus HBOC 48+/-13 x 10(3), p conservation of the platelet mass occurs, a portion of which is not exposed to the deleterious effects of hypothermia and cardiopulmonary bypass.

  13. Gastric bypass: why Roux-en-Y? A review of experimental data.

    Science.gov (United States)

    Collins, Brendan J; Miyashita, Tomoharu; Schweitzer, Michael; Magnuson, Thomas; Harmon, John W

    2007-10-01

    To highlight the clinical and experimental rationales that support why the Roux-en-Y limb is an important surgical principle for bariatric gastric bypass. We reviewed PubMed citations for open Roux-en-Y gastric bypass (RYGBP), laparoscopic RYGBP, loop gastric bypass, chronic alkaline reflux gastritis, and duodenoesophageal reflux. We reviewed clinical and experimental articles. Clinical articles included prospective, retrospective, and case series of patients undergoing RYGBP, laparoscopic RYGBP, or loop gastric bypass. Experimental articles that were reviewed included in vivo and in vitro models of chronic duodenoesophageal reflux and its effect on carcinogenesis. No formal data extraction was performed. We reviewed published operative times, lengths of stay, and anastomotic leak rates for laparoscopic RYGBP and loop gastric bypass. For in vivo and in vitro experimental models of duodenoesophageal reflux, we reviewed the kinetics and potential molecular mechanisms of carcinogenesis. Recent data suggest that laparoscopic loop gastric bypass, performed without the creation of a Roux-en-Y gastroenterostomy, is a faster surgical technique that confers similarly robust weight loss compared with RYGBP or laparoscopic RYGBP. In the absence of a Roux limb, the long-term effects of chronic alkaline reflux are unknown. Animal models and in vitro analyses of chronic alkaline reflux suggest a carcinogenic effect.

  14. Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Hammeken, Lianna Hede; Betsagoo, Ramsina; Jensen, Ann Nygaard

    2017-01-01

    OBJECTIVE: Roux-en-Y gastric bypass surgery and small-for-gestational-age births are known to be associated although the etiology is not fully understood. This study aimed to investigate pregnancy outcomes and maternal nutritional status among pregnant women with a history of Roux-en-Y gastric...... obstetric clinic at Aalborg University Hospital in Denmark and gave birth between 1 January 2010 and 31 December 2013 were included. Each Roux-en-Y-gastric-bypass-operated woman was closely matched with a non-Roux-en-Y-gastric-bypass-operated woman. Primary outcomes were small-for-gestational-age birth.......169) between women with a history of Roux-en-Y gastric bypass (11.51kg±8.97 standard deviation (SD)) and non- Roux-en-Y-gastric-bypass-operated women (12.18kg±6.28 SD). CONCLUSION: A history of Roux-en-Y gastric bypass surgery increases the risk of small-for-gestational-age birth and anemia, while a finding...

  15. Experimental investigations of the steady flow through an idealized model of a femoral artery bypass

    Directory of Open Access Journals (Sweden)

    Giurgea Corina

    2014-03-01

    Full Text Available The present paper presents the steps taken by the authors in the first stage of an experimental program within a larger national research project whose objective is to characterize the flow through a femoral artery bypass with a view to finding solutions for its optimization. The objective of the stage is to investigate by means of the PIV method the stationary flow through a bypass model with an idealized geometry. A bypass assembly which reunites the idealized geometry models of the proximal and distal anastomoses, and which respects the lengths of a femoral artery bypass was constructed on the basis of data for a real patient provided by medical investigations. With the aim of testing the model and the established experimental set-up with regard to their suitability for the assessment of the velocity field associated to the steady flow through the bypass, three zones that can restore the whole distal anastomosis were PIV investigated. The measurements were taken in the conditions of maintained inflow at the bypass entry of 0.9 l / min (Re = 600. The article presents comparatively the flow spectra and the velocity fields for each zone obtained in two situations: with the femoral artery completely occluded and completely open.

  16. Deoxypyrimidine monophosphate bypass therapy for thymidine kinase 2 deficiency.

    Science.gov (United States)

    Garone, Caterina; Garcia-Diaz, Beatriz; Emmanuele, Valentina; Lopez, Luis C; Tadesse, Saba; Akman, Hasan O; Tanji, Kurenai; Quinzii, Catarina M; Hirano, Michio

    2014-08-01

    Autosomal recessive mutations in the thymidine kinase 2 gene (TK2) cause mitochondrial DNA depletion, multiple deletions, or both due to loss of TK2 enzyme activity and ensuing unbalanced deoxynucleotide triphosphate (dNTP) pools. To bypass Tk2 deficiency, we administered deoxycytidine and deoxythymidine monophosphates (dCMP+dTMP) to the Tk2 H126N (Tk2(-/-)) knock-in mouse model from postnatal day 4, when mutant mice are phenotypically normal, but biochemically affected. Assessment of 13-day-old Tk2(-/-) mice treated with dCMP+dTMP 200 mg/kg/day each (Tk2(-/-200dCMP/) (dTMP)) demonstrated that in mutant animals, the compounds raise dTTP concentrations, increase levels of mtDNA, ameliorate defects of mitochondrial respiratory chain enzymes, and significantly prolong their lifespan (34 days with treatment versus 13 days untreated). A second trial of dCMP+dTMP each at 400 mg/kg/day showed even greater phenotypic and biochemical improvements. In conclusion, dCMP/dTMP supplementation is the first effective pharmacologic treatment for Tk2 deficiency. © 2014 The Authors. Published under the terms of the CC BY 4.0 license.

  17. The determinants of HMOs' contracting with hospitals for bypass surgery.

    Science.gov (United States)

    Gaskin, Darrell J; Escarce, José J; Schulman, Kevin; Hadley, Jack

    2002-08-01

    Selective contracting with health care providers is one of the mechanisms HMOs (Health Maintenance Organizations) use to lower health care costs for their enrollees. However, are HMOs compromising quality to lower costs? To address this and other questions we identify factors that influence HMOs' selective contracting for coronary artery bypass surgery (CABG). Using a logistic regression analysis, we estimated the effects of hospitals' quality, costliness, and geographic convenience on HMOs' decision to contract with a hospital for CABG services. We also estimated the impact of HMO characteristics and market characteristics on HMOs' contracting decision. A 1997 survey of a nationally representative sample of 50 HMOs that could have potentially contracted with 447 hospitals. About 44 percent of the HMO-hospital pairs had a contract. We found that the probability of an HMO contracting with a hospital increased as hospital quality increased and decreased as distance increased. Hospital costliness had a negative but borderline significant (0.10 penetration did not affect the probability of contracting. HMO characteristics also had significant effects on contracting decisions. The results suggest that HMOs value quality, geographic convenience, and costliness, and that the importance of quality and costliness vary with HMO. Greater HMO competition encourages broader hospital networks whereas greater hospital competition leads to more restrictive networks.

  18. Thrombosed aneurysm of saphenous vein coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Rodolfo Mendes; Nastri Filho, Rogerio; Ferez, Marcus Antonio; Costa, Mauro Jose Brandao da; Laguna, Claudio Benedini; Valentin, Marcus Vinicius Nascimento, E-mail: rod_queiroz@hotmail.com [Documenta - Hospital Sao Francisco, Ribeirao Preto, SP (Brazil). Departamento de Radiologia e Diagnostico por Imagem; Hospital Sao Francisco, Ribeirao Preto, SP (Brazil). Centro de Terapia Intensiva

    2017-06-15

    We describe the case of a male patient, aged 76 years, referred for cardiac investigation due to retrosternal chest pain and dyspnea. He had a history of acute myocardial infarction and angioplasties in the last 30 years, including a saphenous vein coronary artery bypass grafting (SVCABG). Echocardiogram showed hypoechoic oval formation near the right ventricle, suggesting a pericardial cyst. Computed angiotomography revealed a predominantly fusiform and thrombosed aneurysmal dilation of the SVCABG to the right coronary artery. SVCABG aneurysms are very rare and potentially fatal. They usually appear in the late postoperative period, and patients are often asymptomatic. On radiography, it is frequently presented as enlargement of the mediastinum, with echocardiography, computed tomography and magnetic resonance imaging being very useful for diagnosis. Coronary angiography is the gold standard to detect these cases. Our report illustrates a rare situation arising late from a relatively common surgery. Due to its severity, proper recognition in the routine assessment of patients with a similar history is essential. (author)

  19. Rplp1 bypasses replicative senescence and contributes to transformation

    Energy Technology Data Exchange (ETDEWEB)

    Artero-Castro, A. [Pathology Department, Fundacio Institut de Recerca Hospital Vall d' Hebron, Passeig Vall d' Hebron 119-129, 08035 Barcelona (Spain); Kondoh, H. [Department of Geriatric Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507 (Japan); Fernandez-Marcos, P.J.; Serrano, M. [Spanish National Cancer Research Center (CNIO), 3 Melchor Fernandez Almagro St, Madrid 28029 (Spain); Ramon y Cajal, S. [Pathology Department, Fundacio Institut de Recerca Hospital Vall d' Hebron, Passeig Vall d' Hebron 119-129, 08035 Barcelona (Spain); LLeonart, M.E., E-mail: melleona@ir.vhebron.net [Pathology Department, Fundacio Institut de Recerca Hospital Vall d' Hebron, Passeig Vall d' Hebron 119-129, 08035 Barcelona (Spain)

    2009-05-01

    To determine whether genes expressed by embryonic stem cells have a proliferative effect in primary cells, primary mouse embryonic fibroblasts were infected with an ES cell cDNA library. This led to identification of the ribosomal protein, Rplp1, a member of the P group of ribosomal proteins, whose putative role for bypassing replicative senescence in MEFs was investigated. Our results show that Rplp1 produces a two-fold increase in the expression of an E2F1 promoter and upregulation of cyclin E in MEFs. Therefore, this study is the first to show that overexpression of a single ribosomal protein, Rplp1, is a cause and not a consequence of cell proliferation. In addition, co-expression of Rplp1 with mutant ras{sup Val12} contributed to transformation in NIH3T3 cells, as was evidenced by colony production in soft-agar assays. Moreover, the Rplp1 protein was upregulated in MEFs and NIH3T3 cells upon expression of a p53 dominant negative mutant gene designated p53R175H. Hence, mutation of p53 may facilitate immortalization in vitro by upregulating Rplp1. Lastly, Rplp1 mRNA was found to be upregulated in 16 of 26 human colon cancer biopsy specimens, a finding that may be of relevance to cancer research.

  20. Amiodaron in atrial fibrillation: post coronary artery bypass graft.

    Science.gov (United States)

    Habibollahi, Paria; Jam, Shahrzad Hashemi; Vahdati, Samad Shams; Baghi, Hamidreza Morteza; Amiri, Hassan

    2016-01-01

    Atrial fibrilation (AF) is the most common complication following heart surgeries; it often occurs in patients after coronary artery bypass graft (CABG). The purpose of this review is to categorize prophylaxes or treatment by administration of Amiodaron in patients with CABG. We searched google scholar, pubmed, and Cochrane Library databases (the period 1970-2010) for articles on Amiodaron in CABG and cardiac surgery. A total of 1 561 articles were identified, and 30 articles met the criteria and were enrolled in this review. Most studies supported Amiodarone for prophylaxi purpose in patients who were performed with CABG; few papers supported Amiodaron as a drug for treating CABG. The prophylaxis can decrease the incidence rate of AF in CABG, but if it uses as a treatment, the side effect of Amiodaron will decrease because all of the patients will not get Amiodarone. In the other hand use of Amiodarone as a treatment does not influence the length of hospital stay significantly but these kinds of study are so few. No appropriate therapeutic method has been defined for AF. At present, the common way of treating AF following cardiac surgery is mainly based on prophylaxis in medical books and references.

  1. Perforated peptic ulcer following gastric bypass for obesity.

    Science.gov (United States)

    Macgregor, A M; Pickens, N E; Thoburn, E K

    1999-03-01

    Peptic ulcer in the excluded segment of a gastric bypass performed in the management of morbid obesity has only rarely been reported in the literature. The purpose of this study is to review our experience with the condition in a series of 4300 patients who underwent gastric-restrictive surgery between 1978 and 1997. Eleven patients presented with acute perforation of a peptic ulcer in the excluded gastric segment. Nine ulcers were duodenal, one was gastric, and one patient had both gastric and duodenal perforations. The time between primary gastric-restrictive surgery and ulcer perforation varied from 20 days to 12 years. All patients presented with upper abdominal pain. The classical radiological sign of perforated peptic ulcer, free air under the diaphragm, did not occur in any patient. Nine patients were initially treated by primary closure of the perforation with subsequent definitive ulcer therapy by vagotomy, pyloroplasty, or gastrectomy. One case, initially treated elsewhere, was managed by placement of a Malecot catheter through the duodenal perforation, gastrostomy, and peritoneal drainage. One recent case remains symptom-free on H2 blockers after simple closure. There was no mortality. Six cases were previously reported in the literature with a 33 per cent mortality rate.

  2. 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.

  3. Rplp1 bypasses replicative senescence and contributes to transformation

    International Nuclear Information System (INIS)

    Artero-Castro, A.; Kondoh, H.; Fernandez-Marcos, P.J.; Serrano, M.; Ramon y Cajal, S.; LLeonart, M.E.

    2009-01-01

    To determine whether genes expressed by embryonic stem cells have a proliferative effect in primary cells, primary mouse embryonic fibroblasts were infected with an ES cell cDNA library. This led to identification of the ribosomal protein, Rplp1, a member of the P group of ribosomal proteins, whose putative role for bypassing replicative senescence in MEFs was investigated. Our results show that Rplp1 produces a two-fold increase in the expression of an E2F1 promoter and upregulation of cyclin E in MEFs. Therefore, this study is the first to show that overexpression of a single ribosomal protein, Rplp1, is a cause and not a consequence of cell proliferation. In addition, co-expression of Rplp1 with mutant ras Val12 contributed to transformation in NIH3T3 cells, as was evidenced by colony production in soft-agar assays. Moreover, the Rplp1 protein was upregulated in MEFs and NIH3T3 cells upon expression of a p53 dominant negative mutant gene designated p53R175H. Hence, mutation of p53 may facilitate immortalization in vitro by upregulating Rplp1. Lastly, Rplp1 mRNA was found to be upregulated in 16 of 26 human colon cancer biopsy specimens, a finding that may be of relevance to cancer research.

  4. In situ saphenous vein bypass for limb salvage.

    Science.gov (United States)

    Sarcina, A; Carlesi, R; Bellosta, R; Agrifoglio, G

    1993-02-01

    A total of 130 infrapopliteal in situ saphenous vein bypasses were performed in 128 patients between January 1980 and June 1991. The indication for surgery was critical ischaemia with impending limb loss in 121 patients; seven suffered from severe claudication. The distal anastomosis was to the popliteal artery below the knee in 60 cases (46.2%) and in 70 (53.8%) to the tibioperoneal arteries. The results, in terms of secondary patency and limb salvage rates, of the first 68 procedures (1980-1985) and subsequent 62 (1986-June 1991) were compared. In the first period, a secondary patency rate of 42.6% and a limb salvage rate of 67.0% were obtained, compared with 71.3 and 80.8% respectively in the second. These differences are significant for patency (P < 0.005) and limb salvage (P < 0.01). These results show that the in situ technique can give acceptable results but a learning period with a high percentage of early failures is to be expected.

  5. Cardiopulmonary bypass considerations for pediatric patients on the ketogenic diet.

    Science.gov (United States)

    Melchior, R W; Dreher, M; Ramsey, E; Savoca, M; Rosenthal, T

    2015-07-01

    There is a population of children with epilepsy that is refractory to anti-epileptic drugs. The ketogenic diet, a high-fat, low-carbohydrate regimen, is one alternative treatment to decrease seizure activity. Special considerations are required for patients on the ketogenic diet undergoing cardiopulmonary bypass (CPB) to prevent exposure to glucose substrates that could alter ketosis, increasing the risk of recurrent seizures. A 2-year-old, 9 kilogram male with a history of infantile spasms with intractable epilepsy, trisomy 21 status post tetralogy of Fallot repair, presented to the cardiac operating room for closure of a residual atrial septal defect. All disciplines of the surgical case minimized the use of carbohydrate-containing and contraindicated medications. Changes to the standard protocol and metabolic monitoring ensured the patient maintained ketosis. All disciplines within cardiac surgery need to be cognizant of patients on the ketogenic diet and prepare a modified protocol. Future monitoring considerations include thromboelastography, electroencephalography and continuous glucose measurement. Key areas of focus with this patient population in the cardiac surgical theater are to maintain a multidisciplinary approach, alter the required CPB prime components, address cardiac pharmacological concerns and limit any abnormal hematological occurrences. © The Author(s) 2014.

  6. Plasma levels of immunosuppressive mediators during cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    E. Borrelli

    1996-01-01

    Full Text Available The aim of this study was to evaluate plasma levels of two mediators with immunosuppressive properties, complement fraction C3a (C3a and transforming growth factor-β1 (TGF-β1, during extracorporeal circulation. The proliferation index after phytohaemagglutinin (PHA stimulation of isolated peripheral blood mononuclear cells was also investigated. Sixteen patients undergoing hypothermic (n = 8, group 1 and normothermic (n = 8, group 2 cardiopulmormry bypass (CPB were enrolled in this study. As a control, we evaluated four patients undergoing thoracovascular operations without CPB. Blood samples were collected before CPB but after anaesthesia, every 30 min during CPB, at the end of CPB and 10 min after protamine administration. Both C3a and TGF-β1 increased significantly during CPB and after protamine administration in the hypothermic as well as the normothermic group. In the latter case the increase of C3a and TGF-β1, although more prominent, was not significantl higher than in the former group. Conversely, the proliferation, index of peripheral mononuclear cells had already decreased 30 min after CPB was started and remained depressed throughout the CPB time. These results suggest a possible role of C3a and TGF-β1 in the immunological changes occurring during extracorporeal circulation.

  7. [Perioperative fibrinogen concentrations in cardiac surgery with cardiopulmonary bypass].

    Science.gov (United States)

    Uji, Makiko; Terada, Yuki; Noguchi, Teruo; Nishida, Takaya; Hasuwa, Kyoko; Shinohara, Kozue; Kumano, Hotaka; Ishimura, Naoko; Nishiwada, Makoto

    2012-08-01

    Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) need many blood products due to deficiency of coagulation factors. Blood transfusion therapy in patients with excessive bleeding after CPB is generally empiric. We checked and studied the fibrinogen concentration and transfusion, as well as bleeding amount in the perioperative period. The study was approved by our institutional ethics committee. Thirty patients were studied. Blood samples were obtained at the induction of anesthesia (before CPB), at the end of CPB, at the end of operation, and on the next morning, or before the patient was given fresh frozen plasma in the intensive care unit. For all cases, fibrinogen concentration and platelet concentration were lowest at the end of CPB. Fibrinogen concentration rose up to before CPB level on the next morning. The group in which fibrinogen concentration was less than 150 mg x dl(-1) at the end of CPB consumed more blood products than the group with fibrinogen concentration of over 150 mg x dl(-1). Blood transfusion therapy based on fibrinogen concentration is needed to maintain adequacy of the perioperative blood transfusion and blood conservation in cardiac surgery.

  8. Effects of graphite surface roughness on bypass flow computations for an HTGR

    Energy Technology Data Exchange (ETDEWEB)

    Tung, Yu-Hsin, E-mail: touushin@gmail.com [Idaho National Laboratory, P.O. Box 1625, M.S. 3855, Idaho Falls, ID (United States); Johnson, Richard W., E-mail: Rich.Johnson@inl.gov [Idaho National Laboratory, P.O. Box 1625, M.S. 3855, Idaho Falls, ID (United States); Sato, Hiroyuki, E-mail: sato.hiroyuki09@jaea.go.jp [Idaho National Laboratory, P.O. Box 1625, M.S. 3855, Idaho Falls, ID (United States)

    2012-11-15

    Highlights: Black-Right-Pointing-Pointer CFD calculations are made of bypass flow between graphite blocks in HTGR. Black-Right-Pointing-Pointer Several turbulence models are employed to compare to friction and heat transfer correlations. Black-Right-Pointing-Pointer Parameters varied include bypass gap width and surface roughness. Black-Right-Pointing-Pointer Surface roughness causes increases in max fuel and coolant temperatures. Black-Right-Pointing-Pointer Surface roughness does not cause increase in outlet coolant temperature variation. - Abstract: Bypass flow in a prismatic high temperature gas reactor (HTGR) occurs between graphite blocks as they sit side by side in the core. Bypass flow is not intentionally designed to occur in the reactor, but is present because of tolerances in manufacture, imperfect installation and expansion and shrinkage of the blocks from heating and irradiation. It is desired to increase the knowledge of the effects of such flow; it has been suggested that it may be as much as 20% of the total helium coolant flow [INL Report 2007, INL/EXT-07-13289]. Computational fluid dynamic (CFD) simulations can provide estimates of the scale and impacts of bypass flow. Previous CFD calculations have examined the effects of bypass gap width, level and distribution of heat generation and effects of shrinkage. The present contribution examines the effects of graphite surface roughness on the bypass flow for different relative roughness factors for three gap widths. Such calculations should be validated using specific bypass flow measurements. While such experiments are currently underway for the specific reference prismatic HTGR design for the next generation nuclear plant (NGNP) program of the U.S. Dept. of Energy, the data are not yet available. To enhance confidence in the present calculations, wall shear stress and heat transfer results for several turbulence models and their associated wall treatments are first compared for steady flow in a

  9. Sodium/hydrogen-exchanger inhibition during cardioplegic arrest and cardiopulmonary bypass: an experimental study.

    Science.gov (United States)

    Cox, Charles S; Sauer, Henning; Allen, Steven J; Buja, L Maximilian; Laine, Glen A

    2002-05-01

    We sought to determine whether pretreatment with a sodium/hydrogen-exchange inhibitor (EMD 96 785) improves myocardial performance and reduces myocardial edema after cardioplegic arrest and cardiopulmonary bypass. Anesthetized dogs (n = 13) were instrumented with vascular catheters, myocardial ultrasonic crystals, and left ventricular micromanometers to measure preload recruitable stroke work, maximum rate of pressure rise (positive and negative), and left ventricular end-diastolic volume and pressure. Cardiac output was measured by means of thermodilution. Myocardial tissue water content was determined from sequential biopsy. After baseline measurements, hypothermic (28 degrees C) cardiopulmonary bypass was initiated. Cardioplegic arrest (4 degrees C Bretschneider crystalloid cardioplegic solution) was maintained for 2 hours, followed by reperfusion-rewarming and separation from cardiopulmonary bypass. Preload recruitable stroke work and myocardial tissue water content were measured at 30, 60, and 120 minutes after bypass. EMD 96 785 (3 mg/kg) was given 15 minutes before bypass, and 2 micromol was given in the cardioplegic solution. Control animals received the same volume of saline vehicle. Arterial-coronary sinus lactate difference was similar in both animals receiving EMD 96 785 and control animals, suggesting equivalent myocardial ischemia in each group. Myocardial tissue water content increased from baseline in both animals receiving EMD 96 785 and control animals with cardiopulmonary bypass and cardioplegic arrest but was statistically lower in animals receiving EMD 96 785 compared with control animals (range, 1.0%-1.5% lower in animals receiving EMD 96 785). Preload recruitable stroke work decreased from baseline (97 +/- 2 mm Hg) at 30 (59 +/- 6 mm Hg) and 60 (72 +/- 9 mm Hg) minutes after cardiopulmonary bypass and cardioplegic arrest in control animals; preload recruitable stroke work did not decrease from baseline (98 +/- 2 mm Hg) in animals receiving

  10. The use of technetium-99m hexamethylpropylene amine oxime labelled white blood cells to detect subclinical inflammation of the heart after cardiopulmonary bypass in children with congenital heart disease

    International Nuclear Information System (INIS)

    Kao Chiahung; Wang Yenliang; Wang Shyhjen; Hsieh Kaisheng

    1992-01-01

    Ten children (6 boys and 4 girls, aged 1-9 years old) underwent operations with a cardiopulmonary bypass, and the technetium-99m hexamehtylpropylene amine oxine ( 99m Tc-HMPAO) labelled white blood cell (WBC) heart scans were used to detect postoperative leukocyte infiltration in the hearts. The results showed that 80% (8/10) of the cases had subclinical inflammation in the hearts (grading of WBC scans ≥score 2), and a positive correlation (R=0.77) was noted between the severity of the inflammation (grading of the WBC scans) and the duration of the cardiopulmonary bypass in the operations. Another control group (9 boys and 2 girls, aged 2-13 years old) underwent operations without a cardiopulmonary bypass, and subclinical inflammation of hearts was demonstrated in only 1 case (9%) by the 99m Tc-HMPAO labelled WBC scans (grading of WBC scans 99m Tc-HMPAO labelled WBC heart scans may provide non-invasive and directly discernible evidence of subclinical inflammation in the heart due to a transient ischaemic state during a cardiopulmonary bypass, even if the clinical symptoms and signs of carditis are not apparent. (orig.)

  11. Energy-efficient and cost-effective in-house substations bypass for improving thermal and DHW (domestic hot water) comfort in bathrooms in low-energy buildings supplied by low-temperature district heating

    DEFF Research Database (Denmark)

    Brand, Marek; Dalla Rosa, Alessandro; Svendsen, Svend

    2014-01-01

    temperature and additional cooling of bypass water by 3.9 °C, reducing the heat loss from the DH network by 13% and covering 40% of the heat used in the bathroom FH. The use of the bypass flow in bathroom FH is a cost-effective solution exploiting the heat that would otherwise be lost in the DH network......Using a bypass to redirect a small flow through the in-house DH (district heating) substation directly to the return pipe is a commonly used but energy-inefficient solution to keep the DH network “warm” during non-heating seasons. Instead, this water can be redirected to the bathroom FH (floor...... heating) to cool down further and thus reduce the heat lost from bypass operation while tempering the bathroom floor and guaranteeing fast provision of DHW (domestic hot water). We used the commercial software IDA-ICE to model a reference building where we implemented various solutions for controlling...

  12. The use of technetium-99m hexamethylpropylene amine oxime labelled white blood cells to detect subclinical inflammation of the heart after cardiopulmonary bypass in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Kao Chiahung; Wang Yenliang; Wang Shyhjen (Taichung Veterans General Hospital (Taiwan). Dept. of Nuclear Medicine); Hsieh Kaisheng (Taichung Veterans General Hospital (Taiwan). Dept. of Pediatrics)

    1992-11-01

    Ten children (6 boys and 4 girls, aged 1-9 years old) underwent operations with a cardiopulmonary bypass, and the technetium-99m hexamehtylpropylene amine oxine ({sup 99m}Tc-HMPAO) labelled white blood cell (WBC) heart scans were used to detect postoperative leukocyte infiltration in the hearts. The results showed that 80% (8/10) of the cases had subclinical inflammation in the hearts (grading of WBC scans {>=}score 2), and a positive correlation (R=0.77) was noted between the severity of the inflammation (grading of the WBC scans) and the duration of the cardiopulmonary bypass in the operations. Another control group (9 boys and 2 girls, aged 2-13 years old) underwent operations without a cardiopulmonary bypass, and subclinical inflammation of hearts was demonstrated in only 1 case (9%) by the {sup 99m}Tc-HMPAO labelled WBC scans (grading of WBC scans directly discernible evidence of subclinical inflammation in the heart due to a transient ischaemic state during a cardiopulmonary bypass, even if the clinical symptoms and signs of carditis are not apparent. (orig.).

  13. 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.

  14. 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.

  15. Numerical solution of heat transfer process in a prismatic VHTR core accompanying bypass and cross flows

    International Nuclear Information System (INIS)

    Wang, Li; Liu, Qiusheng; Fukuda, Katsuya

    2016-01-01

    Highlights: • Three-dimensional CFD analysis is conducted for the thermal analysis in the reactor core. • Hot spot temperature, coolant channel outlet temperature distribution are affected by bypass flow. • Bypass gap size has significant influence on temperature and flow distribution in the core. • Cross flow has some effect on the temperature distribution of the coolant in the core due to flow mixing in the cross gaps. - Abstract: Bypass flow and cross flow gaps both exist in the core of a very high temperature gas-cooled reactor (VHTR), which is inevitable owing to tolerances in manufacturing, thermal expansion and irradiation shrinkage. The coolant mass flow rate distribution, temperature distribution, and hot spot temperature are significantly affected by bypass and cross flows. In the present study, three-dimensional CFD analysis is conducted for thermal analysis of the reactor core. A validation study for the turbulence model is performed by comparing the friction coefficient with published correlations. A sensitivity study of the near wall mesh is conducted to ensure mesh quality. Parametric studies are performed by changing the size of the bypass and cross gaps using a one-twelfth sector of a fuel block. Simulation results show the influence of the bypass gap size on temperature distribution and coolant mass flow rate distribution in the prismatic core. It is shown that the maximum fuel and coolant channel outlet temperatures increase with an increase in the gap size, which may lead to a structural risk to the fuel block. The cross flow is divided into two types: the cross flow from the bypass gap to the coolant channels and the cross flow from the high-pressure coolant channels to low-pressure coolant channels. These two types of flow have an opposing influence on the temperature gradient. It is found that the presence of the cross flow gaps may have a significant effect on the distribution of the coolant in the core due to flow mixing in the

  16. Target vessel detection by epicardial ultrasound in off-pump coronary bypass surgery.

    Science.gov (United States)

    Hayakawa, Masato; Asai, Tohru; Kinoshita, Takeshi; Suzuki, Tomoaki; Shiraishi, Shoichiro

    2013-01-01

    The detection of embedded coronary arteries is difficult especially in off-pump coronary bypass surgery. From June 2010, we introduced high-frequency epicardial ultrasound (ECUS) to assess and evaluate embedded arteries during off-pump coronary bypass surgery. Between June 2010 and June 2011, a total of 89 consecutive patients underwent isolated coronary bypass surgery at our institution. The patients consisted of 72 men and 17 women with a mean age of 67.9 years. We routinely use the VeriQC system (MediStim, Oslo, Norway) to detect the target vessels in the operation. The patients were assigned to one of two groups, depending on whether ECUS was used in the operation (n = 10, ECUS group) or not (n = 79, non-ECUS group). We analyzed the impact of introducing the ECUS in terms of operative outcome. All patients underwent revascularization using the off-pump technique without emergent conversion to cardiopulmonary bypass during surgery. The total number of distal anastomoses was 299, and 12 target vessels could not be identified either visually or on palpation. Thus, the frequency of the embedded coronary arteries was 4.01% (12/299 cases). The preoperative profiles of the two groups were not significantly different. Operation time was significantly longer in the ECUS group (P = 0.02). There were no significant differences in postoperative outcome between the two groups. In the present study, in which the target coronary arteries could not be detected either visually or on palpation in 12 (4.01%) of 299 cases, the use of high-frequency ECUS allowed all patients to undergo off-pump coronary bypass surgery without conversion to cardiopulmonary bypass during the operation. High-frequency ECUS is therefore useful in off-pump coronary bypass surgery.

  17. Hyperhomocysteinemia and mortality after coronary artery bypass grafting.

    Directory of Open Access Journals (Sweden)

    Domenico Girelli

    Full Text Available BACKGROUND: The independent prognostic impact, as well as the possible causal role, of hyperhomocysteinemia (HHcy in coronary artery disease (CAD is controversial. No previous study specifically has addressed the relationship between HHcy and mortality after coronary artery bypass grafting (CABG surgery. The aim of this study is to evaluate the prognostic impact of HHcy after CABG surgery. METHODOLOGY AND PRINCIPAL FINDINGS: We prospectively followed 350 patients who underwent elective CABG between May 1996 and May 1999. At baseline, fasting total homocysteine (tHcy levels were measured in all participants, and a post-methionine loading (PML test was performed in 77.7% of them (n = 272. After a median follow-up of 58 months, 33 patients (9.4% had died, 25 because of cardiovascular events. HHcy, defined by levels higher than the 90th percentile (25.2 micromol/L of the population's distribution, was significantly associated to total and cardiovascular mortality (P = 0.018 [log-rank test 5.57]; P = 0.002 [log-rank test 9.76], respectively. The PML test had no prognostic value. After multiple adjustment for other univariate predictors by Cox regression, including statin therapy (the most powerful predictor in uni-/multivariate analyses, high-sensitivity C Reactive Protein (hs-CRP levels, and all known major genetic (MTHFR 677C-->T polymorphism and non-genetic (B-group vitamin status and renal function tHcy determinants, HHcy remained an independent prognostic factor for mortality (HRs: 5.02, 95% CIs 1.88 to 13.42, P = 0.001. CONCLUSIONS: HHcy is an important prognostic marker after CABG, independent of modern drug therapy and biomarkers.

  18. Is testing for postprandial hyperinsulinemic hypoglycemia after gastric bypass necessary?

    Science.gov (United States)

    Gasser, Michèle; Meier, Claudia; Herren, Sylvia; Aubry, Emilie; Steffen, Rudolf; Stanga, Zeno

    2017-11-23

    Postprandial hyperinsulinemic hypoglycemia (pHH) is an increasingly reported complication after Roux-en-Y gastric bypass (RYGB). As pHH can cause life-threatening emergencies if occurring without warning symptoms, challenge testing may detect patients at risk. The study objective was to determine the frequency of occurrence of pHH with or without symptoms of hypoglycemia after RYGB. We undertook an observational cohort study of consecutive, unselected patients approximately one year after uncomplicated RYGB. To simulate normal habits, all patients received a standardized carbohydrate-rich solid mixed meal. Plasma glucose and insulin were measured at 30, 60, 90, 120, and 150 min thereafter. Symptoms were classified as autonomous or neuroglycopenic. Patients with hypoglycemia (plasma glucose meal. 113 patients were included. Total weight loss at the first follow-up check (14 ± 0.4 months) was 33.97 ± 9.3%. After the carbohydrate-rich meal, glucose dropped to meal. The pHH occurred in 11.5% (n = 13) of patients. Asymptomatic patients (5.3%, n = 6) carried an increased risk (p = 0.008) for pHH. One patient needed emergency treatment after sudden loss of consciousness after the carbohydrate-rich meal. The occurrence of pHH was quite high in our study population with 11.5% thereof 5.3% asymptomatic. We therefore suggest that detection of these patients warrants a screening of patients after RYGB. At-risk patients should than be adequately advised to avoid carbohydrate-rich meals in order to optimize risk management. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  19. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    Directory of Open Access Journals (Sweden)

    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  20. Does gastric bypass surgery change body weight set point?

    Science.gov (United States)

    Hao, Z; Mumphrey, M B; Morrison, C D; Münzberg, H; Ye, J; Berthoud, H R

    2016-12-01

    The relatively stable body weight during adulthood is attributed to a homeostatic regulatory mechanism residing in the brain which uses feedback from the body to control energy intake and expenditure. This mechanism guarantees that if perturbed up or down by design, body weight will return to pre-perturbation levels, defined as the defended level or set point. The fact that weight re-gain is common after dieting suggests that obese subjects defend a higher level of body weight. Thus, the set point for body weight is flexible and likely determined by the complex interaction of genetic, epigenetic and environmental factors. Unlike dieting, bariatric surgery does a much better job in producing sustained suppression of food intake and body weight, and an intensive search for the underlying mechanisms has started. Although one explanation for this lasting effect of particularly Roux-en-Y gastric bypass surgery (RYGB) is simple physical restriction due to the invasive surgery, a more exciting explanation is that the surgery physiologically reprograms the body weight defense mechanism. In this non-systematic review, we present behavioral evidence from our own and other studies that defended body weight is lowered after RYGB and sleeve gastrectomy. After these surgeries, rodents return to their preferred lower body weight if over- or underfed for a period of time, and the ability to drastically increase food intake during the anabolic phase strongly argues against the physical restriction hypothesis. However, the underlying mechanisms remain obscure. Although the mechanism involves central leptin and melanocortin signaling pathways, other peripheral signals such as gut hormones and their neural effector pathways likely contribute. Future research using both targeted and non-targeted 'omics' techniques in both humans and rodents as well as modern, genetically targeted, neuronal manipulation techniques in rodents will be necessary.