WorldWideScience

Sample records for direct simultaneous puncture

  1. CT-guided puncture for direct MR-arthrography of the shoulder: Description of possible techniques

    Directory of Open Access Journals (Sweden)

    Hauth E

    2016-07-01

    Full Text Available The following report describes the possible techniques of CT-guided puncture for direct magnetic resonance (MR arthrography of the shoulder. CT-guided puncture can be regarded as an alternative technique to fluoroscopic- or ultrasound-guided puncture for MR-arthrography of the shoulder with high efficiency, low dose and extremely low complication rate.

  2. Percutaneous Direct Puncture Embolization with N-butyl-cyanoacrylate for High-flow Priapism

    Energy Technology Data Exchange (ETDEWEB)

    Tokue, Hiroyuki, E-mail: tokue@s2.dion.ne.jp; Shibuya, Kei [Gunma University Hospital, Department of Diagnostic and Interventional Radiology (Japan); Ueno, Hiroyuki [Isesaki Municipal Hospital, Department of Radiology (Japan); Tokue, Azusa; Tsushima, Yoshito [Gunma University Hospital, Department of Diagnostic and Interventional Radiology (Japan)

    2016-09-15

    There are many treatment options in high-flow priapism. Those mentioned most often are watchful waiting, Doppler-guided compression, endovascular highly selective embolization, and surgery. We present a case of high-flow priapism in a 57-year-old man treated by percutaneous direct puncture embolization of a post-traumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate. Erectile function was preserved during a 12-month follow-up. No patients with percutaneous direct puncture embolization for high-flow priapism have been reported previously. Percutaneous direct puncture embolization is a potentially useful and safe method for management of high-flow priapism.

  3. Embolization of an Internal Iliac Artery Aneurysm after Image-Guided Direct Puncture

    International Nuclear Information System (INIS)

    Heye, S.; Vaninbroukx, J.; Daenens, K.; Houthoofd, S.; Maleux, G.

    2012-01-01

    Objective: To evaluate the feasibility, safety, and efficacy of embolization of internal iliac artery aneurysm (IIAA) after percutaneous direct puncture under (cone-beam) computed tomography (CT) guidance. Methods: A retrospective case series of three patients, in whom IIAA not accessible by way of the transarterial route, was reviewed. CT-guided puncture of the IIAA sac was performed in one patient. Two patients underwent puncture of the IIAA under cone-beam CT guidance. Results: Access to the IIAA sac was successful in all three patients. In two of the three patients, the posterior and/or anterior division was first embolized using platinum microcoils. The aneurysm sac was embolized with thrombin in one patient and with a mixture of glue and Lipiodol in two patients. No complications were seen. On follow-up CT, no opacification of the aneurysm sac was seen. The volume of one IIAA remained stable at follow-up, and the remaining two IIAAs decreased in size. Conclusion: Embolization of IIAA after direct percutaneous puncture under cone-beam CT/CT-guidance is feasible and safe and results in good short-term outcome.

  4. Direct transfer to angiosuite to reduce door-to-puncture time in thrombectomy for acute stroke.

    Science.gov (United States)

    Ribo, Marc; Boned, Sandra; Rubiera, Marta; Tomasello, Alejandro; Coscojuela, Pilar; Hernández, David; Pagola, Jorge; Juega, Jesús; Rodriguez, Noelia; Muchada, Marian; Rodriguez-Luna, David; Molina, Carlos A

    2018-03-01

    To evaluate direct transfer to the angiosuite protocol of patients with acute stroke, candidates for endovascular treatment (EVT). We studied workflow metrics of all patients with stroke who had undergone EVT in the past 12 months. Patients followed three protocols: direct transfer to emergency room (DTER), CT room (DTCT) or angiosuite (DTAS, only last 6 months if admission National Institute of Health Stroke Scale (NIHSS) score >9 and time from onset DTAS patients underwent cone-beam CT before femoral puncture. Dramatic clinical improvement was defined as 10 NIHSS points drop at 24 hours. 201 patients were included: 87 DTER (43.3%), 74 DTCT (36.8%), 40 DTAS (19.9%).Ten DTAS patients (25%) did not receive EVT: 3 (7.5%) showed intracranial hemorrhage on cone-beam CT and 7 (17.5%) did not show an occlusion on angiography. Mean door-to-puncture (D2P) time was shorter in DTAS (17±8 min) than DTCT (60±29 min; pDTAS: 197±72 min, DTER: 279±156, DTCT: 224±142 min; p=0.01) and symptom-to-recanalization (DTAS: 257±74, DTER: 355±158, DTCT: 279±146 min; pDTAS: 48.6% (DTER 24.1%, DTCT 27.4%); p=0.01). An adjusted model pointed to shorter onset-to-puncture time as an independent predictor of dramatic improvement (OR=1.23, 95% CI 1.13 to 133; p<0.01) CONCLUSION: In a subgroup of patients direct transfer and triage in the angiosuite seems feasible, safe, and achieves significant reduction in hospital workflow times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Embolization by Direct Puncture with a Transpedicular Approach Using an Isocenter Puncture (ISOP) Method in a Patient with a Type II Endoleak After Endovascular Aortic Repair (EVAR)

    International Nuclear Information System (INIS)

    Ogawa, Yukihisa; Hamaguchi, Shingo; Nishimaki, Hiroshi; Kon, Yuri; Chiba, Kiyoshi; Sakurai, Yuka; Murakami, Kenji; Arai, Yasunori; Miyairi, Takeshi; Nakajima, Yasuo

    2015-01-01

    BackgroundEndovascular aortic repair (EVAR) requires further intervention in 20-30 % of cases, often due to type II endoleak (T2EL). Management options for T2EL include transarterial embolization, direct puncture (DP), or transcaval embolization. We report the case of an 80-year-old man with T2EL who successfully underwent DP embolization.MethodsEmbolization by DP was performed with a transpedicular approach using an isocenter puncture (ISOP) method. An isocenter marker (ICM) was placed at a site corresponding to the aneurysm sac on fluoroscopy in two directions (frontal and lateral views). A vertebroplasty needle was inserted tangentially to the ICM under fluoroscopy and advanced to the anterior wall of the vertebral body. A 20 cm-length, 20-G-PTCD needle was inserted through the outer needle of the 13-G needle and advanced to the ICM. Sac embolization using 25 % N-buty-2-cyanoacrylate diluted with Lipiodol was performed. After complete embolization, rotational DA confirmed good filling of the sac with Lipiodol. The outer cannula and 13-G needle were removed and the procedure was completed.ResultsThe patient was discharged the next day. Contrast-enhanced computed tomography 1 and 8 months later showed no Lipiodol washout in the aneurysm sac, no endoleak recurrence, and no expansion of the excluded aneurysm.ConclusionDP with a transpedicular approach using ISOP may be useful when translumbar and transabdominal approaches prove difficult

  6. Treatment of hemorrhagic head and neck lesions by direct puncture and n-BCA embolization.

    Science.gov (United States)

    Deib, Gerard; El Mekabaty, Amgad; Gailloud, Philippe; Pearl, Monica Smith

    2018-04-07

    Life-threatening bleeding in the head and neck region requires urgent management. These hemorrhagic lesions, for example, a ruptured pseudoaneurysm, are often treated by transarterial embolization (TAE), but prior intervention or surgery, inflammation, anatomic variants, and vessel tortuosity may render an endovascular approach challenging, time-consuming, and sometimes impossible. We report two cases of severe head and neck hemorrhages successfully embolized with n -butyl cyanoacrylate via direct puncture, and propose this approach as a fast, safe, and effective alternative to TAE. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Flow characteristics of soft-tissue vascular anomalies evaluated by direct puncture scintigraphy

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Ohtake, Tohru; Wakita, Shinichi; Yoshioka, Naoki; Furuya, Fujio; Nishikawa, Junichi; Sasaki, Yasuhito; Harii, Kiyonori

    1997-01-01

    We have developed a new method, direct puncture scintigraphy, to evaluate in detail the haemodynamics of vascular anomalies under conditions simulating sclerotherapy. Twenty-six soft-tissue vascular anomalies in 21 patients were studied. After 30 MBq of technetium-99m Sn colloid was injected percutaneously into the intravascular space of the lesion, dynamic imaging was performed for 5 min. A time-activity curve for the lesion was generated, with the infiltrated activity on injection subtracted. A monoexponential curve was fitted to the declining phase of the time-activity curve, and mean vascular transit time (MTT) was obtained. The lesions were classified into high-flow and low-flow lesions based on radionuclide angiography with intravenous injection of 99m Tc-labelled red blood cells, and estimates of MTT in the two groups were compared. The imaging procedures were carried out with no major complications, and broad intralesional diffusion of 99m Tc-Sn colloid was achieved in most lesions. The high-flow lesions (six lesions) had a short MTT, ranging from 1.6 to 3.4 s, while the low-flow lesions (20 lesions) had a longer MTT, with no overlap between the groups. MTT showed a wide range in low-flow lesions: it was less than 30 s in six lesions and more than 10 min in five other lesions. Direct puncture scintigraphy provides a quantitative indicator of the flow characteristics of soft-tissue vascular anomalies, and may aid in determining treatment strategies for patients with vascular anomalies. (orig./VHE). With 4 figs

  8. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

    Science.gov (United States)

    Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

    2016-12-01

    To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  10. Direct Puncture Embolization of Scalp Arteriovenous Malformation in a Patient with Severe Hemophilia A: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Mi; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Kyung Hee University Graduate School of Medicine, Seoul (Korea, Republic of); Park, Bong Jin [Dept. of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University Graduate School of Medicine, Seoul (Korea, Republic of); Kim, Keon Ha [Dept. of Radiology, Samsug Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    We present a case of scalp arteriovenous malformation (AVM) in a patient with severe hemophilia A. The 22-year-old man presented with a pulsatile right parietal scalp mass. Digital subtraction angiography revealed an AVM in the right parietal scalp, supplied by superficial temporal and occipital arteries that drained into multiple venous structures. We successfully performed direct puncture embolization followed by surgical resection of the scalp AVM in conjunction with supplemental infusion of coagulation factor VIII before, during and after the embolization and the operation.

  11. Direct Puncture Embolization of Scalp Arteriovenous Malformation in a Patient with Severe Hemophilia A: A Case Report

    International Nuclear Information System (INIS)

    Lee, Kyung Mi; Kim, Eui Jong; Park, Bong Jin; Kim, Keon Ha

    2011-01-01

    We present a case of scalp arteriovenous malformation (AVM) in a patient with severe hemophilia A. The 22-year-old man presented with a pulsatile right parietal scalp mass. Digital subtraction angiography revealed an AVM in the right parietal scalp, supplied by superficial temporal and occipital arteries that drained into multiple venous structures. We successfully performed direct puncture embolization followed by surgical resection of the scalp AVM in conjunction with supplemental infusion of coagulation factor VIII before, during and after the embolization and the operation.

  12. Direct percutaneous transorbital puncture under fluoroscopic guidance with a 3D skull reconstruction overlay for embolisation of intraorbital and cavernous sinus dural arteriovenous fistulas.

    Science.gov (United States)

    Lv, Ming; Jiang, Chuhan; Liu, Dong; Ning, Zhiguang; Yang, Jun; Wu, Zhongxue

    2015-06-01

    To describe the direct percutaneous transorbital puncture technique for embolisation of the selected intraorbital and cavernous sinus dural arteriovenous fistula, which failed to be treated by conventional endovascular techniques. One case of intraorbital and five cases of cavernous sinus dural arteriovenous fistula were embolised through direct percutaneous transorbital puncture in 2012, and the clinical data were reviewed. Under fluoroscopic guidance with a three-dimensional (3D) skull reconstruction overlay, the cavernous sinus or ophthalmic vein was punctured via the superior orbital fissure. Then a microcatheter was inserted via the needle, and Onyx was injected to embolise the fistula with or without a combination of coils. Complete obliteration of the fistula was achieved in all six patients. After operation all the patients experienced transient swelling of the punctured orbit persisting for three to five days. No other complications occurred. Follow-up of six patients at three to six months showed resolution of their initial neuro-ophthalmological symptoms in five and left visual loss in one did not recover. Six months follow-up angiogram showed no recurrence of these fistulas. Direct percutaneous transorbital puncture provides an option for the intraorbital and cavernous sinus dural arteriovenous fistulas, particularly when the conventional transvenous routes are inaccessible. Overlay of the 3D skull reconstruction can facilitate the precise puncture of the superior orbital fissure. © The Author(s) 2015.

  13. Puncture Wounds

    Science.gov (United States)

    ... piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away. Foreign Bodies in Puncture Wounds A variety of foreign bodies can become embedded in a ...

  14. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lv Mingming, E-mail: lvmingming001@163.com; Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ninth People' s Hospital (China); Su Lixin, E-mail: sulixin1975@126.com [Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Ninth People' s Hospital (China); Chen Dong, E-mail: chenjsun@public8.sta.net.cn [Shanghai Jiao Tong University School of Medicine, Department of Otolaryngology, Ninth People' s Hospital (China)

    2013-02-15

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  15. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    International Nuclear Information System (INIS)

    Lv Mingming; Fan, Xin-dong; Su Lixin; Chen Dong

    2013-01-01

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20–25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  16. Absolute Ethanol Embolisation of Mandibular Arteriovenous Malformations Following Direct Percutaneous Puncture and Release of Coils via a Microcatheter.

    Science.gov (United States)

    Wang, D; Su, L; Han, Y; Wang, Z; Zheng, L; Fan, X

    2017-06-01

    To evaluate the safety, efficacy, and medium-term outcome of a modified technique of ethanol embolisation of mandibular arteriovenous malformations (AVMs) following a direct percutaneous transvenous approach to the release of coils via a microcatheter. From January 2012 to July 2014, 18 consecutive patients (mean age 20.9 years [range 10-35 years]) with symptomatic AVMs of the mandible were enrolled. A microcatheter was inserted into the lesion via a direct percutaneous puncture needle. Electrolytically detachable coils and 0.018 mm coils were super-selectively placed to decrease the flow and volume of the arteriovenous fistulas via a microcatheter. Absolute ethanol was injected to obliterate the fistulas. Clinical follow-up was performed in all patients. Therapeutic outcomes were determined by evaluating the degree of devascularisation at follow-up angiography and symptoms and signs. Transvenous release of coils combined with absolute ethanol embolisation were used in all cases. The amount of ethanol used ranged from 5 to 50 mL (mean 25.7 mL) in a single session. Sixteen of 18 patients were cured, and two had partial remission. Follow-up times ranged from 8 to 26 months (medium 15.7 months), and there was no angiographic recurrence of the lesions. Minor complication occurred in five of the 18 patients. There were no major complications. Absolute ethanol embolisation following a direct percutaneous transvenous approach to release coils via a microcatheter is a feasible, safe, and highly effective method for the management of mandibular AVMs. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  17. [Initial experience of catheter ablation of ventricular tachycardia originate from endocardium via direct ventricle puncture access in patients underwent mechanical valve implantation].

    Science.gov (United States)

    Wu, L M; Bao, J R; Zheng, L H; Chen, G; Ding, L G; Yao, Y

    2018-03-24

    Objective: To evaluate the results of catheter ablation of ventricular tachycardia (VT) via direct ventricle puncture access in patients without traditional approach. Methods: Two idiopathic left fasicular VT patients with mechanical aortic and mitrial valve repalcement and 1 patient with right ventricular originated VT post mechanical tricuspid valve repalcement from March 2010 to July 2012 in Fuwai hospital were enrolled in this study. For left fasicular VT patients, catheter ablation was performed using transapical left ventricular access via minithoracotomy. For the patient with right ventricular originated VT, catheter ablation was performed via percutaneous right ventricle puncture at xiphoid. Abaltion was guided under EnSite NavX mapping system. The feasibility of VT ablation via direct ventricle puncture access and long-term VT recurrence were investigated. Results: Catheter ablation was successful in all patients, and all clinical VTs were eliminated. The procedure time was 53, 62 and 74 minutes respectively with radiation time 11, 16 and 20 minutes. The ablation time was 130, 170 and 240 seconds individually. No procedure related complication occurred. After a follow-up time of 76, 55 and 82 months respectively, no VT recurrence was found in patients with left fasicular VT. New-onset VT with different morphology with previous VT was recorded in the patient with right ventricular originated VT, subcutaneous implantable defibrillator was implanted finally in this patient. Conclusions: For patients with endocardial origined ventricular arrhythmias which could not be ablated via traditional approaches, direct ventricle puncture access with hybrid techniques provides a new approach foreliminating VTs in these patients.

  18. Use of Suture-Mediated Closure Device in Percutaneous Direct Carotid Puncture During Chimney-Thoracic Endovascular Aortic Repair

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Gabriel, E-mail: dr.changabriel@gmail.com; Quek, Lawrence Hwee Han, E-mail: lawrence-quek@ttsh.com.sg [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Tan, Glenn Leong Wei, E-mail: glenn-tan@ttsh.com.sg [Tan Tock Seng Hospital, Department of General Surgery (Singapore); Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2016-07-15

    BackgroundInsertion of a carotid chimney graft during thoracic endovascular aortic repair (Ch-TEVAR) is a recognized technique to extend the proximal landing zone into the aortic arch in the treatment of thoracic aortic disease. Conventional technique requires surgical exposure of the carotid artery for insertion of the carotid chimney graft.MethodologyWe describe our experience in the use of a suture-mediated closure device in percutaneous Ch-TEVAR in four patients.ResultsSuccessful hemostasis was achieved in all four patients. No complications related to the carotid puncture were recorded.ConclusionWe conclude that using suture-mediated closure device for carotid closure appears feasible and deserves further studies as a potential alternative to conventional surgical approach.

  19. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  20. Successful treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique.

    Science.gov (United States)

    Huynh, Thien J; Morton, Ryan P; Levitt, Michael R; Ghodke, Basavaraj V; Wink, Onno; Hallam, Danial K

    2017-08-18

    We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture. 2017 BMJ Publishing Group Ltd.

  1. Puncture panel optimization

    International Nuclear Information System (INIS)

    Glass, R.E.; Longenbaugh, R.S.

    1986-01-01

    Sandia National Laboratories developed the TRansUranic PACkage Transporter (TRUPACT) to transport defense contact-handled transuranic wastes. The package has been designed to meet the normal and hypothetical accident conditions in 10CFR71 which includes the demonstrated ability to survive a 1-meter drop onto a mild steel pin. The puncture protection is provided by puncture resistant panels. In conjunction with the development of TRUPACT, a series of experiments has been conducted to reduce the weight of the puncture resistant panels. The initial scoping tests resulted in a preliminary design incorporating 30 layers of Kevlar. This design has been shown to meet the regulatory puncture test. To reduce the weight of this panel, subscale tests were conducted on panels utilizing Kevlar yarns with varying mass per unit length (denier) as well as different resins. This paper reviews the testing undertaken in the original panel development and discusses the results obtained from the recent subscale and full-scale optimization tests

  2. Postdural Puncture Headache

    Directory of Open Access Journals (Sweden)

    Ahmed Ghaleb

    2010-01-01

    Full Text Available Postdural puncture headache (PDPH has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low-pressure headache resulting from leakage of cerebrospinal fluid (CSF from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small-gauge needles, particularly of the pencil-point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle. A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients , for example, age < 50 years, postpartum, large-gauge needle puncture, epidural blood patch should be performed within 24–48 h of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications of AEBP are rare.

  3. Method of exact lung puncture

    Energy Technology Data Exchange (ETDEWEB)

    Voss, L.

    1986-01-01

    The accuracy can be improved, and the risk of complications can be reduced in the case of cytodiagnostic lung puncture, if one optimises the method whereby the puncture needle is inserted into the lesion. The author describes such a procedure incorporating the use of technical aids for marking the exact puncture point of the cannula. At the same time the procedure results in a reduction of radiation exposure of both doctor and patient.

  4. Simultaneous mass detection for direct inlet mass spectrometry

    International Nuclear Information System (INIS)

    Gordon, R.L.

    1979-05-01

    The evolution of analytical techniques for application in trace analysis has led to interest in practical methods for real-time monitoring. Direct inlet mass spectrometry (DIMS) has been the subject of considerable activity in recent years. A DIMS instrument is described which consists of an inlet system designed to permit particles entrained in the inlet air stream to strike a hot, oxidized rhenium filament which serves as a surface ionization source. A mass analyzer and detection system then permits identification of the elemental composition of particulates which strike the filament

  5. Simultaneous magnetically directed drug convection and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yathindranath, V; Hegmann, T [Department of Chemistry, University of Manitoba, Winnipeg, MB, R3T 2N2 (Canada); Van Lierop, J [Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB, R3T 2N2 (Canada); Potter, K; Fowler, C B [DVBIC/DCoE AFIP, Traumatic Brain Injury Research Center, Department of Biophysics, Rockville, MD 20850 (United States); Moore, D F, E-mail: johan@physics.umanitoba.c [Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC 20307 (United States)

    2009-10-07

    Superparamagnetic iron oxide nanoparticles (IO NPs) are of interest for their usefulness in biomedical applications. In this work, we have synthesized iron oxide nanocomposites surface-modified with different biocompatible polymers. Bovine serum albumin (BSA) was physisorbed onto these IO NPs along with an excipient during freeze-drying. The mass transport of the protein attached to the iron oxide core-shell nanoparticles (IO cs-NPs) under a gradient magnetic field of an MRI instrument was observed in vitro and in an egg as a model system for a biological fluid. From the in vitro experiments in agarose gels, it was observed that the protein gets separated from the core during mass transport for some cs-IO, but co-migration was observed for PEG-modified IO cs-NPs. These experiments demonstrated proof-of-concept for the use of IO cs-NPs in magnetically directed drug convection.

  6. Perioperative management of postdural puncture headache: Postdural puncture headache

    Directory of Open Access Journals (Sweden)

    Unić-Stojanović Dragana

    2016-01-01

    Full Text Available Introduction: Postdural puncture headache (PDPH is a complication of puncture of the dura mater. It is a common side effect of spinal anesthesia, lumbar puncture and occasionally, may accidentally occur in epidural anesthesia. The headache is defined as a bilateral headache that develops within 7 days after lumbar puncture and disappears within 14 days. It has been described in some cases that headaches can last from a few mounts to even years. Factors that increase the risk of PDPH is young age, female sex and pregnancy. Incidence is strongly related to the needle size and type. Case Report: We report a case of a 49-year-old man who was admitted to our Institute for elective veins surgery. We choose spinal anesthesia for this operation and use 25 gauged spinal needle. Patient was hemodynamically stable during the whole surgery without headache and he was discharged home at 1st post operative day. However, after two days, patient came to the hospital complaining of severe headache in frontal and occipital areas, followed by neck stiffness. Our first approach in treatment was conservative therapy. Recumbent positioning, oral and intravenous fluid, 500 mg coffeine iv. bid and morphine 4 qid. The headache persisted for the next 2 days, despite conservative therapy. Our next approach was epidural blood patch like effective treatment for PDPH. First we placed patient in the lateral position and inserted epidural needle at the level L3 - L4. Then we injected 15 ml of autologes blood into epidural space. His headache resolved within one hour of procedure, he denied any further headache one month after discharge. Conclusion: In our case, it was shown that lumbar puncture is an important cause of iatrogenic morbidity in the form of postdural puncture headache. Incidence of headache can be resolved by using thinner needle. When the headache does not respond to conservative therapy, epidural blood patch is a reasonable and effective treatment. Surgical

  7. Evolving a puncture black hole with fixed mesh refinement

    International Nuclear Information System (INIS)

    Imbiriba, Breno; Baker, John; Centrella, Joan; Meter, James R. van; Choi, Dae-Il; Fiske, David R.; Brown, J. David; Olson, Kevin

    2004-01-01

    We present an algorithm for treating mesh refinement interfaces in numerical relativity. We discuss the behavior of the solution near such interfaces located in the strong-field regions of dynamical black hole spacetimes, with particular attention to the convergence properties of the simulations. In our applications of this technique to the evolution of puncture initial data with vanishing shift, we demonstrate that it is possible to simultaneously maintain second order convergence near the puncture and extend the outer boundary beyond 100M, thereby approaching the asymptotically flat region in which boundary condition problems are less difficult and wave extraction is meaningful

  8. Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

    Directory of Open Access Journals (Sweden)

    Zupanc Andrea

    2009-06-01

    Full Text Available Abstract Background Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact – a key principle of effective medical care. Second, simultaneous task performance ('multitasking' which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested. Methods 35 participant observations of internists and surgeons of a German municipal 300-bed hospital were conducted. Complete day shifts of hospital physicians on wards, emergency ward, intensive care unit, and operating room were continuously observed. Assessed variables of interest were time allocation, share of direct patient contact, and simultaneous activities. Inter-rater agreement of Kappa = .71 points to good reliability of the instrument. Results Hospital physicians spent 25.5% of their time at work in direct contact with patients. Most time was allocated to documentation and conversation with colleagues and nursing staff. Physicians performed parallel simultaneous activities for 17–20% of their work time. Communication with patients, documentation, and conversation with colleagues and nursing staff were the most frequently observed simultaneous activities. Applying logit-linear analyses, specific primary activities increase the probability of particular simultaneous activities. Conclusion Patient-related working time in hospitals is limited. The potential detrimental effects of frequently observed simultaneous activities on performance outcomes need further consideration.

  9. Technique for Performing Lumbar Puncture in Microgravity Using Portable Radiography.

    Science.gov (United States)

    Lerner, David J; Parmet, Allen J; Don, Steven; Shimony, Joshua S; Goyal, Manu S

    2016-08-01

    Visual Impairment and Intracranial Pressure Syndrome (VIIP) has caused symptomatology during and after long duration missions on the International Space Station (ISS). Only indirect measurements of intracranial pressure (ICP), such as ultrasound, have been performed on ISS. Discussion and interest has happened at NASA about performing lumbar puncture (LP) in microgravity. Only the "blind" palpation approach and the ultrasound-assisted approach have been discussed. This article, as proof of concept, discusses the possibility of portable radiography to assist lumbar punctures in microgravity. An anthropomorphic radiological phantom of an adult lumbar spine was made containing a fluid-filled space in the spinal canal with a latex membrane which simulated the dural sac and cerebrospinal fluid. A portable direct-digital radiography system with wireless transmitting image receptor and screen was used to perform image-guided lumbar puncture. Using the same equipment and technique, this procedure was then performed on a cadaver for final proof of concept. Technical success was achieved in all approaches on the first try without needle redirection. There was no difference between the cadaver model and the phantom model in terms of difficulty in reaching the fluid space or visually confirming needle location. Portable radiography via proof of concept has the potential to guide lumbar puncture while minimizing volume and mass of equipment. This could be ideal for assisting in performing lumbar puncture in microgravity, as this is the standard of care on Earth for difficult or failed "blind" lumbar punctures. Lerner DJ, Parmet AJ, Don S, Shimony JS, Goyal MS. Technique for performing lumbar puncture in microgravity using portable radiography. Aerosp Med Hum Perform. 2016; 87(8):745-747.

  10. Large scale earthquake simulator of 3-D (simultaneous X-Y-Z direction)

    International Nuclear Information System (INIS)

    Shiraki, Kazuhiro; Inoue, Masao

    1983-01-01

    Japan is the country where earthquakes are frequent, accordingly it is necessary to examine sufficiently the safety against earthquakes of important machinery and equipment such as nuclear and thermal power plants and chemical plants. For this purpose, aseismatic safety is evaluated by mounting an actual thing or a model on a vibration table and vibrating it by the magnitude several times as large as actual earthquakes. The vibration tables used so far can vibrate only in one direction or in two directions simultaneously, but this time, a three-dimensional vibration table was completed, which can vibrate in three directions simultaneously with arbitrary wave forms, respectively. By the advent of this vibration table, aseismatic test can be carried out, using the earthquake waves close to actual ones. It is expected that this vibration table achieves large role for the improvement of aseismatic reliability of nuclear power machinery and equipment. When a large test body is vibrated on the vibration table, the center of gravity of the test body and the point of action of vibrating force are different, therefore the rotating motion around three axes is added to the motion in three axial directions, and these motions must be controlled so as to realize three-dimensional earthquake motion. The main particulars and the construction of the vibration table, the mechanism of three-direction vibration, the control of the table and the results of test of the table are reported. (Kako, I.)

  11. Direct and simultaneous estimation of cardiac four chamber volumes by multioutput sparse regression.

    Science.gov (United States)

    Zhen, Xiantong; Zhang, Heye; Islam, Ali; Bhaduri, Mousumi; Chan, Ian; Li, Shuo

    2017-02-01

    Cardiac four-chamber volume estimation serves as a fundamental and crucial role in clinical quantitative analysis of whole heart functions. It is a challenging task due to the huge complexity of the four chambers including great appearance variations, huge shape deformation and interference between chambers. Direct estimation has recently emerged as an effective and convenient tool for cardiac ventricular volume estimation. However, existing direct estimation methods were specifically developed for one single ventricle, i.e., left ventricle (LV), or bi-ventricles; they can not be directly used for four chamber volume estimation due to the great combinatorial variability and highly complex anatomical interdependency of the four chambers. In this paper, we propose a new, general framework for direct and simultaneous four chamber volume estimation. We have addressed two key issues, i.e., cardiac image representation and simultaneous four chamber volume estimation, which enables accurate and efficient four-chamber volume estimation. We generate compact and discriminative image representations by supervised descriptor learning (SDL) which can remove irrelevant information and extract discriminative features. We propose direct and simultaneous four-chamber volume estimation by the multioutput sparse latent regression (MSLR), which enables jointly modeling nonlinear input-output relationships and capturing four-chamber interdependence. The proposed method is highly generalized, independent of imaging modalities, which provides a general regression framework that can be extensively used for clinical data prediction to achieve automated diagnosis. Experiments on both MR and CT images show that our method achieves high performance with a correlation coefficient of up to 0.921 with ground truth obtained manually by human experts, which is clinically significant and enables more accurate, convenient and comprehensive assessment of cardiac functions. Copyright © 2016 Elsevier

  12. Interventional treatment of iliofemoral venous obstruction through popliteal vein puncture

    International Nuclear Information System (INIS)

    Gu Jianping; He Xu; Lou Wensheng; Chen Liang; Su Haobo; Chen Guoping

    2005-01-01

    Objective: To determine the clinical value of popliteal vein puncture in the interventional treatment of iliofemoral venous obstruction. Methods: Popliteal vein puncture and synthetic interventioal therapy were performed in 58 cases, including catheter-directed thrombolysis in 42 cases, transcatheter aspiration in 25 cases, thrombectomy in 49 cases, angioplasty in 41 cases, and stenting in 35 cases, and inferior vena cava filter was inserted in 52 cases. The mean kind of interventional therapy performed in each patient was 5.2. The total efficiency was graded on a scale of 1 (excellent), 2 (good), 3 (mild), and 4 (no changes) according to the follow-up venography and physical sign. Anticoagulation therapy for 1 month and antiplatelet for 6 months were performed after dischargement and follow-up venography was performed after six months. Results: The technical successful rate of popliteal vein puncture was 96.7% (58/60). Two popliteal vein puncture failed without ultrasound or fluoroscopy guidance. The efficiency of 58 cases at discharge was as follows: 19 of grade 1, 30 of grade 2, 8 of grade 3, and 1 of grade 4, respectively. 42 cases had six months follow-up data including 18 grade 1, 20 of grade 2, 1 of grade 3, and 3 of grade 4, respectively. Conclusion: Interventional treatment of iliofemoral venous obstruction by popliteal vein puncture is safe and effective. (authors)

  13. Effect of calcium trisodium DTPA in rats with puncture wound contaminated by 90Y-chloride

    International Nuclear Information System (INIS)

    Watanabe, N.; Tanada, S.; Sasaki, Y.

    2005-01-01

    The efficacy of diethylenetriaminepentaacetate calcium trisodium (CaNa 3 DTPA) in a dose of 34.7 μmol kg -1 as a function of its route of administration was investigated in rats with a puncture wound contaminated by 90 Y-chloride at a concentration of 2.55 MBq kg -1 . Approximately 60% of 90 Y-chloride at a puncture wound was absorbed into the body of rats over 72 h post-puncture and radioactivity in femoral bone increased during the timed-release of 90 Y. Intravenous administration of CaNa 3 DTPA (systemic treatment) at 15 min post-puncture reduced 90 Y at a puncture wound and in bone up to 75.6 and 84.3% of controls, respectively. Direct infiltration of CaNa 3 DTPA into a puncture wound site (local treatment) at 15 min post-puncture diminished radioactivity at the puncture wound and in bone up to 34.9 and 52.5% of controls, respectively. Thus, prompt local treatment may be effective for removing 90 Y from a puncture wound and minimising 90 Y-distribution to bone compared with systemic treatment. (authors)

  14. Transtracheal puncture: a forgotten procedure

    Science.gov (United States)

    Almeida, E.P.; Almeida, A.C.; Almeida, F.F.; Montessi, J.; Gomes, C.A.; Ferreira, L.E.V.V.C.

    2015-01-01

    Transtracheal puncture has long been known as a safe, low-cost procedure. However, with the advent of bronchoscopy, it has largely been forgotten. Two researchers have suggested the use of α-amylase activity to diagnose salivary aspiration, but the normal values of this enzyme in tracheobronchial secretions are unknown. We aimed to define the normal values of α-amylase activity in tracheobronchial secretions and verify the rate of major complications of transtracheal puncture. From October 2009 to June 2011, we prospectively evaluated 118 patients without clinical or radiological signs of salivary aspiration who underwent transtracheal puncture before bronchoscopy. The patients were sedated with a solution of lidocaine and diazepam until they reached a Ramsay sedation score of 2 or 3. We then cleaned the cervical region and anesthetized the superficial planes with lidocaine. Next, we injected 10 mL of 2% lidocaine into the tracheobronchial tree. Finally, we injected 10 mL of normal saline into the tracheobronchial tree and immediately aspirated the saline with maximum vacuum pressure to collect samples for measurement of the α-amylase level. The α-amylase level mean ± SE, median, and range were 1914 ± 240, 1056, and 24-10,000 IU/L, respectively. No major complications (peripheral desaturation, subcutaneous emphysema, cardiac arrhythmia, or hemoptysis) occurred among 118 patients who underwent this procedure. Transtracheal aspiration is a safe, low-cost procedure. We herein define for the first time the normal α-amylase levels in the tracheobronchial secretions of humans. PMID:26176310

  15. Aerosol can puncture device test report

    Energy Technology Data Exchange (ETDEWEB)

    Leist, K.J.

    1994-10-01

    This test report documents the evaluation of an aerosol can puncture device to replace a system currently identified for use in the WRAP-1 facility. The new system is based upon a commercially available puncture device, as recommended by WHC Fire Protection. With modifications found necessary through the testing program, the Aerosol Can Puncture Device was found able to puncture and drain aerosol cans without incident. Modifications include the addition of a secondary collection bottle and the modification of the can puncture needle. In the course of testing, a variety of absorbents were tested to determine their performance in immobilizing drained fluids. The visibility of the puncture with Non-Destructive Examination techniques were also reviewed.

  16. Lateral cervical puncture for cervical myelography

    International Nuclear Information System (INIS)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck

    1985-01-01

    Eleven cervical myelograms were performed by lateral cervical puncture using Metrizamide. So, following results were obtained: 1. Site of lateral cervical puncture; Posterior one third of bony cervical canal at C 1-2 level. 2. Advantages as compared with lumbar puncture for cervical myelograms; 1) Small amount of contrast media 2) Excellent image 3) Less position charge 4) Short time 5) Well visualization of superior margin of obstructive lesion in spinal canal 3. Cessation of lateral cervical puncture, when; 1) Pain during injection of contrast media 2) Localized collection of contrast media

  17. Simultaneous recording of electroretinogram and visual evoked response. Focal stimulation under direct observation.

    Science.gov (United States)

    Hirose, T; Miyake, Y; Hara, A

    1977-07-01

    A system has been tested that allows simultaneous recording of the retinal response (electroretinogram [ERG]) and the occipital response (visual evoked response [VER]) with focal photic stimulation of the retina under direct observation of the fundus. A helium-neon gas laser is used as a stimulus source. The laser is chopped either by a pen motor or a rotating disc. The laser is attached to a biomicroscope through which the examiner can observe the fundus of the subject during the entire recording session. The optically clear contact lens is made with a flat surface that neutralizes refraction due to the cornea, thereby allowing fundus observation by microscope. Two metal wires mounted inside and outside of the lens serve as the electrode for the ERG. Graticules consisting of concentric circles and radial lines are projected onto the subject's fundus, providing a pattern that the examiner can use to determine the exact location to be stimulated in the fundus. With proper adjustment of stimulus and background illumination, local ERG and VER can be recorded simultaneously by stimulating the macula.

  18. Mechanism of Simultaneous Tripping of Ground Directional Relays in a 6.6kV Distribution System

    Science.gov (United States)

    Suzuki, Naoto

    In Kyushu Electric Power's 6.6kV distribution system, after a single-phase ground fault occurred in the circuit of a distribution line, we experienced a phenomenon in which the analogue ground directional relays of the other circuits linked to the same bank were simultaneously tripped. In this paper, focus is placed on the mechanism and possibility of simultaneous tripping of ground directional relays. This mechanism was examined in an experiment carried out using an analogue simulator. The results of the test revealed that such simultaneous tripping was attributable to the neutral instability phenomenon of grounding potential transformers installed in an isolated neutral system.

  19. Changing the needle for lumbar punctures

    DEFF Research Database (Denmark)

    Engedal, Thorbjørn Søndergaard; Ording, H.; Vilholm, O. J.

    2015-01-01

    Objective: Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar punctures. Both a non-cutting needle design and the use of smaller size needles have been shown to greatly reduce the risk of PDPH. Nevertheless, larger cutting needles are still widely used. This study d...

  20. Intraoperative ventricular puncture during supraorbital craniotomy via an eyebrow incision. Technical note.

    NARCIS (Netherlands)

    Menovsky, T.; Vries, J. de; Wurzer, J.A.; Grotenhuis, J.A.

    2006-01-01

    The authors determined the landmarks and coordinates for intraoperative ventricular puncture directly from the supraorbital craniotomy opening via an eyebrow incision. Fifty magnetic resonance (MR) imaging studies were obtained from patients with no pathological cerebral characteristics or

  1. The zero-wall puncture: a novel angiographic puncture technique with substantial benefits

    Energy Technology Data Exchange (ETDEWEB)

    Leswick, D.A.; Szkup, P.; Stoneham, G.W. [Univ. of Saskatchewan, Royal Univ. Hospital, Dept. of Radiology, Saskatoon, Saskatchewan (Canada)]. E-mail: davidleswick@hotmail.com

    2005-04-15

    Medical education can be busy, exhausting, and stressful, with potential adverse effects on trainees' physical and mental health. Radiology residency is no exception. In addition to increased daily workload and study requirements, Canadian radiology residents are performing a diverse and increasing number of emergent diagnostic examinations after hours. In an attempt to improve resident self-worth and efficiency during angiographic rotations, we investigated the effects of a novel angiographic puncture procedure on various resident lifestyle indexes. Standard techniques for accessing the femoral artery are either the single-wall puncture or double-wall puncture (Seldinger technique). Both of these techniques are widely known and practiced. Following procedure completion, hemostasis must be achieved at the puncture site. This has traditionally required manual compression at the puncture site, which may require 15 to 20 minutes. At our institution the standard policy is that 'whoever makes the puncture, compresses the groin,' also known as 'you broke it, you fix it'. This has prompted our industrious resident complement to develop a novel, previously undescribed, angiographic puncture technique known as the 'zero-wall puncture technique.' Preliminary unpublished results from our institution show that when residents employ the zero-wall puncture technique the attending staff radiologist subsequently both performs the puncture and compresses the groin at the end of the procedure. We investigated the effect of zero-wall puncture on various resident lifestyle indexes. (author)

  2. Microwave assisted direct saponification for the simultaneous determination of cholesterol and cholesterol oxides in shrimp.

    Science.gov (United States)

    Souza, Hugo A L; Mariutti, Lilian R B; Bragagnolo, Neura

    2017-05-01

    A novel microwave-assisted direct saponification method for the simultaneous determination of cholesterol and cholesterol oxides in shrimp was developed and validated. Optimal saponification conditions, determined by means of an experimental design, were achieved using 500mg of sample and 20mL of 1mol/L KOH ethanol solution for 16min at 45°C at maximum power at 200W and magnetic stirring at 120rpm. Higher extraction of cholesterol oxides in a reduced saponification time (∼75 times) was achieved in comparison with the direct cold saponification method. The new method showed low detection (≤0.57μg/mL) and quantification (≤1.73μg/mL) limits, good repeatability (≤10.50% intraday and ≤8.56% interday) and low artifact formation (evaluated by using a deuterated cholesterol-D6 standard). Raw, salted and dried-salted shrimps were successfully analyzed by the validated method. The content of cholesterol oxides increased after salting and decreased after drying. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Bulging Fontanelle and Need for Lumbar Puncture

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-10-01

    Full Text Available Etiologies of bulging fontanelle and fever and clinical evidence for lumbar puncture were determined from medical records of 153 infants treated at Assaf Harofeh Medical Center, Israel.

  4. Management of accidental dural puncture and post-dural puncture headache after labour: a Nordic survey

    DEFF Research Database (Denmark)

    Darvish, B; Gupta, A; Alahuhta, S

    2011-01-01

    a major risk with epidural analgesia is accidental dural puncture (ADP), which may result in post-dural puncture headache (PDPH). This survey was conducted to explore the incidence of ADP, the policy for management of PDPH and the educational practices in epidural analgesia during labour in the N......a major risk with epidural analgesia is accidental dural puncture (ADP), which may result in post-dural puncture headache (PDPH). This survey was conducted to explore the incidence of ADP, the policy for management of PDPH and the educational practices in epidural analgesia during labour...

  5. PUNCTURE: a computer program for puncture analysis of radioactive material transport casks

    Energy Technology Data Exchange (ETDEWEB)

    Ikushima, Takeshi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-09-01

    In the drop puncture analyses for radioactive transport casks, it has become possible to perform them in detail by using interaction evaluation computer programs such as DYNA3D. However, the considerable cost and the computer time are necessitated to perform analyses by these programs. To decrease the computer cost and time, a simplified computer program PUNCTURE has been developed. The PUNCTURE is a static calculation computer program based on the Onat`s theory and Asada`s research. The PUNCTURE is capable of evaluating the acceleration of cask bodies, the deformation of punctured plates and, the stress and the deformation of puncture bars. Main features of the computer program are as follows; (1) three analysis models for punctured plate are used that are the fixed supported bending plate model, the simply supported bending plate model and the fixed supported membrane plate model, (2) it is capable of graphical representations for calculation results and (3) not only main frame computers (OS MSP) but also work stations (OS: UNIX) and personal computers (OS: Windows) are available for use of PUNCTURE. In the paper, brief illustration of calculation method using the Onat`s theory and Asada`s research is presented. The second section presents comparisons between calculation and experimental results. The third section provides a user`s guide for PUNCTURE. (author)

  6. Aerosol can puncture device operational test plan

    International Nuclear Information System (INIS)

    Leist, K.J.

    1994-01-01

    Puncturing of aerosol cans is performed in the Waste Receiving and Processing Facility Module 1 (WRAP 1) process as a requirement of the waste disposal acceptance criteria for both transuranic (TRU) waste and low-level waste (LLW). These cans have contained such things as paints, lubricating oils, paint removers, insecticides, and cleaning supplies which were used in radioactive facilities. Due to Westinghouse Hanford Company (WHC) Fire Protection concerns of the baseline system's fire/explosion proof characteristics, a study was undertaken to compare the baseline system's design to commercially available puncturing devices. While the study found no areas which might indicate a risk of fire or explosion, WHC Fire Protection determined that the puncturing system must have a demonstrated record of safe operation. This could be obtained either by testing the baseline design by an independent laboratory, or by substituting a commercially available device. As a result of these efforts, the commercially available Aerosolv can puncturing device was chosen to replace the baseline design. Two concerns were raised with the system. Premature blinding of the coalescing/carbon filter, due to its proximity to the puncture and draining operation; and overpressurization of the collection bottle due to its small volume and by blinding of the filter assembly. As a result of these concerns, testing was deemed necessary. The objective of this report is to outline test procedures for the Aerosolv

  7. Optimizing Residents' Performance of Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

    2018-01-01

    Background: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given...... of three interventions as preparation for performing lumbar puncture: 1) goal- and learner-centered video (GLV) presenting procedure-specific process goals and learner-centered information; 2) traditional video (TV) providing expert-driven content, but no process goals; and 3) written text (WT...... a traditionally designed video or written text. Participants’ self-confidence was not predictive of their actual performance....

  8. A method of simultaneous no-screen X-ray film taking with direct twofold magnification of hands and feet

    International Nuclear Information System (INIS)

    Zajgner, J.; Szymanska-Prach, H.

    1978-01-01

    The authors propose an original method of X-ray examination of hands and feet which makes possible simultaneous radiography without screen and direct twofold magnified film taking. The method is not connected with the necessity of exposing the patient to an additional dose of X-rays. It has been tried in 20 patients with suspected rheumatoid arthritis. It requires an X-ray tube with 0.3 x 0.3 mm microfocus. (author)

  9. Simultaneous Detection of Bacteroides forsythus and Prevotella intermedia by 16S rRNA Gene-Directed Multiplex PCR

    Science.gov (United States)

    Conrads, Georg; Flemmig, Thomas F.; Seyfarth, Ilse; Lampert, Friedrich; Lütticken, Rudolf

    1999-01-01

    In a 16S rRNA gene-directed multiplex PCR, Prevotella intermedia- and Bacteroides forsythus-specific reverse primers were combined with a single conserved forward primer. A 660-bp fragment and an 840-bp fragment that were specific for both species could be amplified simultaneously. A total of 152 clinical samples, subgingival plaque and swabs of three different oral mucosae, from 38 periodontitis patients were used for the evaluation. PMID:10203541

  10. Effect of Body Position on Energy Expenditure of Preterm Infants as Determined by Simultaneous Direct and Indirect Calorimetry.

    Science.gov (United States)

    Bell, Edward F; Johnson, Karen J; Dove, Edwin L

    2017-04-01

    Background  Indirect calorimetry is the standard method for estimating energy expenditure in clinical research. Few studies have evaluated indirect calorimetry in infants by comparing it with simultaneous direct calorimetry. Our purpose was (1) to compare the energy expenditure of preterm infants determined by these two methods, direct calorimetry and indirect calorimetry; and (2) to examine the effect of body position, supine or prone, on energy expenditure. Study Design  We measured energy expenditure by simultaneous direct (heat loss by gradient-layer calorimeter corrected for heat storage) and indirect calorimetry (whole-body oxygen consumption and carbon dioxide production) in 15 growing preterm infants during two consecutive interfeeding intervals, once in the supine position and once in the prone position. Results  The mean energy expenditure for all measurements in both positions did not differ significantly by the method used: 2.82 (standard deviation [SD] 0.42) kcal/kg/h by direct calorimetry and 2.78 (SD 0.48) kcal/kg/h by indirect calorimetry. The energy expenditure was significantly lower, by 10%, in the prone than in the supine position, whether examined by direct calorimetry (2.67 vs. 2.97 kcal/kg/h, p  position than in the supine position. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. How to perform a lumbar puncture

    African Journals Online (AJOL)

    2016-11-04

    Nov 4, 2016 ... Clinical Fellow, Acute and Elderly Care Medicine, Ashford and St Peter's Hospitals NHS Foundation Trust ... The Lumbar. Puncture was a procedure dedicated to the relief of symptoms (at that time mainly meningitis or raised intracranial pressure) [4]. .... in the back as a consequence of the trauma of the.

  12. Lumbar Puncture for First Simple Febrile Seizure

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-01-01

    Full Text Available Compliance with American Academy of Pediatrics consensus statement recommendations regarding lumbar puncture for infants 6-18 months of age with a first simple febrile seizure was investigated by a retrospective review of 704 infants evaluated in the pediatric emergency medicine division at Children’s Hospital Boston, MA, Oct 1995-Oct 2006.

  13. Multiple Puncture Tuberculin Reactions | Collins | South African ...

    African Journals Online (AJOL)

    The multiple puncture tuberculin test plays a vital role in the tuberculosis control programme of the Republic of South Africa, where emphasis is placed on BCG vaccination for the uninfected, and chemotherapy for the infected. Confluent reactions (Heaf grades 11, III and IV) are regarded as evidence of specific infection, ...

  14. Simultaneous reflection masking: dependency on direct sound level and hearing-impairment

    DEFF Research Database (Denmark)

    Buchholz, Jörg; Mihai, Paul Glad

    2008-01-01

    Simultaneous reflection masked thresholds (RMTs) were measured for 3 normal-hearing (NH) and 3 hearing-impaired (HI) subjects as a function of reflection delay. All stimuli were presented diotically and dichotically, using a 200 ms long broadband noise (100-50000 Hz) as input signal. For 55 d...... delays. Hence, in contrast to binaural reflection enhancement, binaural reflection suppression seems to involve mechanisms that are robust to auditory-internal noise-floor and hearing-impairment. Moreover, differences between the RMTs for HI- and NH-listeners were in prin-ciple agreement with differences...

  15. Simultaneous direct holographic fabrication of photonic cavity and graded photonic lattice with dual periodicity, dual basis, and dual symmetry.

    Science.gov (United States)

    Lowell, D; Lutkenhaus, J; George, D; Philipose, U; Chen, B; Lin, Y

    2017-06-26

    For the first time, to the authors' best knowledge, this paper demonstrates the digital, holographic fabrication of graded, super-basis photonic lattices with dual periodicity, dual basis, and dual symmetry. Pixel-by-pixel phase engineering of the laser beam generates the highest resolution in a programmable spatial light modulator (SLM) for the direct imaging of graded photonic super-lattices. This technique grants flexibility in designing 2-D lattices with size-graded features, differing periodicities, and differing symmetries, as well as lattices having simultaneously two periodicities and two symmetries in high resolutions. By tuning the diffraction efficiency ratio from the SLM, photonic cavities can also be generated in the graded super-lattice simultaneously through a one-exposure process. A high quality factor of over 1.56 × 10 6 for a cavity mode in the graded photonic lattice with a large super-cell is predicted by simulations.

  16. Teichmüller theory of the punctured solenoid

    DEFF Research Database (Denmark)

    Penner, Robert; Sari´c, Dragomir

    2008-01-01

    The punctured solenoid plays the role of an initial object for the category of punctured surfaces with morphisms given by finite covers branched only over the punctures. The (decorated) Teichmüller space of is introduced, studied, and found to be parametrized by certain coordinates on a fixed tri...

  17. Directionality effects in simultaneous language interpreting: the case of sign language interpreters in The Netherlands.

    Science.gov (United States)

    Van Dijk, Rick; Boers, Eveline; Christoffels, Ingrid; Hermans, Daan

    2011-01-01

    The quality of interpretations produced by sign language interpreters was investigated. Twenty-five experienced interpreters were instructed to interpret narratives from (a) spoken Dutch to Sign Language of The Netherlands (SLN), (b) spoken Dutch to Sign Supported Dutch (SSD), and (c) SLN to spoken Dutch. The quality of the interpreted narratives was assessed by 5 certified sign language interpreters who did not participate in the study. Two measures were used to assess interpreting quality: the propositional accuracy of the interpreters' interpretations and a subjective quality measure. The results showed that the interpreted narratives in the SLN-to-Dutch interpreting direction were of lower quality (on both measures) than the interpreted narratives in the Dutch-to-SLN and Dutch-to-SSD directions. Furthermore, interpreters who had begun acquiring SLN when they entered the interpreter training program performed as well in all 3 interpreting directions as interpreters who had acquired SLN from birth.

  18. The super period matrix with Ramond punctures

    Science.gov (United States)

    Witten, Edward

    2015-06-01

    We generalize the super period matrix of a super Riemann surface to the case that Ramond punctures are present. For a super Riemann surface of genus g with 2 r Ramond punctures, we define, modulo certain choices that generalize those in the classical theory (and assuming a certain generic condition is satisfied), a g | r × g | r period matrix that is symmetric in the Z2-graded sense. As an application, we analyze the genus 2 vacuum amplitude in string theory compactifications to four dimensions that are supersymmetric at tree level. We find an explanation for a result that has been found in orbifold examples in explicit computations by D'Hoker and Phong: with their integration procedure, the genus 2 vacuum amplitude always vanishes "pointwise" after summing over spin structures, and hence is given entirely by a boundary contribution.

  19. Laser puncture therapy of nervous system disorders

    Energy Technology Data Exchange (ETDEWEB)

    Anishchenko, G.; Kochetkov, V.

    1984-08-29

    The authors discuss experience with treatment of nervous system disorders by means of laser-puncture therapy. Commenting on the background of the selection of this type of treatment, they explain that once researchers determined the biological action of laser light on specific nerve receptors of the skin, development of laser apparatus capable of concentrating the beam in the millimeter band was undertaken. The devices that are being used for laser-puncture are said to operate in the red helium-neon band of light. The authors identify beam parameters that have been selected for different groups of acupuncture points of the skin, and the courses of treatment (in seconds of radiation) and their time intervals. They go on to discuss the results of treatment of over 800 patients categorized in a group with disorders of the peripheral nervous system and a second group with disorders of the central nervous system.

  20. The reasons for delay lumbar puncture

    Directory of Open Access Journals (Sweden)

    MH. Lotfi

    2017-04-01

    Full Text Available Early diagnosis of meningitis and encephalitis and prompt initiation of appropriate therapy is vital and any delay will lead to high mortality and serious and permanent morbidity. The main purpose of this study was to evaluate the management of 220 patients with suspected central nervous system (CNS infections (meningitis and encephalitis to determine the percentage of patients’ suspected CNS infection undergo lumbar puncture in acceptable time (in accordance with conventional algorithms. In this descriptive study, patients with suspected CNS infections admitted to Bu-Ali and Qods hospitals, in the period July 2013 to December 2015 were studied. Information of 220 patients was collected. Continuous variables were summarized as means ± standard deviation and categorical variables as frequencies and percentages. Lumbar puncture (LP in patients was delayed in 200 cases (91%. Most common causes of delay in performing LP were prolongation of the process of determining patient needs to puncture, satisfying patients, CT scan delay and the delay in allowing LP by neurologist. In this study, delaying LP rate was higher than other studies. It seems certain pattern in assistants’ visits for counseling. CT requests and neurologic consultation before LP performed for all adult patients.

  1. Restricting minimum size of DGs to confirm correct operation of fast directional protection switches in their simultaneous allocation with DGs

    International Nuclear Information System (INIS)

    Dorkhosh, Seyed Salman; Samet, Haidar

    2015-01-01

    Highlights: • Simultaneous allocation of DGs and fast directional protection switches (FPDSs) is made. • A protection constraint is proposed which restricts the allowable size of DGs. • The proposed constraint ensures the correct operation of upstream installed FDPS in all conditions. - Abstract: This paper presents simultaneous allocation of distributed generations (DGs) and fast directional protection switches (FDPSs) to decrease energy losses and enhance reliability of the network. The main contribution of the paper is restricting the allowable size of DGs to ensure the correct operation of upstream installed FDPS in all conditions. The paper introduces a method based on genetic algorithm to solve the optimization problem. Finally, to confirm the effectiveness of the proposed method some simulations considering a 33 bus test network are performed. The optimization problem with and without applying protection constraint is solved. Customer’s load is modeled by a three level yearly load. Time value of money and load growth rate are also considered. To assess the importance of the proposed protection constraint, fault studies after adding DGs and FDPSs to a 33 bus test network are performed. Results confirm the importance of the proposed protection constraint

  2. Causal relationships between energy consumption, foreign direct investment and economic growth: Fresh evidence from dynamic simultaneous-equations models

    International Nuclear Information System (INIS)

    Omri, Anis; Kahouli, Bassem

    2014-01-01

    This paper examines the interrelationships between energy consumption, foreign direct investment and economic growth using dynamic panel data models in simultaneous-equations for a global panel consisting of 65 countries. The time component of our dataset is 1990–2011 inclusive. To make the panel data analysis more homogenous, we also investigate this interrelationship for a number of sub-panels which are constructed based on the income level of countries. In this way, we end up with three income panels; namely, high income, middle income, and low income panels. In the empirical part, we draw on the growth theory and augment the classical growth model, which consists of capital stock, labor force and inflation, with foreign direct investment and energy. Generally, we show mixed results about the interrelationship between energy consumption, FDI and economic growth. - Highlights: • We examine the energy–FDI–growth nexus for a global panel of 65 countries. • Dynamic simultaneous-equation panel data models are used to address this issue. • We also investigate this nexus for three sub-panels which are constructed based on the income level of countries. • We show mixed results about the interrelationship between the three variables

  3. Evaluation of pancreatic tissue fluid pressure measurements intraoperatively and by sonographically guided fine-needle puncture

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J

    1990-01-01

    pressure measurements via direct puncture. Furthermore, no significant difference was seen between pancreatic duct and tissue fluid pressure. The technical evaluation was performed by repeated pressure measurements in human pancreatic autopsy specimens and living rats in a pressure chamber at various...

  4. Perspectives on How Human Simultaneous Multi-Modal Imaging Adds Directionality to Spread Models of Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Julia Neitzel

    2018-01-01

    Full Text Available Previous animal research suggests that the spread of pathological agents in Alzheimer’s disease (AD follows the direction of signaling pathways. Specifically, tau pathology has been suggested to propagate in an infection-like mode along axons, from transentorhinal cortices to medial temporal lobe cortices and consequently to other cortical regions, while amyloid-beta (Aβ pathology seems to spread in an activity-dependent manner among and from isocortical regions into limbic and then subcortical regions. These directed connectivity-based spread models, however, have not been tested directly in AD patients due to the lack of an in vivo method to identify directed connectivity in humans. Recently, a new method—metabolic connectivity mapping (MCM—has been developed and validated in healthy participants that uses simultaneous FDG-PET and resting-state fMRI data acquisition to identify directed intrinsic effective connectivity (EC. To this end, postsynaptic energy consumption (FDG-PET is used to identify regions with afferent input from other functionally connected brain regions (resting-state fMRI. Here, we discuss how this multi-modal imaging approach allows quantitative, whole-brain mapping of signaling direction in AD patients, thereby pointing out some of the advantages it offers compared to other EC methods (i.e., Granger causality, dynamic causal modeling, Bayesian networks. Most importantly, MCM provides the basis on which models of pathology spread, derived from animal studies, can be tested in AD patients. In particular, future work should investigate whether tau and Aβ in humans propagate along the trajectories of directed connectivity in order to advance our understanding of the neuropathological mechanisms causing disease progression.

  5. Puncture resistance of Type B transport systems

    International Nuclear Information System (INIS)

    Rack, H.J.; Cheresh, M.C.

    1980-01-01

    This report describes a recent attempt to develop a test method for use in screening materials and for evaluating the effects of certain parameters, for example section stiffness, on container penetration resistance. In addition, it illustrates the application of this procedure to the selection of a sheet steel for a transuranic waste (TRUPACT) container. The test consists of penetrating a specimen, normally 0.6 m square, with a punch (tup) attached to a falling weight and recording and analyzing the force-time history to determine the energy absorption during the impact event. The test as developed simulates certain aspects of the 10CFR71 drop test in order to provide a means of comparing, for example, the penetrating resistance of various steels, this resistance being defined as the energy required to initiate fracture in the specimen. In summary, this examination suggests that it should be possible to develop a laboratory test to rank and select materials for maximum puncture resistance. Although the initial results appear promising, more effort will be required before this procedure can be routinely applied to examining the various factors which control the puncture resistance of these materials. These results do, nonetheless, show that high-strength, low-alloy steels do offer significant advantages over mild steel for container penetration protection. Indeed, one of these steels, NAX-80, is presently considered as a prime candidate for the TRUPACT container being developed at Sandia National Laboratories

  6. C6 plate puncture testing report.

    Energy Technology Data Exchange (ETDEWEB)

    Vangoethem, Douglas J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cordova, Theresa Elena [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reu, Phillip L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2013-04-01

    There are numerous scenarios where critical systems could be subject to penetration by projectiles or fixed objects (e.g., collision, natural disaster, act of terrorism, etc.). It is desired to use computational models to examine these scenarios and make risk-informed decisions; however, modeling of material failure is an active area of research, and new models must be validated with experimental data. The purpose of this report is to document the experimental work performed from FY07 through FY08 on the Campaign Six Plate Puncture project. The goal of this project was to acquire experimental data on the puncture and penetration of metal plates for use in model validation. Of particular interest is the PLH failure model also known as the multilinear line segment model. A significant amount of data that will be useful for the verification and validation of computational models of ductile failure were collected during this project were collected and documented herein; however, much more work remains to be performed, collecting additional experimental data that will further the task of model verification.

  7. Cerebrospinal fluid loss at lumbar puncture for caesarean section ...

    African Journals Online (AJOL)

    Background Post dural puncture headache (PDPH) is an unpleasant complication of spinal anaesthesia. Several studies have attempted explanation of its pathophysiology. A widely held view is that it results from loss of cerebrospinal fluid volume resulting from leak following a hole left in the dura after the puncture.

  8. Punctured Parallel Viterbi Decoding Of Long Constraint Length ...

    African Journals Online (AJOL)

    This paper considers puncturing applied to the parallel Viterbi decoding of long constraint length convolutional codes involving partitioning of the basic code. It is shown that the combination of the two techniques of parallel Viterbi decoding and puncturing provides a considerable reduction in decoding complexity, which ...

  9. [Less pain during puncture by a peripheral venous catheter; a bibliographical review on adults].

    Science.gov (United States)

    Prat González, Irene; Fuentes i Pumarola, Concepció; Bertran Noguer, Carme; Ballester Ferrando, David; Juvinyà Canal, Dolors; Vila Vidal, Dalmau

    2010-06-01

    Canalizing veins is a habitual technique carried out by nurses. Inserting a catheter in a peripheral vein causes pain. The importance of fine quality in nursing treatment implicitly bears on a person's well-being. In daily practice, health professionals do not use any method to reduce pain when inserting a catheter. The authors observations led them to believe in the need to carry out a bibliographical review whose objective was to discover all the methods used to reduce pain caused by puncturing a peripheral vein. Six randomly assigned clinical tests and a meta-analysis evaluate the effectiveness of: The use of Valsalva, an analgesic cream which contains two local amino-amide anesthetics; lidocaine and prylocaine (EMLA) compared to another analgesic cream, Myolaxin; a meta-analysis of twenty studies evaluates the degree by which pain is diminished by one such method: an EMLA cream; an anti-inflammatory skin dressing (diclofenaco), a diclofenaco dressing versus an EMLA anesthetic dressing, 0.25 ml subcutaneous injection of 1% mepivaína, an amida type local anesthetic; and direct photography moments before puncture occurs to use the effects of a flash of light. All these methods studied proved effective in reducing pain. Creams and dressing prove to be unaggressive methods but require some time for application prior to puncture. Using a camera flash, subcutaneous injection of mepivacaine and the application of Valsalva can be effective alternatives to reduce pain when puncturing veins in patients who require emergency care.

  10. Simultaneous determination of alkyl mesilates and alkyl besilates in finished drug products by direct injection GC/MS.

    Science.gov (United States)

    Wollein, Uwe; Schramek, Nicholas

    2012-01-23

    We report a specific, fast and feasible method for the simultaneous determination of methyl mesilate (MMS), ethyl mesilate (EMS), isopropyl mesilate (IMS), methyl besilate (MBS) and ethyl besilate (EBS) in finished drug products by GC/MS. Sample preparation was carried out by liquid extraction. The analytes were directly injected into the chromatographic system and quantified with the internal standard method using methyl tosylate (MTS) as internal standard (ISTD). The method gives excellent sensitivity for all the alkyl and aryl esters at typical target analyte level, according to the acceptance criteria that are described in the Guideline on the Limits of Genotoxic Impurities which has been issued in 2007 by the European Medicines Agency (EMA). The average recovery for methanesulfonic acid esters (mesilates) was not lower than 71%, for benzenesulfonic acid esters (besilates) not lower than 94%. A linear range with R² ≥ 0.9998 has been established for concentrations between 0.01 and 1.33 μg/ml. Validation of the method was carried out on a sample matrix containing MMS, EMS, IMS, MBS and EBS at relevant levels and was further confirmed on finished products containing APIs as mesilate salts (Bromocriptine mesilate, Doxazosin mesilate). Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Simultaneous Profiling of Lysoglycerophospholipids in Rice (Oryza sativa L.) Using Direct Infusion-Tandem Mass Spectrometry with Multiple Reaction Monitoring.

    Science.gov (United States)

    Lim, Dong Kyu; Mo, Changyeun; Long, Nguyen Phuoc; Kim, Giyoung; Kwon, Sung Won

    2017-03-29

    White rice is the final product after the hull and bran layers have been removed during the milling process. Although lysoglycerophospholipids (lysoGPLs) only occupy a small proportion in white rice, they are essential for evaluating rice authenticity and quality. In this study, we developed a high-throughput and targeted lipidomics approach that involved direct infusion-tandem mass spectrometry with multiple reaction monitoring to simultaneously profile lysoGPLs in white rice. The method is capable of characterizing 17 lysoGPLs within 1 min. In addition, unsupervised and supervised analyses exhibited a considerably large diversity of lysoGPL concentrations in white rice from different origins. In particular, a classification model was built using identified lysoGPLs that can differentiate white rice from Korea, China, and Japan. Among the discriminatory lysoGPLs, for the lysoPE(16:0) and lysoPE(18:2) compositions, there were relatively small within-group variations, and they were considerably different among the three countries. In conclusion, our proposed method provides a rapid, high-throughput, and comprehensive format for profiling lysoGPLs in rice samples.

  12. Direct and simultaneous detection of organic and inorganic ingredients in herbal powder preparations by Fourier transform infrared microspectroscopic imaging.

    Science.gov (United States)

    Chen, Jian-Bo; Sun, Su-Qin; Tang, Xu-Dong; Zhang, Jing-Zhao; Zhou, Qun

    2016-08-05

    Herbal powder preparation is a kind of widely-used herbal product in the form of powder mixture of herbal ingredients. Identification of herbal ingredients is the first and foremost step in assuring the quality, safety and efficacy of herbal powder preparations. In this research, Fourier transform infrared (FT-IR) microspectroscopic identification method is proposed for the direct and simultaneous recognition of multiple organic and inorganic ingredients in herbal powder preparations. First, the reference spectrum of characteristic particles of each herbal ingredient is assigned according to FT-IR results and other available information. Next, a statistical correlation threshold is determined as the lower limit of correlation coefficients between the reference spectrum and a larger number of calibration characteristic particles. After validation, the reference spectrum and correlation threshold can be used to identify herbal ingredient in mixture preparations. A herbal ingredient is supposed to be present if correlation coefficients between the reference spectrum and some sample particles are above the threshold. Using this method, all kinds of herbal materials in powder preparation Kouqiang Kuiyang San are identified successfully. This research shows the potential of FT-IR microspectroscopic identification method for the accurate and quick identification of ingredients in herbal powder preparations. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Simultaneous multislice magnetic resonance fingerprinting (SMS-MRF) with direct-spiral slice-GRAPPA (ds-SG) reconstruction.

    Science.gov (United States)

    Ye, Huihui; Cauley, Stephen F; Gagoski, Borjan; Bilgic, Berkin; Ma, Dan; Jiang, Yun; Du, Yiping P; Griswold, Mark A; Wald, Lawrence L; Setsompop, Kawin

    2017-05-01

    To develop a reconstruction method to improve SMS-MRF, in which slice acceleration is used in conjunction with highly undersampled in-plane acceleration to speed up MRF acquisition. In this work two methods are employed to efficiently perform the simultaneous multislice magnetic resonance fingerprinting (SMS-MRF) data acquisition and the direct-spiral slice-GRAPPA (ds-SG) reconstruction. First, the lengthy training data acquisition is shortened by employing the through-time/through-k-space approach, in which similar k-space locations within and across spiral interleaves are grouped and are associated with a single set of kernel. Second, inversion recovery preparation (IR prepped), variable flip angle (FA), and repetition time (TR) are used for the acquisition of the training data, to increase signal variation and to improve the conditioning of the kernel fitting. The grouping of k-space locations enables a large reduction in the number of kernels required, and the IR-prepped training data with variable FA and TR provide improved ds-SG kernels and reconstruction performance. With direct-spiral slice-GRAPPA, tissue parameter maps comparable to that of conventional MRF were obtained at multiband (MB) = 3 acceleration using t-blipped SMS-MRF acquisition with 32-channel head coil at 3 Tesla (T). The proposed reconstruction scheme allows MB = 3 accelerated SMS-MRF imaging with high-quality T 1 , T 2 , and off-resonance maps, and can be used to significantly shorten MRF acquisition and aid in its adoption in neuro-scientific and clinical settings. Magn Reson Med 77:1966-1974, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  14. Retrograde vs. Antegrade Puncture for Infra-Inguinal Angioplasty

    International Nuclear Information System (INIS)

    Nice, C.; Timmons, G.; Bartholemew, P.; Uberoi, R.

    2003-01-01

    This study was done to compare antegrade punctures with a retrograde puncture technique for infrainguinal angioplasty. A group of 100 consecutive patients (71 men, 29 women) were randomized for antegrade puncture or retrograde puncture of the common femoral artery. Following retrograde puncture the guidewire was 'turned' and placed into the superficial femoral artery. The time for gaining access, screening time, radiation dose, patient height, weight and complications were recorded. All patients were reviewed the day after the procedure and within 3 months. Data from 46 patients (34 males and 12 females) in the retrograde group and 44 (28 males and 16 females) in the antegrade group were available for analysis. Mean procedure time,screening time, radiation dose, height and weight were 8.3 minutes(range 3-22), 2.1 minutes (0.3-6.5), 7950 mGy cm -2 (820-71250), 169 cm (149-204) and 79 kg (32-108) for retrograde puncture and 8 min (2-60), 0.7 min (0.0-3.2), 1069 mGycm -2 (0-15400), 169 cm (152-186) and 75 kg (39-125) for antegrade punctures, respectively. An average of 1.2 (1-2) punctures was required for retrograde and 1.75 (1-8) for antegrade. Seven small hematomas occurred with antegrade and three for retrograde puncture.Retrograde puncture is technically easier with a tendency to fewer complications but results in a higher radiation dose. This technique should be used in difficult patients at high risk of haematoma formation

  15. Semi-analytical approach to estimate railroad tank car shell puncture

    Science.gov (United States)

    2011-03-16

    This paper describes the development of engineering-based equations to estimate the puncture resistance of railroad tank cars under a generalized shell or side impact scenario. Resistance to puncture is considered in terms of puncture velocity, which...

  16. Computed-Tomography-Guided Punctures Using a New Guidance Device

    International Nuclear Information System (INIS)

    Magnusson, A.; Radecka, E.; Loennemark, M.; Raland, H.

    2005-01-01

    PURPOSE: To evaluate a new adjunctive guidance device, a puncture guide, constructed to simplify computed tomography (CT)-guided punctures and to make the procedure more accurate and safe. MATERIAL AND METHODS: 17 patients referred for CT-guided punctures were included in the study. There were 10 thoracic and 7 abdominal or pelvic lesions with a mean maximum diameter of 29 ± 18 mm. All punctures were performed using a laser guide combined with the new device. The needle guide created a streak artefact in the image, indicating the needle path. RESULTS: The puncture was successful at the first attempt in 15 of the 17 patients. The artefact was visible in all patients, and in the majority there was a distinct artefact reaching from the entry point to the lesion. The deviation between the angle of the streak artefact and the final angle of the needle was 1.1 degrees. CONCLUSION: The benefits of the puncture guide were the artefact pointing at the target, the needle support, and accuracy when performing CT-guided punctures

  17. Simultaneous retrieval of aerosol and surface optical properties from combined airborne- and ground-based direct and diffuse radiometric measurements

    Directory of Open Access Journals (Sweden)

    C. K. Gatebe

    2010-03-01

    Full Text Available This paper presents a new method for simultaneously retrieving aerosol and surface reflectance properties from combined airborne and ground-based direct and diffuse radiometric measurements. The method is based on the standard Aerosol Robotic Network (AERONET method for retrieving aerosol size distribution, complex index of refraction, and single scattering albedo, but modified to retrieve aerosol properties in two layers, below and above the aircraft, and parameters on surface optical properties from combined datasets (Cloud Absorption Radiometer (CAR and AERONET data. A key advantage of this method is the inversion of all available spectral and angular data at the same time, while accounting for the influence of noise in the inversion procedure using statistical optimization. The wide spectral (0.34–2.30 μm and angular range (180° of the CAR instrument, combined with observations from an AERONET sunphotometer, provide sufficient measurement constraints for characterizing aerosol and surface properties with minimal assumptions. The robustness of the method was tested on observations made during four different field campaigns: (a the Southern African Regional Science Initiative 2000 over Mongu, Zambia, (b the Intercontinental Transport Experiment-Phase B over Mexico City, Mexico (c Cloud and Land Surface Interaction Campaign over the Atmospheric Radiation Measurement (ARM Central Facility, Oklahoma, USA, and (d the Arctic Research of the Composition of the Troposphere from Aircraft and Satellites (ARCTAS over Elson Lagoon in Barrow, Alaska, USA. The four areas are dominated by different surface characteristics and aerosol types, and therefore provide good test cases for the new inversion method.

  18. Simultaneous determination of mercury and organic carbon using a direct mercury analyzer: Mercury profiles in sediment cores from oxbow lakes in the Mississippi Delta

    Science.gov (United States)

    Sediment cores from seasonal wetland and open water areas from six oxbow lakes in the Mississippi River alluvial flood plain were analyzed for total-mercury (Hg) using a direct mercury analyzer (DMA). In the process we evaluated the feasibility of simultaneously determining organic matter content by...

  19. Kit for performing puncture test on HV insulators

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, O.B.; Mello, D.R.; Cerqueira, W.R.; Alvarenga, E. [CEPEL, Rio de Janeiro, RJ (Brazil)

    1997-12-31

    A compact and easy way to handle puncture tests in high voltage electrical equipment was introduced. The characteristics of the main components of a new type of kit and some examples of its application were described. It is necessary to perform puncture tests on insulators used to support line conductors and to keep the necessary clearances between conductors and the tower. A puncture test is conducted by stressing the insulator with steep and short duration high voltage impulses. The special kit to handle the puncture tests was developed at CEPEL`s high voltage laboratory for performing tests up to 500 kV peak. The kit is composed of dry and compressed air insulated sphere gap, a very fast resistive divider and a structure which makes it easier to connect to conventional high voltage impulse generators. 3 refs., 1 tab., 7 figs.

  20. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  1. EXIT Chart Aided Design of Periodically Punctured Turbo Codes

    OpenAIRE

    Babich, F.; Crismani, A.; Maunder, R. G.

    2010-01-01

    EXtrinsic Information Transfer (EXIT) charts have proved to be an effective tool for studying the convergence behaviour of iterative decoders. However, classical EXIT chart analysis fails to assess the performance of turbo codes in which the systematic bits are punctured periodically. In this letter, a novel 3-Dimensional (3D) EXIT chart technique is proposed for accurately modeling the convergence behaviour of turbo codes that are punctured following a periodic pattern. Finally, the novel 3D...

  2. Bilateral subdural hematoma secondary to accidental dural puncture

    OpenAIRE

    Ramírez, Sofía; Gredilla, Elena; Martínez, Blanca; Gilsanz, Fernando

    2015-01-01

    We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medic...

  3. Direct reciprocity stabilizes simultaneous hermaphroditism at high mating rates: A model of sex allocation with egg trading.

    Science.gov (United States)

    Henshaw, Jonathan M; Kokko, Hanna; Jennions, Michael D

    2015-08-01

    Simultaneous hermaphroditism is predicted to be unstable at high mating rates given an associated increase in sperm competition. The existence of reciprocal egg trading, which requires both hermaphroditism and high mating rates to evolve, is consequently hard to explain. We show using mathematical models that the presence of a trading economy creates an additional fitness benefit to egg production, which selects for traders to bias their sex allocation toward the female function. This female-biased sex allocation prevents pure females from invading a trading population, thereby allowing simultaneous hermaphroditism to persist stably at much higher levels of sperm competition than would otherwise be expected. More generally, our model highlights that simultaneous hermaphroditism can persist stably when mating opportunities are abundant, as long as sperm competition remains low. It also predicts that reciprocity will select for heavier investment in the traded resource. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  4. Teaching Health Care Students the Radial Arterial Puncture Procedure.

    Science.gov (United States)

    Collins, Kevin P; Russian, Christopher J; Gonzales, Joshua F

    2016-01-01

    The radial artery puncture is a frequently ordered medical procedure for patients requiring blood gas analysis. Deviating from the proper procedure increases the likelihood of error and jeopardizes patient safety. The teaching methodology for the radial artery puncture is rarely addressed in the medical literature. First-year respiratory care students enrolled in a clinical practice course participated in an expanded curriculum on arterial puncture technique. The new five-step curriculum included: 1) a face-to-face lecture, 2) radial artery localization, 3) blunt-tipped needle simulation, 4) manikin arm puncture, and 5) a peer assessment video. Students participated in an inter-rater reliability exercise for step five. The multi-step process for teaching the arterial puncture stressed process over outcome. Students were required to master each step with a satisfactory evaluation to successfully pass the unit. Students also demonstrated high inter-rater evaluation scores of a peer video of the arterial puncture. Additional research is needed to determine if widespread application of the curriculum across other respiratory care programs and other healthcare disciplines is possible. The detailed report of our new curriculum offers other academic researchers the ability to formally study its usefulness.

  5. Intraarterial digital subtraction angiography after plastic surgery by thin-needle puncture

    Energy Technology Data Exchange (ETDEWEB)

    Langer, M.; Fiegler, W.; Claussen, C.; Koehler, D.; Felix, R.; Hepp, W.

    1984-06-01

    Over the period of a year (1983), 44 intraarterial digital subtraction angiographies (DSA) via direct thin-needle puncture of a vascular bypass or following vascular graft were carried the rough. The only complication that occurred: paravasal injection, was clinically insignificant and could be avoided by a change in the puncture-technique. It was possible to carry through the investigation in out-patients. In all cases, diagnostically useful picture material for a possible surgical intervention was obtained. The pictures always were high-grade, independently of the patient's circulation time. Because this is a simple investigation and because of the small risk of complications, it has come to be regularly carried through as a routine in the authors' clinic. According to investigations carried through on the collective of patients of a vascular surgery department, occlusions or anastomotic aneurismus account for most of the angiological disorders.

  6. Intraarterial digital subtraction angiography after plastic surgery by thin-needle puncture

    International Nuclear Information System (INIS)

    Langer, M.; Fiegler, W.; Claussen, C.; Koehler, D.; Felix, R.; Hepp, W.

    1984-01-01

    Over the period of a year (1983), 44 intraarterial digital subtraction angiographies (DSA) via direct thin-needle puncture of a vascular bypass or following vascular graft were carried the rough. The only complication that occured: paravasal injection, was clinically insignificant and could be avoided by a change in the puncture-technique. It was possible to carry through the investigation in out-patients. In all cases, diagnostically useful picture material for a possible surgical intervention was obtained. The pictures always were high-grade, independently of the patient's circulation time. Because this is a simple investigation and because of the small risk of complications, it has come to be regularly carried through as a routine in the authors' clinic. According to investigations carried through on the collective of patients of a vascular surgery department, occlusions or anastomotic aneurismus account for most of the angiological disorders. (orig.) [de

  7. Study of DSA-guided percutaneous puncture location of foramen oval

    International Nuclear Information System (INIS)

    Zhao Xiaojun; He Jiawei; Bai Guanghui; Shi Jianjing; Xu Chongyong; Zhan Gonghao

    2008-01-01

    Objective: To study the technique of digital substraction angiography (DSA)-guided percutaneous puncture location of foramen oval. Methods: 39 cases of trigeminal neuralgia were included in the study from Feb. 2004 to Oct. 2006. The patients were punctured by the amending anterior position. The f0ramen oval was displayed by moving the tube tilted 20-28 degree to the caudal and 16-23 degree to the healthy side. The direction and depth of the needles was determined on the lateral view. Then, radio-frequency thermocoagulation therapy was performed. Results: The needles were located in oval foramen in all the patients. Pain disappeared in 36 cases, alleviated in other cases, and no serious complication occurred during therapy. Conclusions: Oval foramen locations by DSA can improve the successful rate of operation. The foramen oval can be clearly displayed by DSA-guided in amending position, with comfortable position for patients. (authors)

  8. Simultaneous direct detection of Shiga-toxin producing Escherichia coli (STEC) strains by gold nanoparticle optical sensing

    Science.gov (United States)

    Shiga-toxin producing Escherichia coli (STEC) strains (“Big Six” – O26, O45, O103, O111, O121, O145, and O157) represent significant groups of pathogens responsible for foodborne diseases. The objective of this study was to develop a colorimetric optical sensing assay that can simultaneously detect ...

  9. Complications of the lateral C1-C2 puncture myelography for cervical spinal canal

    International Nuclear Information System (INIS)

    Mihale, J.; Traubner, P.

    1998-01-01

    This reviewed the complications of 106 patients of the lateral C1-C2 puncture myelography for cervical spinal canal and cervical spinal cord disorders. Spinal cord puncture and contrast injection, puncture between the occiput and C1, and blood vessel puncture were the main complications. These principally depended on the misdirection of the X ray beam. For preventing major arterial puncture determined the pathway of the vertebral arteries and incidence of anomaly. (authors)

  10. Pre-puncture ultrasound guided epidural insertion before vaginal delivery.

    Science.gov (United States)

    Nassar, Mahmoud; Abdelazim, Ibrahim A

    2015-10-01

    Palpation method is widely used in clinical practice to identify the puncture site during combined spinal-epidural (CSE) blocks. Tuffier's line, is an anatomical landmark between two iliac crests (inter-cristal), which is widely used to identify the puncture site during CSE blocks is not always an indicator for specific vertebral level or inter-vertebral space. One hundred and Ten (110) women were scheduled for normal vaginal delivery and were randomized into two equal groups; palpation group and an ultrasound guided group to detect the efficacy of puncture ultrasound before CSE blocks to increase chances of successful CSE procedure on the first attempt and to reduce the number of attempts or punctures during insertion of CSE catheter. There were no significant differences between two studied groups regarding; maternal age, weight and height, while, there was a significant difference between two studied groups regarding; parity. Percentage of successful CSE procedure on the first attempt was significantly higher (67.27%) in ultrasound compared to palpation group (40%). Number of punctures (attempts) were significantly less in ultrasound (1.2 ± 0.6) compared to palpation group (2.3 ± 0.8) and the number of redirections was also significantly less in ultrasound (1.4 ± 0.5) compared to palpation group (2.8 ± 1.6). Although, time to identify puncture site was significantly longer in ultrasound compared to palpation group and total procedure time was longer in ultrasound (9.1 ± 1.5 min) compared to palpation group (6.2 ± 1.2 min), there was no significant difference between two studied groups regarding; time to identify puncture site and total procedure time. Two cases of dural puncture in palpation versus no cases in ultrasound group and two cases of intravascular catheter placement (one in each group), with no significant difference between two groups. Pre- puncture ultrasound guided epidural insertion before vaginal delivery, increases the chance of a

  11. Relativistic hydrodynamics in the presence of puncture black holes

    International Nuclear Information System (INIS)

    Faber, Joshua A.; Etienne, Zachariah B.; Shapiro, Stuart L.; Taniguchi, Keisuke; Baumgarte, Thomas W.

    2007-01-01

    Many of the recent numerical simulations of binary black holes in vacuum adopt the moving puncture approach. This successful approach avoids the need to impose numerical excision of the black hole interior and is easy to implement. Here we wish to explore how well the same approach can be applied to moving black hole punctures in the presence of relativistic hydrodynamic matter. First, we evolve single black hole punctures in vacuum to calibrate our Baumgarte-Shapiro-Shibata-Nakamura implementation and to confirm that the numerical solution for the exterior spacetime is invariant to any junk (i.e., constraint-violating) initial data employed in the black hole interior. Then we focus on relativistic Bondi accretion onto a moving puncture Schwarzschild black hole as a numerical test bed for our high-resolution shock-capturing relativistic hydrodynamics scheme. We find that the hydrodynamical equations can be evolved successfully in the interior without imposing numerical excision. These results help motivate the adoption of the moving puncture approach to treat the binary black hole-neutron star problem using conformal thin-sandwich initial data

  12. Protective materials with real-time puncture detection capability

    Energy Technology Data Exchange (ETDEWEB)

    Hermes, R.E.; Stampfer, J.F. [Los Alamos National Lab., NM (United States); Valdez-Boyle, L.S. [New Mexico Univ., Albuquerque, NM (United States). School of Medicine; Ramsey, D.R. [Paradigm Systems Corp, 1018 100th Place N.E., Bellevue, WA (United States)

    1996-08-01

    The protection of workers from chemical, biological, or radiological hazards requires the use of protective materials that can maintain their integrity during use. An accidental puncture in the protective material can result in a significant exposure to the worker. A five ply material has been developed that incorporates two layers of an electrically conductive polymer sandwiched between three layers of a nonconductive polymer. A normally open circuit that is connected between the conductive layers will be closed by puncturing the material with either a conductive or nonconductive object. This can be used to activate an audible alarm or visual beacon to warn the worker of a breach in the integrity of the material. The worker is not connected to the circuit, and the puncture can be detected in real-time, even when caused by a nonconductor.

  13. A new device of CT-targeted percutaneous punctures

    International Nuclear Information System (INIS)

    Ozdoba, C.

    1990-01-01

    This paper reports on a device for CT-targeted percutaneous punctures. After extensive phantom studies, punctures of vertebral disk space (diskography/nucleotomy) and orbit retrobulbar anesthesia/biopsy were performed in 15 patients. The new device is easy to mount on the CT scanner and does not require additional devices affixed to the patient. Its design and construction permit exact calculation of needle angle and depth, even when the gantry is tilted. Percutaneous biopsies can be performed in approximately 40 minutes. The device is accurate within ±0.5 mm, thereby allowing puncture of even small lesions deep in the orbital cone. Retrobulbar anesthesia can be performed safely in patients with a long myopic bulbus; in nucleotomy, instant control of the instrument's position within the disk space is possible

  14. Side effects after diagnostic lumbar puncture and lumbar iohexol myelography

    International Nuclear Information System (INIS)

    Sand, T.; Stovner, L.J.; Salvesen, R.; Dale, L.

    1987-01-01

    A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n=97) and diagnostic lumbar puncture (n=85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (16 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effets after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent. (orig.)

  15. Rapid Clearance of Lateral Ventricular Hematoma via Frontal Eminence Puncture and Aspiration: A Technical Note.

    Science.gov (United States)

    Li, Zhaojian; Yao, Weicheng; Han, Kun; Lan, Xiaolei; Bo, Yongli

    2017-01-01

    Background  Intraventricular extension of a parenchymal hemorrhage is an independent predictor of poor outcome and might be complicated by delayed hydrocephalus. We describe a method for the rapid and effective removal of a lateral ventricular hematoma via catheter-based puncture and aspiration. Methods  A catheter-based aspiration of a ventricular hematoma via a frontal eminence (FE) puncture was performed in 10 patients with thalamic and ganglionic hemorrhage perforating into the lateral ventricle. Paralleling the long axis of the lateral ventricle, a flexible silicone catheter was moved anteroposteriorly and rotated simultaneously to facilitate clot aspiration and removal. Computed tomography scans before and after surgery were compared for assessment of ventricular clot volume, Graeb score, and the ventriculocranial ratio (VCR). The Glasgow Coma Scale (GCS) score and Glasgow Outcome Scale (GOS) score were assessed at 14 days and 12 months following surgery, respectively. Results  In all 10 patients, catheter-based aspiration resulted in substantial hematoma removal with a clearance rate of 64.9%, a reduced Graeb score by 61.8%, and an elevated GCS score by 52.7%. The procedure was performed safely without occurrence of another hemorrhage, infection, and catheter obstruction in any case. At 12-month follow-up, VCR was reduced by 22.5%, no delayed hydrocephalus occurred, and a favorable outcome with an average GOS of 4.6 was observed in this small cohort of patients. Conclusion  Catheter-based aspiration of a ventricular hematoma via FE puncture rapidly, efficiently, and safely reduced the clot in the ventricular system, prevented delayed hydrocephalus sufficiently, and produced a favorable outcome. Georg Thieme Verlag KG Stuttgart · New York.

  16. Why should we use atraumatic needles in lumbar puncture?

    Directory of Open Access Journals (Sweden)

    Sandro Luiz de Andrade Matas

    2013-09-01

    Full Text Available Diagnostic lumbar puncture is essential to the diagnosis of central nervous system infections, subarachnoid haemorrhage and others neurological diseases. Myeloradicular involvement or life-threatening adverse events due to the procedure are rare, but less severe complications are more frequent. Post-lumbar puncture headache is the most common complication, by spinal fluid leakage due to delayed closure of a dural defect. Therefore, the development of fine needles, with differentiated atraumatic bevel, has contributed to minimize that problem. These generically called atraumatic needles cause less deformation of the dura mater then the Quincke® ones. So, why don't we use these atraumatic needles?

  17. Simultaneous delivery of hydrophobic small molecules and siRNA using Sterosomes to direct mesenchymal stem cell differentiation for bone repair.

    Science.gov (United States)

    Cui, Zhong-Kai; Sun, Justin A; Baljon, Jessalyn J; Fan, Jiabing; Kim, Soyon; Wu, Benjamin M; Aghaloo, Tara; Lee, Min

    2017-08-01

    The use of small molecular drugs with gene manipulation offers synergistic therapeutic efficacy by targeting multiple signaling pathways for combined treatment. Stimulation of mesenchymal stem cells (MSCs) with osteoinductive small molecule phenamil combined with suppression of noggin is a promising therapeutic strategy that increases bone morphogenetic protein (BMP) signaling and bone repair. Our cationic Sterosome formulated with stearylamine (SA) and cholesterol (Chol) is an attractive co-delivery system that not only forms stable complexes with small interfering RNA (siRNA) molecules but also solubilizes hydrophobic small molecules in a single vehicle, for directing stem cell differentiation. Herein, we demonstrate the ability of SA/Chol Sterosomes to simultaneously deliver hydrophobic small molecule phenamil and noggin-directed siRNA to enhance osteogenic differentiation of MSCs both in in vitro two- and three-dimensional settings as well as in a mouse calvarial defect model. These results suggest a novel liposomal platform to simultaneously deliver therapeutic genes and small molecules for combined therapy. Application of phenamil, a small molecular bone morphogenetic protein (BMP) stimulator, combined with suppression of natural BMP antagonists such as noggin is a promising therapeutic strategy to enhance bone regeneration. Here, we present a novel strategy to co-deliver hydrophobic small molecule phenamil and noggin-targeted siRNA via cationic Sterosomes formed with stearylamine (SA) and high content of cholesterol (Chol) to enhance osteogenesis and bone repair. SA/Chol Sterosomes demonstrated high phenamil encapsulation efficiency, supported sustained release of encapsulated drugs, and significantly reduced drug dose requirements to induce osteogenic differentiation of mesenchymal stem cells (MSCs). Simultaneous deliver of phenamil and noggin siRNA in a single vehicle synergistically enhanced MSC osteogenesis and calvarial bone repair. This study suggests

  18. CSF RBC count in successful first-attempt lumbar puncture: the interest of atraumatic needle use.

    Science.gov (United States)

    Renard, Dimitri; Thouvenot, Eric

    2017-12-01

    The objective of this study is to analyze CSF red blood cell (RBC) count from first-attempt lumbar punctures and to analyze parameters associated with first-attempt lumbar punctures and hemorrhagic lumbar puncture. This is a prospective analysis of consecutive patients who underwent lumbar puncture for any reason other than suspected acute subarachnoid hemorrhage. Analyzed parameters were the following: age, indication for lumbar puncture, aPTT ratio, PTT, platelet count, patient's position, needle type (atraumatic/standard), needle diameter, person performing lumbar puncture (medical student/resident/attending physician), number of lumbar levels punctured, necessity of needle repositioning, CSF RBC and white blood cell count, and protein level. Lumbar puncture resulting in RBC count > 5 RBC/mm 2 was classified as hemorrhagic lumbar puncture (different cut-offs were studied: > 5/> 10/> 100/> 500/> 1000 RBC). In total, 169 elective lumbar punctures in 165 different patients were included. First-attempt lumbar puncture occurred in 22% > 5 RBC, in 19.5% > 10 RBC, in 4.5% > 100 RBC, in 3% > 500 RBC, and 1.5% > 1000 RBC count. First-attempt lumbar puncture was associated with non-hemorrhagic lumbar puncture for each of the RBC count cut-offs (OR for non-hemorrhagic lumbar puncture in first-attempt lumbar puncture 2.8, 95% CI 1.4-5.7). The presence of a hemorrhagic disorder (concerning cerebral amyloid angiopathy in all patients) and higher aPTT ratio were associated with hemorrhagic lumbar puncture. Atraumatic needle use was associated with non-hemorrhagic lumbar puncture for RBC count cut-offs ≤ 5 and ≤ 10 RBC (OR for non-hemorrhagic lumbar puncture in atraumatic needle use 2.5 [95% CI 1.3-4.8] and 2.2 [95% CI 1.1-4.4], respectively). First-attempt lumbar puncture and hemorrhagic lumbar puncture were not associated with other parameters. Slightly elevated CSF RBC count after first-attempt lumbar puncture occurs relatively frequently, but is even more

  19. Direct Ethanol Production from Breadfruit Starch (Artocarpus communis Forst. by Engineered Simultaneous Saccharification and Fermentation (ESSF using Microbes Consortium

    Directory of Open Access Journals (Sweden)

    Iftachul Farida

    2015-02-01

    Full Text Available Breadfruit (Artocarpus communis Forst. is one of sources for ethanol production, which has high starch content (89%. Ethanol production from breadfruit starch was conducted by Simultaneous Saccharification and Fermentation (SSF technology using microbes consortium. The aim of the research was to examine a method to produce ethanol by SSF technology using microbes consortium at high yield and efficiency. The main research consisted of two treatments, namely normal SSF and enginereed SSF. The results showed that normal SSF using aeration and agitation during cultivation could produce ethanol at 11.15 ± 0.18 g/L, with the yield of product (Yp/s 0.34 g ethanol/g substrate; and yield of biomass (Yx/s 0.29 g cell/g substrate, respectively. A better result was obtained using engineered SSF in which aeration was stopped after biomass condition has reached the end of the exponential phase. The ethanol produced was 12.75 ± 0.04 g/L, with the yields of product (Yp/s 0.41 g ethanol/g substrate, and the yield of cell (Yx/s 0.09 g cell/g substrate.

  20. Simultaneous light-directed synthesis of mirror-image microarrays in a photochemical reaction cell with flare suppression.

    Science.gov (United States)

    Sack, Matej; Kretschy, Nicole; Rohm, Barbara; Somoza, Veronika; Somoza, Mark M

    2013-09-17

    The use of photolabile protecting groups is a versatile and well-established means of synthesizing high complexity microarrays of biopolymers, such as nucleic acids and peptides, for high-throughput analysis. The synthesis takes place in a photochemical reaction cell which positions the microarray substrate at the focus of the optical system delivering the light and which can be connected to a fluidics system which delivers appropriate reagents to the surface in synchrony with the light exposure. Here we describe a novel photochemical reaction cell which allows for the simultaneous synthesis of microarrays on two substrates. The reaction cell positions both substrates within the limited depth-of-focus of the optical system while maintaining the necessary reagent flow conditions. The resulting microarrays are mirror images of each other but otherwise essentially identical. The new reaction cell doubles the throughput of microarray synthesis without increasing the consumption of reagents. In addition, a secondary flow chamber behind the reaction cell can be filled with an absorbent and index-matching fluid to eliminate reflections from light exiting the reaction cell assembly, greatly reducing unintended light exposure that reduces the sequence fidelity of the microarray probes.

  1. ÉTALE COVERS OF A PUNCTURED p -ADIC DISC

    African Journals Online (AJOL)

    ÉTALE COVERS OF A PUNCTURED p -ADIC DISC. Werner Lütkebohmert, Thorsten Schmechta. Abstract. To view the abstract for this article click on the link below. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.2989/16073600509486124.

  2. Single Puncture Arthrocentesis for the Inflammatory Temporomandibular Joint Disorders

    Directory of Open Access Journals (Sweden)

    Naveen Rao

    2015-01-01

    Conclusions: Arthrocentesis is a simple conservative surgical procedure with minimal inVASion performed to flush the inflamed TMJ. Single puncture arthrocentesis technique with a dual needle device further simplifies the procedure which is evident with significant results. Future studies with larger sample size and longer duration of follow up will test the true efficacy of this technique.

  3. On Railroad Tank Car Puncture Performance: Part I - Considering Metrics

    Science.gov (United States)

    2016-04-12

    This paper is the first in a two-part series on the puncture performance of railroad tank cars carrying hazardous materials in the event of an accident. Various metrics are often mentioned in the open literature to characterize the structural perform...

  4. On Railroad Tank Car Puncture Performance: Part II - Estimating Metrics

    Science.gov (United States)

    2016-04-12

    This paper is the second in a two-part series on the puncture performance of railroad tank cars carrying hazardous materials in the event of an accident. Various metrics are often mentioned in the open literature to characterize the structural perfor...

  5. Routine Cranial Computed Tomography before Lumbar Puncture in ...

    African Journals Online (AJOL)

    Background: Current international guidelines recommend that a cranial computed tomography (CT) be performed on all HIV-positive patients presenting with new onset seizures, before a lumbar puncture (LP) is performed. In the South African setting, however this delay could be life threatening. The present study sought to ...

  6. Complications of lumbar puncture in a child treated for leukaemia

    Energy Technology Data Exchange (ETDEWEB)

    Staebler, Melanie; Delpierre, Isabelle; Damry, Nash; Christophe, Catherine [Children' s University Hospital Queen Fabiola, Department of Medical Imaging, Brussels (Belgium); Azzi, Nadira [Children' s University Hospital Queen Fabiola, Haematology-Oncology Unit, Brussels (Belgium); Sekhara, Tayeb [Children' s University Hospital Queen Fabiola, Department of Neurology, Brussels (Belgium)

    2005-11-01

    Lumbar puncture may lead to neurological complications. These include intracranial hypotension, cervical epidural haematomas, and cranial and lumbar subdural haematomas. MRI is the modality of choice to diagnose these complications. This report documents MRI findings of such complications in a child treated for leukaemia. (orig.)

  7. Lumbar puncture in acute admissions to an adult medical ward

    African Journals Online (AJOL)

    Suspected multiple sclerosis - very rare in. Africa. Methods. From January t6 June 1986, 1,908 patients were admitted to the adult medical wards,. Kamuzu Central Hospital, Lilongwe. Lumbar puncture was considered necessary in 15 I, patients because of a clinical suspicion' of meningitis or subarachnoid haemorrhage. A.

  8. Lumbar Puncture in Brain Abscessor Subdural Empyema: Not an ...

    African Journals Online (AJOL)

    Objective To assess the role of lumbar puncture (LP) in aiding diagnosis and influencing outcome in patients with intracranial brain abscess or subdural empyema. Methods The records of patients admitted with space occupying intracranial infective mass lesions (brain abscess and subdural empyema) to the neurosurgical ...

  9. Complications of lumbar puncture in a child treated for leukaemia

    International Nuclear Information System (INIS)

    Staebler, Melanie; Delpierre, Isabelle; Damry, Nash; Christophe, Catherine; Azzi, Nadira; Sekhara, Tayeb

    2005-01-01

    Lumbar puncture may lead to neurological complications. These include intracranial hypotension, cervical epidural haematomas, and cranial and lumbar subdural haematomas. MRI is the modality of choice to diagnose these complications. This report documents MRI findings of such complications in a child treated for leukaemia. (orig.)

  10. Possibilities of Simultaneous In-Cylinder Reduction of Soot and NOx Emissions for Diesel Engines with Direct Injection

    OpenAIRE

    Wagner, U.; Eckert, P.; Spicher, U.

    2008-01-01

    Up to now, diesel engines with direct fuel injection are the propulsion systems with the highest efficiency for mobile applications. Future targets in reducing CO2 -emissions with regard to global warming effects can be met with the help of these engines. A major disadvantage of diesel engines is the high soot and nitrogen oxide emissions which cannot be reduced completely with only engine measures today. The present paper describes two different possibilities for the sim...

  11. An audit of consent practices and perceptions of lumbar puncture, Botswana inpatient setting experience

    Directory of Open Access Journals (Sweden)

    M.B. King

    2015-06-01

    Conclusion: Contrasting responses between doctors and patients indicates a need for standard consenting practices among doctors. Also, patients’ attitudes and receptiveness to lumbar punctures can be improved through education on lumbar puncture indications, benefits, and risks.

  12. Puncture mechanics of cnidarian cnidocysts: a natural actuator

    Directory of Open Access Journals (Sweden)

    Eddington David T

    2009-09-01

    Full Text Available Abstract Background Cnidocysts isolated from cnidarian organisms are attractive as a drug-delivery platform due to their fast, efficient delivery of toxins. The cnidocyst could be utilized as the means to deliver therapeutics in a wearable drug-delivery patch. Cnidocysts have been previously shown to discharge upon stimulation via electrical, mechanical, and chemical pathways. Cnidocysts isolated from the Portuguese Man O' War jellyfish (Physalia physalis are attractive for this purpose because they possess relatively long threads, are capable of puncturing through hard fish scales, and are stable for years. Results As a first step in using cnidocysts as a functional component of a drug delivery system, the puncture mechanics of the thread were characterized. Tentacle-contained cnidocysts were used as a best-case scenario due to physical immobilization of the cnidocysts within the tentacle. Ex vivo tentacle-contained cnidocysts from Physalia possessed an elastic modulus puncture threshold of approximately 1-2 MPa, based on puncture tests of materials with a gamut of hardness. Also, a method for inducing discharge of isolated cnidocysts was found, utilizing water as the stimulant. Preliminary lectin-binding experiments were performed using fluorophore-conjugated lectins as a possible means to immobilize the isolated cnidocyst capsule, and prevent reorientation upon triggering. Lectins bound homogeneously to the surface of the capsule, suggesting the lectins could be used for cnidocyst immobilization but not orientation. Conclusion Cnidocysts were found to puncture materials up to 1 MPa in hardness, can be discharged in a dry state using water as a stimulant, and bind homogeneously to lectins, a potential means of immobilization. The information gained from this preliminary work will aid in determining the materials and design of the patch that could be used for drug delivery.

  13. Simultaneous measurement of temperature and tensile loading using superstructure FBGs developed by laser direct writing of periodic on-fiber metallic films

    International Nuclear Information System (INIS)

    Alemohammad, Hamidreza; Toyserkani, Ehsan

    2009-01-01

    This paper addresses the development of superstructure fiber Bragg gratings (FBGs) by laser-assisted direct writing of on-fiber metallic films. A novel laser direct write method is characterized to fabricate periodic films of silver nanoparticles on the non-planar surface of as-fabricated FBGs. Silver films with a thickness of 9 µm are fabricated around a Bragg grating optical fiber. The performance of the superstructure FBG is studied by applying temperature and tensile stress on the fiber. An opto-mechanical model is also developed to predict the optical response of the synthesized superstructure FBG under thermal and structural loadings. The results show that the reflectivity of sidebands in the reflection spectrum can be tuned up to 20% and 37% under thermal and structural loadings, respectively. In addition, the developed superstructure FBG is used for simultaneous measurement of force and temperature to eliminate the inherent limitation of regular FBGs in multi-parameter sensing

  14. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    International Nuclear Information System (INIS)

    Hirata, Masaaki; Watanabe, Ryouhei; Koyano, Yasuhiro; Sugata, Shigenori; Takeda, Yukie; Nakamura, Seiji; Akamune, Akihisa; Tsuda, Takaharu; Mochizuki, Teruhito

    2017-01-01

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  15. An inexpensive, simple technique to improve the safety of femoral arterial puncture.

    Science.gov (United States)

    Mehan, Vivek K; Patil, Sachinkumar; Patel, Mehul

    2015-01-01

    We describe a safe and inexpensive technique of avoiding femoral access site complications. Initial fluoroscopic screening of a fully inserted local anesthetic needle helps localize the anticipated arterial puncture site. Repeating fluoroscopy after guide wire insertion through the puncture needle confirms the exact puncture site in the artery. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  16. Using a Motion Sensor-Equipped Smartphone to Facilitate CT-Guided Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Masaaki, E-mail: masaaki314@gmail.com [Matsuyama Shimin Hospital, Department of Radiology (Japan); Watanabe, Ryouhei; Koyano, Yasuhiro [Matsuyama Shimin Hospital, Department of Surgery (Japan); Sugata, Shigenori; Takeda, Yukie [Ehime Prefectural Imabari Hospital, Department of Radiology (Japan); Nakamura, Seiji; Akamune, Akihisa [Matsuyama Shimin Hospital, Department of Radiology (Japan); Tsuda, Takaharu; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Radiology (Japan)

    2017-04-15

    PurposeTo demonstrate the use of “Smart Puncture,” a smartphone application to assist conventional CT-guided puncture without CT fluoroscopy, and to describe the advantages of this application.Materials and MethodsA puncture guideline is displayed by entering the angle into the application. Regardless of the angle at which the device is being held, the motion sensor ensures that the guideline is displayed at the appropriate angle with respect to gravity. The angle of the smartphone’s liquid crystal display (LCD) is also detected, preventing needle deflection from the CT slice image. Physicians can perform the puncture procedure by advancing the needle using the guideline while the smartphone is placed adjacent to the patient. In an experimental puncture test using a sponge as a target, the target was punctured at 30°, 50°, and 70° when the device was tilted to 0°, 15°, 30°, and 45°, respectively. The punctured target was then imaged with a CT scan, and the puncture error was measured.ResultsThe mean puncture error in the plane parallel to the LCD was less than 2°, irrespective of device tilt. The mean puncture error in the sagittal plane was less than 3° with no device tilt. However, the mean puncture error tended to increase when the tilt was increased.ConclusionThis application can transform a smartphone into a valuable tool that is capable of objectively and accurately assisting CT-guided puncture procedures.

  17. Hemosiderin-laden macrophages in the cerebrospinal fluid of a neonate after traumatic lumbar puncture.

    Science.gov (United States)

    Wusthoff, Courtney J; Abend, Nicholas S; Tennekoon, Gihan

    2008-01-01

    Macrophages in cerebrospinal fluid are described as indicators of pathology. We present findings from the lumbar puncture of a child without neurologic disease. Cerebrospinal fluid obtained after an initial, traumatic lumbar puncture attempt included a high proportion of macrophages, some containing erythrocyte fragments and hemosiderin. This suggests that although macrophages may indicate pathology, they can also accumulate after traumatic lumbar puncture.

  18. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

    Gordon, K. L.; Working, D. C.; Wise, K. E.; Bogert, P. B.; Britton, S. M.; Topping, C.C.; Smith, J. Y.; Siochi, E. J.

    2009-01-01

    Self-healing materials provide a route for enhanced damage tolerance in materials for aerospace applications. In particular, puncture-healing upon impact has the potential to mitigate significant damage caused by high velocity micrometeoroid impacts. This type of material also has the potential to improve damage tolerance in load bearing structures to enhance vehicle health and aircraft durability. The materials being studied are those capable of instantaneous puncture healing, providing a mechanism for mechanical property retention in lightweight structures. These systems have demonstrated healing capability following penetration of fast moving projectiles -- velocities that range from 9 mm bullets shot from a gun (approx.330 m/sec) to close to micrometeoroid debris velocities of 4800 m/sec. In this presentation, we report on a suite of polymeric materials possessing this characteristic. Figure 1 illustrates the puncture healing concept. Puncture healing in these materials is dependent upon how the combination of a polymer's viscoelastic properties responds to the energy input resulting from the puncture event. Projectile penetration increases the temperature in the vicinity of the impact. Self-healing behavior occurs following puncture, whereby energy must be transferred to the material during impact both elastically and inelastically, thus establishing two requirements for puncture healing to occur: a.) The need for the puncture event to produce a local melt state in the polymer material and b.) The molten material has to have sufficient melt elasticity to snap back and close the hole. 1,2 Previous ballistic testing studies revealed that Surlyn materials warmed up to a temperature approx.98 C during projectile puncture (3 C higher than it s melting temperature). 1,2 The temperature increase produces a localized flow state and the melt elasticity to snap back thus sealing the hole. Table 1 lists the commercially polymers studied here, together with their physical

  19. Rare patterns of dorsal puncture in Pterostichus oblongopunctatus (Coleoptera: Carabidae

    Directory of Open Access Journals (Sweden)

    Axel Schwerk

    2018-04-01

    Full Text Available Background The carabid beetle species Pterostichus oblongopunctatus is common in different types of forests in Poland and Europe. With respect to this species, some unclarities exist concerning the morphological feature of punctures on the elytra. P. oblongopunctatus has dorsal pits in the third interval of the elytra, the available identification keys, however, provide inconsistent information concerning the puncture in other intervals. During long-term studies at different study sites in Poland, the first author rarely but regularly discovered individuals with unusual dorsal puncture patterns, i.e., pits in the fifth and even in the seventh interval of the elytra. Since such rare patterns might be connected with special habitat characteristics, and thus have a potential as an indicator, the aim of the study was to test if they are connected with specific subpopulations (interaction groups, if they are related to the sex or size of the beetles, and if they are related to specific habitat conditions. Material and Methods We counted the pits on the elytra, determined the sex, and measured the length of the right elytron of individuals of P. oblongopunctatus collected at numerous study sites located within the borders of the Regional Directory of National Forests in Piła (Western Poland over the period 2014–2016. Results Altogether, 1,058 individuals of P. oblongopunctatus were subjected to statistical analysis. Almost 19% of the individuals had a dorsal puncture in the fifth interval of the elytra and about 0.7% had a dorsal puncture in the seventh interval of the elytra. In 2014 and 2015, significantly more females exhibited such unusual patterns of dorsal puncture than males. Even if not statistically significant, in 2016 also relatively more females showed such a pattern. Neither males nor females of the analysed individuals with usual puncture patterns showed a significant difference in the length of the right elytron from those with

  20. Effect of acetate to biomass ratio on simultaneous polyhydroxybutyrate generation and direct microbial growth in fast growing microbial culture.

    Science.gov (United States)

    Biros, Yester; Çokgör, Emine Ubay; Yağcı, Nevin; Pala-Ozkok, Ilke; Çakar, Zeynep Petek; Sözen, Seval; Orhon, Derin

    2014-11-01

    The study investigated the effect of variations in the acetate to biomass ratio on substrate storage potential, and the kinetics of substrate utilization. A series of batch experiments were conducted with biomass taken from the fill and draw reactor operated at a sludge age of 2 d. One of the batch reactors duplicated the substrate loading in the main reactor. The others were started with different initial acetate to biomass ratios both in lower and higher ranges. Increasing available acetate did not totally divert excess substrate to storage; the microbial culture adjusted the kinetics of the metabolic reactions to a higher growth rate so that more substrate could be utilized for direct growth at high acetate levels. Conversely, storage rate was increased, utilizing a higher substrate fraction for polyhydroxybutyrate generation when acetate concentration was lowered. The physiological and molecular bases of storage at low substrate levels were discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Understanding of percutaneous puncture under guidance of ultrasound in treating peritoneal and perinephritic abscess

    International Nuclear Information System (INIS)

    Huang Liying; Wang Jiagang

    2010-01-01

    Objective: To explore the clinical value of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess. Methods: To summarize 68 patients with peritoneal abscess underwent percutaneous puncture under guidance of ultrasound to analyse the method of operation and therapeutic effect. Results: effective power of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess was 96.8%. Conclusion: Percutaneous puncture under guidance of ultrasound in treating peritoneal abscess may avoid injury induced by blinded puncture, with characteristic of easier operation, slighter trauma. higher safety, significant therapeutic effect, and can be spreaded to the clinical application. (authors)

  2. CT-guided needle puncture for diagnosis and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Takashi; Kaji, Tatsumi; Ashida, Hiroshi; Nakajima, Yasuo; Nosaka, Shunsuke; Kuroki, Kazunori; Kurihara, Yasuyuki; Hara, Akihiko; Ishikawa, Tohru

    1987-12-01

    CT-guided needle puncture was performed in 16 aspiration biopsies, 12 nerve neurolysis, 6 percutaneous treatment such as abscess drainage. CT-guidance was better than fluoroscopic or sonographic control, in dealing with small, deeply-located lesions where precise location of needle is inevitable. We used the slotted 20 gauge thin-walled needle for biopsy, 21 or 22-gauge chiba-needle for other purposes. Over-all accuracy was 93.3 % in aspiration biopsies and technical successful rate in nerve neurolysis was 100 %. Only one pneumothorax was noted as a complication. CT-guided needle puncture was safe and exact, especially when fluoroscopic or sonographic guidance was not possible.

  3. Pleural puncture with thoracic epidural: A rare complication?

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2011-01-01

    Full Text Available Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.

  4. [Bilateral subdural hematoma secondary to accidental dural puncture].

    Science.gov (United States)

    Ramírez, Sofía; Gredilla, Elena; Martínez, Blanca; Gilsanz, Fernando

    2015-01-01

    We report the case of a 25-year-old woman, who received epidural analgesia for labour pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Bilateral subdural hematoma secondary to accidental dural puncture.

    Science.gov (United States)

    Ramírez, Sofía; Gredilla, Elena; Martínez, Blanca; Gilsanz, Fernando

    2015-01-01

    We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  6. Use of mutated self-cleaving 2A peptides as a molecular rheostat to direct simultaneous formation of membrane and secreted anti-HIV immunoglobulins.

    Science.gov (United States)

    Yu, Kenneth K; Aguilar, Kiefer; Tsai, Jonathan; Galimidi, Rachel; Gnanapragasam, Priyanthi; Yang, Lili; Baltimore, David

    2012-01-01

    In nature, B cells produce surface immunoglobulin and secreted antibody from the same immunoglobulin gene via alternative splicing of the pre-messenger RNA. Here we present a novel system for genetically programming B cells to direct the simultaneous formation of membrane-bound and secreted immunoglobulins that we term a "Molecular Rheostat", based on the use of mutated "self-cleaving" 2A peptides. The Molecular Rheostat is designed so that the ratio of secreted to membrane-bound immunoglobulins can be controlled by selecting appropriate mutations in the 2A peptide. Lentiviral transgenesis of Molecular Rheostat constructs into B cell lines enables the simultaneous expression of functional b12-based IgM-like BCRs that signal to the cells and mediate the secretion of b12 IgG broadly neutralizing antibodies that can bind and neutralize HIV-1 pseudovirus. We show that these b12-based Molecular Rheostat constructs promote the maturation of EU12 B cells in an in vitro model of B lymphopoiesis. The Molecular Rheostat offers a novel tool for genetically manipulating B cell specificity for B-cell based gene therapy.

  7. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

    Directory of Open Access Journals (Sweden)

    Jin Hyoung Park

    2015-10-01

    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  8. Puncture Self-Healing Polymers for Aerospace Applications

    Science.gov (United States)

    Gordon, Keith L.; Penner, Ronald K.; Bogert, Phil B.; Yost, W. T.; Siochi, Emilie J.

    2011-01-01

    Space exploration launch costs on the order of $10K per pound provide ample incentive to seek innovative, cost-effective ways to reduce structural mass without sacrificing safety and reliability. Damage-tolerant structural systems can provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show great promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to heal instantaneously following projectile penetration while retaining structural integrity. Poly(ethylene-co-methacrylic acid) (EMMA), also known as Surlyn is an ionomer-based copolymer that undergoes puncture reversal (self-healing) following high impact puncture at high velocities. However EMMA is not a structural engineering polymer, and will not meet the demands of aerospace applications requiring self-healing engineering materials. Current efforts to identify candidate self-healing polymer materials for structural engineering systems are reported. Rheology, high speed thermography, and high speed video for self-healing semi-crystalline and amorphous polymers will be reported.

  9. Impact of Corrugated Paperboard Structure on Puncture Resistance

    Directory of Open Access Journals (Sweden)

    Vaidas Bivainis

    2015-03-01

    Full Text Available Thanks to its excellentprotective properties, lightness, a reasonable price, and ecology, corrugated paperboardis one of the most popular materials used in the production of packaging for variousproducts. During transportation or storage, packaging with goods can be exposedto the mass of other commodities, dropping from heights and transportationshock loads, which can lead to their puncture damage. Depending on the purposeand size of the packaging, the thickness, grammage, constituent paper layers,numbers of layers and type of fluting of corrugated paperboard used in itsproduction differ. A standard triangular prism, corrugated paperboard fixationplates and a universal tension-compression machine were used to investigate theimpact of corrugated paperboard structure and other parameters on the punctureresistance of the material. The investigation determines the maximum punctureload and estimates energy required to penetrate the corrugated paperboard. Itwas found that the greatest puncture resistance is demonstrated by paperboardwith a larger number of corrugating flutings and the board produced from harderpaper with a smaller amount of recycled paper. It was established that thegrammage of three-layered paperboard with two different fluting profiles has thegreatest impact on the level of static puncture energy.DOI: http://dx.doi.org/10.5755/j01.ms.21.1.5713

  10. Simultaneous enantiomeric determinations of acid and ester imidazolinone herbicides in a soil sample by two-dimensional direct chiral liquid chromatography.

    Science.gov (United States)

    Polo-Díez, L M; Santos-Delgado, M J; Valencia-Cabrerizo, Y; León-Barrios, Y

    2015-11-01

    A two-dimensional HPLC method for the simultaneous direct chiral enantiomeric determination of acid and ester IMI herbicides has been described. Difficulties arising from differences in polarity were overcome. Firstly, the imazaphyr, imazethapyr and imazamethabenz methyl herbicides were separated in a C18 achiral column. Then, their respective enantiomers were separated using a protein chiral AGP(TM) column; a heart-cut mode was used. Mobile phases of the two systems were compatibilized, after optimizing by factorial design using multiple response analysis. The proposed method has been validated by recovery studies from an enriched soil sample. Important enantiomer parameters such as enantioresolution higher than 1.12, enantiomeric ratio (ER) close to 1 and enantiomeric fraction (EF) around 0.5 were obtained for standards, confirming that herbicides are present as racemates. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Discussion on the method to increase the successful rate of L5/S1 intervertebral disc puncture

    International Nuclear Information System (INIS)

    Zhong Xianyi; Li Liangjun; Yu Chengxin

    2007-01-01

    Objective: To study the effective methods of L 5 /S 1 intervertebral disc puncture without drilling to solve the barriers from iliaca. Methods: (1) puncturing with belly-buttock sticking out: to enlarge waist sacro-iliaca angle to move the puncture point up; (2) puncturing through intervertebral edge: puncturing through L 5 to 1/3 intervertebral disc to make the puncture point move Up; (3) puncturing through L 5 /S 1 intervertebral disc with the self-made puncture location instrument. Results with the methods, 280 cases with L 5 /S 1 intervertebral disc protrusion have been successfully punctured, with successful rate 100%. Conclusion: These methods are ideal and easy to use to treat L 5 /S 1 intervertebral disc protrusion puncture, and worth popularizing. (authors)

  12. Simultaneous quantification of polar and non-polar volatile organic compounds in water samples by direct aqueous injection-gas chromatography/mass spectrometry.

    Science.gov (United States)

    Aeppli, Christoph; Berg, Michael; Hofstetter, Thomas B; Kipfer, Rolf; Schwarzenbach, René P

    2008-02-15

    A direct aqueous injection-gas chromatography/mass spectrometry (DAI-GC/MS) method for trace analysis of 24 volatile organic compounds (VOCs) in water samples is presented. The method allows for the simultaneous quantification of benzene, toluene, ethyl benzene, and xylenes (BTEX), methyl tert-butyl ether (MTBE), tert-butyl alcohol (TBA), as well as a variety of chlorinated methanes, ethanes, propane, enthenes and benzenes. Applying a liquid film polyethylene glycol or a porous layer open tubular (PLOT) divinylbenzene GC capillary column to separate the water from the VOCs, volumes of 1-10 microL aqueous sample are directly injected into the GC. No enrichment or pretreatment steps are required and sample volumes as low as 100 microL are sufficient for accurate quantification. Method detection limits determined in natural groundwater samples were between 0.07 and 2.8 microg/L and instrument detection limits of VOCs. DAI-GC/MS offers both good accuracy and precision (relative standard deviations VOC concentration measurements in a polluted aquifer. The wide range of detectable compounds and the lack of labor-intensive sample preparation illustrate that the DAI method is robust and easily applicable for the quantification of important organic groundwater contaminants.

  13. Direct duplex real-time loop mediated isothermal amplification assay for the simultaneous detection of cow and goat species origin of milk and yogurt products for field use.

    Science.gov (United States)

    Kim, Mi-Ju; Kim, Hae-Yeong

    2018-04-25

    A multiple loop-mediated isothermal amplification (LAMP) method was developed to detect cow and goat milk in the field using a portable fluorescence device. For rapid on-site detection, this duplex LAMP assay was used in combination with direct amplification, without DNA extraction. The cow- and goat-specific LAMP primer sets were designed based on the mitochondrial cytochrome b gene, and showed specificity against 13 other animal species in the reactions. The sensitivity of the duplex LAMP assay for cow and goat was 0.1 and 1 pg, respectively. The detection limit for both target species in milk mixtures was 2%. This assay successfully amplified and identified the two target species in 24 samples of commercial milk and yogurt products, with 30 min sampling-to-result analysis time. Therefore, this direct duplex real-time LAMP assay is useful for on-site simultaneous detection of cow and goat milk in commercial products, a capability needed to confirm accurate labeling. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  15. The effects of needle deformation during lumbar puncture

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Özdemir

    2015-01-01

    Full Text Available Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP. Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1% of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3% of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%. Forty-seven (41.5% patients experienced post lumbar puncture headache (PLPH and 13 (11.5% patients experienced intracranial hypotension (IH. No statistically significant correlation between the degree of deflection and headache was found (P > 0.05. Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

  16. The effects of needle deformation during lumbar puncture

    Science.gov (United States)

    Özdemir, Hasan Hüseyin; Demir, Caner F.; Varol, Sefer; Arslan, Demet; Yıldız, Mustafa; Akil, Eşref

    2015-01-01

    Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH. PMID:25883480

  17. Punctured torus groups and 2-bridge knot groups

    CERN Document Server

    Akiyoshi, Hirotaka; Wada, Masaaki; Yamashita, Yasushi

    2007-01-01

    This monograph is Part 1 of a book project intended to give a full account of Jorgensen's theory of punctured torus Kleinian groups and its generalization, with application to knot theory. Although Jorgensen's original work was not published in complete form, it has been a source of inspiration. In particular, it has motivated and guided Thurston's revolutionary study of low-dimensional geometric topology. In this monograph, we give an elementary and self-contained description of Jorgensen's theory with a complete proof. Through various informative illustrations, readers are naturally led to an intuitive, synthetic grasp of the theory, which clarifies how a very simple fuchsian group evolves into complicated Kleinian groups.

  18. Simultaneous direct determination of aluminum, calcium and iron in silicon carbide and silicon nitride powders by slurry-sampling graphite furnace AAS.

    Science.gov (United States)

    Minami, Hirotsugu; Yada, Masako; Yoshida, Tomomi; Zhang, Qiangbin; Inoue, Sadanobu; Atsuya, Ikuo

    2004-03-01

    A fast and accurate analytical method was established for the simultaneous direct determination of aluminum, calcium and iron in silicon carbide and silicon nitride powders by graphite furnace atomic absorption spectrometry using a slurry sampling technique and a Hitachi Model Z-9000 atomic absorption spectrometer. The slurry samples were prepared by the ultrasonication of silicon carbide or silicon nitride powders with 0.1 M nitric acid. Calibration curves were prepared by using a mixed standard solution containing aluminum, calcium, iron and 0.1 M nitric acid. The analytical results of the proposed method for aluminum, calcium and iron in silicon carbide and silicon nitride reference materials were in good agreement with the reference values. The detection limits for aluminum, calcium and iron were 0.6 microg/g, 0.15 microg/g and 2.5 microg/g, respectively, in solid samples, when 200 mg of powdered samples were suspended in 20 ml of 0.1 M nitric acid and a 10 microl portion of the slurry sample was then measured. The relative standard deviation of the determination of aluminum, calcium and iron was 5 - 33%.

  19. Direct and simultaneous quantification of tannin mean degree of polymerization and percentage of galloylation in grape seeds using diffuse reflectance fourier transform-infrared spectroscopy.

    Science.gov (United States)

    Pappas, Christos; Kyraleou, Maria; Voskidi, Eleni; Kotseridis, Yorgos; Taranilis, Petros A; Kallithraka, Stamatina

    2015-02-01

    The direct and simultaneous quantitative determination of the mean degree of polymerization (mDP) and the degree of galloylation (%G) in grape seeds were quantified using diffuse reflectance infrared Fourier transform spectroscopy and partial least squares (PLS). The results were compared with those obtained using the conventional analysis employing phloroglucinolysis as pretreatment followed by high performance liquid chromatography-UV and mass spectrometry detection. Infrared spectra were recorded in solid state samples after freeze drying. The 2nd derivative of the 1832 to 1416 and 918 to 739 cm(-1) spectral regions for the quantification of mDP, the 2nd derivative of the 1813 to 607 cm(-1) spectral region for the degree of %G determination and PLS regression were used. The determination coefficients (R(2) ) of mDP and %G were 0.99 and 0.98, respectively. The corresponding values of the root-mean-square error of calibration were found 0.506 and 0.692, the root-mean-square error of cross validation 0.811 and 0.921, and the root-mean-square error of prediction 0.612 and 0.801. The proposed method in comparison with the conventional method is simpler, less time consuming, more economical, and requires reduced quantities of chemical reagents and fewer sample pretreatment steps. It could be a starting point for the design of more specific models according to the requirements of the wineries. © 2015 Institute of Food Technologists®

  20. Direct imprinting of indium–tin-oxide precursor gel and simultaneous formation of channel and source/drain in thin-film transistor

    Science.gov (United States)

    Haga, Ken-ichi; Kamiya, Yuusuke; Tokumitsu, Eisuke

    2018-02-01

    We report on a new fabrication process for thin-film transistors (TFTs) with a new structure and a new operation principle. In this process, both the channel and electrode (source/drain) are formed simultaneously, using the same oxide material, using a single nano-rheology printing (n-RP) process, without any conventional lithography process. N-RP is a direct thermal imprint technique and deforms oxide precursor gel. To reduce the source/drain resistance, the material common to the channel and electrode is conductive indium–tin-oxide (ITO). The gate insulator is made of a ferroelectric material, whose high charge density can deplete the channel of the thin ITO film, which realizes the proposed operation principle. First, we have examined the n-RP conditions required for the channel and source/drain patterning, and found that the patterning properties are strongly affected by the cooling rate before separating the mold. Second, we have fabricated the TFTs as proposed and confirmed their TFT operation.

  1. Capillary column switching restricted-access media-liquid chromatography-electrospray ionization-tandem mass spectrometry system for simultaneous and direct analysis of drugs in biofluids.

    Science.gov (United States)

    Santos-Neto, Alvaro J; Markides, Karin E; Sjöberg, Per J R; Bergquist, Jonas; Lancas, Fernando M

    2007-08-15

    Capillary online restricted-access media-liquid chromatography-electrospray ionization-tandem mass spectrometry (RAM-LC-ESI-MS/MS) for direct analysis of drugs and metabolites spiked in biological fluids was developed. Using a column switching setup it was possible to perform effective sample preparation and analysis of raw biological fluids (plasma and urine) without matrix effects in the electrospray mass spectrometric detection step. The peak focusing efficiency of the extraction column was more effective in backflush compared to foreflush mode. The system was able to concentrate diminished samples of polar drugs and their metabolites reaching quantifiable results as low as 1 ng/mL utilizing a sample volume of only 333 nL of biofluids. New column hardware was developed to circumvent clogging problems experienced with plasma injections. The glass fiber filter frit, which is commonly used, was replaced with a short piece of 20 microm i.d. fused silica capillary. The extraction columns were able to handle up to 60 injections and showed a high loading capacity, making the saturation of the MS detector the limiting factor on the linear dynamic range. The simultaneous separation and detection of 10 drugs and metabolites was obtained in 8 min of analysis, including the online sample preparation and enrichment step.

  2. A MEMS-based heating holder for the direct imaging of simultaneous in-situ heating and biasing experiments in scanning/transmission electron microscopes.

    Science.gov (United States)

    Mele, Luigi; Konings, Stan; Dona, Pleun; Evertz, Francis; Mitterbauer, Christoph; Faber, Pybe; Schampers, Ruud; Jinschek, Joerg R

    2016-04-01

    The introduction of scanning/transmission electron microscopes (S/TEM) with sub-Angstrom resolution as well as fast and sensitive detection solutions support direct observation of dynamic phenomena in-situ at the atomic scale. Thereby, in-situ specimen holders play a crucial role: accurate control of the applied in-situ stimulus on the nanostructure combined with the overall system stability to assure atomic resolution are paramount for a successful in-situ S/TEM experiment. For those reasons, MEMS-based TEM sample holders are becoming one of the preferred choices, also enabling a high precision in measurements of the in-situ parameter for more reproducible data. A newly developed MEMS-based microheater is presented in combination with the new NanoEx™-i/v TEM sample holder. The concept is built on a four-point probe temperature measurement approach allowing active, accurate local temperature control as well as calorimetry. In this paper, it is shown that it provides high temperature stability up to 1,300°C with a peak temperature of 1,500°C (also working accurately in gaseous environments), high temperature measurement accuracy (in-situ S/TEM imaging experiments, but also elemental mapping at elevated temperatures using energy-dispersive X-ray spectroscopy (EDS). Moreover, it has the unique capability to enable simultaneous heating and biasing experiments. © 2016 Wiley Periodicals, Inc.

  3. Feasibility of internal standardization in the direct and simultaneous determination of As, Cu and Pb in sugar-cane spirits by graphite furnace atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Caldas, Naise Mary; Ruella Oliveira, Silvana; Anchieta Gomes Neto, Jose

    2009-01-01

    Bismuth and Sb were evaluated as internal standards (IS) to minimize matrix effects on the direct and simultaneous determination of As, Cu, and Pb in cachaca by graphite furnace atomic absorption spectrometry using W-coated platform plus Pd-Mg(NO 3 ) 2 as modifier. For 20 μL injected sample, calibration within the 0.5-10 μg L -1 As, 100-1000 μg L -1 Cu and 0.5-30 μg L -1 Pb intervals were established using the ratios As absorbance to Sb absorbance, Cu absorbance to Bi absorbance and Pb absorbance to Bi absorbance versus analytes concentration, respectively. Typical linear correlations of 0.998, 0.999 and 0.999 were, respectively, obtained. The proposed method was applied for direct determination of As, Cu and Pb in 10 commercial cachaca samples and results were in agreement with those obtained by inductively coupled plasma mass spectrometry at 95% confidence level. The found characteristic masses were 30 pg As, 274 pg Cu and 39 pg Pb. The useful lifetime of the graphite tube was around 760 firings. Recoveries of As, Cu and Pb added to cachaca samples varied, respectively, from 98% to 109%, 97% to 108% and 98% to 104% with internal standards and from 48% to 54%, 53% to 92% and 62% to 97% without internal standards. The limits of detection were 0.13 μg L -1 As, 22 μg L -1 Cu and 0.05 μg L -1 Pb. The relative standard deviations (n = 12) for a spiked sample containing 20 μg L -1 As, Pb and 500 μg L -1 Cu were 1.6%, 1.0%, and 1.8% with IS and 4.3%, 5.2%, and 5.5% without IS

  4. Gelatin model for training ultrasound-guided puncture

    Directory of Open Access Journals (Sweden)

    Alexandre Campos Moraes Amato

    2015-09-01

    Full Text Available BACKGROUND: It is indispensable that members of the medical profession receive the technical training needed to enable them to rapidly obtain effective vascular access. Training procedures should be used judiciously to familiarize students with the technique. However, existing models are expensive or ineffective, and models need to be developed that are similar to what will be encountered in real patients.OBJECTIVES: To demonstrate creation and application of a gelatin model for training ultrasound-guided puncture.METHOS: The model was made using a mixture of colorless gelatin and water in a transparent plastic receptacle with two pairs of orifices of different diameters, through which two plastic tubes were inserted, to simulate blood vessels.RESULTS: The model was a close approximation to the real medical procedure in several aspects, since gelatin has a similar consistency to human tissues, providing a more faithful reproduction of the tactile sensation at the moment when the needle reaches the interior of a vessel and its contents are aspirated.CONCLUSIONS: The method proposed here can be used to easily construct a low-cost model using everyday materials that is suitable for large-scale training of ultrasound-guided puncture.

  5. Revision of Paine's technique for intraoperative ventricular puncture.

    Science.gov (United States)

    Park, Jaechan; Hamm, In-Suk

    2008-11-01

    The aim of this study was to determine the ideal point for a ventricular puncture in pterional craniotomies. Using a circle that had its center around the junction of the columns of the fornix and conforming to the surface of the frontal lobe on an axial computed tomography scan 2.5 cm superior to the lateral orbital roof, we simulated the introduction of a catheter perpendicular to the cortex by drawing the radii of the circle in 70 patients with an acute subarachnoid hemorrhage. The cortical point at which perpendicular puncture provides the best trajectory for ventricular access, traversing the least brain tissue and avoiding important brain structures, such as the head of the caudate nucleus, anterior limb of the internal capsule, and Broca's cortex in the dominant hemisphere, was measured. The new landmark was located at the point 44 +/- 4 mm anterior to the sylvian fissure on the level of 2.5 cm superior to the lateral orbital roof and was consistent regardless of the ventricular dimensions and sex. Clinical trial of the ventriculostomy in 32 patients with a ruptured aneurysm approved the new landmark. An intraoperative ventriculostomy can be performed safely and reliably using the new landmark 2.5 cm superior to the lateral orbital roof and 4.5 cm anterior to the sylvian fissure in aneurysm surgery using a pterional craniotomy.

  6. Binary black hole coalescence in semianalytic puncture evolution

    International Nuclear Information System (INIS)

    Gopakumar, Achamveedu; Schaefer, Gerhard

    2008-01-01

    Binary black hole coalescence is treated semianalytically by a novel approach. Our prescription employs the conservative Skeleton Hamiltonian that describes orbiting Brill-Lindquist wormholes (termed punctures in numerical relativity) within a waveless truncation to the Einstein field equations [G. Faye, P. Jaranowski, and G. Schaefer, Phys. Rev. D 69, 124029 (2004)]. We incorporate, in a transparent Hamiltonian way and in Burke-Thorne gauge structure, the effects of gravitational radiation reaction into the above Skeleton dynamics with the help of 3.5PN accurate angular momentum flux for compact binaries in quasicircular orbits to obtain a semianalytic puncture evolution to model merging black hole binaries. With the help of the TaylorT4 approximant at 3.5PN order, we perform a first-order comparison between gravitational-wave phase evolutions in numerical relativity and our approach for equal-mass binary black holes. This comparison reveals that a modified Skeletonian reactive dynamics that employs flexible parameters will be required to prevent the dephasing between our scheme and numerical relativity, similar to what is pursued in the effective one-body approach. A rough estimate for the gravitational waveform associated with the binary black hole coalescence in our approach is also provided

  7. Emergency medical technician-performed point-of-care blood analysis using the capillary blood obtained from skin puncture.

    Science.gov (United States)

    Kim, Changsun; Kim, Hansol

    2017-12-09

    Comparing a point-of-care (POC) test using the capillary blood obtained from skin puncture with conventional laboratory tests. In this study, which was conducted at the emergency department of a tertiary care hospital in April-July 2017, 232 patients were enrolled, and three types of blood samples (capillary blood from skin puncture, arterial and venous blood from blood vessel puncture) were simultaneously collected. Each blood sample was analyzed using a POC analyzer (epoc® system, USA), an arterial blood gas analyzer (pHOx®Ultra, Nova biomedical, USA) and venous blood analyzers (AU5800, DxH2401, Beckman Coulter, USA). Twelve parameters were compared between the epoc and reference analyzers, with an equivalence test, Bland-Altman plot analysis and linear regression employed to show the agreement or correlation between the two methods. The pH, HCO 3 , Ca 2+ , Na + , K + , Cl - , glucose, Hb and Hct measured by the epoc were equivalent to the reference values (95% confidence interval of mean difference within the range of the agreement target) with clinically inconsequential mean differences and narrow limits of agreement. All of them, except pH, had clinically acceptable agreements between the two methods (results within target value ≥80%). Of the remaining three parameters (pCO 2, pO 2 and lactate), the epoc pCO 2 and lactate values were highly correlated with the reference device values, whereas pO 2 was not. (pCO 2 : R 2 =0.824, y=-1.411+0.877·x; lactate: R 2 =0.902, y=-0.544+0.966·x; pO 2 : R 2 =0.037, y=61.6+0.431·x). Most parameters, except only pO 2 , measured by the epoc were equivalent to or correlated with those from the reference method. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Clinical application of CT-guided percutaneous puncturing biopsy of subcarinal lymph node

    International Nuclear Information System (INIS)

    Yuan Xiaodong; Wang Jianhua; Zuo Changjing; Tian Jianming

    2011-01-01

    Objective: To discuss the safety and clinical significance of CT-guided percutaneous puncturing biopsy of subcarinal lymph node. Methods: During the period of July 2006-July 2010, CT-guided percutaneous puncturing biopsy of subcarinal lymph node was carried out in 17 patients (11 males and 6 females, with an average age of 54 years) with enlarged subcarinal lymph nodes. The clinical data were retrospectively analyzed. Immediately after the puncturing procedure was completed, CT scanning was performed to observe if there any complications and to evaluate the safety of puncturing biopsy. Biopsy specimens were sent for pathological examination to assess the puncturing accuracy and to make the pathologic diagnosis. The clinical usefulness of this technique was evaluated. Results: Of the total 17 cases, successful puncturing into the enlarged subcarinal lymph nodes with single procedure was achieved in 14 and sufficient tissue sample was obtained. The biopsy failed in three cases at initial puncturing procedure as the needle could not be placed into the enlarged subcarinal lymph nodes, the puncturing biopsy had to given up in two patients because of hemoptysis and in another patient the second puncturing biopsy performed one week later was successful. The total technical successful rate was 88.2% (15/17). Of the fifteen cases with successful puncturing, definitive pathological diagnosis was obtained in 13 and the diagnosis was uncertain in the remaining two, with a diagnosis positive rate of 86.7% (13/15). Pathologically, the diagnoses included metastatic lymphadenopathy from lung cancer (n=10), proliferative inflammatory lymphadenopathy (n=2) and tuberculous enlargement of lymph nodes (n=1). Complications occurred in 4 patients (23.5%, 4/17), which mainly were pneumothorax and pulmonary hemorrhage. Conclusion: With high successful rate and diagnostic accuracy, CT-guided percutaneous puncturing biopsy of subcarinal lymph node is a safe and effective technique if the

  9. Simultaneous determination of Cd and Fe in grain products using direct solid sampling and high-resolution continuum source electrothermal atomic absorption spectrometry.

    Science.gov (United States)

    dos Santos, Lisia M G; Araujo, Rennan G O; Welz, Bernhard; Jacob, Silvana do C; Vale, Maria Goreti R; Becker-Ross, Helmut

    2009-04-30

    Cadmium and iron are antagonistic elements in the sense that they produce different effects in the human body. Both elements have to be determined routinely in grain products, cadmium because of its toxicity, and iron because all grain products, according to Brazilian law, have to contain a minimum of 42 mg kg(-1) Fe to combat anemia. A routine screening method has been developed for the quasi simultaneous determination of cadmium and iron using high-resolution continuum source electrothermal atomic absorption spectrometry and direct solid sampling. The primary absorption line at 228.802 nm has been used for Cd, and an adjacent secondary line at 228.726 nm for the determination of Fe. Various chemical modifiers have been investigated, and a mixture of tungsten and iridium, applied as a permanent modifier, showed the best performance; it stabilized Cd up to a pyrolysis temperature of 700 degrees C and did not over-stabilize Fe. Two atomization temperatures were used sequentially, 1700 degrees C for Cd and 2600 degrees C for Fe, because of their significantly different volatilities. The characteristic masses obtained were 0.9 pg for Cd and 1.2 ng for Fe. The limits of detection (3 sigma, n=10) were 0.6 microg kg(-1) for Cd and 0.5 mg kg(-1) for Fe. The relative standard deviation ranged from 3 to 7% for Cd and from 4 to 13% for Fe, which is satisfactory for the purpose. The accuracy of the method was confirmed by the analysis of three certified reference materials; the results were in agreement with the certified values at a 95% confidence interval. The Cd content in the investigated grain products was between 0.9 and 10.5 microg kg(-1), but most of them did not contain the required minimum amount of iron.

  10. Direct and simultaneous determination of 5-aminolaevulinic acid and porphobilinogen in urine by hydrophilic interaction liquid chromatography-electrospray ionisation/tandem mass spectrometry.

    Science.gov (United States)

    Benton, Christopher M; Couchman, Lewis; Marsden, Joanne T; Rees, David C; Moniz, Caje; Lim, Chang Kee

    2012-08-01

    Urinary concentrations of 5-aminolaevulinic acid (ALA) and porphobilinogen (PBG) are elevated in patients with acute hepatic porphyrias, especially during acute attacks. Current assays require lengthy sample pre-treatment and derivatisation steps. We report here a rapid, sensitive and specific hydrophilic interaction liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, for the direct and simultaneous quantitation of ALA and PBG in urine following simple dilution with acetonitrile and centrifugation prior to injection. ALA and PBG were detected using selected reaction monitoring mode, following positive electrospray ionisation. Urine samples (N = 46) from active and latent mutation-confirmed acute hepatic porphyria patients and normal subjects (N = 45) were analysed and the results compared with those of a commercially available spectrophotometric method. The validated calibration range was 3-3000 µmol/L for ALA and 2-2000 µmol/L for PBG. For both analytes, imprecision (relative standard deviation) was less than 5% and accuracy (percentage nominal concentrations) was between 88 and 109%. The lower limit of quantitation was 0.1 μmol/L for both analytes. The calculated LC-MS/MS and spectrophotometric results from patient samples compared well [Pearson correlation (r²) of 0.99 and 0.95, for ALA and PBG, respectively]. The method was successfully applied to the measurement of ALA and PBG in urine samples for the screening, biochemical diagnosis and treatment monitoring of patients with acute hepatic porphyrias. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study

    NARCIS (Netherlands)

    Lirk, P.; Keller, C.; Colvin, J.; Colvin, H.; Rieder, J.; Maurer, H.; Moriggl, B.

    2004-01-01

    The cephalic antebrachial vein is often used for venous access. However, superficial radial arteries of the forearm are known and unintentional arterial puncture can result from attempts to cannulate the lateral veins of the arm. Accidental puncture of a superficial radial artery during peripheral

  12. Punctured Scheduling for Critical Low Latency Data on a Shared Channel with Mobile Broadband

    DEFF Research Database (Denmark)

    Pedersen, Klaus I.; Gerardino, Guillermo Andrés Pocovi; Steiner, Jens

    2017-01-01

    In this paper, we present a punctured scheduling scheme for efficient transmission of low latency communication (LLC) traffic, multiplexed on a downlink shared channel with enhanced mobile broadband traffic (eMBB). Puncturing allows to schedule eMBB traffic on all shared channel resources, without...

  13. Analysis of the indications for routine lumbar puncture and results of ...

    African Journals Online (AJOL)

    Lumbar puncture (LP) is an important diagnostic tool for investigating neurological conditions/diseases. This study was carried out to compare the indications for lumbar puncture and findings of cerebrospinal fluid examination in children admitted to Muhimbili National Hospital (MNH) in Dar-es-salaam, Tanzania and Kilifi ...

  14. There is room for improvement in the prevention and treatment of headache after lumbar puncture

    DEFF Research Database (Denmark)

    Stendell, Line; Fomsgaard, Jonna S; Olsen, Karsten S

    2012-01-01

    The incidence of post dural puncture headache (PDPH) after lumbar puncture (LP) can be reduced from 36% to 0-9% by use of an atraumatic needle size 24 gauge (G)/0.56 mm rather than a traumatic needle size 22 G/0.7 mm. The evidence supporting some of the prophylactic and therapeutically treatments...

  15. Quasi-static puncture resistance behaviors of high-strength polyester fabric for soft body armor

    Directory of Open Access Journals (Sweden)

    Qiu-Shi Wang

    Full Text Available A series of economical and flexible fabrics were prepared using high-strength polyester yarns with different fabric structures, weft density and number of layers. The effect of these factors on quasi-static puncture resistance was comparatively studied. The failure mode of the fabrics was analyzed with SEM photographs. Findings indicate that the structure and the weft density affected the quasi-static puncture resistance property of the fabrics, the plain fabrics had better puncture resistance property than twill and satin fabrics. The max puncture force and puncture energy of the plain fabrics with 160 yarn/10 cm reached the max values which were 107.43 N and 0.44 J, respectively. The number of layers had a linear relationship to quasi-static puncture resistance. The contact pressure and friction of the probe against the fibers were the main hindrance during the quasi-static puncture process and the breakage of the fibers during the penetration was caused by the bend and tensile deformation. Keywords: High-strength polyester fabrics, Fabric structure, Multiple-layer fabrics, Quasi-static puncture resistance

  16. Development of a new bench for puncturing of irradiated fuel rods in STAR hot laboratory

    Directory of Open Access Journals (Sweden)

    Petitprez B.

    2018-01-01

    After leak tests of the device and remote handling simulation in a mock-up cell, several punctures of calibrated specimens have been performed in 2016. The bench will be implemented soon in hot cell 2 of STAR facility for final qualification tests. PWR rod punctures are already planned for 2018.

  17. Assessment of Residents Readiness to Perform Lumbar Puncture

    DEFF Research Database (Denmark)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle

    2017-01-01

    and 18 novices performing the procedure in a simulated, ward-like setting with a standardized patient. Procedural performance was assessed by three content experts. We used generalizability theory to explore reliability. The discriminative ability of the tool was explored by comparing performance scores......Background: Lumbar puncture is a common procedure in many specialties. The procedure serves to diagnose life-threatening conditions, often requiring rapid performance. However, junior doctors possess uncertainties regarding performing the procedure and frequently perform below expectations. Hence...... between the two groups. The contrasting groups method was used to set a pass/fail standard and the consequences of this was explored. Key results: The interviews identified that in addition to the technical aspects of the procedure, non-technical elements involving planning and conducting the procedure...

  18. Lumbar puncture during spaceflight: operational considerations, constraints, concerns, and limitations.

    Science.gov (United States)

    Barr, Yael R

    2014-12-01

    Lumbar puncture (LP) is a commonly performed low-risk procedure terrestrially, used diagnostically for evaluation of cerebrospinal fluid (CSF) pressure as well as for collection of CSF for analysis. NASA is investigating noninvasive means for measurement of intracranial pressure (ICP) to assess the potential contribution of elevated intracranial pressures to recently reported changes in astronauts' visual acuity and eye anatomy, known collectively as the Visual Impairment/Intracranial Pressure risk. However, many of these noninvasive technologies are still under development, have limited clinical validation, are several years away from being ready for in-flight use, or only provide qualitative rather than quantitative ICP values. Therefore, performance of in-flight LPs, as part of crewmember evaluation, has also been considered by NASA. This manuscript summarizes the unique operational considerations, constraints, concerns, and limitations of using traditional LP as an adjunct or as an alternative to noninvasive ICP measurements during spaceflight.

  19. Papillary vs Nonpapillary Puncture in Percutaneous Nephrolithotomy: A Prospective Randomized Trial.

    Science.gov (United States)

    Kallidonis, Panagiotis; Kyriazis, Iason; Kotsiris, Dimitrios; Koutava, Adamantia; Kamal, Wissam; Liatsikos, Evangelos

    2017-04-01

    Literature suggests that the percutaneous punctures for percutaneous nephrolithotomy (PCNL) must be performed at the papilla of the renal calix and a puncture at the infundibulum or the direction of the pelvis is not advisable because of increased hemorrhagic risk. A prospective randomized study was conducted to investigate the safety in terms of blood loss of the infundibular approach for PCNL. Patients with renal stones with an accumulative size of at least 2 cm were randomly assigned to one of two parallel groups to undergo PCNL with either papillary (Group 1) or infundibular (Group 2) renal access. The primary outcome measures were the reduction in hemoglobin on first postoperative day and the need for transfusion during the first postoperative month. Secondary endpoints included the operative and fluoroscopy time, number of accesses performed, overall complication rate, hospitalization time, and complications up to 3 months. In total, 27 and 28 patients were enrolled in Groups 1 and 2, respectively. Patient age, body mass index, and stone size were similar among the groups (p = 0.672, 0.256, and 0.889, respectively). Reduction in hemoglobin and transfusion rate did not differ among Groups 1 and 2 (p = 0.916, p = 1.0, respectively). Operative time was higher in the case of Group 1 (p = 0.027). The overall complications rate was 7.4% for Group 1 and 7.14% for Group 2. Hospitalization time was not significantly different in the study groups (p = 0.724). The infundibular approach for PCNL to the posterior middle renal calices is not associated with higher blood loss or transfusion rate in comparison with the respective approach to the fornix of the papilla when the currently described technique is performed.

  20. A Novel Deep Inspiration Maneuver for Difficult Transseptal Puncture.

    Science.gov (United States)

    Aksu, Tolga; Guler, Tumer Erdem; Yalin, Kivanc; Golcuk, Sukriye Ebru; Ozcan, Kazim Serhan; Guler, Niyazi

    2017-02-01

    Transseptal puncture (TSP) may not be possible in cases of an elastic, aneurysmal, or thickened interatrial septum (IAS). During deep inspiration (DI), the chest wall expands and the diaphragm descends. This makes intrapleural pressure to become more negative, which leads to movement of the IAS to the right side. The aim of this study was to verify prospectively the feasibility, safety, and outcome of DI associated with conventional TSP technique in patients with challenging IAS anatomy. From September 2012 to May 2016, 224 patients underwent TSP due to different indications. Patients were divided into 2 groups: 213 patients in whom the left atrium was successfully accessed in 3 attempts were grouped as conventional TSP group and 11 patients in whom left atrium access was failed after 3 conventional attempts were grouped as DI-TSP group. Conventional TSP was successful in 89.6% of patients with the first attempt. Second and third attempts were required in 4.1% and 1.4%, respectively. Septal puncture was achieved at the first attempt in 10 patients within a median of 1 second of DI maneuver (interquartile range, 1 to 3) and without any complications. Challenging IAS anatomy consisting of IAS aneurysm, a thick IAS, and an excessively mobile IAS were more frequent in the DI-TSP group (45% to 8%, 27% to 3%, and 21% to 5%, respectively, p <0.001). In conclusion, TSP by using the DI maneuver may be a reliable and safe method after failed conventional attempts. If there is any doubt about the correct location of the needle, additional imaging modalities have to be used. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Prestrain-induced Reduction in Skin Tissue Puncture Force of Microneedle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jonghun; Park, Sungmin; Nam, Gyungmok; Yoon, Sang-Hee [Inha Univ., Incheon (Korea, Republic of)

    2016-10-15

    Despite all the recent advances in biodegradable material-based microneedles, the bending and failure (especially buckling) of a biodegradable microneedle during skin tissue insertion remains a major technical hurdle for its large-scale commercialization. A reduction in skin tissue puncture force during microneedle insertion remains an essential issue in successfully developing a biodegradable microneedle. Here, we consider uniaxial and equibiaxial prestrains applied to a skin tissue as mechanophysical stimuli that can reduce the skin tissue puncture force, and investigate the effect of prestrain on the changes in skin tissue puncture force. For a porcine skin tissue similar to that of humans, the skin tissue puncture force of a flat-end microneedle is measured with a z-axis stage equipped with a load cell, which provides a force-time curve during microneedle insertion. The findings of this study lead to a quantitative characterization of the relationship between prestrain and the skin tissue puncture force.

  2. Prestrain-induced Reduction in Skin Tissue Puncture Force of Microneedle

    International Nuclear Information System (INIS)

    Kim, Jonghun; Park, Sungmin; Nam, Gyungmok; Yoon, Sang-Hee

    2016-01-01

    Despite all the recent advances in biodegradable material-based microneedles, the bending and failure (especially buckling) of a biodegradable microneedle during skin tissue insertion remains a major technical hurdle for its large-scale commercialization. A reduction in skin tissue puncture force during microneedle insertion remains an essential issue in successfully developing a biodegradable microneedle. Here, we consider uniaxial and equibiaxial prestrains applied to a skin tissue as mechanophysical stimuli that can reduce the skin tissue puncture force, and investigate the effect of prestrain on the changes in skin tissue puncture force. For a porcine skin tissue similar to that of humans, the skin tissue puncture force of a flat-end microneedle is measured with a z-axis stage equipped with a load cell, which provides a force-time curve during microneedle insertion. The findings of this study lead to a quantitative characterization of the relationship between prestrain and the skin tissue puncture force

  3. Lumbar puncture opening pressure is not a reliable measure of intracranial pressure in children.

    Science.gov (United States)

    Cartwright, Cathy; Igbaseimokumo, Usiakimi

    2015-02-01

    There is very little data correlating lumbar puncture pressures to formal intracranial pressure monitoring despite the widespread use of both procedures. The hypothesis was that lumbar puncture is a single-point measurement and hence it may not be a reliable evaluation of intracranial pressure. The study was therefore carried out to compare lumbar puncture opening pressures with the Camino bolt intracranial pressure monitor in children. Twelve children with a mean age of 8.5 years who had both lumbar puncture and intracranial pressure monitoring were analyzed. The mean lumbar puncture opening pressure was 22.4 mm Hg versus a mean Camino bolt intracranial pressure of 7.8 mm Hg (P intracranial pressure in children. There were no complications from the intracranial pressure monitoring, and the procedure changed the treatment of all 12 children avoiding invasive operative procedures in most of the patients. © The Author(s) 2014.

  4. Comparative study of decomposable and indecomposable biopsy needle in lung puncture biopsy

    International Nuclear Information System (INIS)

    Wang Bo; Sheng Zhanxin; Wen Yamin; Zhang Liping; Wen Zongqiu

    2007-01-01

    Objective: To contrast the clinical practice characteristics with decomposable and indecomposable biopsy needle in the CT-guided lung puncture biopsy. Methods: 50 patients with lung tumour carried on puncture biopsy under the CT guidance were divided in two groups randomly: Group A (25 examples): using the indecomposable BioPinceTM biopsy needle; Group B(25 examples): using the decomposable Precisa or Vitesse biopsy needle. The puncture biopsy organization quantity, the first time puncture success rate, the pathological diagnosis result and the incidence of puncture complication were compared in two groups. Results: More striped structures were gained obviously in group A than in group B: 24/25 and 11/25 respectively (P>0.05), The pathological diagnosis 'serious extrusion amoebocyte and nature undetermined' only occurred in group B. But the first time puncture success rate was lower in group A than in B: 52%(13/25) and 80%(20/25) respectively (P>0.05), The incidence of hemorrhage and pneumothorax in group A was higher slightly: 84% and 72%, 16% and 4% respectively (P>0.05). Conclusion: The indecomposable needle (BioPinceTM) was better in lung puncture biopsy, but the lower first time puncture success rate also increases the risk of operation and complication in some degree because of the structure of the needle. On the contrary, decomposable needle (the Precisa or the Vitesse) was not the best choice in lung puncture biopsy. But it had the original superiority, especially regarding the special patient such as patient with small tumour, thin thoracic wall, bad physique for its nimble operation. It is essential for us to use the two different types of biopsy needle rationally to enhance the level of CT-guided lung puncture biopsy. (authors)

  5. The transabdominal chorionic villus sampling puncture guided by color Doppler ultrasound during early pregnancy

    International Nuclear Information System (INIS)

    Liang Weixiang; Chen Zhiyi; Yuan Wenlin; Cai Kuan; Zhu Junlin; Wang Weiqun; Chen Xia

    2008-01-01

    Objective: To study the operation of chorionic villus sampling (CVS) guided by color Doppler ultrasound (CDU) via abdomen puncture during early pregnancy and investigate the advertences during the operation. Methods: CVS guided by CDU probe via abdomen puncture were operated on 28 pregnant women who had the indications of antenatal diagnosis. CDU was used to observe the implantation position of the fo1iaceous villis and help setting mark of the puncture point and puncture range on body surface before operation. The needle was punctured under real-time ultrasound guidance and villis were aspirated during the operation: The choice of the right time of puncture and the operation skills were emphasized in the study. Results: The CVS puncture approach should be set through CDU ob servation, which attend to avoid the surrounding blood vessels, intestinal canal and surrounding important organs. The puncture point should be chosen in a point where lobif0rmed villis distributed wider and with a larger scope. The operations were performed from 10 to13 weeks of pregnancy, with an average of 11 weeks. Among these 28 cases, 9.6 were successfully drawn materials in one time, 1 in twice and l failure, with the total ratio of achievement was 96.4%. For all the cases, fetal heart pulsating could be seen by real-time CDU observation fight after the operation, and no larger hematoma echo in the placental site occurred. Ultrasound reexamined one week after the operation, fetal heart pulsation could be found in all cases, and no abortion cases occurred after regular follow-up in 25 continued pregnant patients. Conclusion: Abdominal CVS puncture guided by CDU probe is conveniently operated, safe and available in clinic. It is an important method for antenatal diagnosis during early pregnancy. The puncture localization, skills and the time are the key points for the success in obtaining the materials. (authors)

  6. Puncture mechanics of soft elastomeric membrane with large deformation by rigid cylindrical indenter

    Science.gov (United States)

    Liu, Junjie; Chen, Zhe; Liang, Xueya; Huang, Xiaoqiang; Mao, Guoyong; Hong, Wei; Yu, Honghui; Qu, Shaoxing

    2018-03-01

    Soft elastomeric membrane structures are widely used and commonly found in engineering and biological applications. Puncture is one of the primary failure modes of soft elastomeric membrane at large deformation when indented by rigid objects. In order to investigate the puncture failure mechanism of soft elastomeric membrane with large deformation, we study the deformation and puncture failure of silicone rubber membrane that results from the continuous axisymmetric indentation by cylindrical steel indenters experimentally and analytically. In the experiment, effects of indenter size and the friction between the indenter and the membrane on the deformation and puncture failure of the membrane are investigated. In the analytical study, a model within the framework of nonlinear field theory is developed to describe the large local deformation around the punctured area, as well as to predict the puncture failure of the membrane. The deformed membrane is divided into three parts and the friction contact between the membrane and indenter is modeled by Coulomb friction law. The first invariant of the right Cauchy-Green deformation tensor I1 is adopted to predict the puncture failure of the membrane. The experimental and analytical results agree well. This work provides a guideline in designing reliable soft devices featured with membrane structures, which are present in a wide variety of applications.

  7. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO System: A Cadaver Study.

    Directory of Open Access Journals (Sweden)

    Guoxin Fan

    Full Text Available Percutaneous transforaminal endoscopic discectomy (PTED usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence.This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO system in puncture reduction of PTED.Cadaver study.Comparative groups.HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A. Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B. On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C.At L4/L5 level, there was significant difference in puncture times between Group A and Group B (P0.05. There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05.Small-sample preclinical study.HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127.

  8. Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO) System: A Cadaver Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Sun, Qi; Hu, Annan; Zhu, Yanjie; Gu, Guangfei; Zhang, Hailong; He, Shisheng

    2015-01-01

    Percutaneous transforaminal endoscopic discectomy (PTED) usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence. This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO) system in puncture reduction of PTED. Cadaver study. Comparative groups. HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A). Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B). On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C). At L4/L5 level, there was significant difference in puncture times between Group A and Group B (PHELLO system reduced 39%-45% radiation dosage when comparing Group A and Group B, but there was no significant difference in radiation exposure between Group A and Group C whatever at L4/L5 level or L5/S1 level (P>0.05). There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05). Small-sample preclinical study. HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127).

  9. Estimating rates of denitrification enzyme activity in wetland soils and direct simultaneous quantification of nitrogen and nitrous oxide by membrane inlet mass spectrometry

    Science.gov (United States)

    Denitrification enzyme activity (DEA) was measured in short-term (4 h) anaerobic assays using Membrane Inlet Mass Spectrometry (MIMS) and electron capture gas chromatography (GC-ECD). Using MIMS, modifications of the instrument and sample handling allowed for the simultaneous me...

  10. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis.

    Science.gov (United States)

    Patel, Kajal Nitin; Gandhi, Shruti P; Sutariya, Harsh C

    2016-10-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge, there is only one case report of development of PA after a single arterial puncture for blood-gas analysis is reported in the past.

  11. Development of puncture resistance tire tube; Nirinsha no taipankusei kojo cube no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Yamagiwa, T.; Nakayama, K.; Kiyota, S.; Tanaka, A. [Honda R and D Co. Ltd., Tokyo (Japan); Makisaka, N.

    1997-10-01

    A new tire tube with a puncture resistance function was developed. The tube is a two-chamber structure having an air chamber and a liquid chamber, and the liquid chamber at the crown-side half of the tube is filled with an anti-puncture sealant during a manufacturing process. In a market test, it was confirmed that the number of puncture cases were reduced by 90 % in comparison with conventional tire tubes by using the newly developed tube. This paper describes the structure of the tube and the characteristics of the tube rubber, and the manufacturing process and durability of the tube. 3 refs., 17 figs.

  12. Use of inelastic analysis to determine the response of packages to puncture accidents

    International Nuclear Information System (INIS)

    Ammerman, D.J.; Ludwigsen, J.S.

    1996-01-01

    The accurate analytical determination of the response of radioactive material transportation packages to the hypothetical puncture accident requires inelastic analysis techniques. Use of this improved analysis method recudes the reliance on empirical and approximate methods to determine the safety for puncture accidents. This paper will discuss how inelastic analysis techniques can be used to determine the stresses, strains and deformations resulting from puncture accidents for thin skin materials with different backing materials. A method will be discussed to assure safety for all of these types of packages

  13. Interactions among biotic and abiotic factors affect the reliability of tungsten microneedles puncturing in vitro and in vivo peripheral nerves: A hybrid computational approach

    International Nuclear Information System (INIS)

    Sergi, Pier Nicola; Jensen, Winnie; Yoshida, Ken

    2016-01-01

    Tungsten is an elective material to produce slender and stiff microneedles able to enter soft tissues and minimize puncture wounds. In particular, tungsten microneedles are used to puncture peripheral nerves and insert neural interfaces, bridging the gap between the nervous system and robotic devices (e.g., hand prostheses). Unfortunately, microneedles fail during the puncture process and this failure is not dependent on stiffness or fracture toughness of the constituent material. In addition, the microneedles' performances decrease during in vivo trials with respect to the in vitro ones. This further effect is independent on internal biotic effects, while it seems to be related to external biotic causes. Since the exact synergy of phenomena decreasing the in vivo reliability is still not known, this work explored the connection between in vitro and in vivo behavior of tungsten microneedles through the study of interactions between biotic and abiotic factors. A hybrid computational approach, simultaneously using theoretical relationships and in silico models of nerves, was implemented to model the change of reliability varying the microneedle diameter, and to predict in vivo performances by using in vitro reliability and local differences between in vivo and in vitro mechanical response of nerves. - Highlights: • We provide phenomenological Finite Element (FE) models of peripheral nerves to study the interactions with W microneedles • We provide a general interaction-based approach to model the reliability of slender microneedles • We evaluate the reliability of W microneedels to puncture in vivo nerves • We provide a novel synergistic hybrid approach (theory + simulations) involving interactions among biotic and abiotic factors • We validate the hybrid approach by using experimental data from literature

  14. Interactions among biotic and abiotic factors affect the reliability of tungsten microneedles puncturing in vitro and in vivo peripheral nerves: A hybrid computational approach

    Energy Technology Data Exchange (ETDEWEB)

    Sergi, Pier Nicola, E-mail: p.sergi@sssup.it [Translational Neural Engineering Laboratory, The Biorobotics Institute, Scuola Superiore Sant' Anna, Viale Rinaldo Piaggio 34, Pontedera, 56025 (Italy); Jensen, Winnie [Department of Health Science and Technology, Fredrik Bajers Vej 7, 9220 Aalborg (Denmark); Yoshida, Ken [Department of Biomedical Engineering, Indiana University - Purdue University Indianapolis, 723 W. Michigan St., SL220, Indianapolis, IN 46202 (United States)

    2016-02-01

    Tungsten is an elective material to produce slender and stiff microneedles able to enter soft tissues and minimize puncture wounds. In particular, tungsten microneedles are used to puncture peripheral nerves and insert neural interfaces, bridging the gap between the nervous system and robotic devices (e.g., hand prostheses). Unfortunately, microneedles fail during the puncture process and this failure is not dependent on stiffness or fracture toughness of the constituent material. In addition, the microneedles' performances decrease during in vivo trials with respect to the in vitro ones. This further effect is independent on internal biotic effects, while it seems to be related to external biotic causes. Since the exact synergy of phenomena decreasing the in vivo reliability is still not known, this work explored the connection between in vitro and in vivo behavior of tungsten microneedles through the study of interactions between biotic and abiotic factors. A hybrid computational approach, simultaneously using theoretical relationships and in silico models of nerves, was implemented to model the change of reliability varying the microneedle diameter, and to predict in vivo performances by using in vitro reliability and local differences between in vivo and in vitro mechanical response of nerves. - Highlights: • We provide phenomenological Finite Element (FE) models of peripheral nerves to study the interactions with W microneedles • We provide a general interaction-based approach to model the reliability of slender microneedles • We evaluate the reliability of W microneedels to puncture in vivo nerves • We provide a novel synergistic hybrid approach (theory + simulations) involving interactions among biotic and abiotic factors • We validate the hybrid approach by using experimental data from literature.

  15. The ameliorative effect of bloodletting puncture at hand twelve Jing-well points on cerebral edema induced by permanent middle cerebral ischemia via protecting the tight junctions of the blood-brain barrier.

    Science.gov (United States)

    Yu, Nannan; Wang, Zhenguo; Chen, Yucen; Yang, Juntao; Lu, Xuan; Guo, Yi; Chen, Zelin; Xu, Zhifang

    2017-09-26

    Cerebral edema, erupting simultaneously with severe ischemic stroke, might lead to increased intracranial pressure, cerebral herniation, and ultimately death. Studies conducted previously by our team have demonstrated the fact that bloodletting puncture at hand twelve Jing-well points (HTWP) could alleviate cerebral edema, which mainly results from the disruption of blood-brain barrier (BBB). The study, therefore, was first designed to demonstrate whether BBB-protection serves an important role in the edema-relief effect of HTWP bloodletting, based on which to research the molecular mechanism underlying. The rats were made into model suffering from permanent middle cerebral artery occlusion (pMCAO) and then bloodletting puncture were treated at HTWP once a day. Wet and dry weight method was adopted to evaluate the degree of brain edema, evans blue extravasation and electron microscopy were used to evaluate the integrity of the BBB, and RT-qPCR was carried out to analyze the expression level of occludin, claudin-5, ICAM-1, and VEGF. Results revealed that bloodletting puncture treatment could reduce water content of brain and the permeability of BBB caused by ischemic stroke. In bloodletting puncture group, ameliorated tight junctions could be observed under electron microscopy. It was demonstrated in further study that, in bloodletting group, compared with pMCAO one, the expression levels of occludin and claudin-5 were up-regulated, while ICAM-1 and VEGF were down-regulated. In conclusion, bloodletting puncture at HTWP might play a significant role in protecting the tight junctions of BBB, thus alleviating cerebral edema induced by ischemic stroke. Therefore, the therapy of bloodletting puncture at HTWP may be a promising strategy for acute ischemic stroke in the future.

  16. The canine fossa puncture technique in chronic odontogenic maxillary sinusitis.

    Science.gov (United States)

    Albu, Silviu; Baciut, Mihaela; Opincariu, Iulian; Rotaru, Horatiu; Dinu, Cristian

    2011-01-01

    Endoscopic sinus surgery (ESS) including middle meatus antrostomy (MMA) has been advocated as the technique of choice in the treatment of maxillary chronic odontogenic sinusitis (COS). However, recently the endoscopic canine fossa puncture (CFP) has been proposed as an alternative surgical technique of accessing the entire antrum when pathology is limited only to the maxillary sinus. This study was designed to assess the outcomes of the CFP approach versus ESS (comprising MMA) in the management of COS. A prospective study was performed on patients with COS produced by odontogenic infections (periapical granulomas or small inflammatory cysts of the molars or bicuspids), oroantral fistula (OAF), large odontogenic cysts, and maxillary foreign bodies (dental fillings, teeth roots, and implants). Patients were randomly allocated into two groups: 56 patients underwent CFP and in 54 patients the maxillary sinus was approached through MMA. After a mean follow-up of 18.5 months, recurrence rates were compared between the two groups. During the follow-up period, OAF recurred in 10 patients: 4 in the MMA group (7.4%) and 6 in the CFP group (10.7%). The difference is not statistically significant (p = 0.39, Fisher exact test). In patients with COS a conservative approach with avoidance of endonasal surgery is suggested: in COS without a fistula, CFP at the time of dental treatment will be sufficient. In OAF cases, CFP yielded similar results with MMA. Nevertheless, additional study with a larger sample and a longer follow-up is required to validate these results.

  17. Factors Influencing Successful Lumbar Puncture in Alzheimer Research.

    Science.gov (United States)

    Moulder, Krista L; Besser, Lilah M; Beekly, Duane; Blennow, Kaj; Kukull, Walter; Morris, John C

    2017-01-01

    Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States. A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). In all, 64 LP Requestor, 579 Patient/Initial, and 404 Patient/Follow-up surveys were collected. Logistic regression analyses with generalized estimating equations were used to assess factors associated with LP agreement and post-LP complications. Asians and those viewing LP negatively were less likely to agree to LP. Three hundred fifty-two participants had an LP; LP headache occurred in 11.9% (blood patch required in 1.4%) and 9.9% reported other complications. Younger individuals, women, those diagnosed with mild cognitive impairment, use of a Quincke needle, ≤20 mL cerebrospinal fluid drawn, and hemorrhage during LP were associated with LP headache. Use of gravity flow during LP was associated with fewer other complications (nausea, dizziness, vasovagal response, back pain, neck stiffness, and/or nerve root pain). LP in Alzheimer disease research is generally safe and well tolerated. Factors influencing LP agreement potentially could be studied to advance participant acceptance of the procedure.

  18. Research on the improvement of nuclear safety - Development of a technique for simultaneous measurement of particle size and velocity for direct containment heating accident analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Yong; Song, Si Hong; Koh, Kwang Woong; Kim, Joo Yeon; Kim, Jong Moon; Choi, Chul Jin [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1995-08-01

    The main objective is to develop a high performance software routine to process the output signals from the phase/Doppler device for simultaneous measurement of drop sizes and two-dimensional velocities of spray drops/particles. The present work has been carried out as an extension work of the first year`s research, where the principles and the limitation of this measuring technique have been thoroughly reviewed. In order to verify the performance and reliability of this software for simultaneous measurement of sizes and velocities of spray drops with two-dimensional motions, the results were compared with those from commercial signal processor DSA by Aerometrics, and concluded to be satisfactory. The routine developed throughout this project is applicable not only to the DCH model experiments but also to the measurements of sizes and velocities of drops/particles in combustors, dryers, humidifiers, and in various two-phase equipments. 20 refs., 5 tabs., 21 figs. (author)

  19. Budd-Chiari syndrome: puncturing occlusion of inferior vena cava with blunt wire

    International Nuclear Information System (INIS)

    Han Xinwei; Wu Gang; Ding Pengxu; Gao Xuemei; Ma Nan; Wang Yanli; Guan Sheng

    2006-01-01

    Objective: To explore the safety of puncturing occlusion of inferior vena cava with blunt wire for Budd-Chiari syndrome. Methods: Under the fluoroscopic guidance, occlusions of inferior vena cava were punctured with blunt wire for 63 patients with membranous occlusion of inferior vena cava and 33 with segmental occlusion of the inferior vena cava; including 15 patients with hepatic vein stenosis or occlusion. Results: 96 patients with Budd-Chiari syndrome were operated successfully. All occlusions of inferior vena cava were punctured with patent rate of 100% and no serious complications occurred. Conclusion: Puncturing occlusion of IVC with blunt guide wire is safe, efficient, no serious complication and simple economic method, worthy to be recommended. (authors)

  20. The influence of punctural millimeter wave therapy on clinical presentation of patients with essential hypertention

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to estimate the influence of punctural millimeter wave therapy on clinical presentation. Material and methods. This study includes 102 patients with essential hypertension the I and II stage. Patients were divided into three equal groups depending on the method of treatment: some of them received procedures of punctural millimeter wave therapy, some of them received these procedures as the "placebo" and those who had not received specified procedures. Dynamics of clinical symptomatology and condition of eye bottom vessels was estimated. It was shown that addition of punctural millimeter wave therapy in complex therapy of patients with essential hypertension promotes the expressed regress of clinical symptomatology and state normalization the retinal vessels at these patients. Results. Addition of punctural millimeter wave therapy into the complex therapy was shown to lead to pronounced regress of clinical symptoms. Conclusion. The received results allow to recommend this method to be used in clinical practice for treating patients with essential hypertension.

  1. Closure Using a Surgical Closure Device of Inadvertent Subclavian Artery Punctures During Central Venous Catheter Placement

    International Nuclear Information System (INIS)

    Berlet, Matthew H.; Steffen, Diana; Shaughness, George; Hanner, James

    2001-01-01

    Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA)

  2. Detailed puncture analyses tank cars : analysis of different impactor threats and impact conditions.

    Science.gov (United States)

    2013-03-01

    There has been significant research in recent years to analyze and improve the impact behavior and puncture resistance of railroad tank cars. Much of this research has been performed using detailed nonlinear finite element analyses supported by full ...

  3. Stenting-plasty with brachial puncture in the treatment of subclavian steal syndrome

    International Nuclear Information System (INIS)

    Chen Quan; Jing Zaiping; Zhao Zhiqing; Feng Xiang; Lu Qingsheng; Mei Zhijun

    2007-01-01

    Objective: To study the clinical effect of stenting-plasty with retrograde brachial puncture for subclavian steal syndrome patients. Methods: To analyze the clinical results of stenting-plasty with retrograde brachial puncture in 15 patients with subclavian steal syndrome. Results: MRA or DSA showed the subclavian arteries with different degrees of stenosis (80%-100%) in all patients. Stenting-plasty with retrograde brachia] puncture was used in all patients. After placement of wall or polmaz stent, the pulse recovered and the syndrome disappeared. Postoperative angiography showed patency of the artery and stent. The patients were followed up for 3-30 months without recurrence of symptoms. Conclusions: Stenting-plasty with retrograde brachial puncture is a rather proper method to treat subclavian steal syndrome with more coincidence to the vascular anatomy, decrease the maneuver trouble and increase the successful rate. (authors)

  4. [Intraosseous puncture in preclincal emergency medicine. Experiences of an air rescue service].

    Science.gov (United States)

    Helm, M; Breschinski, W; Lampl, L; Frey, W; Bock, K H

    1996-12-01

    In prehospital emergency treatment, the timely establishment of a secure vascular access, especially in infants and small children, can be difficult or even impossible. An alternative to the puncture of peripheral or central veins is intraosseous (IO) puncture However, experience with this method in prehospital emergency medicine within the Federal Republic of Germany is extremely limited at present. After intensive theoretical and practical training of our trauma anaesthesiologists, IO puncture was introduced in our rescue helicopter program "Christoph 22" as an alternative to peripheral or central venous puncture in the prehospital treatment of patients up to 6 years of age. IO puncture is indicated after a maximum of three failed peripheral venous puncture attempts. The purpose of this study was to collect data and summarise first-hand experience on the prehospital use of the IO method as well as the practicability of our prescribed IO puncture algorithm in order to subject them to critical review and evaluation. A restrospective study by the rescue helicopter service "Christoph 22" was carried out for the period 1 June 1993-31 August 1995. In a total of 1,455 primary rescue missions flown, the proportion of patients < and = 6 years of age, was 6.2% (n = 90). Ten patients in this partial collective (11.1%) were subjected to IO puncture (Fig. 3). In all of these cases (10/10), the first IO puncture attempt was successful. A standardized puncture technique was performed using the proximal tibia. The time required to successful placement of the IO infusion line was < and = 60 s in all cases. Complications, especially incorrect needle position, did not occur during the study period. Materials infused by IO infusion before hospitalisation included crystalloids (Lactated Ringer's, Päd OP) as well as colloids (hydroxyethylstarch, human albumin), adrenaline, atropine, ketamine, thiopentone, diazepam, fentanyl, succinylcholine, and vecuronium (Table 3). Prehospital

  5. Use of a vegetable model as a training tool for PCNL puncture.

    Science.gov (United States)

    Sinha, Maneesh; Krishnamoorthy, Venkatesh

    2015-01-01

    Training residents to perform a PCNL puncture is hampered by the non-availability of a good inanimate model that can be used for demonstration and practice. The ethics of surgical training during actual surgeries is being questioned and the role of simulation is increasingly important. Virtual reality trainers, however, are prohibitively expensive and the use of animal models is fraught with regulatory and ethical concerns. We have devised a model that can be used to teach the concept of depth perception during a PCNL puncture. A bottle gourd was used to mimic the posterior abdominal wall. Cotton pledgets dipped in intravenous contrast were fitted into 4 mm holes made at staggered levels in the bottle gourd which was strapped onto the operating table with the cotton pledgets facing away from the surgeon. Surgeons with varying degrees of experience made fluoroscopy-guided punctures onto the cotton pledgets. We recorded the time taken for puncture in seconds and the distance of the needle exit site from the center of the cotton ball. Speed was measured by recording the fluoroscopy time in seconds on the C-arm. Accuracy was documented by using a Vernier caliper to measure the distance from the edge of the target to the actual puncture. One second of fluoroscopy time and 0.1 mm distance were each given one point. The total points accumulated over a set of 10 punctures was added to give a total score. Longer fluoroscopy times and inaccurate punctures resulted in higher scores. A surgeon with more than 1000 PCNLs to his credit had a score of 99. The average score of five residents was 555. The bottle gourd model provides an ethically acceptable, inexpensive, easy to replicate model that can be used to train residents in the PCNL puncture.

  6. Heme oxygenase-1 modulates degeneration of the intervertebral disc after puncture in Bach 1 deficient mice.

    Science.gov (United States)

    Ohta, Ryo; Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Kamei, Naosuke; Nakamae, Toshio; Izumi, Bunichiro; Fujioka, Yuki; Ochi, Mitsuo

    2012-09-01

    Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complex-Tramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/- and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/- and wild-type mice. In the age-related model, there were no significant differences between Bach 1-/- and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/- mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/- mice. Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.

  7. Clinical value of a self-designed training model for pinpointing and puncturing trigeminal ganglion.

    Science.gov (United States)

    He, Yu-Quan; He, Shu; Shen, Yun-Xia; Qian, Cheng

    2014-04-01

    OBJECTIVES. A training model was designed for learners and young physicians to polish their skills in clinical practices of pinpointing and puncturing trigeminal ganglion. METHODS. A head model, on both cheeks of which the deep soft tissue was replaced by stuffed organosilicone and sponge while the superficial soft tissue, skin and the trigeminal ganglion were made of organic silicon rubber for an appearance of real human being, was made from a dried skull specimen and epoxy resin. Two physicians who had experiences in puncturing foramen ovale and trigeminal ganglion were selected to test the model, mainly for its appearance, X-ray permeability, handling of the puncture, and closure of the puncture sites. Four inexperienced physicians were selected afterwards to be trained combining Hartel's anterior facial approach with the new method of real-time observation on foramen ovale studied by us. RESULTS. Both appearance and texture of the model were extremely close to those of a real human. The fact that the skin, superficial soft tissue, deep muscles of the cheeks, and the trigeminal ganglion made of organic silicon rubber all had great elasticity resulted in quick closure and sealing of the puncture sites. The head model made of epoxy resin had similar X-ray permeability to a human skull specimen under fluoroscopy. The soft tissue was made of radiolucent material so that the training can be conducted with X-ray guidance. After repeated training, all the four young physicians were able to smoothly and successfully accomplish the puncture. CONCLUSION. This self-made model can substitute for cadaver specimen in training learners and young physicians on foramen ovale and trigeminal ganglion puncture. It is very helpful for fast learning and mastering this interventional operation skill, and the puncture accuracy can be improved significantly with our new method of real-time observation on foramen ovale.

  8. Mechanical deformation and glycosaminoglycan content changes in a rabbit annular puncture disc degeneration model.

    Science.gov (United States)

    Chan, Deva D; Khan, Safdar N; Ye, Xiaojing; Curtiss, Shane B; Gupta, Munish C; Klineberg, Eric O; Neu, Corey P

    2011-08-15

    Evaluation of degenerated intervertebral discs from a rabbit annular puncture model by using specialized magnetic resonance imaging (MRI) techniques, including displacement encoding with stimulated echoes and a fast-spin echo (DENSE-FSE) acquisition and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). To evaluate a rabbit disc degeneration model by using various MRI techniques. To determine the displacements and strains, spin-lattice relaxation time (T1), and glycosaminoglycan (GAG) distribution of degenerated discs as compared to normal and adjacent level discs. Annular puncture of the intervertebral disc produces disc degeneration in rabbits. DENSE-FSE has been previously demonstrated in articular cartilage for the measurement of soft tissue displacements and strains. MRI also can measure the T1 of tissue, and dGEMRIC can quantify GAG concentration in cartilage. METHODS.: In eight New Zealand white rabbits, the annulus fibrosis of a lumbar disc was punctured. After 4 weeks, the punctured and cranially adjacent motion segments were isolated for MRI and histology. MRI was used to estimate the disc volume and map T1. DENSE-FSE was used to determine displacements for the estimation of strains. dGEMRIC was then used to determine GAG distributions. Histology and standard MRI indicated degeneration in punctured discs. Disc volume increased significantly at 4 weeks after the puncture. Displacement of the nucleus pulposus was distinct from that of the annulus fibrosis in most untreated discs but not in punctured discs. T1 was significantly higher and GAG concentration significantly lower in punctured discs compared with untreated adjacent level discs. Noninvasive and quantitative MRI techniques can be used to evaluate the mechanical and biochemical changes that occur with animal models of disc degeneration. DENSE-FSE, dGEMRIC, and similar techniques have potential for evaluating the progression of disc degeneration and the efficacy of treatments.

  9. Gauge conditions for binary black hole puncture data based on an approximate helical Killing vector

    OpenAIRE

    Tichy, Wolfgang; Bruegmann, Bernd; Laguna, Pablo

    2003-01-01

    We show that puncture data for quasicircular binary black hole orbits allow a special gauge choice that realizes some of the necessary conditions for the existence of an approximate helical Killing vector field. Introducing free parameters for the lapse at the punctures we can satisfy the condition that the Komar and ADM mass agree at spatial infinity. Several other conditions for an approximate Killing vector are then automatically satisfied, and the 3-metric evolves on a timescale smaller t...

  10. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

    Directory of Open Access Journals (Sweden)

    Gorchynski, Julie

    2008-01-01

    Full Text Available Background: Lumbar Puncture (LP is an invasive procedure frequently used to diagnose meningitis among the pediatric population. Neonates and infants have not routinely received local anesthesia prior to LP. Study Objective: To determine whether emergency medicine physicians and pediatricians use local analgesics on neonates and infants prior to performing an LP and to identify which local anesthetics, if any, were used. Methods: Prospective, cohort study of all infants, six months of age or less, that received an LP in the emergency department (ED or inpatient pediatric units for suspected meningitis during a period of year at a university tertiary care hospital. Results: A total sample population of 111 infants that received an LP within the study period. A control population of 42 adults received an LP. Only 40.4% (45/111 of the infants received local analgesia prior to LP: either 1% lidocaine, EMLA or a combination of the two. Infants were less likely to receive lidocaine or EMLA prior to LP compared to adult subjects (OR= 0.27; 95% CI0.12 to 0.62. No neonates that were less than one month of age received local procedural anesthesia by emergency medicine or pediatric physicians. ED physicians’ use of local anesthesia prior to LP increased with increasing age of the infant. The pediatricians in this study used local anesthesia prior to LP when the infant was at least five months of age. Discussion: The data objectively support recent literature regarding the under use or lack of use of analgesia prior to LP among neonates and infants. Local anesthetics should be used routinely without exception prior to performing an LP in the pediatric population.

  11. [Sphenopalatine ganglion block for postdural puncture headache in ambulatory setting].

    Science.gov (United States)

    Cardoso, José Miguel; Sá, Miguel; Graça, Rita; Reis, Hugo; Almeida, Liliana; Pinheiro, Célia; Machado, Duarte

    Postdural puncture headache (PDPH) is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Supportive therapy is the usual initial approach. Epidural blood patch (EBP) is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB) may be a safer alternative. We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before. We administrated 1l of crystalloids, Dexamethasone 4mg, parecoxib 40mg, acetaminophen 1g and caffeine 500mg without significant relief after 2hours. We performed a bilateral SPGB with a cotton-tipped applicator saturated with 0.5% Levobupivacaine under standard ASA monitoring. Symptoms relief was reported 5minutes after the block. The patient was monitored for an hour after which she was discharged and prescribed acetaminophen 1g and ibuprofen 400mg every 8hours for the following 2 days. She was contacted on the next day and again after a week reporting no pain in both situations. SPGB may attenuate cerebral vasodilation induced by parasympathetic stimulation transmitted through neurons that have synapses in the sphenopalatine ganglion. This would be in agreement with the Monro-Kellie concept and would explain why caffeine and sumatriptan can have some effect in the treatment of PDPH. Apparently, SPGB has a faster onset than EBP with better safety profile. We suggest that patients presenting with PDPH should be considered primarily for SPGB. Patients may have a rescue EBP if needed. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Sphenopalatine ganglion block for postdural puncture headache in ambulatory setting

    Directory of Open Access Journals (Sweden)

    José Miguel Cardoso

    Full Text Available Abstract Background and objectives: Postdural puncture headache (PDPH is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Suportive therapy is the usual initial approach. Epidural blood patch (EBP is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB may be a safer alternative. Case report: We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before. We administrated 1 l of crystalloids, Dexamethasone 4 mg, parecoxib 40 mg, acetaminophen 1 g and caffeine 500 mg without significant relief after 2 hours. We performed a bilateral SPGB with a cotton-tipped applicator saturated with 0.5% Levobupivacaine under standard ASA monitoring. Symptoms relief was reported 5 minutes after the block. The patient was monitored for an hour after which she was discharged and prescribed acetaminophen 1 g and ibuprofen 400 mg every 8 hours for the following 2 days. She was contacted on the next day and again after a week reporting no pain in both situation. Conclusions: SPGB may attenuate cerebral vasodilation induced by parasympathetic stimulation transmitted through neurons that have synapses in the sphenopalatine ganglion. This would be in agreement with the Monro-Kellie concept and would explain why caffeine and sumatriptan can have some effect in the treatment of PDPH. Apparently, SPGB has a faster onset than EBP with better safety profile. We suggest that patients presenting with PDPH should be considered primarily for SPGB. Patients may have a rescue EBP if needed.

  13. Methods in laboratory investigation. Identification and evaluation of histopathology at microelectrode puncture sites.

    Science.gov (United States)

    Cole, M A; Bernick, S; Puffer, H W; Warner, N E; Crawford, D W

    1983-11-01

    Tissue puncture techniques using microelectrodes for various measurements have been criticized for producing undetermined degrees of tissue damage. Therefore, a method permitting routine identification of puncture tracks was developed to determine local microelectrode-induced injury. Rabbits were anesthetized and the femoral arteries surgically exposed. A 3-ml mixture of saline-India ink suspension was introduced through an ear vein. Oxygen-sensitive (pO2) microcathodes were advanced into and through the arterial wall at 10- or 20-micron intervals using a stepping microdrive to 150 to 450 micron and then withdrawn. The arteries were fixed in 10% formalin and gelatin embedded, and serial frozen sections (less than or equal to 15 micron) of the microelectrode puncture area were made. We observed within 5 minutes of microcathode withdrawal a dark, punctate, microscopic discoloration within the arterial wall. Histologically, ink distribution within the arterial wall demonstrated an acute permeability change: puncture depths generally less than 300 micron showed ink-lined microelectrode tracks (generally less than 2 micron wide) in the media, and greater puncture depths showed local hemorrhage and focal laminar accumulation of ink which extended from the track. The immediate adjacent area to microelectrode puncture depths less than 300 micron showed an apparent intact internal elastic lamina and media. Therefore, microelectrode damage has been shown to be primarily limited to microelectrode tissue tracks.

  14. Point of impact: the effect of size and speed on puncture mechanics.

    Science.gov (United States)

    Anderson, P S L; LaCosse, J; Pankow, M

    2016-06-06

    The use of high-speed puncture mechanics for prey capture has been documented across a wide range of organisms, including vertebrates, arthropods, molluscs and cnidarians. These examples span four phyla and seven orders of magnitude difference in size. The commonality of these puncture systems offers an opportunity to explore how organisms at different scales and with different materials, morphologies and kinematics perform the same basic function. However, there is currently no framework for combining kinematic performance with cutting mechanics in biological puncture systems. Our aim here is to establish this framework by examining the effects of size and velocity in a series of controlled ballistic puncture experiments. Arrows of identical shape but varying in mass and speed were shot into cubes of ballistic gelatine. Results from high-speed videography show that projectile velocity can alter how the target gel responds to cutting. Mixed models comparing kinematic variables and puncture patterns indicate that the kinetic energy of a projectile is a better predictor of penetration than either momentum or velocity. These results form a foundation for studying the effects of impact on biological puncture, opening the door for future work to explore the influence of morphology and material organization on high-speed cutting dynamics.

  15. Incidence and predictors of immediate complications following perioperative non-obstetric epidural punctures

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    Meyer-Bender Andreas

    2012-12-01

    Full Text Available Abstract Background Epidural Anesthesia (EA is a well-established procedure. The aim of the present study was to evaluate the incidence of immediate complications following epidural puncture, such as sanguineous puncture, accidental dural perforation, unsuccessful catheter placement or insufficient analgesia and to identify patient and maneuver related risk factors. Methods A total of 7958 non-obstetrical EA were analyzed. The risk of each complication was calculated according to the preconditions and the level of puncture. For probabilistic evaluation we used a logistic regression model with forward selection. Results The risk of sanguineous puncture (n = 247, 3.1% increases with both the patient’s age (P = 0.013 and the more caudal the approach (P Conclusions Compared to more cranial levels, EA of the lower spine is associated with an increased risk of sanguineous and unsuccessful puncture. Insufficient analgesia more often accompanies high thoracic and low lumbar approaches. The risk of a sanguineous puncture increases in elderly patients. Gender, weight and body mass index seem to have no influence on the investigated complications.

  16. Internal Jugular Vein Catheterization with Seldinger Technique, previous Needle Puncture: Complications

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    Carrizo G

    2016-06-01

    Full Text Available Central venous catheterization (CVC is a common procedure performed daily for its outnumbered indications, complication rates range are up to 15%. The previous puncture with a fine needle with the Seldinger technique can reduce even more the possible complications, guaranteeing a high percentage of success. The objective was to determine the number of CVC per puncture with Seldinger technique performed by general surgery residents and identify number and type of mechanical complications, related to the residence year. A descriptive transversal cut study has been carried out, between March and November of 2014. A number of 243 patients were evaluated, observing that 41% of the cases were to measure CVP and hemodynamic monitoring; 76% of the punctures were done by 1º and 2º year residents, presenting only 10% on mechanic complications, most frequently on arterial puncture. In conclusion, previous puncture with needle with the Seldinger technique is safer, more secure, lower cost, and reduces the number of complications, it is a variant puncture under ultrasound guidance.

  17. Developing a puncture-free in ovo chicken transfection strategy based on bypassing albumen nucleases.

    Science.gov (United States)

    Amini, Hamid-Reza; Pakdel, Abbas; Shahr-Babak, Hossein Moradi; Eghbalsaied, Shahin

    2017-03-15

    Chicken is a dual-purpose animal important from both agricultural and medical aspects. Even though significant improvements have been made in chicken transgenesis technologies, chicken genome manipulation has not been widely used in developmental biology. This study was aimed to evaluate chicken egg white nuclease properties and thereof plausibility of devising an in vivo transfection technology without causing physical damage to the embryo. First, the nuclease activity of egg albumen was assessed. The egg white nucleases were strongly active in degrading DNA and RNA. The egg white DNase activity was comparable to commercially available DNase-I. Nuclease activities were also assessed after heating, proteinase K, or EDTA treatment. Unlike proteinase K, both heating and EDTA were noticeably effective for the nuclease inactivation. Simultaneous application of lipoplex form of DNA (1 μg pDB2: 3 μl Lipofectamine2000) and EDTA showed a synergistic effect in protection against egg white nucleases. Finally, we injected the lipoplexes with or without EDTA close to the embryo at day0, but outside the embryonic epiblast. Implementation of a scrutinized PCR assay indicated that transfection took place only when EDTA was complemented to the lipoplexes. The transfection rate of day4 embryos and the hatched chicks were 54.5 and 30.0%, respectively. EGFP expression was detected in two out of three transgenic chicks. In conclusion, this study provided a detail analysis of chicken egg albumen nuclease properties and suggested the feasibility of developing a puncture-free handmade technology for transfection of the chicken embryo. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Simultaneous alcohol and cannabis expectancies predict simultaneous use

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    Earleywine Mitch

    2006-10-01

    Full Text Available Abstract Background Simultaneous use of alcohol and cannabis predicts increased negative consequences for users beyond individual or even concurrent use of the two drugs. Given the widespread use of the drugs and common simultaneous consumption, problems unique to simultaneous use may bear important implications for many substance users. Cognitive expectancies offer a template for future drug use behavior based on previous drug experiences, accurately predicting future use and problems. Studies reveal similar mechanisms underlying both alcohol and cannabis expectancies, but little research examines simultaneous expectancies for alcohol and cannabis use. Whereas research has demonstrated unique outcomes associated with simultaneous alcohol and cannabis use, this study hypothesized that unique cognitive expectancies may underlie simultaneous alcohol and cannabis use. Results: This study examined a sample of 2600 (66% male; 34% female Internet survey respondents solicited through advertisements with online cannabis-related organizations. The study employed known measures of drug use and expectancies, as well as a new measure of simultaneous drug use expectancies. Expectancies for simultaneous use of alcohol and cannabis predicted simultaneous use over and above expectancies for each drug individually. Discussion Simultaneous expectancies may provide meaningful information not available with individual drug expectancies. These findings bear potential implications on the assessment and treatment of substance abuse problems, as well as researcher conceptualizations of drug expectancies. Policies directing the treatment of substance abuse and its funding ought to give unique consideration to simultaneous drug use and its cognitive underlying factors.

  19. Knowledge and attitudes of Iranian patients with regard to lumbar puncture

    International Nuclear Information System (INIS)

    Borhani-Haghighi, Afshin; Shariat, Abolhamid; Rezaei, Razieh; Etemadi, Samaneh; Ghaem, Haleh

    2009-01-01

    To investigate the knowledge and attitudes of patients towards lumbar puncture (LP), its complications, and indications. In a questionnaire survey, patients who were referred to the general neurology outpatient clinic at Nemazee Hospital in Shiraz, Iran, from January 2007 to January 2008 were invited to complete a questionnaire consisting of items on demographic and socioeconomic variables, experiences with LP and complications, and knowledge of and attitudes regarding LP. A total of 410 patients were recruited (58% women, mean age 33.2 + - 2.7 years). Poor knowledge of LP was highly prevalent (92.6%), and negative attitudes toward LP were also common (63%) among our patients. Skepticism regarding LP was directly related to lack of information (p=0.00007). Lower socioeconomic status, lower educational level, and residence in rural areas were associated with being less well informed about LP, but interestingly those who had experience with LP before were better informed and had more positive attitudes. It is possible to overcome reluctance to undergo LP through education of its indications, contraindications, and complications. (author)

  20. Evaluation of M43B Lumbar puncture simulator-II as a training tool for identification of the epidural space and lumbar puncture.

    Science.gov (United States)

    Uppal, V; Kearns, R J; McGrady, E M

    2011-06-01

    The identification of the epidural space, insertion of an epidural catheter and lumbar puncture are advanced technical skills that can be challenging to teach to novice anaesthetists. The M43B Lumbar puncture simulator-II (Limbs & Things Ltd., Sussex Street, Bristol, UK) is a teaching aid designed for epidural and spinal insertion. The aim of this study was to determine if experienced anaesthetists thought this simulator may be a useful tool for training novice anaesthetists in these procedures. Experienced anaesthetists performed an epidural insertion followed by a lumbar puncture procedure on the simulator model. Various aspects of both epidural and lumbar puncture insertions were scored by the anaesthetists for likeness to a real patient using a Likert scale (0--strongly disagree; 1--disagree; 2--neither agree nor disagree; 3--agree; 4--strongly agree). The simulator was found to be life-like for most aspects of epidural insertion. Median (IQR [range]) scores were: iliac crests 3.0 (3.0-3.2 [3-4]); spinous processes 3.0 (3.0-3.2 [2-4]); skin puncture 3.0 (3.0-3.0 [1-4]); subcutaneous tissues 3.0 (2.7-3.0 [1-4]); and loss of resistance 3.0 (3.0-4.0 [3-4]). The scores for supraspinous ligament 2.0 (1.0-3.0 [0-3]), interspinous ligament 2.5 (1.7-3.0 [0-3]) and ligamentum flavum 2.0 (1.0-3.0 [0-4]) were borderline for life-likeness. The volunteers found threading of the epidural catheter difficult and rated it unlike a real patient (score 1.0 (0.2-2.0 [0-3])). During lumbar puncture, dural puncture scored 3.0 (3.0-4.0 [2-4]) and intrathecal injection scored 2.5 (1.0-3.0 [1-4]). However, the overall impression was that the simulator could be a useful tool for training of both epidurals (score 3.0 (3.0-4.0 [3-4])) and spinals (score 3.0 (3.0-3.5 [2-4])). © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  1. Spectrophotometric Determination of Iron(II and Cobalt(II by Direct, Derivative, and Simultaneous Methods Using 2-Hydroxy-1-Naphthaldehyde-p-Hydroxybenzoichydrazone

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    V. S. Anusuya Devi

    2012-01-01

    Full Text Available Optimized and validated spectrophotometric methods have been proposed for the determination of iron and cobalt individually and simultaneously. 2-hydroxy-1-naphthaldehyde-p-hydroxybenzoichydrazone (HNAHBH reacts with iron(II and cobalt(II to form reddish-brown and yellow-coloured [Fe(II-HNAHBH] and [Co(II-HNAHBH] complexes, respectively. The maximum absorbance of these complexes was found at 405 nm and 425 nm, respectively. For [Fe(II-HNAHBH], Beer’s law is obeyed over the concentration range of 0.055–1.373 μg mL−1 with a detection limit of 0.095 μg mL−1 and molar absorptivity ɛ, 5.6 × 104 L mol−1 cm−1. [Co(II-HNAHBH] complex obeys Beer’s law in 0.118–3.534 μg mL−1 range with a detection limit of 0.04 μg mL−1 and molar absorptivity, ɛ of 2.3 × 104 L mol−1 cm−1. Highly sensitive and selective first-, second- and third-order derivative methods are described for the determination of iron and cobalt. A simultaneous second-order derivative spectrophotometric method is proposed for the determination of these metals. All the proposed methods are successfully employed in the analysis of various biological, water, and alloy samples for the determination of iron and cobalt content.

  2. [Intraosseous puncture in preclinical emergency medicine. Ten years experience in air rescue service].

    Science.gov (United States)

    Helm, M; Hauke, J; Bippus, N; Lampl, L

    2007-01-01

    The intraosseous puncture (IO) is a fast and safe alternative to the puncture of peripheral veins in emergency situations in children < or =6 years of age. The purpose of this paper is to summarize 10 years of experience on the prehospital use of the IO method by the Helicopter Emergency Medical Service (HEMS) "Christoph 22", Ulm. This was a retrospective study from 1 January 1996 to 31 December 2005. Out of a total of 9,549 missions, the proportion of children was 11.1%. In 27 children (4.2% of the children < or =6 years of age) an IO puncture was performed. Patients of the IO group were younger (1.0 vs. 3.7 years of age; p<0.001) and showed a higher degree of injury severity (NACA 6 vs. 4; p<0.001) compared to the total children group. In all children of the IO group (100%), the intraosseous puncture was the method of first choice to obtain access to the vascular system by the HEMS team. In 96.4% of these cases (26/27), the first IO puncture attempt was successful - in one child, a second puncture attempt was necessary. A standardized puncture technique was performed using the proximal tibia. The time required for successful placement of the IO infusion line was 60 s or less in all cases. In 37% of the cases (10/27) the IO infusion line was used for induction of general anaesthesia; dosage and onset of administered drugs were described as being equivalent to a peripheral infusion line. In all cases, the IO needle was replaced in-hospital within 2 h by a central or peripheral iv line. No complications were observed. The IO infusion technique is a simple, fast and safe alternative method for emergency access to the vascular system in children < or =6 years of age in the prehospital setting.

  3. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years

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    Mueller Michael

    2012-12-01

    Full Text Available Abstract Background Ultrasonographically guided punctures of the liver represent a decisive tool in the diagnosis of many diseases of the liver. Objective of the study was to determine the extent to which the complication rate for ultrasonographically guided punctures of the liver is affected by less comprehensively studied risk factors. Methods A total of 2,229 liver biopsies were performed in 1,961 patients (55.5% males; 44.5% females. We recorded actual complications and assessed the following risk factors: needle gauge, puncture technique, examiner experience, coagulation status, puncture target (focal lesion versus parenchyma, lesion size, patient sex and age. Results he rate of complications stood at 1.2% (n = 27, of which 0.5% (n = 12 were major and 0.7% (n = 15 minor complications. A significant increase in complications involving bleeding was observed with larger-gauge needles compared with smaller-gauge needles and for cutting biopsy punctures compared with aspiration biopsies (Menghini technique. In the bivariate analysis complications were 2.7 times more frequent in procedures performed by experienced examiners compared with those with comparatively less experience. Lower values for Quick’s test and higher partial thromboplastin times were associated with a higher rate of bleeding. Neither the puncture target, lesion size or patient sex exerted any measurable influence on the puncture risk. Advanced patient age was associated with a higher rate of complications involving bleeding. Conclusions Our study helps to establish the importance of potential and less comprehensively studied risk factors and may contribute to further reduction in complications rates in routine clinical practice.

  4. MR imaging with gadolinium in patients with and without post-lumbar puncture headache

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    Hannerz, J. [Karolinska Hospital, Stockholm (Sweden). Dept. of Neurology; Ericson, K.; Bro Skejoe, H.P. [Karolinska Hospital, Stockholm (Sweden). Dept. of Neuroradiology

    1999-03-01

    Purpose: To study frequency and extent of meningeal enhancement in patients with and without post-lumbar puncture headache (PLPH) with cerebral MR with Gd-DTPA. Material and methods: Ten consecutive patients with PLPH and 9 consecutive patients without PLPH were included in the study. Nine of the PLPH patients were reinvestigated when the PLPH was over and all non-PLPH patients during the week after the lumbar puncture. Results: Eight of the 9 patients with PLPH showed more enhancement of meningeal structures during PLPH than when PLPH had disappeared. The differences were slight in 5, more marked in 2, and pronounced in 1 patient. The 9th patient showed no change at all. In the 9 patients without PLPH, there was mainly slight enhancement before lumbar puncture and no change in enhancement after lumbar puncture as compared with before. Conclusion: PLPH is related to increased Gd-DTPA enhancement of the meninges, although the increase in enhancement during PLPH is minor in most cases. Pronounced enhancement of the meninges after lumbar puncture may predict long duration of the PLPH. (orig.)

  5. Comparison of dural puncture epidural technique versus conventional epidural technique for labor analgesia in primigravida

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    Pritam Yadav

    2018-01-01

    Full Text Available >Background: Dural puncture epidural (DPE is a method in which a dural hole is created prior to epidural injection. This study was planned to evaluate whether dural puncture improves onset and duration of labor analgesia when compared to conventional epidural technique.Methods and Materials: Sixty term primigravida parturients of ASA grade I and II were randomly assigned to two groups of 30 each (Group E for conventional epidural and Group DE for dural puncture epidural. In group E, epidural space was identified and 18-gauge multi-orifice catheter was threaded 5 cm into the epidural space. In group DE, dura was punctured using the combines spinal epidural (CSE spinal needle and epidural catheter threaded as in group E followed by 10 ml of injection of Ropivacaine (0.2% with 20 mcg of Fentanyl (2 mcg/ml in fractions of 2.5 ml. Later, Ropivacaine 10 ml was given as a top-up on patient request. Onset, visual analouge scale (VAS, sensory and motor block, haemodynamic variables, duration of analgesia of initial dose were noted along with mode of delivery and the neonatal outcome.Results: Six parturients in group DE achieved adequate analgesia in 5 minutes while none of those in group E (P 0.05.Conclusions: Both techniques of labor analgesia are efficacious; dural puncture epidural has the potential to fasten onset and improve quality of labor analgesia when compared with conventional epidural technique.

  6. [Puncture Point Hemostatic Effect Observation of Different Materials with Modified Seldinger Technique in PICC Catheter].

    Science.gov (United States)

    Wan, Guangming; Yan, Meiqiong

    2015-09-01

    To explore the improvement the dingle technology through the PICC catheter puncture point elbow hemostatic effect. Selection. Between January 2013 and December 2013, chest hospital affiliated to Shanghai jiaotong university under the guidance of ultrasound improved the Ding Gehang PICC catheter patients of 997 cases were randomly divided into three groups A, B, C, respectively, using gauze pad, calcium alginate wound dressings, calcium alginate wound dressings with hemostatic gauze pad three methods to puncture point, compare the three groups within 48 h after puncture biopsy in patients with some local bleeding, treatment times and catheter after 1 week of the maintenance costs of the catheter. Compared with A, B two groups, patients of group C tube after 48 hours the puncture point local oppression hemostasis effect is better than that of group A and B, the difference was statistically significant (all P PICC for surgery after the puncture point of oppression hemostasis method choice, the effect of calcium alginate dressings hemostatic gauze pad is better than that of gauze pads and calcium alginate dressings, calcium alginate dressings and gauze pad is more effective and economic, in clinical use.

  7. The Potential of the Bi-Directional Gaze: A Call for Neuroscientific Research on the Simultaneous Activation of the Sympathetic and Parasympathetic Nervous Systems through Tantric Practice

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    Jeffrey S. Lidke

    2016-11-01

    Full Text Available This paper is a call for the development of a neuroscientific research protocol for the study of the impact of Tantric practice on the autonomic nervous system. Tantric texts like Abhinavagupta’s Tantrāloka map out a complex meditative ritual system in which inward-gazing, apophatic, sense-denying contemplative practices are combined with outward-gazing, kataphatic sense-activating ritual practices. Abhinavagupta announces a culminating “bi-directional” state (pratimīlana-samādhi as the highest natural state (sahaja-samādhi in which the practitioner becomes a perfected yogi (siddhayogi. This state of maximized cognitive capacities, in which one’s inward gaze and outward world-engagement are held in balance, appears to be one in which the anabolic metabolic processes of the parasympathetic nervous system and the catabolic metabolic processes of the sympathetic nervous systems are simultaneously activated and integrated. Akin to secularized mindfulness and compassion training protocols like Emory’s CBCT, I propose the development of secularized “Tantric protocols” for the development of secular and tradition-specific methods for further exploring the potential of the human neurological system.

  8. The clinical value of trans-vaginal ultrasound-guided puncture in the treatment of pelvic abscess

    International Nuclear Information System (INIS)

    Wang Ping; Gong Wei

    2008-01-01

    Objective: To investigate the clinical value of trans-vaginal ultrasound-guided (TVS) puncture in the treatment of pelvic abscess. Methods 30 cases with pelvic abscess were treated by transvaginal ultrasound-guided puncture. The long-dated effects were followed-up. Results: 29 cases were cured by TVS puncture. Operation was performed in 1 patient because of invalid effect. The cure rate was 97%. Conclusion: Ultrasound-guided puncture is a safe and convenient method in the treatment of pelvic abscess. (authors)

  9. Fabrication of Bonding-Type Hollow Microneedle Array by Injection Molding and Evaluation of its Puncture Characteristics

    Science.gov (United States)

    Ogai, Noriyuki; Sugimura, Ryo; Tamaru, Takuya; Takiguchi, Yoshihiro

    A microneedle array which consists from small needles compared to a conventional metal injection needle is expected as a low invasive transdermal medical treatment device, and many fabrication approach have been conducted. In this study, we fabricated plastic hollow microneedle array by a fabrication method based on the combination of injection molding, bonding and assembly techniques. To evaluate puncture characteristics of the fabricated needle, we measured a puncture force to silicone rubber by experimental equipment using loadcell and automatic stage. Furthermore, we propose and demonstrate a new method to measure actual punctured depth from punctured trace on the needle surface modified by O2 plasma treatment.

  10. Changes in cerebral haemodynamics in cases of post-lumbar puncture headache: a prospective transcranial Doppler ultrasound study

    International Nuclear Information System (INIS)

    Goebel, H.; Klostermann, H.; Lindner, V.; Schenkl, S.

    1990-01-01

    Transcranial Doppler ultrasonography was used in 45 patients to investigate if changes in haemodynamics in the major arteries of the brain base occurred after lumbar puncture and whether or not patients with or without post-lumbar puncture headache differ with respect to their cerebral haemodynamic parameters before and after lumbar puncture. Before lumbar puncture, patients with post-lumbar puncture headache differed from patients withoput post-lumbar puncture headache in that they showed significantly higher flow velocities and significant asymmetry of flow velocities with lateralization to the right. Patients without post-lumbar puncture headache, on the other hand, showed non-significant flow velocity lateralization to the left. Forty-eight hours after lumbar puncture, both groups demonstrated symmetrical flow velocities. In addition, only patients with post-lumbar puncture headache showed a significant reduction in the flow velocity of the right middle cerebral artery. These findings suggest that it is not only absolute flow velocity that plays a part in the event of headache; the interhemispheric relation of cerebral haemodynamics also plays a fundamental role. 14 refs., 3 figs., 2 tabs

  11. The super period matrix with Ramond punctures in the supergravity formulation

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    Eric D'Hoker

    2015-10-01

    Full Text Available In a very recent preprint, Witten showed how to construct a g|r×g|r super period matrix for super Riemann surfaces of genus g with 2r Ramond punctures, which is symmetric in the Z2 graded sense. He also showed how it can be applied to analyze supersymmetry breaking in string compactifications which are supersymmetric at tree-level. Witten's construction is in the purely holomorphic formulation of super Riemann surfaces. In this paper, a construction is given in the formulation of two-dimensional supergravity. The variations of the super period matrix with respect to supermoduli deformations are also given, as well as an explicit illustration of how the super period matrix with two Ramond punctures would emerge from a degeneration of the super period matrix without punctures in higher genus.

  12. [Research on Optical Parameter along Puncture Path in Spinal Surgery Navigation Based on Near Infrared Spectroscopy].

    Science.gov (United States)

    Wang, Yuyan; Qian, Zhiyu; Li, Weitao; Liu, Yangyang; Xie, Jieru

    2015-06-01

    Accurate placement of pedicle screws is a key factor of spinal surgery. Investigation of a new real-time intra-operative monitoring method is an important area of clinical application research which makes a contribution to planting pedicle screw accurately. Porcine spines were chosen as experimental objects. The changes of reduced scattering coefficient (μ'(s)) along normal puncture path, medial perforation path and lateral perforation path were measured and studied. A conclusion is drawn that there are two distinct peaks throughout the puncture process, appearing at the junction of cancellous bone and cortical bone, at the beginning and at the end, respectively. The reduced scattering coefficient is proved to be a good monitoring factor which can identify whether the screw is about to reach the critical position of the spine puncture. Moreover, the variation provides an important reference for spinal surgical navigation process.

  13. An evaluation of the Johnson-Cook model to simulate puncture of 7075 aluminum plates.

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    Corona, Edmundo; Orient, George Edgar

    2014-02-01

    The objective of this project was to evaluate the use of the Johnson-Cook strength and failure models in an adiabatic finite element model to simulate the puncture of 7075- T651 aluminum plates that were studied as part of an ASC L2 milestone by Corona et al (2012). The Johnson-Cook model parameters were determined from material test data. The results show a marked improvement, in particular in the calculated threshold velocity between no puncture and puncture, over those obtained in 2012. The threshold velocity calculated using a baseline model is just 4% higher than the mean value determined from experiment, in contrast to 60% in the 2012 predictions. Sensitivity studies showed that the threshold velocity predictions were improved by calibrating the relations between the equivalent plastic strain at failure and stress triaxiality, strain rate and temperature, as well as by the inclusion of adiabatic heating.

  14. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated.

  15. [Ethyl chloride aerosol spray for local anesthesia before arterial puncture: randomized placebo-controlled trial].

    Science.gov (United States)

    Ballesteros-Peña, Sendoa; Fernández-Aedo, Irrintzi; Vallejo-De la Hoz, Gorka

    2017-06-01

    To compare the efficacy of an ethyl chloride aerosol spray to a placebo spray applied in the emergency department to the skin to reduce pain from arterial puncture for blood gas analysis. Single-blind, randomized placebo-controlled trial in an emergency department of Hospital de Basurto in Bilbao, Spain. We included 126 patients for whom arterial blood gas analysis had been ordered. They were randomly assigned to receive application of the experimental ethyl chloride spray (n=66) or a placebo aerosol spray of a solution of alcohol in water (n=60). The assigned spray was applied just before arterial puncture. The main outcome variable was pain intensity reported on an 11-point numeric rating scale. The median (interquartile range) pain level was 2 (1-5) in the experimental arm and 2 (1-4.5) in the placebo arm (P=.72). Topical application of an ethyl chloride spray did not reduce pain caused by arterial puncture.

  16. Unintentional dural puncture with a Tuohy needle increases risk of chronic headache.

    Science.gov (United States)

    Webb, Christopher Allen-John; Weyker, Paul David; Zhang, Li; Stanley, Susan; Coyle, D Tyler; Tang, Timothy; Smiley, Richard M; Flood, Pamela

    2012-07-01

    Neuraxial analgesia is chosen by almost half of women who give birth in the United States. Unintentional dural puncture is the most common complication of this pain management technique, occurring in 0.4% to 6% of parturients. Severe positional headaches develop acutely in 70% to 80% of these parturients. Acute postdural puncture headaches are well known, but few studies have investigated long-term sequelae. We investigated the incidence of and risk factors for chronic headache and chronic back pain in parturients who experienced unintentional dural puncture with a 17-gauge Tuohy needle compared with matched controls. In a case control design, 40 parturients who sustained unintentional dural puncture with a 17-gauge Tuohy needle over an 18-month period and 40 controls matched for age, weight, and time of delivery were recruited by telephone and 2 validated questionnaires were administered assessing headache and back pain symptoms 12 to 24 months after delivery. The incidence of chronic headaches in the study group (28%) was significantly higher than in the matched controls (5%) (OR = 7, P = 0.0129). Subjects who experienced dural punctures were more likely than controls to report chronic back pain (OR = 4, P = 0.0250), but treatment with an epidural blood patch was not a risk factor for chronic back pain. Patients who incur unintentional dural punctures with large-gauge needles are surprisingly likely to continue to suffer chronic headaches. Treatment with an epidural blood patch does not enhance the risk of chronic back pain. The pathophysiology underlying these symptoms and the best treatment for this syndrome are not known.

  17. Development and psychometric evaluation of the arterial puncture self-efficacy scale.

    Science.gov (United States)

    Hernández-Padilla, José Manuel; Granero-Molina, José; Márquez-Hernández, Verónica V; Suthers, Fiona; Fernández-Sola, Cayetano

    2016-05-01

    Arterial puncture for arterial blood gases (ABG) analysis can be a risky, painful, difficult-to-perform procedure that is often insufficiently practised and generates stress and discomfort amongst patients and healthcare professionals. Self-efficacy is a key component in the acquisition of procedural skills. Therefore, professionals' self-efficacy in arterial puncture should be measured before attempting the procedure on real patients. To develop and psychometrically assess a self-efficacy scale in arterial puncture. An observational cross-sectional design was used in this study. Faculty of Education Sciences, Nursing and Physiotherapy in a higher education institution in the south of Spain. A convenience sample of 342 nursing students entered and completed the study. All participants met the following inclusion criteria: (1) ≥18years old and (2) enrolled in a nursing degree programme during the 2014/2015 academic year. Participants were 74% female (n=254) and their age ranged from 18 to 50, with a mean age of 21.74years (SD=5.14). The Arterial Puncture Self-Efficacy Scale (APSES) was developed and psychometrically tested. Reliability and content validity were studied. Predictive validity and concurrent validity assessed criterion validity. In addition, principal component analysis and known-group analysis evaluated construct validity. Principal component analysis revealed the two-subscale structure of the final 22-item version of the Arterial Puncture Self-Efficacy Scale (APSES). A total Cronbach's alpha coefficient of 0.97 showed its high reliability. The APSES' content validity index was excellent (S-CVI/Ave=0.95). Predictive and concurrent validity analysis demonstrated the good criterion validity of the tool. Supporting the APSES' sensitivity and specificity, known-groups analysis evidenced significant differences (pgood psychometric properties for measuring self-efficacy in arterial puncture for ABG analysis. Copyright © 2016 Elsevier Ltd. All rights

  18. A fast and direct spectrophotometric method for the simultaneous determination of methyl paraben and hydroquinone in cosmetic products using successive projections algorithm.

    Science.gov (United States)

    Esteki, M; Nouroozi, S; Shahsavari, Z

    2016-02-01

    To develop a simple and efficient spectrophotometric technique combined with chemometrics for the simultaneous determination of methyl paraben (MP) and hydroquinone (HQ) in cosmetic products, and specifically, to: (i) evaluate the potential use of successive projections algorithm (SPA) to derivative spectrophotometric data in order to provide sufficient accuracy and model robustness and (ii) determine MP and HQ concentration in cosmetics without tedious pre-treatments such as derivatization or extraction techniques which are time-consuming and require hazardous solvents. The absorption spectra were measured in the wavelength range of 200-350 nm. Prior to performing chemometric models, the original and first-derivative absorption spectra of binary mixtures were used as calibration matrices. Variable selected by successive projections algorithm was used to obtain multiple linear regression (MLR) models based on a small subset of wavelengths. The number of wavelengths and the starting vector were optimized, and the comparison of the root mean square error of calibration (RMSEC) and cross-validation (RMSECV) was applied to select effective wavelengths with the least collinearity and redundancy. Principal component regression (PCR) and partial least squares (PLS) were also developed for comparison. The concentrations of the calibration matrix ranged from 0.1 to 20 μg mL(-1) for MP, and from 0.1 to 25 μg mL(-1) for HQ. The constructed models were tested on an external validation data set and finally cosmetic samples. The results indicated that successive projections algorithm-multiple linear regression (SPA-MLR), applied on the first-derivative spectra, achieved the optimal performance for two compounds when compared with the full-spectrum PCR and PLS. The root mean square error of prediction (RMSEP) was 0.083, 0.314 for MP and HQ, respectively. To verify the accuracy of the proposed method, a recovery study on real cosmetic samples was carried out with satisfactory

  19. Development of a new bench for puncturing of irradiated fuel rods in STAR hot laboratory

    Science.gov (United States)

    Petitprez, B.; Silvestre, P.; Valenza, P.; Boulore, A.; David, T.

    2018-01-01

    A new device for puncturing of irradiated fuel rods in commercial power plants has been designed by Fuel Research Department of CEA Cadarache in order to provide experimental data of high precision on fuel pins with various designs. It will replace the current set-up that has been used since 1998 in hot cell 2 of STAR facility with more than 200 rod puncturing experiments. Based on this consistent experimental feedback, the heavy-duty technique of rod perforation by clad punching has been preserved for the new bench. The method of double expansion of rod gases is also retained since it allows upgrading the confidence interval of volumetric results obtained from rod puncturing. Furthermore, many evolutions have been introduced in the new design in order to improve its reliability, to make the maintenance easier by remote handling and to reduce experimental uncertainties. Tightness components have been studied with Sealing Laboratory Maestral at Pierrelatte so as to make them able to work under mixed pressure conditions (from vacuum at 10-5 mbar up to pressure at 50 bars) and to lengthen their lifetime under permanent gamma irradiation in hot cell. Bench ergonomics has been optimized to make its operating by remote handling easier and to secure the critical phases of a puncturing experiment. A high pressure gas line equipped with high precision pressure sensors out of cell can be connected to the bench in cell for calibration purposes. Uncertainty analyses using Monte Carlo calculations have been performed in order to optimize capacity of the different volumes of the apparatus according to volumetric characteristics of the rod to be punctured. At last this device is composed of independent modules which allow puncturing fuel pins out of different geometries (PWR, BWR, VVER). After leak tests of the device and remote handling simulation in a mock-up cell, several punctures of calibrated specimens have been performed in 2016. The bench will be implemented soon in hot

  20. Subcutaneous Emphysema Induced by Cryotherapy: A Complication due to Previous Punctures

    Directory of Open Access Journals (Sweden)

    Jared Martínez-Coronado

    2015-01-01

    Full Text Available Cryosurgery is a common therapeutic modality used in dermatology; therefore we must be aware of its possible adverse effects. We report a case of a patient with subcutaneous emphysema which occurred following the application of cryotherapy after multiple punctures of local anesthetic and intralesional steroids in a chest keloid scar. Despite the fact that this condition was gradually resolved after expectant observation, we warn about this complication when sprayed cryotherapy is preceded by multiple punctures on cutaneous lesions above bony surfaces. In similar settings, cryotherapy must be first administered or a cotton-tip applicator should be used.

  1. Repeat Lumbar Puncture: CSF Lactic Acid Levels are Predictive of Cure with Acute Bacterial Meningitis

    Directory of Open Access Journals (Sweden)

    Burke A. Cunha

    2013-12-01

    Full Text Available A common clinical problem concerns the utility of repeat lumbar puncture (LP in adults with acute bacterial meningitis (ABM, e.g., pneumococcal meningitis [1]. An LP is initially done for diagnostic purposes in patients with suspected ABM, i.e., diagnostic lumbar puncture (DLP. A repeat LP (RLP may be done 1–3 days after the initial DLP, if the patient shows no improvement. If a patient with ABM is not doing well after three days, adequacy of antimicrobial therapy is the main concern. Other reasons for RLP is to detect possible intracranial complications of ABM unrelated to adequacy of therapy [1–2].

  2. Simultaneous determination of volatile trace elements in nickel-base alloys using a direct insertion probe and inductively coupled plasma emission spectrometry

    Science.gov (United States)

    McLeod, C. W.; Clarke, P. A.; Mowthorpe, D. J.

    The direct determination of volatile trace elements in Ni-base alloys has been studied using direct insertion-inductively coupled plasma-atomic emission spectrometry. A graphite probe which accommodated mg quantities of alloy chips was raised, semi-automatically, into the ICP and the volatile elements Cd, Mg, Pb and Zn were rapidly vaporised from the involatile host matrix and underwent excitation. Emission response for the elements as a function of applied rf power and observation zone was examined. It was established that aqueous multielement standard solutions (non-matrix matched) could be used for calibration and the viability of the approach was tested using certified reference materials and previously analysed Ni-base samples. Limits of detection, based on a 5 mg sample were 0.004-0.08 μg g -1 and precision at the μg g -1 level was in the range 6-14 % RSD. The method was not applicable to the determination of As and Se.

  3. [Bilateral greater occipital nerve block for treatment of post-dural puncture headache after caesarean operations].

    Science.gov (United States)

    Uyar Türkyilmaz, Esra; Eryilmaz, Nuray Camgöz; Güzey, Nihan Aydin; Moraloğlu, Özlem

    2016-01-01

    Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region. GON blockage has been used for the treatment of many kinds of headache. The aim of this retrospective study is to present the results of PDPH treated with GON block over 1 year period in our institute. 16 patients who had been diagnosed to have PDPH, and performed GON block after caesarean operations were included in the study. GON blocks were performed as the first treatment directly after diagnose of the PDPH with levobupivacaine and dexamethasone. The mean VAS score of the patients was 8.75 (±0.93) before the block; 3.87 (±1.78) 10min after the block; 1.18 (±2.04) 2h after the block and 2.13 (±1.64) 24h after the block. No adverse effects were observed. Treatment of PDPH with GON block seems to be a minimal invasive, easy and effective method especially after caesarean operations. A GON block may be considered before the application of a blood patch. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Oviposition punctures in cucurbit fruits and their economic damage caused by the sterile female melon fly, Bactrocera cucurbitae Coquillett

    International Nuclear Information System (INIS)

    Miyatake, T.; Irabu, T.; Higa, R.

    1993-01-01

    Oviposition punctures caused by sterile females of the tephritid Bactrocera cucurbitae in cucurbit fruits were examined and economic damage was evaluated in Okinawa, Ryukyu Archipelago, Japan. Cage experiments in the field confirmed that sterile females make punctures (sterile stings) on fruits. The features of sterile stings differed depending on fruit species and were classified into 5 types

  5. Ultrasound-guided fine-needle aspiration of thyroid nodules: assessment of the ideal number of punctures

    Directory of Open Access Journals (Sweden)

    Sandro Ceratti

    2012-06-01

    Full Text Available OBJECTIVE: To determine the number of punctures in fine-needle aspiration biopsies required for a safe cytological analysis of thyroid nodules. MATERIALS AND METHODS: Cross-sectional study with focus on diagnosis. The study population included 94 patients. RESULTS: The mean age of the patients participating in the study was 52 years (standard-deviation = 13.7 and 90.4% of them were women. Considering each puncture as an independent event, the first puncture has showed conclusive results in 78.7% of cases, the second, in 81.6%, and the third, in 71.8% of cases. With a view to the increasing chance of a conclusive diagnosis at each new puncture, two punctures have showed conclusive results in 89.5% of cases, and three punctures, in 90.6% of cases with at least one conclusive result. CONCLUSION: Two punctures in fine-needle aspiration biopsies of thyroid nodules have lead to diagnosis in 89.5% of cases in the study sample, suggesting that there is no need for multiple punctures to safely obtain the diagnosis of thyroid nodules.

  6. SIMULTANEOUS SPACE VECTOR MODULATION DIRECT TORQUE CONTROL OF TWO INDUCTION MOTORS USED IN ELECTRIC VEHICLES BY A NINE-SWITCH INVERTER

    Directory of Open Access Journals (Sweden)

    A. R. SHAMLOU

    2017-12-01

    Full Text Available In this paper, a novel two output nine switch-inverter is proposed in order to increase the synchronization speed of induction motors used in electric vehicles (EVs while improving the efficiency and controllability of the system. The number of switches in the proposed inverter is reduced by 25% compared to double six-switch inverters which conventionally used in EVs. The main characteristics of the considered inverter can be noted as follows: sinusoidal input and outputs, unity output power factor, and specifically, low construction cost due to active switch number reduction. The classical direct torque control method causes torque ripple and speed fluctuations. Therefore, in order to increase accuracy and dynamics of drive system, the SVM-DTC method is proposed, leading to less torque ripple and constant switching frequency. The obtained torque ripple is 2% which is less than the existing structures In order to illustrate advantages of the proposed approach, performance of the EVs in the standard cycles is evaluated.

  7. Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients

    Directory of Open Access Journals (Sweden)

    Rajesh Thosani

    2016-01-01

    Full Text Available Background: The modification in technique is useful for successful right-sided internal jugular vein (IJV cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients. Materials and Methods: This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95 and female (n = 65 who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French using Seldinger technique. Results: Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred. All five patients were cannulated successfully on the same side with this modified technique without any significant major complications. They were managed by application of blocker at the end of arterial needle puncture without removing it. In our routine practice, we were used to removing this needle and applying compression for few minutes to prevent hematoma formation after an arterial puncture. In this study, cannula was used as a marker or guideline for the relocation of IJV on the same side and recannulation was performed by changing the direction of needle on same side lateral to the previous one and without going towards the same direction to prevent the arterial puncture again. Conclusion: Most simple and useful modified technique for institutes where the complications are most common with trainee doctors and in hospitals where there is no advanced facility like ultrasound-guided cannulation available. By this modification, it will be time saving, very comfortable, and user-friendly technique with high success rate.

  8. Common Rail Direct Injection Mode of CI Engine Operation with Different Injection Strategies - A Method to Reduce Smoke and NOx Emissions Simultaneously

    Directory of Open Access Journals (Sweden)

    S. V. Khandal

    2018-03-01

    Full Text Available Compression ignition (CI engines are most efficient and robust prime movers used in transportation, power generation applications but suffer from the problems of higher level of exhaust smoke and NOx tailpipe emissions with increased use of fossil fuels. Alternative fuel that replaces diesel and at the same time that result in lower smoke and NOx emissions is presently needed. Therefore the main aim of this experimental study is to lower the smoke and NOx emissions and to use non edible oils that replace the diesel. For this locally available honge biodiesel (BHO and cotton seed biodiesel (BCO were selected as alternative fuels to power CI engine operated in common rail direct injection (CRDI mode. In the first part, optimum fuel injection timing (IT and injection pressure (IP for maximum engine brake thermal efficiency (BTE was obtained. In the second part, performance, combustion and emission characteristics of the CRDI engine was studied with two different fuel injectors having 6 and 7 holes each having 0.2 mm orifice diameter. The CRDI engine results obtained were compared with the baseline date reported. The combustion chamber (CC used for the study was toroidal re-entrant (TRCC. The experimental tests showed that BHO and BCO fuelled CRDI engine showed overall improved performance with 7 hole injector when engine was operated at optimized fuel IT of 10° before top dead centre (bTDC and IP of 900 bar. The smoke emission reduced by 20% to 26% and NOx reduced by 16% to 20% in diesel and biodiesel powered CRDI engine as compared to conventional CI mode besides replacing diesel by biodiesel fuel (BDF.

  9. Eggshell strength of an obligate brood parasite: a test of the puncture resistance hypothesis

    Czech Academy of Sciences Publication Activity Database

    Antonov, A.; Stokke, B. G.; Moksnes, A.; Kleven, O.; Honza, Marcel; Roskaft, E.

    2006-01-01

    Roč. 60, č. 1 (2006), s. 11-18 ISSN 0340-5443 Grant - others:Research Council of Norway(NO) 151641/432 Institutional research plan: CEZ:AV0Z60930519 Keywords : brood parasitism * eggshell thickness * puncture resistance * Acrocephalus * cuckoo Subject RIV: EG - Zoology Impact factor: 2.316, year: 2006

  10. Classical and quantum Liouville theory on the Riemann sphere with n>3 punctures (III)

    International Nuclear Information System (INIS)

    Shen Jianmin; Sheng Zhengmao; Wang Zhonghua

    1992-02-01

    We study the Classical and Quantum Liouville theory on the Riemann sphere with n>3 punctures. We get the quantum exchange algebra relations between the chiral components in the Liouville theory from our assumption on the principle of quantization. (author). 5 refs

  11. On the extrema of Dirichlet's first eigenvalue of a family of punctured ...

    Indian Academy of Sciences (India)

    Home; Journals; Proceedings – Mathematical Sciences; Volume 122; Issue 2. On the Extrema of Dirichlet's First Eigenvalue of a Family of Punctured Regular Polygons in Two Dimensional Space Forms. A R Aithal Rajesh Raut. Volume 122 Issue 2 May 2012 pp 257-281 ...

  12. Repeated therapeutic lumbar punctures in cryptococcal meningitis - necessity and/or opportunity?

    Science.gov (United States)

    Chang, Christina C; Perfect, John R

    2016-12-01

    Overall, 50-70% of patients with cryptococcal meningitis have raised intracranial pressure (ICP). Multiple international treatment guidelines recommend repeated therapeutic lumbar punctures as adjunctive management. Here, we review the recent evidence for the role of repeated lumbar punctures on clinical outcome in cryptococcal meningitis and also review the increasing body of data utilizing these repeated cerebrospinal fluid (CSF) samples as a window into understanding immunopathogenesis of cryptococcal meningitis. Adjunctive dexamethasone led to higher adverse advents and disability and poorer CSF fungal clearance. Performance of a therapeutic lumbar puncture is associated with 69% relative survival protection. An activated innate immune system in the CSF is associated with future cryptococcosis-associated immune reconstitution inflammatory syndrome development. The zebrafish model is being utilized in cryptococcal studies allowing live visualization of central nervous system invasion. Therapeutic lumbar punctures are a critical part of cryptococcal meningitis management and CSF immunological assays are increasingly being performed in research settings. Finer manipulation of CSF removal and safer surgical techniques for intracranial pressure management applicable to resource-limited settings are needed. More precise and validated guidelines in resource-available settings would be an improvement for care. We look forward to identifying a set of biomarkers, easily performed in routine laboratories or at point-of-care, so as to translate these assays into clinical care. Wide-scale '-omic' studies are likely to be required in future cryptococcal meningitis studies to improve our understanding of this deadly fungus.

  13. On the extrema of Dirichlet's first eigenvalue of a family of punctured ...

    Indian Academy of Sciences (India)

    On the extrema of Dirichlet's first eigenvalue of a family of punctured regular polygons in two dimensional space forms. A R AITHAL and RAJESH RAUT. Department of Mathematics, University of Mumbai, Vidyanagari,. Mumbai 400 098, India. R. D. National College & W. A. Science College, Bandra, Mumbai 400 050, India.

  14. Cecal ligation and puncture induced sepsis impairs host defense against Enterococcus faecium peritonitis

    NARCIS (Netherlands)

    Leendertse, Masja; Willems, Rob J.; Giebelen, Ida A.; Florquin, Sandrine; van den Pangaart, Petra S.; Bonten, Marc J.; van der Poll, Tom

    2009-01-01

    Multiresistant and vancomycin resistant Enterococcus faecium (VRE) can cause serious infections in hospitalized patients with various co-morbid diseases. We investigated the course of VRE peritonitis after cecal ligation and puncture (CLP)-induced sepsis and compared this to sham operated mice. Mice

  15. Use of a Collagen-Based Device for Closure of Low Brachial Artery Punctures

    International Nuclear Information System (INIS)

    Belenky, A.; Aranovich, D.; Greif, F.; Bachar, G.; Bartal, G.; Atar, E.

    2007-01-01

    Purpose. To report our experience with the Angioseal vascular closure device for hemostasis of distal brachial artery puncture. Methods. Between September 2003 and August 2005, 64 Angioseal vascular closure devices were inserted in 64 patients (40 men, 24 women; mean age 65 years) immediately after diagnostic or therapeutic arterial angiographies performed through a 5 Fr to 7 Fr sheath via the distal brachial artery. Ultrasound examination of the brachial artery preceded the angiography in all cases and only arteries wider than 4 mm were closed by the Angioseal. In cases of a sonographically evident thin subcutaneous space of the cubital fossa, tissue tumescence, using 1% Lidocaine, was performed prior to the arterial closure. Results. The deployment success rate was 100%. No major complications were encountered; only 2 patients developed puncture site hematoma, and these were followed conservatively. Conclusions. Closure of low brachial artery punctures with the Angioseal is simple and safe. No additional manual compression is required. We recommend its use after brachial artery access interventions, through appropriately wide arteries, to improve early patient ambulation and potentially reduce possible puncture site complications

  16. Risk Factors for Puncture Site Complications After Endovascular Procedures in Patients With Peripheral Arterial Disease.

    Science.gov (United States)

    Hackl, Gerald; Gary, Thomas; Belaj, Klara; Hafner, Franz; Eller, Philipp; Brodmann, Marianne

    2015-10-01

    To compare femoral access site closure techniques and to highlight risk factors for puncture site complications after lower extremity endovascular procedures. This retrospective study included 787 patients. Procedures were performed according to a standardized protocol. Puncture site complications within 24 hours were regarded as study end points. Ninety (11.5%) puncture site complications were registered. Conventional manual compression (n = 87, 11.1%) was significantly associated with puncture site complications (odds ratio [OR] 2.08, P = .03). Body mass index > 25 kg/m(2) (OR 0.54, P = .01) and prothrombin time > 70% (OR 0.38, P = .04) were protective. All bleeding occurred in procedures >45 minutes. Blood pressure >200 mm Hg and below the knee (BTK) procedures were strong predictors for access site complications (OR 4.21, P = .01 and OR 3.33, P = .02). We observed an inferiority of conventional manual compression. Age, procedure duration > 45 minutes, BTK procedures, uncontrolled hypertension, and impaired coagulation were risk factors. © The Author(s) 2015.

  17. Effects of High-Definition Anodal Transcranial Direct Current Stimulation Applied Simultaneously to Both Primary Motor Cortices on Bimanual Sensorimotor Performance

    Directory of Open Access Journals (Sweden)

    Nils H. Pixa

    2017-07-01

    Full Text Available Many daily activities, such as tying one’s shoe laces, opening a jar of jam or performing a free throw in basketball, require the skillful coordinated use of both hands. Even though the non-invasive method of transcranial direct current stimulation (tDCS has been repeatedly shown to improve unimanual motor performance, little is known about its effects on bimanual motor performance. More knowledge about how tDCS may improve bimanual behavior would be relevant to motor recovery, e.g., in persons with bilateral impairment of hand function. We therefore examined the impact of high-definition anodal tDCS (HD-atDCS on the performance of a bimanual sequential sensorimotor task. Thirty-two volunteers (age M = 24.25; SD = 2.75; 14 females participated in this double-blind study and performed sport stacking in six experimental sessions. In sport stacking, 12 specially designed cups must be stacked (stacked up and dismantled (stacked down in predefined patterns as fast as possible. During a pretest, posttest and follow-up test, two sport stacking formations (3-6-3 stack and 1-10-1 stack were performed. Between the pretest and posttest, all participants were trained in sport stacking with concurrent brain stimulation for three consecutive days. The experimental group (STIM-M1 received HD-atDCS over both primary motor cortices (M1, while the control group received a sham stimulation (SHAM. Three-way analysis of variance (ANOVA revealed a significant main effect of TIME and a significant interaction of TIME × GROUP. No significant effects were found for GROUP, nor for the three-way interaction of TIME × GROUP × FORMATION. Further two-way ANOVAs showed a significant main effect of TIME and a non-significant main effect for GROUP in both sport stacking formations. A significant interaction between TIME × GROUP was found only for the 3-6-3 formation, indicating superior performance gains for the experimental group (STIM-M1. To account and control for

  18. Effects of High-Definition Anodal Transcranial Direct Current Stimulation Applied Simultaneously to Both Primary Motor Cortices on Bimanual Sensorimotor Performance

    Science.gov (United States)

    Pixa, Nils H.; Steinberg, Fabian; Doppelmayr, Michael

    2017-01-01

    Many daily activities, such as tying one’s shoe laces, opening a jar of jam or performing a free throw in basketball, require the skillful coordinated use of both hands. Even though the non-invasive method of transcranial direct current stimulation (tDCS) has been repeatedly shown to improve unimanual motor performance, little is known about its effects on bimanual motor performance. More knowledge about how tDCS may improve bimanual behavior would be relevant to motor recovery, e.g., in persons with bilateral impairment of hand function. We therefore examined the impact of high-definition anodal tDCS (HD-atDCS) on the performance of a bimanual sequential sensorimotor task. Thirty-two volunteers (age M = 24.25; SD = 2.75; 14 females) participated in this double-blind study and performed sport stacking in six experimental sessions. In sport stacking, 12 specially designed cups must be stacked (stacked up) and dismantled (stacked down) in predefined patterns as fast as possible. During a pretest, posttest and follow-up test, two sport stacking formations (3-6-3 stack and 1-10-1 stack) were performed. Between the pretest and posttest, all participants were trained in sport stacking with concurrent brain stimulation for three consecutive days. The experimental group (STIM-M1) received HD-atDCS over both primary motor cortices (M1), while the control group received a sham stimulation (SHAM). Three-way analysis of variance (ANOVA) revealed a significant main effect of TIME and a significant interaction of TIME × GROUP. No significant effects were found for GROUP, nor for the three-way interaction of TIME × GROUP × FORMATION. Further two-way ANOVAs showed a significant main effect of TIME and a non-significant main effect for GROUP in both sport stacking formations. A significant interaction between TIME × GROUP was found only for the 3-6-3 formation, indicating superior performance gains for the experimental group (STIM-M1). To account and control for baseline

  19. A Randomized Controlled Trial on the Effect of Needle Gauge on the Pain and Anxiety Experienced during Radial Arterial Puncture.

    Directory of Open Access Journals (Sweden)

    Maxime Patout

    Full Text Available Arterial punctures for assessment of arterial blood-gases can be a painful procedure. Lidocaine can be used to reduce pain prior to needle insertion but it is not a widely accepted practice. The purpose of this study was to determine whether a large size needle induces more pain compared to a smaller size needle for radial arterial puncture and to assess the anxiety associated with radial arterial punctures.We conducted a prospective, double-blind, randomized, controlled, monocentric study including all outpatients who had a planned assessment of arterial blood gas analysis. Patients were randomized to have the arterial puncture performed with a 23 or a 25 G needle. The main judgement criteria was pain during arterial puncture. Visual analogue scale for pain (VAS-P and visual analogue scale for anxiety (VAS-A were used to assess pain and anxiety during radial arterial puncture.Two hundred consecutive patients were randomized. The 25 G needle was as painful as the 23 G needle (6.63 mm [0-19 mm] vs. 5.21 mm [0-18.49 mm], respectively, p = 0.527. Time for arterial puncture was longer with the 25 G needle than with the 23 G needle (42 s [35-55 s] vs. 33 s [24.5-35 s], respectively, p = 0.002. There was a correlation between the level of anxiety prior to the arterial puncture and the pain experienced by the patients (p: 0.369, p<0.0001. There was a correlation between the pain experienced by patients and the anxiety experienced in anticipation of another arterial puncture (p: 0.5124, p<0.0001.The use of 23 G needle allows quicker arterial sampling and is not associated with increased pain and symptoms. Anxiety was correlated with the pain experienced by patients during arterial punctures.Clinicaltrials.gov: NCT02320916.

  20. Simultaneous determination of Cd and Fe in beans and soil of different regions of Brazil using high-resolution continuum source graphite furnace atomic absorption spectrometry and direct solid sampling.

    Science.gov (United States)

    dos Santos, Lisia M G; Welz, Bernhard; Araujo, Rennan G O; Jacob, Silvana do C; Vale, Maria Goreti R; Martens, Andreas; Gonzaga Martens, Irland B; Becker-Ross, Helmut

    2009-11-11

    A fast routine screening method for the simultaneous determination of cadmium and iron in bean and soil samples is proposed, using high-resolution continuum source graphite furnace atomic absorption spectrometry and direct solid sampling. The primary absorption line at 228.802 nm has been used for the determination of cadmium, and an adjacent secondary line, at 228.726 nm, for iron. Fourteen bean samples and 10 soil samples from nine states all over Brazil have been analyzed. The limits of detection (3 sigma, n = 10) were 2.0 microg kg(-1) for Cd and 4.5 mg kg(-1) for Fe. The relative standard deviation ranged from 4 to 7% for Cd and from 5 to 28% for Fe, which is usually acceptable for a screening method. The accuracy of the method has been confirmed by the analysis of two certified reference materials; the results were in agreement with the certified values at a 95% confidence interval.

  1. Direct and simultaneous quantitation of 5-aminolaevulinic acid and porphobilinogen in human serum or plasma by hydrophilic interaction liquid chromatography-atmospheric pressure chemical ionization/tandem mass spectrometry.

    Science.gov (United States)

    Benton, Christopher M; Couchman, Lewis; Marsden, Joanne T; Rees, David C; Moniz, Caje; Lim, Chang Kee

    2013-02-01

    Serum/plasma concentrations of 5-aminolaevulinic acid (ALA) and porphobilinogen (PBG) are elevated in patients with acute hepatic porphyrias, especially during acute attacks. Current assays require lengthy sample pre-treatment and derivatization steps. We report here a rapid, sensitive and specific hydrophilic interaction liquid chromatography-tandem mass spectrometry method for the direct and simultaneous quantitation of ALA and PBG in serum or plasma following simple protein precipitation with acetonitrile and centrifugation prior to injection. ALA and PBG were detected using selected reaction monitoring mode, following positive atmospheric pressure chemical ionization. Calibration was linear from 0.05 to 50 µmol/L for ALA and PBG. For both analytes, imprecision (relative standard deviation) was PBG in serum or plasma samples for the screening, biochemical diagnosis and treatment monitoring of patients with acute hepatic porphyrias. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Hybrid Approach for Biliary Interventions Employing MRI-Guided Bile Duct Puncture with Near-Real-Time Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wybranski, Christian, E-mail: Christian.Wybranski@uk-koeln.de [University Hospital of Cologne, Department of Diagnostic and Interventional Radiology (Germany); Pech, Maciej [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany); Lux, Anke [Otto-von-Guericke University Medical School, Institute of Biometry and Medical Informatics (Germany); Ricke, Jens; Fischbach, Frank; Fischbach, Katharina [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany)

    2017-06-15

    ObjectiveTo assess the feasibility of a hybrid approach employing MRI-guided bile duct (BD) puncture for subsequent fluoroscopy-guided biliary interventions in patients with non-dilated (≤3 mm) or dilated BD (≥3 mm) but unfavorable conditions for ultrasonography (US)-guided BD puncture.MethodsA total of 23 hybrid interventions were performed in 21 patients. Visualization of BD and puncture needles (PN) in the interventional MR images was rated on a 5-point Likert scale by two radiologists. Technical success, planning time, BD puncture time and positioning adjustments of the PN as well as technical success of the biliary intervention and complication rate were recorded.ResultsVisualization even of third-order non-dilated BD and PN was rated excellent by both radiologists with good to excellent interrater agreement. MRI-guided BD puncture was successful in all cases. Planning and BD puncture times were 1:36 ± 2.13 (0:16–11:07) min. and 3:58 ± 2:35 (1:11–9:32) min. Positioning adjustments of the PN was necessary in two patients. Repeated capsular puncture was not necessary in any case. All biliary interventions were completed successfully without major complications.ConclusionA hybrid approach which employs MRI-guided BD puncture for subsequent fluoroscopy-guided biliary intervention is feasible in clinical routine and yields high technical success in patients with non-dilated BD and/or unfavorable conditions for US-guided puncture. Excellent visualization of BD and PN in near-real-time interventional MRI allows successful cannulation of the BD.

  3. Bioengineered vascular access maintains structural integrity in response to arteriovenous flow and repeated needle puncture.

    Science.gov (United States)

    Tillman, Bryan W; Yazdani, Saami K; Neff, Lucas P; Corriere, Matthew A; Christ, George J; Soker, Shay; Atala, Anthony; Geary, Randolph L; Yoo, James J

    2012-09-01

    Tissue-engineered blood vessels (TEBV) have been proposed as an alternative to prosthetic grafts for dialysis access. However, arteriovenous (AV) grafts must withstand extreme flow rates and frequent needle trauma. In a proof-of-concept study, we sought to determine whether scaffold-based TEBV could withstand the hemodynamic and mechanical challenges of chronic dialysis access. TEBV were constructed using decellularized arterial scaffolds seeded with autologous ovine endothelial cells (EC) derived from circulating endothelial progenitor cells (EPC) using a novel high-affinity capture approach. Seeded scaffolds were preconditioned to arterial pressure and flow in a bioreactor for 2 weeks prior to implantation to create carotid artery to jugular vein AV grafts in each animal. TEBV were healed for 1 month before initiating percutaneous needle puncture 3 days/week. TEBV wall geometry and patency were monitored using duplex imaging and were either explanted for histologic analysis at 2 months (n = 5) or followed for up to 6 months until venous outflow stenosis threatened AV graft patency (n = 6). Despite high flow, TEBV maintained stable geometry with only modest wall dilation (under 6%) by 4 months after implantation. Needle access was well tolerated with a single puncture site complication, a small pseudoaneurysm, occurring in the late group. Time-to-hemostasis at puncture sites averaged 4 ± 2 minutes. Histologic analysis at 2 months demonstrated repopulation of the outer TEBV wall by host cells and healing of needle punctures by cellular ingrowth and new matrix deposition along the tract. TEBV followed beyond 2 months showed stable wall geometry but, consistent with the primary mode of clinical AV graft failure, all TEBV eventually developed venous anastomotic stenosis (mean, 4.4 ± 0.9 months; range, 3.3-5.6 months postimplantation; n = 6). This pilot study supports the concept of creating dialysis access from scaffold-based autologous TEBV. Engineered AV grafts

  4. Western diet enhances hepatic inflammation in mice exposed to cecal ligation and puncture

    Directory of Open Access Journals (Sweden)

    Houghton Jeff

    2010-10-01

    Full Text Available Abstract Background Obese patients display an exaggerated morbidity during sepsis. Since consumption of a western-style diet (WD is a major factor for obesity in the United States, the purpose of the present study was to examine the influence of chronic WD consumption on hepatic inflammation in mice made septic via cecal ligation and puncture (CLP. Feeding mice diets high in fat has been shown to enhance evidence of TLR signaling and this pathway also mediates the hepatic response to invading bacteria. Therefore, we hypothesized that the combined effects of sepsis and feeding WD on TRL-4 signaling would exacerbate hepatic inflammation. Male C57BL/6 mice were fed purified control diet (CD or WD that was enriched in butter fat (34.4% of calories for 3 weeks prior to CLP. Intravital microscopy was used to evaluate leukocyte adhesion in the hepatic microcirculation. To demonstrate the direct effect of saturated fatty acid on hepatocytes, C3A human hepatocytes were cultured in medium containing 100 μM palmitic acid (PA. Quantitative real-time PCR was used to assess mRNA expression of tumor necrosis factor-alpha (TNF-α, monocyte chemotactic protein-1 (MCP-1, intercellular adhesion molecule-1 (ICAM-1, toll-like receptor-4 (TLR-4 and interleukin-8 (IL-8. Results Feeding WD increased firm adhesion of leukocytes in the sinusoids and terminal hepatic venules by 8-fold six hours after CLP; the increase in platelet adhesion was similar to the response observed with leukocytes. Adhesion was accompanied by enhanced expression of TNF-α, MCP-1 and ICAM-1. Messenger RNA expression of TLR-4 was also exacerbated in the WD+CLP group. Exposure of C3A cells to PA up-regulated IL-8 and TLR-4 expression. In addition, PA stimulated the static adhesion of U937 monocytes to C3A cells, a phenomenon blocked by inclusion of an anti-TLR-4/MD2 antibody in the culture medium. Conclusions These findings indicate a link between obesity-enhanced susceptibility to sepsis and

  5. [A safe method for infraclavicular puncture of the subclavian vein].

    Science.gov (United States)

    Anderhuber, F; Lechner, P; Tesch, N P

    1988-01-01

    Investigations of 25 human cadavers, using various anatomical techniques, led to the development of a safe and simple method of subclavian venipuncture. This method was tested with special regard to possible complications. The authors describe the guidelines for the choice of the point where the skin has to be penetrated as well as of the point towards which the needle has to be directed. While the latter is situated a little beyond the spinous process of the seventh cervical vertebra, the other is determined as follows: the distance between the acromion and the sternoclavicular joint is divided into three parts, and the junction between the medial and central third of this distance is marked on the skin. Starting from this point a vertical is dropped towards the line between the acromion and the sternal angle. The point of intersection between this line and the vertical is where the cannula penetrates the skin. After a distance of between 2.5 and 4.5 cm the top of the needle reaches the subclavian vein. Even if the vessel is pierced through and through, no complication such as pneumothorax, laceration of arteries, lesions of the adjacent nerves, etc., can occur. Using this method the authors performed catheterization of the subclavian vein in 200 patients, and there were no complications at all.

  6. Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward

    DEFF Research Database (Denmark)

    Møller, Anders; Bjerrum, Ole Weis; Afshari, Arash

    2015-01-01

    BACKGROUND/AIMS: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure. METHODS......: An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark. RESULTS: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar...... performed in 4 (36%) departments. CONCLUSION: We report considerable variation in the routine handling of antithrombotics and thrombocytopenia in patients set for lumbar puncture in Danish haematology departments. The diversity may be explained by and related to different opinions in the literature. Common...

  7. Atraumatic needles for lumbar puncture: why haven't neurologists changed?

    Science.gov (United States)

    Davis, A; Dobson, R; Kaninia, S; Giovannoni, G; Schmierer, K

    2016-02-01

    Diagnostic lumbar puncture is a key procedure in neurology; however, it is commonly complicated by post-lumbar puncture headache. Atraumatic needle systems can dramatically reduce the incidence of this iatrogenic complication. However, only a minority of neurologists use such needles. In this paper, we discuss possible reasons why neurologists have not switched to new technology, looking more at diffusion of innovation rather than lack of evidence. We suggest ways to overcome this failure to adopt change, ranging from local interventions to patient empowerment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Effect of puncture through frontal lobe in the treatment of intracranial hematoma

    Directory of Open Access Journals (Sweden)

    DOU Bo-sheng

    2013-12-01

    Full Text Available This study aims to discuss the effect of an easy puncture through frontal lobe in the treatment of deep brain hematoma. The lesions of 37 patients with basal ganglia hemorrhage were accurately positioned by CT scan. Drainage tube was placed in the center of hematoma through frontal lobe and blood was aspirated. Urokinase 30 × 103 U was injected in the hematoma postoperatively to promote the evacuation of hematoma. Postoperative CT scan showed more than 75% hematoma was cleared in all patients after 3-7 d. Two patients died of complications; 2 patients were severely disabled; 3 rebleeding happened. Almost 33 patients had a good recovery. Minimal invasion, convenient operation and exact location were the adventages of this puncture and it does not need complicated device.

  9. Postpartum cortical venous thrombosis: An unusual presentation of postdural puncture headache

    Directory of Open Access Journals (Sweden)

    Opal Raj

    2016-01-01

    Full Text Available Headache is a common occurrence during pregnancy. A postural headache is invariably considered to be a postdural puncture headache in patients who receive neuraxial anesthesia with or without obvious or incidental dural puncture. Cerebral venous thrombosis (CVT is rare in pregnancy and in the postpartum period, with an incidence of 1:10,000–1:25,000. Pregnancy-induced changes in coagulation result in a hypercoagulable state, which may naturally reduce the incidence of postpartum hemorrhage, but may also increase the risk of CVT. Postpartum headache being frequently encountered may complicate the diagnosis of CVT. We report a case of a woman who developed a postpartum CVT after an accidental wet tap and intrathecal catheter placement during labor.

  10. [Puncture scrotostomy--a treatment method in acute inflammatory diseases of the scrotal organs].

    Science.gov (United States)

    Shapoval, V I; Asimov, D A; Lesovoĭ, V N

    1989-01-01

    A method for the treatment of acute inflammatory diseases of the scrotal organs by means of puncture scrotostomy, which consists in passing the indwelling micro-irrigator into a cavity of the serous sheath of the testis and epididymis and administration via this route of antibacterial and resolving preparations for 4-5 days, is suggested. A method approved in treatment of 45 patients permits to avoid surgical intervention, and is highly effective.

  11. Posture and lumbar puncture headache: a controlled trial in 50 patients.

    OpenAIRE

    Handler, C E; Smith, F R; Perkin, G D; Rose, F C

    1982-01-01

    A prospective single blind trial in 50 patients was performed to investigate the effect of posture on post lumbar puncture headache (LPH). A difference between the frequency of headache at five hours between the two groups (prone for four hours, versus 30 degrees head down tilt for 30 minutes followed by supine posture for 3 1/2 hours) did not reach significance. These findings do not support the suggestion that a prone posture, by possibly reducing cerebrospinal fluid (CSF) leakage, signific...

  12. The Effect of Therapeutic Lumbar Punctures on Acute Mortality From Cryptococcal Meningitis

    OpenAIRE

    Rolfes, Melissa A.; Hullsiek, Kathy Huppler; Rhein, Joshua; Nabeta, Henry W.; Taseera, Kabanda; Schutz, Charlotte; Musubire, Abdu; Rajasingham, Radha; Williams, Darlisha A.; Thienemann, Friedrich; Muzoora, Conrad; Meintjes, Graeme; Meya, David B.; Boulware, David R.

    2014-01-01

    Introduction. ?Cryptococcal meningitis is the most common cause of adult meningitis in sub-Saharan Africa. Raised intracranial pressure (ICP) is common in cryptococcosis. Prior studies suggest elevated ICP is associated with mortality, and guidelines recommend frequent lumbar punctures (LPs) to control ICP. However, the magnitude of the impact of LPs on cryptococcal-related mortality is unknown. Methods. ?In sum, 248 individuals with human immunodeficiency virus (HIV)-associated cryptococcal ...

  13. Development of Postdural Puncture Headache Following Therapeutic Acupuncture Using a Long Acupuncture Needle

    OpenAIRE

    Jo, Dae-Jean; Lee, Bong Jae; Sung, Joon Kyung; Yi, Jae-Woo

    2010-01-01

    Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. This case report describes a suspected postdural puncture headache following acupuncture for lower back pain. Considering the high opening pressure, cerebrospinal fluid leakage, and the patien...

  14. A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method.

    Science.gov (United States)

    Kawada, Masaya; Okubo, Tetsuyuki; Poudel, Saseem; Suzuki, Yoshinori; Kawarada, Yo; Kitashiro, Shuji; Okushiba, Shunichi; Katoh, Hiroyuki

    2013-03-01

    While performing thoracoscopic wedge resection of the lung, the location of the lesion is generally identified by visual inspection or palpation. When difficulty in identification of the lesion by thoracoscopy is anticipated, preoperative marking is performed. However, complications and technical difficulties plague current marking techniques. To overcome this problem, we designed a new, safe and easy marking technique that avoids pleural puncture, called the intrathoracic stamping method.

  15. A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method

    OpenAIRE

    Kawada, Masaya; Okubo, Tetsuyuki; Poudel, Saseem; Suzuki, Yoshinori; Kawarada, Yo; Kitashiro, Shuji; Okushiba, Shunichi; Katoh, Hiroyuki

    2012-01-01

    While performing thoracoscopic wedge resection of the lung, the location of the lesion is generally identified by visual inspection or palpation. When difficulty in identification of the lesion by thoracoscopy is anticipated, preoperative marking is performed. However, complications and technical difficulties plague current marking techniques. To overcome this problem, we designed a new, safe and easy marking technique that avoids pleural puncture, called the intrathoracic stamping method.

  16. [Complications after the use of a StarClose® vascular closure device for femoral punctures].

    Science.gov (United States)

    Quintana Martínez, I; Guillén Subirán, M E; Zaragozano Guillén, R; Hilario González, J

    2014-01-01

    The StarClose(®) arterial device (Abbot Vascular Devices, Abbot Laboratories, Redwood City, CA, USA) rapidly seals a femoral artery puncture by means of a nitinol clip in the adventitia of the artery. It is a safe and effective device, with advantages as regards manual compression, but is not free of complications. We present two cases with complications after using a StarClose(®) vascular device. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  17. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture

    International Nuclear Information System (INIS)

    Galan, J.; Vuelta, R. V.; Oleaga, L.; Grande, D.

    1999-01-01

    The magnetic resonance (MR) findings are presented for three patients who developed intracranial hypotension syndrome following lumbar puncture, one of the most common causes of this complication. All three patients presented the MR findings characteristically associated with this event, consisting of diffuse dural enhancement after administration of a paramagnetic contrast medium, as well as extraaxial collection that played either an accompanying or a causative role. (Author) 7 refs

  18. Generating families of surface triangulations. The case of punctured surfaces with inner degree at least 4

    OpenAIRE

    Chávez de Diego, María José; Negami, Seiya; Quintero Toscano, Antonio Rafael; Villar Liñán, María Trinidad

    2015-01-01

    We present two versions of a method for generating all triangulations of any punctured surface in each of these two families: (1) triangulations with inner vertices of degree ≥ 4 and boundary vertices of degree ≥ 3 and (2) triangulations with all vertices of degree ≥ 4. The method is based on a series of reversible operations, termed reductions, which lead to a minimal set of triangulations in each family. Throughout the process the triangulations remain within the corresponding family. Mo...

  19. Microneedle-based minimally-invasive measurement of puncture resistance and fracture toughness of sclera.

    Science.gov (United States)

    Park, Seung Hyun; Lee, Kang Ju; Lee, JiYong; Yoon, Jae Hyoung; Jo, Dong Hyun; Kim, Jeong Hun; Kang, Keonwook; Ryu, WonHyoung

    2016-10-15

    The sclera provides the structural support of the eye and protects the intraocular contents. Since it covers a large portion of the eye surface and has relatively high permeability for most drugs, the sclera has been used as a major pathway for drug administration. Recently, microneedle (MN) technology has shown the possibility of highly local and minimally-invasive drug delivery to the eye by MN insertion through the sclera or the suprachoroidal space. Although ocular MN needs to be inserted through the sclera, there has been no systematic study to understand the mechanical properties of the sclera, which are important to design ocular MNs. In this study, we investigated a MN-based method to measure the puncture resistance and fracture toughness of the sclera. To reflect the conditions of MN insertion into the sclera, force-displacement curves obtained from MN-insertion tests were used to estimate the puncture resistance and fracture toughness of sclera tissue. To understand the effect of the insertion conditions, dependency of the mechanical properties on insertion speeds, pre-strain of the sclera, and MN sizes were analyzed and discussed. Measurement of mechanical property of soft biological tissue is challenging due to variations between tissue samples or lack of well-defined measurement techniques. Although non-invasive measurement techniques such as nano/micro indentation were employed to locally measure the elastic modulus of soft biological materials, mechanical properties such as puncture resistance or fracture toughness, which requires "invasive" measurement and is important for the application of "microneedles or hypodermic needles", has not been well studied. In this work, we report minimally-invasive measurement of puncture resistance and fracture toughness of sclera using a double MN insertion method. Parametric studies showed that use of MN proved to be advantageous because of minimally-invasive insertion into tissue as well as higher sensitivity to

  20. General Anesthesia for Lumbar Puncture and Bone Marrow Aspiration /Biopsy in Children

    OpenAIRE

    Ali Ghasemi

    2014-01-01

    Background  Multiple procedures (Lumbar puncture and bone marrow aspiration /biopsy) cause pain, stress, depression and etc for the patients and their families. Various methods have been recommended for pain reduction during invasive procedures. The aim of this study is to report the complications following general anesthesia. Methods In this prospective observational study, two hundred and two children with cancer were enrolled. All patients received propofol 2.5 mg /kg and fentanyl...

  1. General Anesthesia for Lumbar Puncture and Bone Marrow Aspiration /Biopsy in Children with Cancer

    OpenAIRE

    Ghasemi, A; Gharavi Fard, M; Sabzevari, AR

    2013-01-01

    Background Multiple procedures (Lumbar puncture and bone marrow aspiration /biopsy) cause pain, stress, depression and etc for the patients and their families. Various methods have been recommended for pain reduction during invasive procedures. The aim of this study is to report the complications following general anesthesia. Materials and Methods In this prospective observational study, two hundred and two children with cancer were enrolled. All patients received propofol 2.5 mg /kg and fent...

  2. A simple 2-directional high-performance thin-layer chromatographic method for the simultaneous determination of curcumin, metanil yellow, and sudan dyes in turmeric, chili, and curry powders.

    Science.gov (United States)

    Dixit, Sumita; Khanna, Subhash K; Das, Mukul

    2008-01-01

    A method using simple extraction and 2-directional high-performance thin-layer chromatography (HPTLC) was developed for the simultaneous determination of curcumin, metanil yellow, and sudan dyes in turmeric, chili, and various mixed curry powder formulations. The method offers resolution (Rf) of turmeric pigments, namely, curcumin (0.77), demethoxycurcumin (0.69), bis(demethoxy)curcumin (0.61), and the synthetic dye metanil yellow (0.05) by the first-directional mobile phase, chloroform-methanol (9 + 1, v/v). The resolution (Rf) of sudan I (0.30) and sudan IV (0.23) was achieved by the second-directional mobile phase, toluene-hexane-acetic acid (50 + 50 + 1, v/v/v). Natural pigments of both turmeric and chili showed no interference in the detection and quantification of synthetic colors. The limit of detection and limit of quantification values for curcumin, metanil yellow, sudan I, and sudan IV were 17.39, 42.90, 15.45, and 7.01 and 52.71,130.0, 46.80, and 21.24 ng/spot, respectively. Analysis of a few market samples showed the presence of metanil yellow (1.5-4.6 mg/g), sudan I (4.8-12.1 mg/g), and sudan IV (0.9-2.0 mg/g) in loose turmeric and chili samples, whereas the curcumin content in turmeric and mixed curry powder samples ranged from 6.5 to 36.4 and from 0.3 to 1.9 mg/g, respectively. The method is relatively simple, offers reasonable sensitivity, and can be used to screen a large number of samples.

  3. Lumbar puncture for suspected meningitis after intensive care unit admission is likely to change management.

    Science.gov (United States)

    Khasawneh, Faisal A; Smalligan, Roger D; Mohamad, Tammam N; Moughrabieh, Mohamad K; Soubani, Ayman O

    2011-02-01

    The aim of this study was to determine the outcome of lumbar punctures (LPs) in critically ill medical patients and how likely the results were to change case management. A retrospective review was conducted on the medical records of all 168 patients who underwent LP during their medical intensive care unit (MICU) admission at a university hospital during a 4.5-year period beginning in January 2000. Lumbar puncture was performed a mean of 2.8 days after MICU admission. The most common symptoms that prompted LP were changes in mental status and fever. Seventy-four percent of patients were on antibiotics at the time of LP, and 98% of patients had a computed tomography scan of the head performed before the procedure. Lumbar puncture confirmed meningitis in 47 (30%) patients and provided a specific bacteriologic diagnosis in 5 (3%) patients. The results of the procedure led to a change in management in 50 (30%) patients. The presence of meningeal signs and use of antibiotics at the time of the procedure were the factors that predicted change in management. Although the likelihood that LP will yield a specific bacteriologic diagnosis in critically ill patients is low, the procedure frequently provides important information that can lead to a change in case management, most commonly de-escalation of antibiotic therapy.

  4. Post dural puncture headache in obstetric patients: experience from a West African teaching hospital.

    Science.gov (United States)

    Nafiu, O O; Salam, R A; Elegbe, E O

    2007-01-01

    This prospective, non-randomised study examined the frequency and severity of post dural puncture headache in 96 Ghanaian women who consented to spinal anaesthesia for caesarean section at the Korle Bu Teaching Hospital, Accra, Ghana. Spinal anaesthesia was performed using 22-gauge (n = 22), 25-gauge (n = 46) or 26-gauge (n = 38) Quincke needles. Patients were followed up to determine the incidence and severity of post spinal headache. The overall incidence of post dural puncture headache was 8.3%, but was significantly higher (33%) in patients in whom 22-gauge Quincke needles were used than in the other two groups (4% and 5% respectively: P = 0.003). Most patients rated their headache as mild to moderate on a 10-cm visual analogue scale. In view of the high incidence of headache and the need for treatment associated with the use of the 22-gauge Quincke needle, we recommend that this should not be used in the obstetric population. We are also aware that the incidence of post dural puncture headache could be further reduced by the use of small calibre pencil-point needles but these are currently very expensive and many obstetric units in developing countries may not be able to afford them.

  5. Correlation of Descriptive Analysis and Instrumental Puncture Testing of Watermelon Cultivars.

    Science.gov (United States)

    Shiu, J W; Slaughter, D C; Boyden, L E; Barrett, D M

    2016-06-01

    The textural properties of 5 seedless watermelon cultivars were assessed by descriptive analysis and the standard puncture test using a hollow probe with increased shearing properties. The use of descriptive analysis methodology was an effective means of quantifying watermelon sensory texture profiles for characterizing specific cultivars' characteristics. Of the 10 cultivars screened, 71% of the variation in the sensory attributes was measured using the 1st 2 principal components. Pairwise correlation of the hollow puncture probe and sensory parameters determined that initial slope, maximum force, and work after maximum force measurements all correlated well to the sensory attributes crisp and firm. These findings confirm that maximum force correlates well with not only firmness in watermelon, but crispness as well. The initial slope parameter also captures the sensory crispness of watermelon, but is not as practical to measure in the field as maximum force. The work after maximum force parameter is thought to reflect cellular arrangement and membrane integrity that in turn impact sensory firmness and crispness. Watermelon cultivar types were correctly predicted by puncture test measurements in heart tissue 87% of the time, although descriptive analysis was correct 54% of the time. © 2016 Institute of Food Technologists®

  6. Experimental impact and puncture evaluation of the prototype quarter scale TRU transporter package

    International Nuclear Information System (INIS)

    Meyer, R.J.; Plonski, B.A.; Vigil, M.G.; Joseph, B.J.

    1983-01-01

    The impact tests consist of the TRUPACT model free-falling 9 meters onto a flat, horizontal, unyielding surface as specified in 10CFR71. The model was dropped at five different orientations including: (1) flat on the door end; (2) flat on the side; (3) center of gravity over impact corner; (4) flat on edge; and (5) corner impact edge slapdown. The model instrumentation for these tests included: (1) sixty strain gages located throughout the model structure used to obtain impact stresses; (2) three displacement transducers used to measure relative motion between the inner door and inner cavity frame structure (seal integrity); and (3) two triaxial accelerometers used to estimate the impact forces on the inner and outer frame structures. The drop/puncture tests consisted of the TRUPACT-I model free-falling one meter onto a 38-millimeter (1.5-inch) diameter mild steel punch 0.9 meters (36 inches) long. The punch was welded to an unyielding surface. Model drop/puncture orientations included: (1) flat on the model sides; (2) flat on the door and back ends; and (3) model center of gravity over impact point at various locations of the model (door end, back end, near door seals, near tubular frame structure, center of panels). The test results and subsequent analysis of the data have been used to support the final design of TRUPACT-I and to determine the most damaging impact and puncture orientations for testing the full scale prototype

  7. Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures.

    NARCIS (Netherlands)

    Bicanic, T.; Brouwer, A.E.; Meintjes, G.; Rebe, K.; Limmathurotsakul, D.; Chierakul, W.; Teparrakkul, P.; Loyse, A.; White, N.J.; Wood, R.; Jaffar, S.; Harrison, T.

    2009-01-01

    OBJECTIVES: To assess impact of serial lumbar punctures on association between cerebrospinal fluid (CSF) opening pressure and prognosis in HIV-associated cryptococcal meningitis; to explore time course and relationship of opening pressure with neurological findings, CSF fungal burden, immune

  8. Evaluating the long-term effect of ultrasound-guided needle puncture without aspiration on calcifying supraspinatus tendinitis.

    Science.gov (United States)

    Zhu, Jiaan; Jiang, Yeqing; Hu, Yizhou; Xing, Chunyan; Hu, Bing

    2008-11-01

    The aim of this study was to evaluate whether aspiration affects patient outcome during ultrasound-guided needle puncture treatment for calcifying supraspinatus tendinitis. Eighty-one patients with calcifying supraspinatus tendinitis received needle puncture therapy under ultrasonography guidance. Group A received ultrasound-guided percutaneous needle punctures and aspiration of calcareous deposits, while Group B received ultrasound-guided punctures only. Patients were evaluated using a visual analog scale (VAS) for pain, shoulder function, and satisfaction 1, 2, 3, 6, 12, 24, and 36 weeks after treatment. The different VAS parameters were combined and the differences between groups were analyzed. In both groups, VAS scores significantly decreased over the 36 weeks following treatment (Ptreatment method for calcifying supraspinatus tendinitis.

  9. A Highly Damped, High-Strength, Puncture-Resistant Fabric for Multi-Threat Protective Uniforms. Phase 1

    National Research Council Canada - National Science Library

    Paine, Jeffrey

    1999-01-01

    The Phase I project was very successful in demonstrating the feasibility of using a superelastic Nitinol shape memory alloy to improve cut, tear, and puncture resistance of military Battle Dress Uniform (BDU) fabric...

  10. Determining the angle and depth of puncture for fluoroscopy-guided percutaneous renal access in the prone position

    OpenAIRE

    Sharma, Gyanendra; Sharma, Anshu

    2015-01-01

    Introduction: Optimal renal access is necessary for ensuring a successful and complication-free percutaneous nephrolithotomy. We describe a technique to determine the angle and depth of puncture for fluoroscopy-guided percutaneous renal access in the prone position. Materials and Methods: Forty-two consecutive patients undergoing percutaneous nephrolithotomy from January 2014 had a fluoroscopy-guided access in the prone position. Using the bull′s eye technique, the site of skin puncture ...

  11. Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing

    Directory of Open Access Journals (Sweden)

    Adiningsih Srilestari

    2017-05-01

    Full Text Available Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers.Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group or sham stimulation (the control group were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1 were measured every week and compared between the two groups and analyzed by Mann-Whitney test.Results: The initial median ulcer size were 4.75 (0.10–9.94 cm2 and 2.33 (0.90–9.88 cm2 in laser-puncture and sham groups, respectively (p=0.027. The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09 vs -0.36 (-0.81 to -1.47 cm2, (p=0.000; at week 3–1 was -1.70 (-3.15 to -0.01 vs -0.36 (-0.80 to -0.28 cm2, (p=0.000; and at week 4–1 was -1.22 (-2.72 to 0.00 vs -0.38 (-0.74 to -0.57 cm2, (p=0.012.Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.

  12. [Examination of the optimal midazolam dose required for loss of puncture memory at the time of spinal anesthesia].

    Science.gov (United States)

    Boku, Aiji; Koyama, Shinichi; Kishimoto, Naotaka; Nakatani, Keiji; Kurita, Satoshi; Nagata, Noboru; Niwa, Hitoshi

    2011-08-01

    We examined midazolam ED50 according to age that was necessary for loss of puncture memory at the time of spinal anesthesia and determined whether we could estimate the presence of puncture memory from the degree of sedation after midazolam administration. We enrolled patients with ASA PS 1 or 2 and patients from 50 to 80 years of age who had been planned for surgery with spinal anesthesia. We divided the patients into groups according to their age--50s, 60s, and 70s as L, M, and H groups, respectively. We evaluated the degree of sedation with six phases of scores after intravenous administration of midazolam and spinal anesthesia was performed. The midazolam dose was based on the ups and downs method. The midazolam ED50s required for the loss of puncture memory in groups L, M, and H were 0.043, 0.035, and 0.026 mg x kg(-1), respectively. We estimated the association between the sedation degree score after midazolam administration and the puncture memory from ROC curve, but AUC was 0.56 for all cases. The midazolam ED50 required for the loss of puncture memory decreased with age but it was difficult to estimate puncture memory from the degree of sedation.

  13. Simple method for the simultaneous quantification of medium-chain fatty acids and ethyl hexanoate in alcoholic beverages by gas chromatography-flame ionization detector: development of a direct injection method.

    Science.gov (United States)

    Takahashi, Kei; Goto-Yamamoto, Nami

    2011-10-28

    Free medium-chain fatty acids (MCFAs) can negatively influence the fermentation process and taste quality in alcoholic beverages. Ethyl hexanoate is important in providing a fruit-like flavour to drinks, particularly in Japanese sake. In this study, we developed a direct injection method for a gas chromatography-flame ionization detector following the semi-purification of chemical components, such as esters, alcohols and MCFAs in alcoholic beverages. Evaluation of MCFAs by this method gave a limit of detection on the order of sub-ppm and relative standard deviations less than 10% in standard solution. Good repeatability and recovery rates against MCFAs and ethyl hexanoate were also obtained in non-distilled real alcoholic beverages. Because this method enabled us to simultaneously quantify the concentrations of MCFAs and ethyl hexanoate, the proportion of ester against MCFAs was proposed as a quality control index. This method could be suitable for routine analysis in the alcohol beverage industry. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Cobalt internal standard for Ni to assist the simultaneous determination of Mo and Ni in plant materials by high-resolution continuum source graphite furnace atomic absorption spectrometry employing direct solid sample analysis.

    Science.gov (United States)

    de Babos, Diego Victor; Bechlin, Marcos André; Barros, Ariane Isis; Ferreira, Edilene Cristina; Gomes Neto, José Anchieta; de Oliveira, Silvana Ruella

    2016-05-15

    A new method is proposed for the simultaneous determination of Mo and Ni in plant materials by high-resolution continuum source graphite furnace atomic absorption spectrometry (HR-CS GFAAS), employing direct solid sample analysis (DSS) and internal standardization (IS). Cobalt was used as internal standard to minimize matrix effects during Ni determinations, enabling the use of aqueous standards for calibration. Correlation coefficients for the calibration curves were typically better than 0.9937. The performance of the method was checked by analysis of six plant certified reference materials, and the results for Mo and Ni were in agreement with the certified values (95% confidence level, t-test). Analysis was made of different types of plant materials used as renewable sources of energy, including sugarcane leaves, banana tree fiber, soybean straw, coffee pods, orange bagasse, peanut hulls, and sugarcane bagasse. The concentrations found for Mo and Ni ranged from 0.08 to 0.63 ng mg(-1) and from 0.41 to 6.92 ng mg(-1), respectively. Precision (RSD) varied from 2.1% to 11% for Mo and from 3.7% to 10% for Ni. Limits of quantification of 0.055 and 0.074 ng were obtained for Mo and Ni, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. [Assessment of amylase and lipase levels following puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions].

    Science.gov (United States)

    Membrillo-Romero, Alejandro; Gonzalez-Lanzagorta, Rubén; Rascón-Martínez, Dulce María

    Puncture biopsy and fine needle aspiration guided by endoscopic ultrasound has been used as an effective technique and is quickly becoming the procedure of choice for diagnosis and staging in patients suspected of having pancreatic cancer. This procedure has replaced retrograde cholangiopancreatography and brush cytology due to its higher sensitivity for diagnosis, and lower risk of complications. To assess the levels of pancreatic enzymes amylase and lipase, after the puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions and the frequency of post-puncture acute pancreatitis. A longitudinal and descriptive study of consecutive cases was performed on outpatients submitted to puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions. Levels of pancreatic enzymes such as amylase and lipase were measured before and after the pancreatic puncture. Finally we documented post-puncture pancreatitis cases. A total of 100 patients who had been diagnosed with solid and cystic lesions were included in the study. Significant elevation was found at twice the reference value for lipase in 5 cases (5%) and for amylase in 2 cases (2%), none had clinical symptoms of acute pancreatitis. Eight (8%) of patients presented with mild nonspecific pain with no enzyme elevation compatible with pancreatitis. Pancreatic biopsy needle aspiration guided by endoscopic ultrasound was associated with a low rate of elevated pancreatic enzymes and there were no cases of post-puncture pancreatitis. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  16. Vapocoolant Spray Effectiveness on Arterial Puncture Pain: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shervin Farahmand

    2017-02-01

    Full Text Available Arterial blood gas (ABG sampling is a painful procedure with no perfect technique for quelling the discomfort. An ideal local anesthesia should be rapid, easy to learn, inexpensive, and noninvasive. This study was aimed to compare pain levels from ABG sampling performed with vapocoolant spray in comparison to placebo. We hypothesized that pretreatment with the vapocoolant would reduce the pain of arterial puncture by at least 1 point on a 10 point verbal numeric scale. We have evaluated the effectiveness of a vapocoolant spray in achieving satisfactory pain control in patients undergoing ABG sampling in this randomized placebo controlled trial. Eighty patients were randomized to 2 groups: group A, who received vapocoolant spray, and group B, who received water spray as placebo (Control group. Puncture and spray application pain was assessed with numerical rating scale (0, the absence of pain; 10, greatest imaginable pain and number of attempts was recorded. The pain score during ABG sampling was not lower in group A compared with group B significantly (4.78±1.761 vs. 4.90±1.837; P:0.945. This study showed that while the spray exerts more application pain, the number of attempts required for ABG sampling was not significantly lower in group A compared with group B (1.38±0.54 vs. 1.53±0.68; P=0.372. Vapocoolant spray was not effective in ABG pain reduction, had milder application pain compared to placebo (P<0.05, but did not reduce sampling attempts. At present, this spray cannot be recommended for arterial puncture anesthesia, and further study on different timing is necessary.

  17. Unusual Relapse of Primary Central Nervous System Lymphoma at Site of Lumbar Puncture

    Directory of Open Access Journals (Sweden)

    Zartaj Ahmed

    2014-01-01

    Full Text Available Primary CNS lymphoma (PCNSL is a rare non-Hodgkin’s lymphoma confined to the CNS. Local relapse of this disease is common, but extracranial or subcutaneous metastasis is rare with only a few cases being reported in literature. We report a 63-year-old male patient, who responded well to treatment for PCNSL but relapsed two and half years later with a lumbosacral nodule at the site of a previous lumbar puncture due to microscopic tumor seeding. Clinicians treating patients with PCNSL must remain alert to the possibility of extracranial solitary relapse even after the resolution of initial disease because prompt treatment can result in a good outcome.

  18. State of some peripheral organs during laser puncture correction of ovarian functional deficiency

    Science.gov (United States)

    Vylegzhanina, T. A.; Kuznetsova, Tatiana I.; Maneeva, O.; Ryzhkovskaya, E. L.; Yemelianova, A.

    2001-01-01

    The findings from studies on structural and functional parameters of the adrenal, thyroid, and pineal glands in conditions of ovarian hypofunction and after its correction by laser puncture are presented. An experimentally induced hypofunction of the ovaries was shown to be accompanied by a decreased hormonal synthesis in the cortical fascicular zone. The epiphysis showed ultra structural signs of increased functional activity. Application of a helium-neon laser to biologically active points of the ovarian reflexogenic zone induced normalization of the ovarian cycle, potentiating of the adrenal functional state, and a decreased thyroid hormone production and abolished the activatory effect of the dark regime on the functional state of the pineal gland.

  19. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  20. Antivesication by Simultaneous Prophylaxis and Detoxification

    National Research Council Canada - National Science Library

    Kwong, Cecil

    1996-01-01

    Our project DAMD17-93-C-3186 entitled 'Antivesication by Simultaneous Prophylaxis and Detoxification' has been directed toward the development of a new topically applied pretreatment that will prevent...

  1. [The relationship between angle of puncture and distribution of bone cement of unilateral percutaneous kyphoplasty for the treatment of thoracolumbar compression fractures].

    Science.gov (United States)

    Wang, Xiang-fu; Fan, You-fu; Shi, Rui-fang; Deng, Qiang; Li, Zhong-feng

    2015-08-01

    To explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP). The clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects. The puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42). Through measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.

  2. European Section of Urotechnology educational video on fluoroscopic-guided puncture in percutaneous nephrolithotomy: all techniques step by step.

    Science.gov (United States)

    Kyriazis, Iason; Liatsikos, Evangelos; Sopilidis, Odysseas; Kallidonis, Panagiotis; Skolarikos, Andreas

    2017-11-01

    To describe the most common fluoroscopic-guided access techniques during percutaneous nephrolithotomy (PCNL) in a step-by-step manner and to assist in the standardisation of their technique and terminology. A high-quality animation video was created for each of the respective fluoroscopic techniques, focusing into the parallel projection of external surgical manoeuvres and their effect in the three-dimensional space of the kidney. Four predominant fluoroscopic-guided percutaneous access techniques are available, each with different advantages and limitations. Monoplanar access is used when a stable single-axis fluoroscopic generator is available and is mostly based on surgeons' experience. Biplanar access uses a second fluoroscopy axis to assess puncture depth. The 'bull's eye' technique follows a coaxial to fluoroscopy puncture path and is associated with a shorter learning curve at the cost of increased hand radiation exposure. Hybrid and conventional triangulate techniques use target projection by two fluoroscopic planes to define the exact localisation of the target in space and access it through a third puncture site. Fluoroscopic guidance during PCNL puncture is a very efficient method for access establishment. The percutaneous surgeon should be familiar with all available variations of fluoroscopic approach in order to be prepared to adapt puncture technique for any given scenario. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  3. An Investigation into Dynamic Puncture Resistance of the Polyester Needled Nonwoven Geotextiles using Video Processing Technique

    Directory of Open Access Journals (Sweden)

    Dehghan-Banadaki Zahra

    2018-03-01

    Full Text Available In this study, the dynamic puncture behavior of nonwoven needle-punched polyester geotextiles has been studied using video processing technique. Twenty-seven needle-punched geotextile samples were produced by changing areal weight, needle penetration depth and punch density as independent variables. Cone drop test was carried out on the samples. In addition to measuring the hole diameter (HD, the video processing technique with a high frame rate camera was employed to calculate the energy absorbed by geotextile fabric up to puncture point (Ep and the hole expansion energy (Ee. Multiple linear regression method was used to develop the predicting relationships between independent and reply variables. The models showed that an increase in areal weight results in an increase in Ep, whereas it causes a decrease in Ee and HD. Moreover, increasing punch density and needle penetration depth, leads to less Ep, and more Ee and HD. In addition, it was also found that significant relationships exist for Ep-HD and Ee-HD.

  4. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH).

    Science.gov (United States)

    Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas, Natalia; Ciapponi, Agustín; Arevalo, Jimmy J; Boogaard, Sabine; Roqué I Figuls, Marta

    2017-04-07

    Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH. To assess the effects of needle tip design (traumatic versus atraumatic) and diameter (gauge) on the prevention of PDPH in participants who have undergone dural puncture for diagnostic or therapeutic causes. We searched CENTRAL, MEDLINE, Embase, CINAHL and LILACS, as well as trial registries via the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal in September 2016. We adopted the MEDLINE strategy for searching the other databases. The search terms we used were a combination of thesaurus-based and free-text terms for both interventions (lumbar puncture in neurological, anaesthesia or myelography settings) and headache. We included randomized controlled trials (RCTs) conducted in any clinical/research setting where dural puncture had been used in participants of all ages and both genders, which compared different tip designs or diameters for prevention of PDPH DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. We included 70 studies in the review; 66 studies with 17,067 participants were included in the quantitative analysis. An additional 18 studies are awaiting classification and 12 are ongoing. Fifteen of the 18 studies awaiting classification mainly correspond to congress summaries published before 2010, in which the available information does not allow the complete evaluation of all their risks of bias and characteristics. Our main outcome was prevention of PDPH, but we also

  5. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Energy Technology Data Exchange (ETDEWEB)

    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  6. Physiological and Pathological Impact of Blood Sampling by Retro-Bulbar Sinus Puncture and Facial Vein Phlebotomy in Laboratory Mice

    DEFF Research Database (Denmark)

    Teilmann, Anne Charlotte; Nygaard Madsen, Andreas; Holst, Birgitte

    2014-01-01

    Retro-bulbar sinus puncture and facial vein phlebotomy are two widely used methods for blood sampling in laboratory mice. However, the animal welfare implications associated with these techniques are currently debated, and the possible physiological and pathological implications of blood sampling...... using these methods have been sparsely investigated. Therefore, this study was conducted to assess and compare the impacts of blood sampling by retro-bulbar sinus puncture and facial vein phlebotomy. Blood was obtained from either the retro-bulbar sinus or the facial vein from male C57BL/6J mice at two...... extensive tissue trauma after both facial vein phlebotomy and retro-bulbar sinus puncture. This study demonstrates that both blood sampling methods have a considerable impact on the animals' physiological condition, which should be considered whenever blood samples are obtained....

  7. Radiation exposure to a patients and personnel resulted from X-ray, TV and computed tomography controlled punctures

    International Nuclear Information System (INIS)

    Blokhina, N.G.; Poltavskij, A.V.; Drygin, V.N.; Artem'eva, N.V.; Bachiashvili, A.K.

    1987-01-01

    Radiation exposures to a patient and personnel resulted from two-pojection X-ray TV and computed tomography controlled diagnostic aimed punctures are studied. Radiation exposure to a patient as measured using a tissue-equivalent phantom. Measurements were conducted by thermoluminescent dosimetry method. It is shown that radiation exposure to a patient makes up 0.0176 Gy±18% under x-ray TV controlled punctures and 0.048 Gy±22% - under tomographic control. Radiation exposure to a doctor is quite high (over 0.3 of the annual maximum permissible dose)

  8. Successful use of nitrous oxide during lumbar punctures: A call for nitrous oxide in pediatric oncology clinics.

    Science.gov (United States)

    Livingston, Mylynda; Lawell, Miranda; McAllister, Nancy

    2017-11-01

    Numerous reports describe the successful use of nitrous oxide for analgesia in children undergoing painful procedures. Although shown to be safe, effective, and economical, nitrous oxide use is not yet common in pediatric oncology clinics and few reports detail its effectiveness for children undergoing repeated lumbar punctures. We developed a nitrous oxide clinic, and undertook a review of pediatric oncology lumbar puncture records for those patients receiving nitrous oxide in 2011. No major complications were noted. Minor complications were noted in 2% of the procedures. We offer guidelines for establishing such a clinic. © 2017 Wiley Periodicals, Inc.

  9. A preliminary study on puncture resistances of top and bottom layers of multi-layered needlepunched nonwoven geotextiles

    Science.gov (United States)

    Alan, G.; Tercan, M.

    2017-10-01

    Needlepunched nonwoven textiles are commonly used as geotextiles for various applications. Considering both environmental and economical benefits, utilization of recycled fibres in nonwoven geotextiles has become an attractive issue. Within this scope, the aim of this study is to evaluate the puncture resistance performances of top and bottom layers of multi-layered needle punched nonwovens made of recycled fibres to be used as membrane protective geotextiles by comparing them with those of made from polypropylene and polyester fibres. Puncture resistance results indicated that nonwovens made of recycled fibres demonstrated good performances at this preliminary stage.

  10. Simultaneous Cake Cutting

    DEFF Research Database (Denmark)

    Balkanski, Eric; Branzei, Simina; Kurokawa, David

    2014-01-01

    We introduce the simultaneous model for cake cutting (the fair allocation of a divisible good), in which agents simultaneously send messages containing a sketch of their preferences over the cake. We show that this model enables the computation of divisions that satisfy proportionality — a popular...

  11. Investigating Efficacy of Melatonin and Gabapentin in Reducing Anxiety and Pain of Lumbar Puncture in Children

    Directory of Open Access Journals (Sweden)

    R Fallah

    2013-10-01

    Full Text Available Introduction: The lumbar puncture is one of the most important diagnostic and therapeutic procedures within children which child’s non-cooperativeness and procedural sedation are regarded necessary to conduct it. This study aimed to compare efficacy and safety of melatonin and gabapentin in reducing anxiety and pain of lumbar puncture in children. Methods: In a parallel single-blinded randomized clinical trial, sixty children aged 6 months -7 years, were evaluated in Pediatric Ward of Shahid Sadoughi Hospital, in Yazd (Iran in 2012. The children were distributedrandomly into two groups (30 children in each group. In group one, they received 0.3 mg/kg/dose of melatonin and theother group received 15 mg/kg/dose of gabapentin. Primary endpoints were success rate in reducing anxiety (anxiety score of≥ four and reducing pain when the needle was inserted to skin for lumbarpuncture (pain score of less than four. The clinicalside effects were investigated as well. Results: Twenty two girls (36.7% and 38 boys (63.3% with mean age of 2.79 ± 1.92 years were evaluated. Anxiety reduction (achieving the anxiety score of ≥ four was obtained in 43.3% in melatonin and in 36.7% in gabapentin groups, respectively and both drugs were equally effective in anxiety reduction (p.value = 0.598.Pain reduction ( achieving the pain score of less than four was obtained in 23.3% in melatonin and in 50% in gabapentin groups, respectively and thus, gabapentin wasproved to be more effective in pain reduction (p.value = 0.032.Mild side effects were observed in 10% of melatonin group and in 16.7% of gabapentin group. No statistically significant differences were seen from viewpoint of safety between the two drugs (p.value=0.448. Conclusion: Melatonin and gabapentin were not effective drugs in anxiety reduction for lumbar puncture of children. However, gabapentin is a safe and effective drug in pain reduction in painful diagnostic therapeutic procedures.

  12. Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Peyman Shirani

    2009-01-01

    Full Text Available A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing that confirmed a diagnosis of Huntington Disease (HD. A CT scan of the head showed wider ventricles than is typical of HD. The head CT and gait change suggested normal pressure hydrocephalus (NPH. Lumbar puncture (LP led to improved neuropsychologic test scores and walking thereby supporting the diagnosis of NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other reports of an association between HD and NPH. NPH should be considered in HD patients with atypical symptoms, such as the inability to walk or rapid progression, as its treatment may lead to improved cognition, gait, and chorea.

  13. Puncturing the pipeline: Do technology companies alienate women in recruiting sessions?

    Science.gov (United States)

    Wynn, Alison T; Correll, Shelley J

    2018-02-01

    A 'chilly' environment limits women's advancement through the educational pipeline leading to jobs in science and technology. However, we know relatively little about the environment women encounter after making it through the educational pipeline. Do technology companies create environments that may dampen women's interest at the juncture when they are launching their careers? Using original observational data from 84 recruiting sessions hosted by technology companies at a prominent university on the US West Coast, we find that company representatives often engage in behaviors that are known to create a chilly environment for women. Through gender-imbalanced presenter roles, geek culture references, overt use of gender stereotypes, and other gendered speech and actions, representatives may puncture the pipeline, lessening the interest of women at the point of recruitment into technology careers.

  14. Comparison of local anesthetic effect of lidocaine by jet injection vs needle infiltration in lumbar puncture.

    Science.gov (United States)

    Hajimaghsoudi, Majid; Vahidi, Elnaz; Momeni, Mehdi; Arabinejhad, Abbas; Saeedi, Morteza

    2016-07-01

    Usual routes of drug administration are often painful and invasive. Nowadays, using jet injection has been introduced successfully, as a noninvasive and painless method of anesthetic delivery in performing different procedures. The objective of the study is to compare the local anesthetic effect of lidocaine by jet injection vs needle infiltration in performing lumbar puncture in the emergency department (ED). A randomized single-blind controlled study was performed in 65 patients needing lumbar puncture recruited from the ED from July to November 2014. We enrolled 44 patients and excluded 21 patients by the exclusion criteria. Local lidocaine was delivered in 1 group by jet injector (group B), whereas in the other group conventional method, needle infiltration was used (group A). In both groups, intravenous midazolam 1 mg was administered as an anxiolytic drug before the procedure. Patients' pain score (visual analog scale [VAS]) from 0 to 10 was recorded both during drug delivery and performing the procedure itself. The observer who collected patients' data and fulfill the questionnaire was blinded to the study. During lidocaine injection, the mean ± SD VAS score was 5.27 ± 1.77 in group A and 2.95 ± 1.81 in group B (mean difference, 2.31; 95% confidence interval, 1.22-3.41) (P= .000). During performing the procedure, the mean ± SD VAS score in groups A and B was 3.77 ± 1.77 vs 2.18 ± 1.50 (mean difference, 1.59; 95% confidence interval, 0.59-2.58) (P= .003). Injecting lidocaine by jet injector is less painful than infiltrating it by needle and syringe. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Rotational Angiography Based Three-Dimensional Left Atrial Reconstruction: A New Approach for Transseptal Puncture.

    Science.gov (United States)

    Koektuerk, Buelent; Yorgun, Hikmet; Koektuerk, Oezlem; Turan, Cem H; Gorr, Eduard; Horlitz, Marc; Turan, Ramazan G

    2016-02-01

    Rotational angiography is a well-known method for the three-dimensional (3-D) reconstruction of left atrium and pulmonary veins during left-sided atrial arrhythmia ablation procedures. In our study, we aimed to review our experience in transseptal puncture (TSP) using 3-D rotational angiography. We included a total of 271 patients who underwent atrial fibrillation ablation using cryoballoon. Rotational angiography was performed to get the three-dimensional left atrial and pulmonary vein reconstructions using cardiac C-arm computed tomography. The image reconstruction was made using the DynaCT Cardiac software (Siemens, Erlangen, Germany). The mean age of the study population was 61 ± 10 years. The indications for left atrial arrhythmia ablation were paroxysmal AF in 140 patients (52%) and persistent AF patients in 131 (48%) patients. The success rate of TSP using only rotational guidance was (264/271 patients, 97.4%). In the remaining seven patients, transesophageal guidance was used after the initial attempt due to thick interatrial septum in five patients and difficult TSP due to abnormal anatomy and mild pericardial effusion in the remaining two patients. Mean fluoroscopy dosage of the rotational angiography was 4896.4 ± 825.3 μGym(2). The mean time beginning from femoral vein puncture to TSP was 12.3 ± 5.5 min. TSP guided by rotational angiography is a safe and effective method. Our results indicate that integration of rotational angiographic images into the real-time fluoroscopy can guide the TSP during the procedure. © 2015 John Wiley & Sons Ltd.

  16. A dedicated lumbar puncture clinic: performance and short-term patient outcomes.

    Science.gov (United States)

    Barreras, Paula; Benavides, David R; Barreras, Jorge F; Pardo, Carlos A; Jani, Ami; Faigle, Roland; Bahouth, Mona N

    2017-10-01

    The purpose of the study was to evaluate patient outcomes, including success rates, factors associated with unsuccessful procedures and frequency of post-lumbar puncture headaches (PLPH), at a dedicated academic outpatient lumbar puncture (LP) clinic. All patients referred to our LP clinic between June 1, 2014 and May 31, 2015 were included in this consecutive observational series. We collected information about patient characteristics, operational parameters of the procedure, and complications. We also recorded rates of participation in biomedical research involving use of cerebrospinal fluid. Univariate analysis used Student's t test and Fisher's exact test. Logistic regression was used to determine independent risk factors associated with unsuccessful LP and PLPH. The mean age of patients referred to our LP clinic was 46 ± 17 years. Of the 307 referrals, 281 patients (92%) started the procedure, with successful acquisition of CSF in 267 (95%). Factors contributing to unsuccessful procedures included higher body mass index [odds ratio (OR) 1.8], older age (OR 1.9), and female sex (OR 10.3). The rate of PLPH was 5.7%. Younger age (OR 0.5), female sex (OR 6.9), high mean arterial pressure (OR 2.2), and a traumatic LP (OR 10.0) were identified as risk factors for PLPH. Notably, 202 patients (72%) consented to biomedical research. A standardized approach to outpatient LP demonstrates high procedural success rate, low PLPH rate, and high participation in biomedical research. Awareness of a group of patients at higher risk for complications including procedure failure or PLPH provides guidance for decision-making regarding referral to the outpatient LP clinic.

  17. Usefulness of sono-guided needle puncture for MR arthrography of the shoulder

    International Nuclear Information System (INIS)

    Choi, Jae Woong; Hong, Suk Ju; Suh, San Il; Yong, Hwan Suk; Kim, Jung Hyuk; Park, Cheol Min; Suh, Won Hyuck; Kim, Myung Gyu

    2000-01-01

    To evaluate the usefulness of sono-guided needle puncture for MR arthrography of the shoulder to locate the path of access and to control the correct placement of the needle into the shoulder. Fifteen patients with suspicion of shoulder pathology were included in this study. Patients were laid in supine positions with the arm extended and slightly abducted, the palm of the hand facing upward. A sonographic unit with a high resolution transducer with 7.5 MHz linear array was used. Axial images in the anterior aspect of the shoulder were obtained to localize the coracoid process and the anteromedical portion of the humerus. Using an aseptic technique, a 21-guage needle was advanced into the shoulder joint under ultrasonographic guidance. When the needle made contract with the articular cartilage of the humeral head, the needle was tiled to position is point in the articular cavity. Solution of 0.1 ml gadopentetate dimeglumine in 25 ml of normal saline was prepared and 12-16 ml was injected into the joint cavity. The intra-articular position of the needle and the compete distension of the shoulder joint were again confirmed by sonography. The needle was accurately placed in 14 out of 15 patients without damage to neighboring structures. It took 10 to 15 minutes to complete the procedure in 14 patients. No side effects attributable to gadopentetate dimeglumine were found. Sono-guided needle puncture for the shoulder MR arthrography can be a substitutable method for fluoroscopic guidance, with easy access, advantages of lacking radiation hazard and eliminating the need for iodized contrast agents.

  18. Cecal Ligation and Puncture Results in Long-Term Central Nervous System Myeloid Inflammation.

    Directory of Open Access Journals (Sweden)

    Benjamin H Singer

    Full Text Available Survivors of sepsis often experience long-term cognitive and functional decline. Previous studies utilizing lipopolysaccharide injection and cecal ligation and puncture in rodent models of sepsis have demonstrated changes in depressive-like behavior and learning and memory after sepsis, as well as evidence of myeloid inflammation and cytokine expression in the brain, but the long-term course of neuroinflammation after sepsis remains unclear. Here, we utilize cecal ligation and puncture with greater than 80% survival as a model of sepsis. We found that sepsis survivor mice demonstrate deficits in extinction of conditioned fear, but no acquisition of fear conditioning, nearly two months after sepsis. These cognitive changes occur in the absence of neuronal loss or changes in synaptic density in the hippocampus. Sepsis also resulted in infiltration of monocytes and neutrophils into the CNS at least two weeks after sepsis in a CCR2 independent manner. Cellular inflammation is accompanied by long-term expression of pro-inflammatory cytokine and chemokine genes, including TNFα and CCR2 ligands, in whole brain homogenates. Gene expression analysis of microglia revealed that while microglia do express anti-microbial genes and damage-associated molecular pattern molecules of the S100A family of genes at least 2 weeks after sepsis, they do not express the cytokines observed in whole brain homogenates. Our results indicate that in a naturalistic model of infection, sepsis results in long-term neuroinflammation, and that this sustained inflammation is likely due to interactions among multiple cell types, including resident microglia and peripherally derived myeloid cells.

  19. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Science.gov (United States)

    Wallace, John R; Mangas, Kirstie M; Porter, Jessica L; Marcsisin, Renee; Pidot, Sacha J; Howden, Brian; Omansen, Till F; Zeng, Weiguang; Axford, Jason K; Johnson, Paul D R; Stinear, Timothy P

    2017-04-01

    Addressing the transmission enigma of the neglected disease Buruli ulcer (BU) is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti) blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24) subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50) in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  20. Linear-motion tattoo machine and prefabricated needle sets for the delivery of plant viruses by vascular puncture inoculation

    Science.gov (United States)

    Vascular puncture inoculation (VPI) of plant viruses previously has been conducted either manually or by use of a commercial engraving tool and laboratory-fabricated needle arrays. In an effort to improve this technique, a linear-motion tattoo machine driving industry-standard needle arrays was tes...

  1. Curative effect of minimally invasive puncture and drainage assisted with alteplase on treatment of acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Jun-Lin Hu

    2017-01-01

    >Conclusions: As for the effect on evacuation of hematoma and also the ameliorative effect on nerve injury, inflammatory reaction and oxidative stress response in treatment of acute intracerebral hemorrhage, minimally invasive puncture and drainage assisted with alteplase was superior to adjuvant therapy with urokinase.

  2. Removal of non-deflatable retained foley catheter in the bladder by percutaneous puncture of catheter balloon

    International Nuclear Information System (INIS)

    Yoo, Jae Duk; Kim, Jae Kyu; Park, Jin Gyun; Chung, Hyon De

    1988-01-01

    Nondeflatable Foley catheter in the bladder is an uncommon event. We recently experienced a patient in whom the urologist were unable to remove a Foley catheter with cystoscope due to public bone fractures. The procedure, which was successfully carried out, consists of puncturing the ballon under fluoroscope.

  3. Sudden headache, lumbar puncture, and the diagnosis of subarachnoid hemorrhage in patients with a normal computed tomography scans.

    Science.gov (United States)

    Valle Alonso, Joaquín; Fonseca Del Pozo, Francisco Javier; Vaquero Álvarez, Manuel; De la Fuente Carillo, Juan José; Llamas, José Carlos; Hernández Montes, Yelda

    2018-02-01

    To assess the usefulness of computed tomography (CT) to identify subarachnoid bleeding in patients with neurologic deficits seeking emergency care for sudden headache within 6 hours of onset of symptoms. Retrospective observational study of patients presenting with sudden nontraumatic headache peaking during the previous hour in the absence of neurologic deficits. We ordered CT scans for all patients, and if the scan was normal we performed a lumbar puncture. All patients were then followed for 6 months. Eighty-five patients were included. Subarachnoid bleeding was identified in 10 (10.2%) patients by CT. Seventy- four lumbar punctures were performed in patients with negative CTs; the lumbar puncture was positive in 1 patient and inconclusive in 2 patients. In all 3 patients, bleeding was ruled out with later images; thus, no cases of subarachnoid hemorrhage were confirmed in the 74 patients who underwent lumbar puncture. Nor were any cases found in any of these patients during follow-up. A CT scan taken within 6 hours of onset of sudden headache is sufficient for confirming or ruling out subarachnoid bleeding in patients with sudden headache who have no neurologic deficits.

  4. Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer.

    Directory of Open Access Journals (Sweden)

    John R Wallace

    2017-04-01

    Full Text Available Addressing the transmission enigma of the neglected disease Buruli ulcer (BU is a World Health Organization priority. In Australia, we have observed an association between mosquitoes harboring the causative agent, Mycobacterium ulcerans, and BU. Here we tested a contaminated skin model of BU transmission by dipping the tails from healthy mice in cultures of the causative agent, Mycobacterium ulcerans. Tails were exposed to mosquito (Aedes notoscriptus and Aedes aegypti blood feeding or punctured with sterile needles. Two of 12 of mice with M. ulcerans contaminated tails exposed to feeding A. notoscriptus mosquitoes developed BU. There were no mice exposed to A. aegypti that developed BU. Eighty-eight percent of mice (21/24 subjected to contaminated tail needle puncture developed BU. Mouse tails coated only in bacteria did not develop disease. A median incubation time of 12 weeks, consistent with data from human infections, was noted. We then specifically tested the M. ulcerans infectious dose-50 (ID50 in this contaminated skin surface infection model with needle puncture and observed an ID50 of 2.6 colony-forming units. We have uncovered a biologically plausible mechanical transmission mode of BU via natural or anthropogenic skin punctures.

  5. Simultaneous consolidation and creep

    DEFF Research Database (Denmark)

    Krogsbøll, Anette

    1997-01-01

    Materials that exhibit creep under constant effective stress typically also show rate dependent behavior. The creep deformations and the rate sensitive behavior is very important when engineering and geological problems with large time scales are considered. When stress induced compaction (consol...... (consolidation) is retarded by slow drainage of excess pore pressure it is expected that consolidation and creep occur simultaneously. A constitutive model adressing the problems of rate sensitive behavior and simultaneous consolidation and creep is presented....

  6. Simultaneity, relativity and conventionality

    Science.gov (United States)

    Janis, Allen I.

    2008-01-01

    The view of simultaneity presented by Max Jammer is almost breathtaking, encompassing, as the book's subtitle suggests, the period from antiquity to the 21st century. Many interesting things are to be found along the way. For example, what Jammer (p. 49) says "may well be regarded as probably the earliest recorded example of an operational definition of distant simultaneity" is due to St. Augustine (in his Confessions, written in 397 A.D.; for a modern translation, see Augustine, 2006). He was arguing against astrology by presenting the story of two women, one rich and one poor, who gave birth simultaneously. Although the two children thus had precisely the same horoscopes, their lives followed quite different courses. And how was it determined that the births were simultaneous? A messenger went from each birth site to the other, leaving the instant the child was born (and, presumably, traveling with equal speeds). Since the messengers met at the midpoint between the locations of the two births, the births must have been simultaneous. This is, of course, quite analogous to Albert Einstein's definition of simultaneity (given more than 1500 years later), which will be discussed in Section 2.1.

  7. Direct cervical arterial access for intracranial endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, R. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); APHP, Hopital Henri Mondor, Service de Neuroradiologie Diagnostique et Therapeutique, Creteil Cedex (France); Piotin, M.; Mounayer, C.; Spelle, L. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, J. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Ophtalmologique Adolphe de Rothschild, Service de Neuroradiologie Interventionnelle, Paris Cedex 19 (France)

    2006-12-15

    Tortuous vasculature is a cause of failure of endovascular treatment of intracranial vascular lesions. We report our experience of direct cervical accesses in patients in whom the arterial femoral route was not attainable. In this retrospective study, 42 direct punctures of the carotid or the vertebral arteries at the neck were performed in 38 patients. The vessel harboring the intracranial lesion was punctured at the neck above the main tortuosity, a sheath was then positioned under fluoroscopic control to allow a stable access to the intracranial circulation. After the procedure, the sheath was removed and hemostasis was gained either by manual compression or by an arterial closure device (4 of 42, 9%). The cervical route allowed access to all intracranial lesions in all 42 procedures. A complication was encountered in six procedures (14%) related to the direct puncture. In 2 of the 42 procedures (4%), a transient vasospasm was encountered. A cervical hematoma formed in 3 of the 42 procedures (7%) after sheath withdrawal (one patient in whom an 8F sheath had been used, required surgical evacuation of a hematoma compressing the upper airways; the other patients did well without surgical evacuation). In the remaining patient (1 of 42 procedures, 2%), a small asymptomatic aneurysm at the puncture site was seen on the follow-up angiogram. Direct cervical arterial approaches to accessing the intracranial circulation is effective in patients in whom the femoral route does not allow the navigation and stabilization of guiding catheters. (orig.)

  8. 78 FR 22213 - Airworthiness Directives; Eurocopter France Helicopters

    Science.gov (United States)

    2013-04-15

    ... comments to the U.S. Department of Transportation, Docket Operations, M-30, West Building Ground Floor... AD would not have a substantial direct effect on the States, on the relationship between the national...) Unfold and visually inspect the float assemblies for any cuts, tears, punctures, or abrasion. Replace the...

  9. Electromagnetic field-based navigation for percutaneous punctures on C-arm CT: experimental evaluation and clinical application.

    Science.gov (United States)

    Meyer, Bernhard C; Peter, Olaf; Nagel, Markus; Hoheisel, Martin; Frericks, Bernd B; Wolf, Karl-Jürgen; Wacker, Frank K

    2008-12-01

    The aim of this study was to prospectively evaluate the needle visualization and placement error and use of an electromagnetic field-based tracking navigation device for puncture procedures based on C-arm CT (CACT) images. A commercially available navigation device was mounted on an angiographic X-ray system setup for CACT. After the target was defined, needle placement was performed under real-time visualization of the virtual needle in CACT images. The final, real needle position was assessed by CACT. Punctures were performed in phantoms (n = 76) and in twelve patients (eight biopsies, three drainages, one injection). Procedure times, system error, user error and total error were assessed. In phantoms, mean total error was 2.3 +/- 0.9 mm, user error was 1.4 +/- 0.8 mm and system error was 1.7 +/- 0.8 mm. In the patient study, the targeted puncture was successful in all twelve cases. The mean total error was 5.4 mm +/- 1.9 mm (maximum 8.1 mm), user error was 3.7 +/- 1.7 mm, system error was 3.2 +/- 1.4 mm and mean skin-to-target time was less than 1 min. The navigation device relying on CACT was accurate in terms of needle visualization and useful for needle placement under both experimental and clinical conditions. For more complex procedures, electromagnetic field-based tracking guidance might be of help in facilitating the puncture and reducing both the puncture risk and procedure time.

  10. Expression of inflammation/pain-related genes in the dorsal root ganglion following disc puncture in rats.

    Science.gov (United States)

    Fujioka, Y; Stahlberg, A; Ochi, M; Olmarker, K

    2016-04-01

    To determine the expression of inflammation- and pain-related genes at days 1 and 3 in the dorsal root ganglion (DRG) of rats with or without disc puncture, using real-time quantitative polymerase chain reaction (RT-qPCR) with the TaqMan low-density array (TLDA). 53 female Sprague-Dawley rats were used. The left facet joint between L4 and L5 was removed, and the DRG and intervertebral disc between the vertebrae were exposed. The L4-5 intervertebral disc was punctured using a 0.4-mm diameter injection needle (disc puncture group) or left unpunctured (sham group). After one or 3 days, the 53 DRGs were harvested, frozen, and assessed for expression of inflammation-related genes. Total RNA was isolated from the DRGs. Expression of 119 genes related to inflammation and pain in the DRG after disc puncture were analysed using RT-qPCR with the TLDA. Of the 95 inflammation-related genes, 78 genes were reliably detected. Two genes were significantly up-regulated: cysteinyl leukotriene receptor 1 (CYSLTR1) at day 3 and interleukin 2 receptor gamma (IL2RG) at day 1, and one gene was significantly down-regulated: phospholipase C beta 3 (PLCB3) at day 1. Of the 24 pain-related genes, 18 genes were reliably detected. Two genes were significantly up-regulated: nitric oxide synthase 1 (NOS1) at days 1 and 3 and 5-HT2A receptor (HTR2A) at day 1. Disc puncture may elicit changes in the expression of a variety of genes. Gene expression profiling is a useful tool for detecting new potential pharmaceutical targets for spinal pain syndromes.

  11. Bilateral simultaneous infective keratitis.

    Science.gov (United States)

    On Annie, Lai Hiu; Ray, Manotosh

    2017-08-01

    To analyze the demographics, risk factors, clinical and microbiological characteristics of cases of bilateral simultaneous infective keratitis. In this retrospective case series, patients with clinical evidence of bilateral simultaneous infective keratitis were identified from January 1, 2011 to August 31, 2016. Demographics, risk factors, clinical and microbiological characteristics, and treatment outcomes were analyzed. Five patients (ten eyes) with bilateral simultaneous infective keratitis were identified. The mean age was 32.8 years (SD,±8.8; range, 24-44). All the patients were disposable soft contact lens wearers before presentation. The average size of the infiltrate was 4.76mm 2 (SD±9.0; range, 0.2-31.34). A total of 4 types of bacteria were isolated, with Pseudomonas aeruginosa being the most frequently isolated bacteria involving 5 eyes of four patients. Infection resolved with medical treatment in 9 eyes, 1 patient required therapeutic corneal transplantation for impending corneal perforation. The average time taken for infection to resolve was 6.7days (SD±4.5; range, 2-16). In this case series, the most common risk factor of bilateral simultaneous microbial keratitis was use of soft disposable contact lens and the most commonly isolated bacteria was Pseudomonas aeruginosa. Bilateral simultaneous infective keratitis is uncommon and is a serious complication of contact lens use in immunocompetent adult patients. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Zhang, Hailong; Wu, Xinbo; Gu, Xin; Gu, Guangfei; Fan, Yunshan; He, Shisheng

    2015-01-01

    Abstract Prospective nonrandomized control study. The study aimed to investigate the implication of the HE's Lumbar LOcation (HELLO) system in improving the puncture accuracy and reducing fluoroscopy in percutaneous transforaminal endoscopic discectomy (PTED). Percutaneous transforaminal endoscopic discectomy is one of the most popular minimally invasive spine surgeries that heavily depend on repeated fluoroscopy. Increased fluoroscopy will induce higher radiation exposure to surgeons and patients. Accurate puncture in PTED can be achieved by accurate preoperative location and definite trajectory. The HELLO system mainly consists of self-made surface locator and puncture-assisted device. The surface locator was used to identify the exact puncture target and the puncture-assisted device was used to optimize the puncture trajectory. Patients who had single L4/5 or L5/S1 lumbar intervertebral disc herniation and underwent PTED were included the study. Patients receiving the HELLO system were assigned in Group A, and those taking conventional method were assigned in Group B. Study primary endpoint was puncture times and fluoroscopic time, and the secondary endpoint was location time and operation time. A total of 62 patients who received PTED were included in this study. The average age was 45.35 ± 8.70 years in Group A and 46.61 ± 7.84 years in Group B (P = 0.552). There were no significant differences in gender, body mass index, conservative time, and surgical segment between the 2 groups (P > 0.05). The puncture time(s) were 1.19 ± 0.48 in Group A and 6.03 ± 1.87 in Group B (P < 0.001). The fluoroscopic times were 14.03 ± 2.54 in Group A and 25.19 ± 4.28 in Group B (P < 0.001). The preoperative location time was 4.67 ± 1.41 minutes in Group A and 6.98 ± 0.94 minutes in Group B (P < 0.001). The operation time was 79.42 ± 10.15 minutes in Group A and 89.65 ± 14.06 minutes in Group B (P

  13. [Efficacies of percutaneous multiple needle puncturing for releasing hip adductor muscle during total hip arthroplasty].

    Science.gov (United States)

    Zhao, Yong; Liu, Kegui; Sun, Tao; Zhao, Yuchi; Zou, Dexin; Tan, Jiangwei; Li, Jingning; Zhang, Shudong; Liu, Yangde

    2014-12-09

    To summarize our experiences of applying percutaneous multiple needle puncturing technique for releasing adductor muscle during total hip arthroplasty (THA) for ischemic necrosis of femoral head and provide rationales for clinical practice. From January 2008 to December 2012, 36 adult patients with ischemic necrosis of femoral head (36 hips) and 36 adult patients with femoral neck fracture (36 hips) were recruited. The group of ischemic necrosis of femoral head was designated as experiment group in which there were 29 males and 7 females with an average age of 67.9 (60-78) years. According to the Ficat system, there were type III (n = 24) and type IV (n = 12) . The affected leg shortening of this group prior to surgery was over 2 cm. The group of femoral neck fracture was selected as control group in which there were 16 males and 20 females with an average age of 70.1 (60-82) years. According to the Garden system, there were type III (n = 16) and type IV (n = 20). All cases underwent THA with Press-fit prosthesis. After fixing prosthetic components, leg length discrepancy was corrected. And percutaneous multiple needle puncturing was applied for releasing adductor muscle in experiment group. The follow-up period was 2 years. The safety and efficiency were evaluated by HHS (Harris Hip Score) and the range of motion (ROM) of hip extorsion and abduction. There was no occurrence of such early complications as palsy of obturator nerve, hematoma in adductor muscle area or serious deep vein embolism.No serious complications of deep infection, femoral head dislocation, recurrent adductor muscle contracture, prosthesis loosening, subsidence, excursion or penetration occurred up until the final follow-up. The range of hip motion of extorsion and abduction: (1) in experimental group, the postoperative ROM (abduction:44.9 ± 0.8, extorsion:45.1 ± 0.9) was significantly larger than that of preoperative (abduction: 30.0 ± 4.6, extorsion:31.5 ± 4.6) ; (2) the postoperative ROM

  14. Simultaneous ultrafiltration and diafiltration

    Directory of Open Access Journals (Sweden)

    Zavargo Zoltan Z.

    2002-01-01

    Full Text Available A model with simultaneous ultrafiltration and diafiltration, which includes the rejection coefficients, is presented in this study. Adding a diafiltration solution at a constant, lower rate than the filtrate rate results in a constant decrease of the solution volume in the tank. This enables the simultaneous attainment of the desired macrosolute concentration and microsulute dilution. The proposed model, based on incomplete macrosolute rejection and incomplete mi-crosolute permeation through a membrane, as well as constant permeate flux, is compared to the classical constant volume, diafiltration process. The obtained results show that less diafiltration volume is necessary with this process. Simultaneously, the duration of the process, for higher purification requirements, is shorter in this case.

  15. Minimal invasive puncture and drainage versus endoscopic surgery for spontaneous intracerebral hemorrhage in basal ganglia

    Directory of Open Access Journals (Sweden)

    Li Z

    2017-01-01

    Full Text Available Zhihong Li,1,* Yuqian Li,1,* Feifei Xu,2,* Xi Zhang,3 Qiang Tian,4 Lihong Li1 1Department of Neurosurgery, Tangdu Hospital, 2Department of Foreign Languages, 3Department of Biomedical Engineering, 4Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, People’s Republic of China *These authors contributed equally to this work Abstract: Two prevalent therapies for the treatment of spontaneous intracerebral hemorrhage (ICH in basal ganglia are, minimally invasive puncture and drainage (MIPD, and endoscopic surgery (ES. Because both surgical techniques are of a minimally invasive nature, they have attracted greater attention in recent years. However, evidence comparing the curative effect of MIPD and ES has been uncertain. The indication for MIPD or ES has been uncertain till now. In the present study, 112 patients with spontaneous ICH in basal ganglia who received MIPD or ES were reviewed retrospectively. Baseline parameters prior to the operation, evacuation rate (ER, perihematoma edema, postoperative complications, and rebleeding incidences were collected. Moreover, 1-year postictus, the long-term functional outcomes of patients with regard to hematoma volume (HV or Glasgow Coma Scale (GCS score were judged, respectively, by the case fatality, Glasgow Outcome Scale (GOS, Barthel Index (BI, and modified Rankin Scale (mRS. The ES group had a higher ER than the MIPD group on postoperative day 1. The MIPD group had fewer adverse outcomes, which included less perihematoma edema, anesthetic time, and blood loss, than the ES group. The functional outcomes represented by GOS, BI, and mRS were better in the MIPD group than in the ES group for patients with HV 30–60 mL or GCS score 9–14. These results indicate that ES is more effective in evacuating hematoma in basal ganglia, while MIPD is less invasive than ES. Patients with HV 30–60 mL or GCS score 9–14 may benefit more from the MIPD

  16. Comparison of two electromagnetic navigation systems for CT-guided punctures. A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Putzer, D.; Arco, D.; Schamberger, B.; Schanda, F.; Mahlknecht, J.; Widmann, G.; Schullian, P.; Jaschke, W.; Bale, R. [Innsbruck Medical University (Austria). Dept. of Radiology

    2016-05-15

    We compared the targeting accuracy and reliability of two different electromagnetic navigation systems for manually guided punctures in a phantom. CT data sets of a gelatin filled plexiglass phantom were acquired with 1, 3, and 5 mm slice thickness. After paired-point registration of the phantom, a total of 480 navigated stereotactic needle insertions were performed manually using electromagnetic guidance with two different navigation systems (Medtronic Stealth Station: AxiEM; Philips: PercuNav). A control CT was obtained to measure the target positioning error between the planned and actual needle trajectory. Using the Philips PercuNav, the accomplished Euclidean distances were 4.42 ± 1.33 mm, 4.26 ± 1.32 mm, and 4.46 ± 1.56 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.84 ± 1.59 mm, 3.84 ± 1.43 mm, and 3.81 ± 1.71 mm, respectively. Using the Medtronic Stealth Station AxiEM, the Euclidean distances were 3.86 ± 2.28 mm, 3.74 ± 2.1 mm, and 4.81 ± 2.07 mm at a slice thickness of 1, 3, and 5 mm, respectively. The mean lateral positional errors were 3.29 ± 1.52 mm, 3.16 ± 1.52 mm, and 3.93 ± 1.68 mm, respectively. Both electromagnetic navigation devices showed excellent results regarding puncture accuracy in a phantom model. The Medtronic Stealth Station AxiEM provided more accurate results in comparison to the Philips PercuNav for CT with 3 mm slice thickness. One potential benefit of electromagnetic navigation devices is the absence of visual contact between the instrument and the sensor system. Due to possible interference with metal objects, incorrect position sensing may occur. In contrast to the phantom study, patient movement including respiration has to be compensated for in the clinical setting.

  17. Incidence of Inadvertent Dural Puncture During CT Fluoroscopy-Guided Interlaminar Epidural Corticosteroid Injections in the Cervical Spine: An Analysis of 974 Cases.

    Science.gov (United States)

    Amrhein, T J; Parivash, S N; Gray, L; Kranz, P G

    2017-09-01

    The objective of this study is to determine the rate of inadvertent dural puncture during CT fluoroscopy-guided cervical interlaminar epidural corticosteroid injection. In addition, in a subanalysis, we aim to assess the rate of inadvertent dural puncture superior to C5-C6 occurring during interlaminar epidural corticosteroid injection using CT fluoroscopy guidance because such injections are not performed using conventional fluoroscopy. Images obtained from consecutive CT fluoroscopy-guided cervical interlaminar epidural corticosteroid injections conducted from November 2009 to November 2015 were reviewed. The following information was recorded: the presence of inadvertent dural puncture, the level of the cervical interlaminar space, approach laterality (left or right), anteroposterior spinal canal diameter, and the presence of a trainee. Two-tailed Fisher exact tests were used for assessment of categoric variables, and t tests were used for continuous variables. A total of 974 cervical interlaminar epidural corticosteroid injections were identified in 728 patients. Inadvertent dural punctures were identified in association with 1.4% (14/974) of these injections; all punctures were recognized during the procedure. Needle placements were performed at every cervical level (C1-C2 through C7-T1). The highest rate of dural puncture (2.8%) occurred at C5-C6. No dural punctures occurred superior to C5-C6 (16.6% of cases). The complication rate was 0.4%. Only greater anteroposterior spinal canal diameter was associated with increased dural puncture rates (p = 0.049). CT fluoroscopy-guided cervical interlaminar epidural corticosteroid injections were performed at all levels throughout the cervical spine. A very low complication rate and a minimal rate of inadvertent dural puncture were noted, similar to previously reported rates for conventional fluoroscopy-guided injections limited to the lower cervical spine only.

  18. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers

    2008-01-01

    . Like leaders, who are caught in paradoxical situations where they have to manage production and logistics simultaneously with making space for creativity and innovation, theatre directors need to find the delicate balance between on one hand renewal of perceptions, acting and interaction......In this article we argue that leaders facing complex challenges can learn from the arts, specifically that leaders can learn by examining how theatre directors direct creativity through creative constraints. We suggest that perceiving creativity as a boundary phenomenon is helpful for directing it...... and on the other hand getting ready for the opening night. We conclude that the art of directing creativity is linked to developing competencies of conscious presence, attention and vigilance, whereas the craft of directing creativity concerns communication, framing and choice....

  19. Method of and device for determining the characteristics and flux distribution of micrometeorites. [scanning puncture holes in sheet material with photoelectric cell

    Science.gov (United States)

    Meissinger, H. F. (Inventor)

    1973-01-01

    A micrometeorite impact sensing method of and device for determining the characteristics and flux distribution of micrometeorites are discussed. The method consists of exposing to the micrometeorite environment, a panel of sheet material of a thickness to be punctured by impacting micrometeorites and then scanning the panel with a scanner which produces an output representing the number and size of the puncture holes in the panel. After, exposure, the panel is scanned for puncture holes by illuminating one side of the panel and retracting the panel into its stowage container past a photoelectric scanner which produces an output representing the incident light.

  20. Bone marrow-derived mononuclear cell transplantation in spinal cord injury patients by lumbar puncture.

    Science.gov (United States)

    Suzuki, Yoshihisa; Ishikawa, Namiko; Omae, Kaoru; Hirai, Tatsuya; Ohnishi, Katsunori; Nakano, Norihiko; Nishida, Hidetaka; Nakatani, Toshio; Fukushima, Masanori; Ide, Chizuka

    2014-01-01

    This study was conducted to assess the safety and feasibility of intrathecal transplantation of autologous bone marrow-derived mononuclear cells for the treatment of patients with spinal cord injury. Ten patients were included in the study. Approximately 120 ml of bone marrow aspirate was obtained from bilateral iliac bone of patients with spinal cord injury. Isolation of mononuclear cells was performed using Ficoll density-gradient centrifugation. Bone marrow mononuclear cells were transplanted into cerebrospinal fluid by lumbar puncture. Functional tests were performed prior to the cell transplantation and six months after cell transplantation. The patients were carefully observed for up to six months. In 5 patients with AIS A prior to cell transplantation, 1 patient converted to AIS B six months after cell transplantation. In 5 patients with AIS B, 1 patient converted to AIS D and 2 patients to AIS C. MRI did not show any complication. Two patients showed slight anemia after aspiration of bone-marrow cells, which returned to normal level within a several weeks. The results of this study suggest that this method may be safe and feasible.

  1. Is the Optic Nerve Head Structure Impacted by a Diagnostic Lumbar Puncture in Humans?

    Science.gov (United States)

    Poli, Muriel; Denis, Philippe; Sellem, Eric; Aho-Glélé, Ludwig-Serge; Bron, Alain M

    2017-11-01

    The purpose of this study is to assess in vivo whether diagnostic lumbar puncture (LP) is followed by optic nerve head (ONH) and parapapillary anatomic changes in normal human eyes. Prospective, single-center, observational case series. ONH structures (prelaminar tissue surface, anterior surface of the lamina cribrosa, central retinal vessels) and parapapillary structures (internal limiting membrane, posterior surfaces of retinal nerve fiber layer and Bruch membrane/retinal pigment epithelium complex, Bruch membrane opening, posterior surface of the choroid) were quantitatively evaluated by means of swept-source optical coherence tomography (Triton Ver.10.05, Topcon, Tokyo, Japan) before and after LP (5, 60, and 360 min). Each of these structures was manually delineated for measurement before being superimposed to detect any displacement, using peripheral margins of parapapillary structures as a reference plane. A total of 16 eyes of 8 nonglaucomatous patients were evaluated. The CSF volume was median (IQR), 1.65 mL (1.16 to 2.00) and none of the ONH structures showed any anatomic changes at any time point after LP. According to the design of this study, diagnostic LP is a safe procedure regarding deep ONH structures in nonglaucomatous subjects.

  2. Herniography: A prospective, randomized study between midline and left iliac fossa puncture techniques

    Energy Technology Data Exchange (ETDEWEB)

    Nadkarni, Sanjay; Brown, Peter W.G.; Beek, Edwin J.R. van; Collins, Michael C

    2001-05-01

    AIM: To determine whether an optimal site of injection exists for herniography. MATERIALS AND METHODS: This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP < 0.05 considered statistically significant RESULTS: Four complications were encountered (4%), and these were equally distributed between the two groups. Adequate initial positioning of the needle was similar in both groups. The volume of local anaesthetic used was correlated with discomfort using a pain scale: a volume of >6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI < 45 kg/m{sup 2}) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement. CONCLUSION: Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches. Nadkarni, S. et al. (2001)

  3. Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture.

    Science.gov (United States)

    Glimåker, Martin; Johansson, Bibi; Grindborg, Örjan; Bottai, Matteo; Lindquist, Lars; Sjölin, Jan

    2015-04-15

    In suspected acute bacterial meningitis (ABM), cerebral computerized tomography (CT) is recommended before lumbar puncture (LP) if mental impairment. Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision. The Swedish quality registry for community-acquired ABM was analyzed retrospectively. Door-to-antibiotic time and outcome were compared among patients treated 2005-2009 (n=394) and 2010-2012 (n=318). The effect of different LP-CT sequences was analyzed during 2008-2012. Adequate treatment was started 1.2 hours earlier, and significantly more patients were treated treatment, significant increase in door-to-antibiotic times of Treatment delay resulted in a significantly increased risk for fatal outcome, with a relative increase in mortality of 12.6% per hour of delay. The deletion of impaired mental status as contraindication for prompt LP and LP without prior CT scan are associated with significantly earlier treatment and a favorable outcome. A revision of current international guidelines should be considered. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Puncture wounds into the navicular bursa of the horse: role of radiographic evaluation

    International Nuclear Information System (INIS)

    Richardson, G.L.; O'Brien, T.R.

    1985-01-01

    Radiography was used to evaluate 32 horses presented for puncture wounds into the navicular bursa. At the initial radiographic examination, 21 horses had no radiographic signs of osteomyelitis, while 11 did. The mean-time interval between injury and radiographic examination was 20.6 days for horses without evidence of osteomyelitis and 59.3 days for those with evidence of osteomyelitis. Radiographic signs of osteomyelitis of the navicular bone included flexor cortical destruction and irregularity of the flexor surface. Other abnormalities included pathologic fracture of the navicular bone, subluxation of the distal interphalangeal joint, or secondary joint disease. The lateromedial and palmaroproximal-palmarodistal oblique projections were most useful for identifying abnormalities of the navicular bone. There was a high correlation between horses that had positive presurgical radiographic signs and surgical findings. However, approximately 50% of horses that had negative radiographic findings initially had positive surgical findings. Ten of 21 horses with negative radiographic findings on initial examination had evidence of bony lesions when reevaluated from 3 weeks to 6 years later. Nine of 11 horses with radiographic signs of osteomyelitis on initial radiographic examination were euthanatized or had an unsatisfactory outcome. Seven of 10 horses with radiographic signs on reexamination were euthanatized. Thirteen of 20 horses with positive surgical findings for navicular bone infection were euthanatized or had an unsatisfactory outcome

  5. Incidental Diagnosis of Cerebral Cortical Venous Thrombosis in Postdural Puncture Headache on Brain Computed Tomography.

    Science.gov (United States)

    Humbertjean, Lisa; Ducrocq, Xavier; Lacour, Jean-Christophe; Mione, Gioia; Richard, Sébastien

    2015-01-01

    Diagnosis of cerebral cortical venous thrombosis in patients with postdural puncture headache (PDPH) is usually secondary to changes in headache pattern or cerebral infarctions. Nevertheless, incidental discovery of asymptomatic forms on brain imaging has never been reported before and its management thus remains ill-defined. We describe 2 cases of patients with asymptomatic cortical vein thrombosis in the context of PDPH. In both cases, brain computed tomography (CT) scans showed an isolated cortical vein thrombosis without cerebral damage. Neurological examination revealed the typical orthostatic feature of PDPH, independently of cortical vein thrombosis which was considered as a radiological incidental finding. Clinical and radiological signs resolved after bed rest, oral caffeine, and anticoagulation therapy. Asymptomatic cortical vein thrombosis may be found on radiological exploration, even basic like brain CT scan without contrast, of PDPH. Utility of anticoagulation therapy, which could increase the risk of cerebral hemorrhagic complications in this specific context, has to be assessed. Copyright © 2014 by the American Society of Neuroimaging.

  6. Research on unequal error protection with punctured turbo codes in jpeg image transmission system

    Directory of Open Access Journals (Sweden)

    Lakhdar Moulay A.

    2007-01-01

    Full Text Available An investigation of Unequal Error Protection (UEP methods applied to JPEG image transmission using turbo codes is presented. The JPEG image is partitioned into two groups, i.e., DC components and AC components according to their respective sensitivity to channel noise. The highly sensitive DC components are better protected with a lower coding rate, while the less sensitive AC components use a higher coding rate. While we use the s-random interleaver and s-random odd-even interleaver combined with odd-even puncturing, we can fix easily the local rate of turbo-code. We propose to modify the design of s-random interleaver to fix the number of parity bits. A new UEP scheme for the Soft Output Viterbi Algorithm (SOVA is also proposed to improve the performances in terms of Bit Error Rate (BER and Peak Signal to Noise Ratio (PSNR. Simulation results are given to demonstrate how the UEP schemes outperforms the equal error protection (EEP scheme in terms of BER and PSNR.

  7. Adaptation of Hybrid FSO/RF Communication System Using Puncturing Technique

    Directory of Open Access Journals (Sweden)

    M. N. Khan

    2016-12-01

    Full Text Available Spectrum of radio frequency (RF communications is limited and expensive to install new applications. Free space optical (FSO communication is a viable technology which offers enormous bandwidth, license free installation, inexpensive deployment and error prone links. The FSO links degrade significantly due to the varying atmospheric and weather conditions (fog, cloud, snow, haze and combination of these. We propose a hybrid FSO/RF communication system which adapts the varying nature of atmosphere and weather. For the adaption of varying atmosphere and weather scenarios, we develop a novel optimization algorithm. The proposed algorithm is based on the well-known puncturing technique. We provide an extrinsic information transfer (EXIT chart for the binary and quaternary mapping scheme for the proposed communication system. We simulate the proposed algorithm for the hybrid communication system and analyze the system performance. The proposed algorithm is computationally less expensive and provide better performance gains over varying atmosphere and weather conditions. The algorithm is suitable for fast speed applications.

  8. Hydrogen sulfide ameliorates cardiovascular dysfunction induced by cecal ligation and puncture in rats.

    Science.gov (United States)

    Abdelrahman, R S; El-Awady, M S; Nader, M A; Ammar, E M

    2015-10-01

    Hydrogen sulfide (H2S) is an endogenously produced gaseous messenger that participates in regulation of cardiovascular functions. This study evaluates the possible protective effect of H2S in cardiovascular dysfunction induced by cecal ligation and puncture (CLP) in rats. After 24 h of induction of CLP, heart rate (HR), mortality, cardiac and inflammation biomarkers (creatine kinase-MB (CK-MB) isozyme, cardiac troponin I (cTnI), C-reactive protein (CRP), and lactate dehydrogenase (LDH)), in vitro vascular reactivity, histopathological examination, and oxidative biomarkers (malondialdehyde (MDA), reduced glutathione (GSH), and superoxide dismutase (SOD)) were determined. CLP induced elevations in HR, mortality, serum CK-MB, cTnI, CRP, and LDH, in addition to impaired aortic contraction to potassium chloride and phenylephrine and relaxation to acetylcholine without affecting sodium nitroprusside responses. Moreover, CLP increased cardiac and aortic MDA and decreased SOD, without affecting GSH and caused a marked subserosal and interstitial inflammation in endocardium. Sodium hydrosulfide, but not the irreversible inhibitor of H2S synthesis dl-propargyl glycine, protected against CLP-induced changes in HR, mortality, cardiac and inflammatory biomarkers, oxidative stress, and myocardium histopathological changes without affecting vascular dysfunction. Our results confirm that H2S can attenuate CLP-induced cardiac, but not vascular, dysfunction possibly through its anti-inflammatory and antioxidant effects. © The Author(s) 2015.

  9. Improved efficiency of nanoneedle insertion by modification with a cell-puncturing protein

    Science.gov (United States)

    Ryu, Seunghwan; Matsumoto, Yuta; Matsumoto, Takahiro; Ueno, Takafumi; Silberberg, Yaron R.; Nakamura, Chikashi

    2018-03-01

    An atomic force microscope (AFM) probe etched into an ultra-sharp cylindrical shape (a nanoneedle) can be inserted into a living cell and mechanical responses of the insertion process are represented as force–distance curves using AFM. A probe-molecule-functionalized nanoneedle can be used to detect intracellular molecules of interest in situ. The insertion efficiencies of nanoneedles vary among cell types due to the cortex structures of cells, and some cell types, such as mouse fibroblast Balb/3T3 cells, show extremely low efficacy of insertion. We addressed this issue by using a cell membrane puncturing protein from bacteriophage T4 (gp5), a needle-like protein that spontaneously penetrates through the cell membrane. Gp5 was immobilized onto a nanoneedle surface. The insertion efficiency of the functionalized nanoneedle increased by over 15% compared to the non-functionalized control. Gp5-modification is a versatile approach in cell manipulation techniques for the insertion of other types of nanostructures into cells.

  10. General anesthesia for lumbar puncture and bone marrow aspiration /biopsy in children with cancer.

    Science.gov (United States)

    Ghasemi, A; Gharavi Fard, M; Sabzevari, Ar

    2013-01-01

    Multiple procedures (Lumbar puncture and bone marrow aspiration /biopsy) cause pain, stress, depression and etc for the patients and their families. Various methods have been recommended for pain reduction during invasive procedures. The aim of this study is to report the complications following general anesthesia. In this prospective observational study, two hundred and two children with cancer were enrolled. All patients received propofol 2.5 mg /kg and fentanyl 1 µg/kg. After adequate anesthesia, procedures were performed by a pediatric oncologist. All anesthesia complications were classified into two groups: Intraoperative and Postoperative complications. Complications which were recorded include: abnormal age-specific bradycardia (≤20 × baseline), decrease in arterial oxygen saturation (≤90%), laryngospasm, vomiting, agitation, headache, hypothermia (37/8 C°), signs of allergy, traumatic LP (bloody), and unusual local bleeding. In this study, 118 males and 84 females underwent 623 general anesthetic procedures with a median of 3 procedures per patient. Intraoperative period complications occurred in 48 of total 623 procedures (7.7 %). The most common complications were traumatic LP, bradycardia and decrease in arterial oxygen saturation which occurred in 25, 6 and 6 cases, respectively. Postoperative period complications occurred in 74 (11.9%) cases. The most common complications were vomiting, agitation and headache, decrease O2 saturation and bradycardia. General anesthesia by propofol and fentanyl may be a good choice for short-term painful procedures in children undergoing treatment for bone marrow aspiration/biopsy and intratechal injection.

  11. Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study.

    Science.gov (United States)

    Costerus, Joost M; Brouwer, Matthijs C; Sprengers, Marieke E S; Roosendaal, Stefan D; van der Ende, Arie; van de Beek, Diederik

    2018-03-07

    It is unclear how often lumbar puncture (LP) is complicated by cerebral herniation in patients with bacterial meningitis and whether cranial CT can be used to identify patients at risk for herniation. We performed a nationwide prospective cohort study of patients with community-acquired bacterial meningitis from 2006 to 2014 and identified patients with clinical deterioration possibly caused by LP. For systematic evaluation of contraindications for LP on cranial CT, these patients were matched to patients in the cohort without deterioration. Four experts, blinded for outcome, scored cranial CT results for contraindications for LP. A Fleiss' generalized Kappa for this assessment was determined. Of 1533 episodes, 47 (3.1%) had deterioration possibly caused by LP. Two patients deteriorated within 1 hour after LP (0.1%). In 43 of 47 patients with deterioration cranial CT was performed prior to LP, so CT results were matched with 43 patients without deterioration. The interrater reliability of assessment of contraindications for LP on cranial CT was moderate (Fleiss' generalized Kappa 0.47). A contraindication for LP was reported by all 4 raters in 6 patients with deterioration (14%) and in 5 without deterioration (11%). LP can be performed safely in the large majority of patients with bacterial meningitis, as it is only very rarely complicated by cerebral herniation. Cranial CT can be considered a screening method for contraindications for LP, but the interrater reliability of this assessment is moderate.

  12. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    Science.gov (United States)

    Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

    2012-01-01

    Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

  13. Exoseal for puncture site closure after antegrade procedures in peripheral arterial disease patients.

    Science.gov (United States)

    Hackl, Gerald; Gary, Thomas; Belaj, Klara; Hafner, Franz; Rief, Peter; Deutschmann, Hannes; Brodmann, Marianne

    2014-01-01

    Exoseal is a vascular clo-sure device consisting of a plug applier and a bio-absorbent polyglycolic acid plug available in sizes 5 F, 6 F, and 7 F. In this study, we aimed to evaluate the effectiveness and safety of the Exoseal vascular closure device (Cordis Corporation, Bridgewater, New Jersey, USA) for puncture site closure after antegrade endovascular procedures in peripheral arterial occlusive disease (PAOD) patients. In this retrospective study, a total of 168 consecutive patients who underwent an interventional procedure due to PAOD, were included. In each case, an antegrade peripheral endovascular procedure was performed via the common femoral artery using the Seldinger technique, and Exoseal 5 F, 6 F, or 7 F was used for access site closure. The primary endpoint was a technically successful application of Exoseal. All complications at the access site within 24 hours were registered as a secondary endpoint. In a group of 168 patients (64.9% men, average age 71.9±11.9 years), the technical application of Exoseal was successful in 166 patients (98.8%). Within the first 24 hours after the procedure, 12 complications (7.2%) were recorded including, three pseudoaneurysms (1.8%) and nine hematomas (5.4%). None of the complications required surgical intervention. Exoseal is a safe and effective device with high technical success and acceptable complication rates for access site closure after antegrade peripheral endovascular procedures.

  14. Puncture black hole initial data: A single domain Galerkin-collocation method for trumpet and wormhole data sets

    Science.gov (United States)

    Clemente, P. C. M.; de Oliveira, H. P.

    2017-07-01

    We present a single-domain Galerkin-collocation method to calculate puncture initial data sets for single and binary black holes, either in the trumpet or wormhole geometries. The combination of aspects belonging to the Galerkin and the collocation methods together with the adoption of spherical coordinates in all cases are shown to be very effective. We propose a unified expression for the conformal factor to describe trumpet and spinning black holes. In particular, for the spinning trumpet black holes, we exhibit the deformation of the limit surface due to the spin from a sphere to an oblate spheroid. We also revisit the energy content in the trumpet and wormhole puncture data sets. The algorithm can be extended to describe binary black holes.

  15. Safety assessment technology on the free drop impact and puncture analysis of the cask for radioactive material transport

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dew Hey [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of); Lee, Young Shin; Ryu, Chung Hyun; Kim, Hyun Su; Lee, Ho Chul; Hong, Song Jin; Choi, Young Jin; Lee, Jae Hyung; Na, Jae Yun [Chungnam National Univ., Taejon (Korea, Republic of)

    2001-03-15

    In this study, the regulatory condition and analysis condition is analyzed for the free drop and puncture impact analysis to develop the safety assessment technology. Impact analysis is performed with finite element method which is one of the many analysis methods of the shipping cask. LS-DYNA3D and ABAQUS is suitable for the free drop and the puncture impact analysis of the shipping cask. For the analysis model, the KSC-4 that is the shipping cask to transport spent nuclear fuel is investigated. The results of both LS-DYNA3D and ABAQUS is completely corresponded. And The integrity of the shipping cask is verified. Using this study, the reliable safety assessment technology is supplied to the staff. The efficient and reliable regulatory tasks is performed using the standard safety assessment technology.

  16. Safety assessment technology on the free drop impact and puncture analysis of the cask for radioactive material transport

    International Nuclear Information System (INIS)

    Lee, Dew Hey; Lee, Young Shin; Ryu, Chung Hyun; Kim, Hyun Su; Lee, Ho Chul; Hong, Song Jin; Choi, Young Jin; Lee, Jae Hyung; Na, Jae Yun

    2001-03-01

    In this study, the regulatory condition and analysis condition is analyzed for the free drop and puncture impact analysis to develop the safety assessment technology. Impact analysis is performed with finite element method which is one of the many analysis methods of the shipping cask. LS-DYNA3D and ABAQUS is suitable for the free drop and the puncture impact analysis of the shipping cask. For the analysis model, the KSC-4 that is the shipping cask to transport spent nuclear fuel is investigated. The results of both LS-DYNA3D and ABAQUS is completely corresponded. And The integrity of the shipping cask is verified. Using this study, the reliable safety assessment technology is supplied to the staff. The efficient and reliable regulatory tasks is performed using the standard safety assessment technology

  17. Utilizing the Flipped Classroom, Simulation-Based Mastery Learning and Group Learning to Teach and Evaluate Lumbar Puncture Skills

    OpenAIRE

    Amanda Crichlow; Jessica Parsons; Varsha Goswami; Srikala Ponnuru; Sharon Griswold

    2018-01-01

    Audience: This lumbar puncture curriculum was developed and implemented to educate and evaluate incoming intern Emergency Medicine (EM) residents. This curriculum can also be used to educate and evaluate senior medical students and senior residents. Introduction: Procedural competency is an important component of healthcare education. With the implementation of milestones, the need for valid assessment tools to determine procedural competency has increased. Simulation-based master...

  18. Gambaran Hasil Kesimpulan Bone Marrow Puncture (BMP) Pada Penderita Leukemia Di RSUP Haji Adam Malik Medan Tahun 2011

    OpenAIRE

    Rizal, Fildzah Yamami

    2013-01-01

    Leukemia is a malignancy of haemopoietic system with a fair incidence rate in Indonesia. The disease been classified to some types based on their each characteristic. This classification needed for choosing the right regiment for therapy, follow-up and predict the prognosis. The gold standard for determining type of leukemia is by doing a procedure called Bone Marrow Puncture (BMP), and then examining the morphology of the marrow cells. Upon that, this study was conduct to find out the result...

  19. Significance of preoperative planning software for puncture and channel establishment in percutaneous endoscopic lumbar DISCECTOMY: A study of 40 cases.

    Science.gov (United States)

    Hu, Zhouyang; Li, Xinhua; Cui, Jian; He, Xiaobo; Li, Cong; Han, Yingchao; Pan, Jie; Yang, Mingjie; Tan, Jun; Li, Lijun

    2017-05-01

    Preoperative planning software has been widely used in many other minimally invasive surgeries, but there is a lack of information describing the clinical benefits of existing software applied in percutaneous endoscopic lumbar discectomy (PELD). This study aimed to compare the clinical efficacy of preoperative planning software in puncture and channel establishment of PELD with routine methods in treating lumbar disc herniation (LDH). From June 2016 to October 2016, 40 patients who had single L4/5 or L5/S1 disc herniation were divided into two groups. Group A adopted planning software for preoperative puncture simulation while Group B took routine cases discussion for making puncture plans. The channel establishment time, operative time, fluoroscopic times and complications were compared between the two groups. The surgical efficacy was evaluated according to the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and modified Macnab's criteria. The mean channel establishment time was 25.1 ± 4.2 min and 34.6 ± 5.4 min in Group A and B, respectively (P  0.05). The findings of modified Macnab's criteria at each follow-up also showed no significant differences (P > 0.05). The application of preoperative planning software in puncture and cannula insertion planning in PELD was easy and reliable, and could reduce the channel establishment time, operative time and fluoroscopic times of PELD significantly. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  20. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN)

    Energy Technology Data Exchange (ETDEWEB)

    Too, Chow Wei, E-mail: toochowwei@gmail.com [Singapore General Hospital (Singapore); Sayani, Raza [Aga Khan University Hospital (Pakistan); Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva [Singapore General Hospital (Singapore); Teo, Terence K. [Mount Elizabeth Novena Hospital (Singapore)

    2016-08-15

    PurposeTo describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results.Materials and MethodsThis is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture.ResultsMean duration of catheter use was 278 days (range 32–503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported.ConclusionThe REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  1. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN)

    International Nuclear Information System (INIS)

    Too, Chow Wei; Sayani, Raza; Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva; Teo, Terence K.

    2016-01-01

    PurposeTo describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results.Materials and MethodsThis is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture.ResultsMean duration of catheter use was 278 days (range 32–503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported.ConclusionThe REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  2. Technical compliance to standard guidelines for lumbar puncture and myelography: survey of academic neuroradiology attendings and fellows.

    Science.gov (United States)

    Zhang, Yi C; Chandler, Alexander J; Kagetsu, Nolan J

    2014-05-01

    To assess technical compliance among neuroradiology attendings and fellows to standard guidelines for lumbar puncture and myelography to minimize procedural complications such as iatrogenic meningitis and spinal headache. We surveyed academic neuroradiology attendings and fellows in the e-mail directory of the Association of Program Directors in Radiology. We queried use of face masks, use of noncutting needles, and dural puncture practices. All data were collected anonymously. A total of 110 survey responses were received: 75 from neuroradiology attendings and 34 from fellows, which represents a 14% response rate from a total of 239 fellows. Forty-seven out of 101 (47%) neuroradiologists do not always wear a face mask during myelograms, and 50 out of 105(48%) neuroradiologists do not always wear a face mask during lumbar punctures, placing patients at risk for iatrogenic meningitis. Ninety-six out of 106 neuroradiologists (91%) use the Quincke cutting needle by default, compared to only 17 out of 109 neuroradiologists (16%) who have ever used noncutting needles proven to reduce spinal headache. Duration of postprocedure bed rest does not influence incidence of spinal headache and may subject patients to unnecessary monitoring. Only 15 out of 109 (14%) neuroradiologists in our study do not prescribe bed rest. There was no statistically significant difference in practice between attendings and fellows. Iatrogenic meningitis and spinal headache are preventable complications of dural puncture that neuroradiologists can minimize by conforming to procedural guidelines. Wearing face masks and using noncutting spinal needles will reduce patient morbidity and lower hospitalization costs associated with procedural complications. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  3. Shrunk loop theorem for the topology probabilities of closed Brownian (or Feynman) paths on the twice punctured plane

    International Nuclear Information System (INIS)

    Giraud, O; Thain, A; Hannay, J H

    2004-01-01

    The shrunk loop theorem proved here is an integral identity which facilitates the calculation of the relative probability (or probability amplitude) of any given topology that a free, closed Brownian (or Feynman) path of a given 'duration' might have on the twice punctured plane (plane with two marked points). The result is expressed as a 'scattering' series of integrals of increasing dimensionality based on the maximally shrunk version of the path. Physically, this applies in different contexts: (i) the topology probability of a closed ideal polymer chain on a plane with two impassable points, (ii) the trace of the Schroedinger Green function, and thence spectral information, in the presence of two Aharonov-Bohm fluxes and (iii) the same with two branch points of a Riemann surface instead of fluxes. Our theorem starts from the Stovicek scattering expansion for the Green function in the presence of two Aharonov-Bohm flux lines, which itself is based on the famous Sommerfeld one puncture point solution of 1896 (the one puncture case has much easier topology, just one winding number). Stovicek's expansion itself can supply the results at the expense of choosing a base point on the loop and then integrating it away. The shrunk loop theorem eliminates this extra two-dimensional integration, distilling the topology from the geometry

  4. [Ropivacaine use in transnasal sphenopalatine ganglion block for post dural puncture headache in obstetric patients - case series].

    Science.gov (United States)

    Furtado, Inês; Lima, Isabel Flor de; Pedro, Sérgio

    2018-02-02

    Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine. We present four obstetrics patients with post dural puncture headache, after epidural or combined techniques, with Tuohy needle 18G that underwent a safe and successful Sphenopalatine ganglion block. We performed the block 24-48h after dural puncture, with 4mL of ropivacaine 0.75% in each nostril. In three cases pain recurred within 12-48h, although less intense. In one patient a second block was performed with complete relief and without further recurrence. In the other two patients a blood patch was performed without success. All patients were asymptomatic within 7 days. The average duration of analgesic effect of the block remains poorly defined. In the cases reported, blocking with ropivacaine was a simple, safe and effective technique, with immediate and sustained pain relief for at least 12-24h. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Modelo simulador para treinamento de punção transpedicular em vertebroplastia percutânea Manikin-type training simulator model for transpedicular puncture in percutaneous vertebroplasty

    Directory of Open Access Journals (Sweden)

    Nitamar Abdala

    2007-08-01

    manikin with an ethyl-vinyl-acetate lining so that direct visualization was not possible. A theoretical course was given to six trainees in radiology and neuroradiology who have tested the models with respect to parameters of similarity with the reality, performing 30 transpedicular punctures in three series of ten punctures a day, with one-week interval between the series. RESULTS: Each student performed 30 transpedicular punctures; however, eight of these punctures were disregarded because of manufacturing defects of the dummies observed during the procedures. Similarity data forms were filled in by all of the trainees following the procedures, with 100% of positive answers as regards the models similarity with the human body. CONCLUSION: It was possible to develop a training model for transpedicular puncture with a satisfactory degree of similarity with the human body, constituting an appropriate tool for training in vertebroplasty.

  6. Simultaneous Spectrophotometric Determination of Valsartan and ...

    African Journals Online (AJOL)

    Purpose: To develop a direct, simple and extraction-free spectrophotometric method for the simultaneous estimation of valsartan and ezetimibe in pharmaceuticals. Methods: A spectrophotometric method for the determination of valsartan and ezetimibe was developed using acidic dyes, namely, bromophenol blue (BPB) ...

  7. Politics Under Electronic Simultaneity

    Directory of Open Access Journals (Sweden)

    Valery P. Terin

    2014-01-01

    Full Text Available In contradistinction to the book and the other typographic products, the electronic media operates on a 24-hour-a-day basis evoking simultaneity as the guiding mode of perception and thinking for all those under its influence. The discovery of this fact manifested itself in the formation and development of the managerial technologies operating by means of the electronic information environment and following the principle of simultaneity in the first place. Thus, at the end of the 1960s already the election campaigns in the U.S.A. began to operate on the basis of the final cause as the guiding principle of the country's mass consciousness motivating to carry out each particular event as if already rejoicing at the victory. With this in mind, there emerged a problem of applying this approach with its enormous managerial potential elsewhere. To add, simultaneity as a norm of perception and thinking turned out to be increasingly important with the advent of the electrical telegraph and the press relying on its short disconnected messages instantaneously arriving from all parts of the world. All the other media, which emerged in the wake of this development, has served to fortify this mode of thought as governing in the electronic information environment. The potential of the electronically operating global managerial technologies is quickly growing. The article also deals with the information overload and pattern recognition problem understood in managerial terms as well as mythologization and demythologization processes as they are necessitated by the electronic media coverage worldwide.

  8. Influence of transvaginal ultrasound-guided follicular punctures in the mare on heart rate, respiratory rate, facial expression changes, and salivary cortisol as pain scoring.

    Science.gov (United States)

    Diego, Rodrigo; Douet, Cécile; Reigner, Fabrice; Blard, Thierry; Cognié, Juliette; Deleuze, Stefan; Goudet, Ghylène

    2016-10-15

    Transvaginal ultrasound-guided follicular punctures are widely used in the mare for diagnosis, research, and commercial applications. The objective of our study was to determine their influence on pain, stress, and well-being in the mare, by evaluating heart rate, breath rate, facial expression changes, and salivary cortisol before, during, and after puncture. For this experiment, 21 pony mares were used. Transvaginal ultrasound-guided aspirations were performed on 11 mares. After injections for sedation, analgesia, and antispasmodia, the follicles from both ovaries were aspirated with a needle introduced through the vagina wall into the ovary. In the control group, 10 mares underwent similar treatments and injections, but no follicular aspiration. Along the session, heart rate and breath rate were evaluated by a trained veterinarian, ears position, eyelid closure, and contraction of facial muscles were evaluated, and salivary samples were taken for evaluation of cortisol concentration. A significant relaxation was observed after sedative injection in the punctured and control mares, according to ear position, eyelid closure, and contraction of facial muscles, but no difference between punctured and control animals was recorded. No significant modification of salivary cortisol concentration during puncture and no difference between punctured and control mares at any time were observed. No significant modification of the breath rate was observed along the procedure for the punctured and the control mares. Heart rate increased significantly but transiently when the needle was introduced in the ovary and was significantly higher at that time for the punctured mares than that for control mares. None of the other investigated parameters were affected at that time, suggesting discomfort is minimal and transient. Improving analgesia, e.g., through a multimodal approach, during that possibly more sensitive step could be recommended. The evaluation of facial expression

  9. Gender dimorphism in differential peripheral blood leukocyte counts in mice using cardiac, tail, foot, and saphenous vein puncture methods

    Directory of Open Access Journals (Sweden)

    Crockett Elahé T

    2003-09-01

    Full Text Available Abstract Background In many animal models that investigate the pathology of various diseases, there is a need to monitor leukocyte counts and differentials. However, various researchers use a range of different techniques in male and female laboratory animals to collect such blood variable information. These studies are then compared to one another without consideration of the possibility that different bleeding sites or techniques as well as gender may produce varying results. In light of this, the peripheral blood leukocyte counts and differentials of C57BL/6 male and female mice were determined using four blood-sampling techniques: cardiac, tail, foot, and saphenous vein punctures. Methods Blood smears were prepared and stained with Wright-stain for differential cell analysis. The total number of peripheral blood leukocytes was determined with the aid of a hemocytometer. Applying ANOVA and Student t-test analysis made comparisons between groups. Results The total leukocyte counts obtained using the cardiac puncture method were significantly lower as compared to the other three blood sources; saphenous, tail and foot. There were no significant differences between leukocyte counts of blood samples collected from the tail, saphenous, and foot. Additionally, no significant differences were observed in total leukocyte counts between male and female mice. Differential analysis showed lymphocytes as the predominant cell type present in the peripheral blood of both male and female mice, comprising 75–90% of the total leukocytes. While no significant differences were observed between male and female differential counts of blood collected from saphenous and tail veins, a significant difference in differential counts of blood obtained via cardiac puncture was observed between the male and female groups, suggesting the role of sex hormones. Further, of the four methods, cardiac puncture appeared to be the fastest and more reliable technique, yielding

  10. The Effect of Therapeutic Lumbar Punctures on Acute Mortality From Cryptococcal Meningitis

    Science.gov (United States)

    Rolfes, Melissa A.; Hullsiek, Kathy Huppler; Rhein, Joshua; Nabeta, Henry W.; Taseera, Kabanda; Schutz, Charlotte; Musubire, Abdu; Rajasingham, Radha; Williams, Darlisha A.; Thienemann, Friedrich; Muzoora, Conrad; Meintjes, Graeme; Meya, David B.; Boulware, David R.

    2014-01-01

    Introduction. Cryptococcal meningitis is the most common cause of adult meningitis in sub-Saharan Africa. Raised intracranial pressure (ICP) is common in cryptococcosis. Prior studies suggest elevated ICP is associated with mortality, and guidelines recommend frequent lumbar punctures (LPs) to control ICP. However, the magnitude of the impact of LPs on cryptococcal-related mortality is unknown. Methods. In sum, 248 individuals with human immunodeficiency virus (HIV)-associated cryptococcal meningitis, screened for the Cryptococcal Optimal ART Timing (COAT) trial in Uganda and South Africa, were observed. Individuals received an LP to diagnose meningitis, and subsequent therapeutic LPs were recommended for elevated ICP (>250 mmH2O) or new symptoms. We compared survival, through 11 days, between individuals receiving at least 1 therapeutic LP with individuals not receiving therapeutic LPs. The COAT trial randomized subjects at 7–11 days; thus, follow-up stopped at time of death, randomization, or 11 days. Results. Seventy-five (30%) individuals had at least 1 therapeutic LP. Individuals receiving therapeutic LPs had higher cerebrospinal fluid (CSF) opening pressures, higher CSF fungal burdens, and were more likely to have altered mental status at baseline than those with no therapeutic LPs. Thirty-one deaths (18%) occurred among 173 individuals without a therapeutic LP and 5 deaths (7%) among 75 with at least 1 therapeutic LP. The adjusted relative risk of mortality was 0.31 (95% confidence interval: .12–.82). The association was observed regardless of opening pressure at baseline. Conclusions. Therapeutic LPs were associated with a 69% relative improvement in survival, regardless of initial intracranial pressure. The role of therapeutic LPs should be reevaluated. PMID:25057102

  11. Script concordance testing: assessing residents' clinical decision-making skills for infant lumbar punctures.

    Science.gov (United States)

    Chang, Todd P; Kessler, David; McAninch, Brett; Fein, Daniel M; Scherzer, D J; Seelbach, Elizabeth; Zaveri, Pavan; Jackson, Jennifer M; Auerbach, Marc; Mehta, Renuka; Van Ittersum, Wendy; Pusic, Martin V

    2014-01-01

    Residents must learn which infants require a lumbar puncture (LP), a clinical decision-making skill (CDMS) difficult to evaluate because of considerable practice variation. The authors created an assessment model of the CDMS to determine when an LP is indicated, taking practice variation into account. The objective was to detect whether script concordance testing (SCT) could measure CDMS competency among residents for performing infant LPs. In 2011, using a modified Delphi technique, an expert panel of 14 attending physicians constructed 15 case vignettes (each with 2 to 4 SCT questions) that represented various infant LP scenarios. The authors distributed the vignettes to residents at 10 academic pediatric centers within the International Simulation in Pediatric Innovation, Research, and Education Network. They compared SCT scores among residents of different postgraduate years (PGYs), specialties, training in adult medicine, LP experience, and practice within an endemic Lyme disease area. Of 730 eligible residents, 102 completed 47 SCT questions. They could earn a maximum score of 47. Median SCT scores were significantly higher in PGY-3s compared with PGY-1s (difference: 3.0; 95% confidence interval [CI] 1.0-4.9; effect size d = 0.87). Scores also increased with increasing LP experience (difference: 3.3; 95% CI 1.1-5.5) and with adult medicine training (difference: 2.9; 95% CI 0.6-5.0). Residents in Lyme-endemic areas tended to perform more LPs than those in nonendemic areas. SCT questions may be useful as an assessment tool to determine CDMS competency among residents for performing infant LPs.

  12. Pre-procedural Ultrasound for Infant Lumbar Puncture: A randomized clinical trial.

    Science.gov (United States)

    Kessler, David; Pahalyants, Vartan; Kriger, Joshua; Behr, Gerald; Dayan, Peter

    2018-04-12

    Our purpose was to determine the potential effect of pre-procedural ultrasound to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized ultrasound protocol. This prospective, two-arm, parallel group randomized trial was conducted in a single-center pediatric emergency department. We compared pre-procedural ultrasound vs. palpation method on success with infant LPs. Infants procedure duration. Clinician satisfaction and sonographer perceptions of ultrasound acceptability and impact were assessed. Eighty-one patients consented and 80 were analyzed (99%): 40 per group. No statistical difference was seen for the primary outcome (p >0.05) between intervention and control groups (difference 3%; 95% CI -19% to 24%). There were no statistical differences between intervention and controls groups for secondary outcomes including the rate of traumatic LPs, number of attempts, and the duration of LP procedure. Most sonographers (84%) strongly agreed or agreed that the US protocol technically easy to perform, well tolerated by the patient (94%), well accepted by the family (100%), and well accepted by the LP procedural clinicians (99%). In the US group, the majority of clinicians who performed the LPs (68.4%) noted that the pre-procedural US influenced their behavior, most commonly helping with overall visualization at the selected interspace (28.9%) or prompting a change in interspace (26.3% higher, 5.3% lower). Seventy seven percent agreed or strongly agreed that they would like to use the technique again for their next LP. The mean ultrasound duration was 4.6 minutes. Pre-procedural US by did not improve the rates of first attempt success when compared with palpation method. Our results suggest ultrasound is feasible and well accepted, with a perceptible impact on care. This article is protected by copyright. All rights reserved. This article is protected by copyright

  13. The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis.

    Science.gov (United States)

    Rolfes, Melissa A; Hullsiek, Kathy Huppler; Rhein, Joshua; Nabeta, Henry W; Taseera, Kabanda; Schutz, Charlotte; Musubire, Abdu; Rajasingham, Radha; Williams, Darlisha A; Thienemann, Friedrich; Muzoora, Conrad; Meintjes, Graeme; Meya, David B; Boulware, David R

    2014-12-01

    Cryptococcal meningitis is the most common cause of adult meningitis in sub-Saharan Africa. Raised intracranial pressure (ICP) is common in cryptococcosis. Prior studies suggest elevated ICP is associated with mortality, and guidelines recommend frequent lumbar punctures (LPs) to control ICP. However, the magnitude of the impact of LPs on cryptococcal-related mortality is unknown. In sum, 248 individuals with human immunodeficiency virus (HIV)-associated cryptococcal meningitis, screened for the Cryptococcal Optimal ART Timing (COAT) trial in Uganda and South Africa, were observed. Individuals received an LP to diagnose meningitis, and subsequent therapeutic LPs were recommended for elevated ICP (>250 mmH2O) or new symptoms. We compared survival, through 11 days, between individuals receiving at least 1 therapeutic LP with individuals not receiving therapeutic LPs. The COAT trial randomized subjects at 7-11 days; thus, follow-up stopped at time of death, randomization, or 11 days. Seventy-five (30%) individuals had at least 1 therapeutic LP. Individuals receiving therapeutic LPs had higher cerebrospinal fluid (CSF) opening pressures, higher CSF fungal burdens, and were more likely to have altered mental status at baseline than those with no therapeutic LPs. Thirty-one deaths (18%) occurred among 173 individuals without a therapeutic LP and 5 deaths (7%) among 75 with at least 1 therapeutic LP. The adjusted relative risk of mortality was 0.31 (95% confidence interval: .12-.82). The association was observed regardless of opening pressure at baseline. Therapeutic LPs were associated with a 69% relative improvement in survival, regardless of initial intracranial pressure. The role of therapeutic LPs should be reevaluated. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Kaempferol attenuates acute lung injury in caecal ligation and puncture model of sepsis in mice.

    Science.gov (United States)

    Rabha, Dipankar Jyoti; Singh, Thakur Uttam; Rungsung, Soya; Kumar, Tarun; Parida, Subhashree; Lingaraju, Madhu Cholenahalli; Paul, Avishek; Sahoo, Monalisa; Kumar, Dinesh

    2018-03-01

    Kaempferol is a flavonoid and important part of the diet. Kaempferol has shown antioxidant, antiinflammatory and antidiabetic activities in various studies. However, protective potential of kaempferol in acute lung injury induced by sepsis and its mechanism remains unclear. The present study was undertaken to evaluate the effect of kaempferol in sepsis-induced acute lung injury in mice and its possible mechanism of action. Acute lung injury was induced by CLP surgery in mice. Kaempferol (100 mg/kg bw) was administered orally one hour before caecal ligation and puncture surgery in mice. Mice were divided into four groups sham, KEM+sham, sepsis (CLP), and KEM+sepsis. Assessment of lung injury was done by estimation of protein content in lung tissue, lung edema, proinflammatory cytokines in plasma and lung tissue, oxidative stress, antioxidant enzymes, nitrite production, and histopathology. Kaempferol pretreated mice showed significant (P Kaempferol pretreatment showed reduction in cytokines IL-6, IL-1β, and TNF-α in plasma as well as in lung tissue in comparison with septic mice without pretreatment. Pretreatment with kaempferol did not show any reduction in MDA level in comparison with septic mice. Antioxidant enzymes SOD and catalase and nonenzymatic antioxidant GSH activities were also increased with kaempferol pretreatment in septic mice. Further, kaempferol pretreatment reduced the lung tissue nitrite level (P Kaempferol pretreatment did not decrease bacterial load in septic mice. Mice pretreated with kaempferol followed by sepsis showed lesser infiltration of cells and more arranged alveolar structure in histopathological analysis. The study suggests that kaempferol showed attenuation in sepsis-induced acute lung injury in mice through suppression of oxidative stress, iNOS, and ICAM-1 pathways.

  15. Endolymphatic hydrops in idiopathic intracranial hypertension: prevalence and clinical outcome after lumbar puncture. Preliminary data.

    Science.gov (United States)

    Ranieri, Angelo; Cavaliere, Michele; Sicignano, Stefania; Falco, Pietro; Cautiero, Federico; De Simone, Roberto

    2017-05-01

    Idiopathic intracranial hypertension is characterized by raised intracranial pressure (ICP) without any underlying pathology, presenting with (IIH) or without papilledema (IIHWOP). Headache, often on daily basis, is the most frequent symptom. Among audiovestibular symptoms, tinnitus and dizziness are commonly reported, while vertigo and hearing impairment are infrequent reports. Endolymphatic hydrops (ELH) is the typical histopathologic feature of Ménière disease, a condition featured by episodes of vertigo, dizziness, fluctuating hearing loss, tinnitus, and aural fullness. Evidences suggest that ICP is transmitted to inner ear. The aim of this study is to investigate the prevalence of ELH symptoms in IIH/IIHWOP and the relationship between the raised ICP and ELH. The prevalence of chronic headache and of ELH symptoms was investigated in a consecutive series of IIH/IIHWOP patients, and a standard audiometry with hearing threshold measurement (pure-tone average-PTA) was performed. Differences in chronic headache and ELH symptoms prevalence and changes of PTA threshold were calculated after ICP normalization by lumbar puncture (LP). Thirty-one patients (17 with IIH and 14 with IIHWOP) were included. Before LP, chronic headache was present in 93.5%. The percentages of patients reporting tinnitus, dizziness, vertigo, and aural fullness were 67.7, 77.4, 22.6, and 61.3%, respectively. Headache frequency as well as ELH symptoms and PTA significantly improved after LP. The improvement of PTA and of ELH symptoms observed after LP in this series of IIH/IIHWOP patients indicates that a raised ICP, a condition known to be involved in the progression and refractoriness of migraine pain, has also a role in ELH. We propose that intracranial hypertension may represent the shared pathogenetic step explaining the large epidemiological comorbidity between migraine and vestibular symptoms, at present conceptualized as "vestibular migraine."

  16. Minimal invasive puncture and drainage versus endoscopic surgery for spontaneous intracerebral hemorrhage in basal ganglia.

    Science.gov (United States)

    Li, Zhihong; Li, Yuqian; Xu, Feifei; Zhang, Xi; Tian, Qiang; Li, Lihong

    2017-01-01

    Two prevalent therapies for the treatment of spontaneous intracerebral hemorrhage (ICH) in basal ganglia are, minimally invasive puncture and drainage (MIPD), and endoscopic surgery (ES). Because both surgical techniques are of a minimally invasive nature, they have attracted greater attention in recent years. However, evidence comparing the curative effect of MIPD and ES has been uncertain. The indication for MIPD or ES has been uncertain till now. In the present study, 112 patients with spontaneous ICH in basal ganglia who received MIPD or ES were reviewed retrospectively. Baseline parameters prior to the operation, evacuation rate (ER), perihematoma edema, postoperative complications, and rebleeding incidences were collected. Moreover, 1-year postictus, the long-term functional outcomes of patients with regard to hematoma volume (HV) or Glasgow Coma Scale (GCS) score were judged, respectively, by the case fatality, Glasgow Outcome Scale (GOS), Barthel Index (BI), and modified Rankin Scale (mRS). The ES group had a higher ER than the MIPD group on postoperative day 1. The MIPD group had fewer adverse outcomes, which included less perihematoma edema, anesthetic time, and blood loss, than the ES group. The functional outcomes represented by GOS, BI, and mRS were better in the MIPD group than in the ES group for patients with HV 30-60 mL or GCS score 9-14. These results indicate that ES is more effective in evacuating hematoma in basal ganglia, while MIPD is less invasive than ES. Patients with HV 30-60 mL or GCS score 9-14 may benefit more from the MIPD procedure than from ES.

  17. Acoustic puncture assist device versus loss of resistance technique for epidural space identification

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mittal

    2016-01-01

    Full Text Available Background and Aims: The conventional techniques of epidural space (EDS identification based on loss of resistance (LOR have a higher chance of complications, patchy analgesia and epidural failure, which can be minimised by objective confirmation of space before catheter placement. Acoustic puncture assist device (APAD technique objectively confirms EDS, thus enhancing success, with lesser complications. This study was planned with the objective to evaluate the APAD technique and compare it to LOR technique for EDS identification and its correlation with ultrasound guided EDS depth. Methods: In this prospective study, the lumbar vertebral spaces were scanned by the ultrasound for measuring depth of the EDS and later correlated with procedural depth measured by either of the technique (APAD or LOR. The data were subjected to descriptive statistics; the concordance correlation coefficient and Bland-Altman analysis with 95% confidence limits. Results: Acoustic dip in pitch and descent in pressure tracing on EDS localisation was observed among the patients of APAD group. Analysis of concordance correlation between the ultrasonography (USG depth and APAD or LOR depth was significant (r ≥ 0.97 in both groups. Bland-Altman analysis revealed a mean difference of 0.171cm in group APAD and 0.154 cm in group LOR. The 95% limits of agreement for the difference between the two measurements were − 0.569 and 0.226 cm in APAD and − 0.530 to 0.222 cm in LOR group. Conclusion: We found APAD to be a precise tool for objective localisation of the EDS, co-relating well with the pre-procedural USG depth of EDS.

  18. Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

    Science.gov (United States)

    Sun, Chenjing; Qi, Xiaokun

    2018-01-01

    Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Do All Children Who Present With a Complex Febrile Seizure Need a Lumbar Puncture?

    Science.gov (United States)

    Guedj, Romain; Chappuy, Hélène; Titomanlio, Luigi; De Pontual, Loic; Biscardi, Sandra; Nissack-Obiketeki, Gisèle; Pellegrino, Béatrice; Charara, Oussama; Angoulvant, François; Denis, Julien; Levy, Corinne; Cohen, Robert; Loschi, Solène; Leger, Pierre Louis; Carbajal, Ricardo

    2017-07-01

    We assess the prevalences of bacterial meningitis and herpes simplex virus meningoencephalitis (HSV-ME) in children with a complex febrile seizure and determine these prevalences in the subgroup of children with a clinical examination result not suggestive of meningitis or encephalitis. This multicenter retrospective study was conducted in 7 pediatric emergency departments (EDs) in the region of Paris, France. Visits of patients aged 6 months to 5 years for a complex febrile seizure from January 2007 to December 2011 were analyzed. We defined a subgroup of patients whose clinical examination result was not suggestive of meningitis or encephalitis. Bacterial meningitis and HSV-ME were sequentially sought for by analyzing bacteriologic and viral data at the visit, looking for data from a second visit to the hospital after the index visit, and telephoning the child's parents. From a total of 1,183,487 visits in the 7 pediatric EDs, 839 patients presented for a complex febrile seizure, of whom 260 (31.0%) had a lumbar puncture. The outcomes bacterial meningitis and HSV-ME were ascertainable for 715 (85%) and 657 (78.3%) visits, respectively, and we found 5 cases of bacterial meningitis (0.7% [95% confidence interval [CI] 0.2% to 1.6%]) and no HSV-ME (0% [95% CI 0% to 0.6%]). Among the 630 visits of children with a clinical examination result not suggesting meningitis or encephalitis, we found no bacterial meningitis (0% [95% CI 0% to 0.7%]) and no HSV-ME (0% [95% CI 0% to 0.8%]). In children with a complex febrile seizure, bacterial meningitis and HSV-ME are unexpected events when the clinical examination after complex febrile seizure is not suggestive of meningitis or encephalitis. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  20. Artesunate Reduces Serum Lipopolysaccharide in Cecal Ligation/Puncture Mice via Enhanced LPS Internalization by Macrophages through Increased mRNA Expression of Scavenger Receptors

    Directory of Open Access Journals (Sweden)

    Bin Li

    2014-01-01

    Full Text Available Innate immunity is the first line of defense in human beings against pathogen infection; monocytes/macrophages are the primary cells of the innate immune system. Recently, macrophages/monocytes have been discovered to participate in LPS clearance, and the clearance efficiency determines the magnitude of the inflammatory response and subsequent organ injury. Previously, we reported that artesunate (AS protected sepsis mice against heat-killed E. coli challenge. Herein, we further confirmed that AS protected cecal ligation/puncture (CLP sepsis mice. Its protection on sepsis mice was related to not only reduction of pro-inflammatory cytokines and serum LPS levels but also improvement of liver function. Based on the fact that AS did not directly bind and neutralize LPS, we hypothesized that the reduction of serum LPS level might be related to enhancement of LPS internalization and subsequent detoxification. Our results showed that AS increased FITC-LPS internalization by peritoneal macrophage and liver Kupffer cell, but enhancement of LPS internalization by AS was not related to the clathrin-dependent pathway. However, AS induced mRNA expression of important scavenger receptors (SRs; SR-A and MARCO mRNA expression was upregulated, suggesting that AS enhancement of LPS internalization and inhibition of pro-inflammatory cytokines was related to changes in mRNA expression of SRs.

  1. Simultaneous immunization against tuberculosis.

    Directory of Open Access Journals (Sweden)

    Elma Z Tchilian

    Full Text Available BCG, the only licensed vaccine against tuberculosis, provides some protection against disseminated disease in infants but has little effect on prevention of adult pulmonary disease. Newer parenteral immunization prime boost regimes may provide improved protection in experimental animal models but are unproven in man so that there remains a need for new and improved immunization strategies.Mice were immunized parenterally, intranasally or simultaneously by both routes with BCG or recombinant mycobacterial antigens plus appropriate adjuvants. They were challenged with Mycobacterium tuberculosis (Mtb and the kinetics of Mtb growth in the lungs measured. We show that simultaneous immunization (SIM of mice by the intranasal and parenteral routes is highly effective in increasing protection over parenteral BCG administration alone. Intranasal immunization induces local pulmonary immunity capable of inhibiting the growth of Mtb in the early phase (the first week of infection, while parenteral immunization has a later effect on Mtb growth. Importantly, these two effects are additive and do not depend on priming and boosting the immune response. The best SIM regimes reduce lung Mtb load by up to 2 logs more than BCG given by either route alone.These data establish SIM as a novel and highly effective immunization strategy for Mtb that could be carried out at a single clinic visit. The efficacy of SIM does not depend on priming and boosting an immune response, but SIM is complementary to prime boost strategies and might be combined with them.

  2. The blind pushing technique for peripherally inserted central catheter placement through brachial vein puncture.

    Science.gov (United States)

    Lee, Jae Myeong; Cho, Young Kwon; Kim, Han Myun; Song, Myung Gyu; Song, Soon-Young; Yeon, Jae Woo; Yoon, Dae Young; Lee, Sam Yeol

    2018-03-01

    The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access. Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. PICC placement was performed using the blind pushing technique and primary brachial vein access. The following data were collected from unified case report forms: access vein, obstacles during PICC advancement, procedure time, and postprocedural complications. During the 12-month study period, 1380 PICCs were placed in 1043 patients. Of these, 1092 PICCs placed in 837 patients were enrolled, with 834 PICCs (76%) and 258 PICCs (34%) placed through brachial vein and nonbrachial vein access, respectively. In both arms, obstacles were most commonly noted in the subclavian veins (n = 220) and axillary veins (n = 94). Successful puncture of the access vein was achieved at first try in 1028 PICCs (94%). The technical success rate was 99%, with 1055 PICCs (97%) placed within 120 seconds of procedure time and 1088 PICCs (99%) having the tip located at the ideal position. Follow-up Doppler ultrasound detected catheter-associated upper extremity deep venous thrombosis (UEDVT) for 18 PICCs in 16 patients and late symptomatic UEDVT for 16 PICCs in 16 patients (3.1%). Catheter-associated UEDVT was noted for 28 PICCs (82%) and 6 PICCs (18%) placed through brachial vein and nonbrachial vein access, respectively. The incidence of obstacles and the procedure time (<120 seconds) differed significantly between brachial vein and nonbrachial vein access (P = .001). There was no statistically significant difference between brachial vein and

  3. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

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    Eric A. Schmidt

    2012-09-01

    Full Text Available Background: Patients with good-grade subarachnoid hemorrhage (SAH are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP is sometimes performed in an attempt to reduce intracranial pressure (ICP and release headaches. We hypothesize that in good-grade SAH patients, a 20-ml LP releases headaches, reduces ICP and improves cerebral blood flow (CBF as measured with O15 PET scan. Methods: Six good-grade (WFNS grade 1or 2 SAH patients (mean age 48 years, 2 women, 4 men were prospectively included. All aneurysms (4 anterior communicating artery and 2 right middle cerebral artery were coiled at day 1. Patients were managed according to our local protocol. LP was performed for severe headache (VAS >7 despite maximal painkiller treatment. Patients were included when the LP was clinically needed. The 20-ml LP was done in the PET scan (mean delay between SAH and LP: 3.5 days. LP allows hydrostatic measurement of ICP. Arterial blood pressure (ABP was noninvasively gauged with photoplethysmography. Every signal was monitored and analyzed off-line. Regional CBF (rCBF was measured semiquantitatively with O15 PET before and after LP. Then we calculated the difference between baseline and post-LP condition for each area: positive value means augmentation of rCBF after the LP, negative value means reduction of rCBF. Individual descriptive analysis of CBF was first performed for each patient; then a statistical group analysis was done with SPM for all voxels using t statistics converted to Z scores (p 3.2. Results: A 20-ml LP yielded a reduction in pain (–4, a drop in ICP (24.3 ± 12.5 to 6.9 ± 4.7 mm Hg, but no change in ABP. Descriptive and statistical image analysis showed a heterogeneous and biphasic change in

  4. AngleNav: MEMS Tracker to Facilitate CT-Guided Puncture.

    Science.gov (United States)

    Li, Rui; Xu, Sheng; Pritchard, William F; Karanian, John W; Krishnasamy, Venkatesh P; Wood, Bradford J; Tse, Zion Tsz Ho

    2018-03-01

    As a low-cost needle navigation system, AngleNav may be used to improve the accuracy, speed, and ease of CT-guided needle punctures. The AngleNav hardware includes a wireless device with a microelectromechanical (MEMS) tracker that can be attached to any standard needle. The physician defines the target, desired needle path and skin entry point on a CT slice image. The accuracy of AngleNav was first tested in a 3D-printed calibration platform in a benchtop setting. An abdominal phantom study was then performed in a CT scanner to validate the accuracy of the device's angular measurement. Finally, an in vivo swine study was performed to guide the needle towards liver targets (n = 8). CT scans of the targets were used to quantify the angular errors and needle tip-to-targeting distance errors between the planned needle path and the final needle position. The MEMS tracker showed a mean angular error of 0.01° with a standard deviation (SD) of 0.62° in the benchtop setting. The abdominal phantom test showed a mean angular error of 0.87° with an SD of 1.19° and a mean tip-to-target distance error of 4.89 mm with an SD of 1.57 mm. The animal experiment resulted in a mean angular error of 6.6° with an SD of 1.9° and a mean tip-to-target distance error of 8.7 mm with an SD of 3.1 mm. These results demonstrated the feasibility of AngleNav for CT-guided interventional workflow. The angular and distance errors were reduced by 64.4 and 54.8% respectively if using AngleNav instead of freehand insertion, with a limited number of operators. AngleNav assisted the physicians to deliver accurate needle insertion during CT-guided intervention. The device could potentially reduce the learning curve for physicians to perform CT-guided needle targeting.

  5. Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles.

    Science.gov (United States)

    Crock, Catherine; Orsini, Francesca; Lee, Katherine J; Phillips, Roderic J

    2014-03-01

    To compare the frequency of headache and the procedure time following lumbar puncture (LP) using a 25-gauge needle compared to a 22-gauge needle. 4-period crossover blinded randomised controlled trial. Oncology unit, Royal Children's Hospital, Melbourne. Children aged 4-15 years at enrolment having LPs as part of their treatment for leukaemia. Each child was allocated a random sequence of four LPs, two with a 22-gauge and two with a 25-gauge needle. The presence of post-LP headache. Secondary outcomes included the presence of any headache, procedure time and impact of headache on the family. Data on 341 procedures in 93 randomised children were analysed. There was little difference in the incidence of post-LP headache between the two needle sizes (22-gauge 7.2%, 95% CI 3.8 to 12.2; 25-gauge 4.6%, 95% CI 2.0 to 8.9, p=0.3) or in the incidence of any headache (22-gauge 18% 95% CI 12.5 to 24.6; 25-gauge 15%, 95% CI 10.0 to 21.1, p=0.4). Use of the 25-gauge needle was associated with longer procedure times. The incidence of post-LP headache showed little evidence of an age effect (OR =1.1, 95% CI 0.98 to 1.3) and was higher in girls than in boys (11% vs 3%, respectively, OR=3.3, 95% CI 1.3 to 8.4, p=0.014). Fifty-five per cent of families with a child with a post-LP headache assessed the overall functional impact as moderate or severe. There was little difference in the occurrence of post-LP headache or any headache between procedures carried out using the 22-gauge or 25-gauge needles. Depending on the circumstances of the procedure and the experience of the operator, either gauge may be appropriate for an LP in a child.

  6. Lumbar puncture in the evaluation of possible asymptomatic congenital syphilis in neonates.

    Science.gov (United States)

    Beeram, M R; Chopde, N; Dawood, Y; Siriboe, S; Abedin, M

    1996-01-01

    To evaluate the usefulness of lumbar puncture (LP) in the initial evaluation of symptom-free infants for congenital syphilis. We retrospectively studied infants who had successful LPs and were born to untreated or inadequately treated seropositive women between 1990 and 1993 in two hospitals in Washington, D.C. We identified 329 such symptom-free infants (syphilis group). The cerebrospinal fluid (CSF) VDRL was reactive in two (0.6%) infants. The CSF leukocyte and protein concentrations of these infants were compared with those in 84 symptom-free control infants who were born to seronegative women and who had LPs performed in 1993 to rule out sepsis because of associated risk factors. Control infants had negative results for bacterial cultures (CSF and blood) and bacterial antigen tests (CSF and urine). Thirty control subjects and 67 infants in the syphilis group had traumatic taps (CSF erythrocytes > 500 x 10(6)/L), and hence were excluded from the analysis of cell count and proteins. Birth weights and gestational ages were similar in both groups. The CSF leukocyte and protein values were similar in the syphilis group and in control infants: mean CSF leukocytes 7.7 x 10(6)/L (mean 7.7/mm3, range 0 to 57/mm3, SD 8.8) versus 6.9 x 10(6)/L (mean 6.9/mm3, range 0 to 31/mm3, SD 7), p = 0.5, and mean protein concentration 981 mg/L (range 270 to 2280 mg/L, SD 376) versus 936 mg/L (range 360 to 1750 mg/L, SD 368), p = 0.96, respectively. The combination of CSF leukocyte values > 5 x 10(6)/L (> 5/mm3) or protein values > 400 mg/L (> 40 mg/dl) was found in 97.8% of the infants in the syphilis group, compared with 95.3% of the control group. Because of the low yield of reactive CSF VDRL and the similar CSF leukocyte and protein values in the syphilis group and the control infants, the role of routine LP in the initial evaluation of symptom-free infants for congenital syphilis should be reconsidered.

  7. Note on Magnetism and Simultaneity

    Science.gov (United States)

    Huggins, Elisha

    2009-01-01

    The paper on "Magnetism and Simultaneity" by Adler provides an excellent new thought experiment involving the lack of simultaneity in Einstein's special relativity. Adler uses the lack of simultaneity rather than the Lorentz contraction to derive the formula for the magnetic force on a moving charged particle. Advantages of his derivation are that…

  8. Emergency Medicine Myths: Computed Tomography of the Head Prior to Lumbar Puncture in Adults with Suspected Bacterial Meningitis - Due Diligence or Antiquated Practice?

    Science.gov (United States)

    April, Michael D; Long, Brit; Koyfman, Alex

    2017-09-01

    Various sources purport an association between lumbar puncture and brainstem herniation in patients with intracranial mass effect lesions. Several organizations and texts recommend head computed tomography (CT) prior to lumbar puncture in selected patients. To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis. Observational studies report a risk of post-lumbar puncture brainstem herniation in the presence of intracranial mass effect (1.5%) that is significantly lower than that reported among all patients with bacterial meningitis (up to 13.3%). It is unclear from existing literature whether identifying patients with intracranial mass effect decreases herniation risk. Up to 80% of patients with bacterial meningitis experiencing herniation have no CT abnormalities, and approximately half of patients with intracranial mass effect not undergoing lumbar puncture herniate. Decision rules to selectively perform CT on only those individuals most likely to have intracranial mass effect lesions have not undergone validation. Despite recommendations for immediate antimicrobial therapy prior to imaging, data indicate an association between pre-lumbar puncture CT and antibiotic delays. Recent data demonstrate shortened door-to-antibiotic times and lower mortality from bacterial meningitis after implementation of new national guidelines, which restricted generally accepted CT indications by removing impaired mental status as imaging criterion. Data supporting routine head CT prior to lumbar puncture are limited. Physicians should consider selective CT for those patients at risk for intracranial mass effect lesions based on decision rules or clinical gestalt. Patients undergoing head CT must receive immediate antibiotic therapy. Published by Elsevier Inc.

  9. Simultaneous Immersion Mirau Interferometry

    Science.gov (United States)

    Lyulko, Oleksandra

    acquisition challenging. This problem was resolved by integration of polarization optics into the optics of the attachment to enable simultaneous creation and spatial separation of two interferograms, which, combined with the background image, are used to reconstruct the intensity map of the specimen. Giving the name Simultaneous Immersion Mirau Interferometry to this approach, simultaneous acquisition of all interferograms per image has eliminated the issue of vibrations. The designed compound microscope attachment has been manufactured and tested; the system produces images of quality, sufficient to perform targeted cellular irradiation experiments.

  10. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    International Nuclear Information System (INIS)

    Minko, Peter; Katoh, Marcus; Gräber, Stefan; Buecker, Arno

    2012-01-01

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10 9 /l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m 2 ; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  11. Curative effect of minimally invasive puncture and drainage assisted with alteplase on treatment of acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Jun-Lin Hu

    2017-01-01

    Full Text Available Objective: To investigate the different effects on evacuation of hematoma, the severity of nerve injury, inflammatory reaction and oxidative stress response in the treatment of acute intracerebral hemorrhage by using minimally invasive puncture and drainage assisted with alteplase or urokinase. Methods: A total of 114 patients with acute intracerebral hemorrhage treated with minimally invasive puncture and drainage in our hospital from May 2012 to October 2015 were retrospectively analyzed and divided into alteplase group and urokinase group, which received adjuvant therapy with alteplase and urokinase, respectively. Before and after treatment, CT was used for scanning, and the volume of hematoma and edema and the distance of midline shift were examined. After treatment, serum was collected for detecting the contents of molecular markers of nerve injury, inflammatory reaction and oxidative stress response. Results: On the 3rd day after treatment, the volume of hematoma and edema and the distance of midline shift in minimally invasive group were significantly lower than those of craniotomy group, and incidence of intracranial infection was lower than that of craniotomy group. There was no significant difference of rebleeding incidence compared to craniotomy group. The serum contents of osteopontin, S100β, glial fibrillary acidic protein, neuron-specific enolase, myelin basic protein, neuropeptide Y, ischemia modified albumin, tumor necrosis factor alpha, interleukin-1β, interleukin-6, interleukin-8, soluble intercellular adhesion molecule-1, highmobility group protein 1, malonaldehyde, advanced oxidation protein products and 8-hydroxy- 2'-deoxyguanosine urine of patients from alteplase group were significantly lower than those of urokinase group. The content of total antioxidant capacity was obviously higher than that of urokinase group. Conclusions: As for the effect on evacuation of hematoma and also the ameliorative effect on nerve injury

  12. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany); Graeber, Stefan [University Hospital Saarland, Institute of Medical Biometry, Epidemiology and Medical Informatics (Germany); Buecker, Arno [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany)

    2012-08-15

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  13. Clinical experiences with application of soft laser puncture for the treatment of chronic painful status of locomotor apparatus in dogs

    International Nuclear Information System (INIS)

    Skalka, J.

    2008-01-01

    A zonal laser therapy in the region of particular dermatomas has been used in 6 dogs of different race, sex and age with different chronic painful states of locomotive organs in the frame of individual laser therapeutical regimens as well as laser puncture in a set of acupuncture points to be selected for each dog separately. Two dogs were assessed as cured. In two dogs the state has considerably improved and in two dogs the state has considerably improved with some parameters at a physiological level. (authors)

  14. Successful Endoscopic Treatment of Severe Pancreaticojejunostomy Strictures by Puncturing the Anastomotic Site with an EUS-guided Guidewire

    Science.gov (United States)

    Nabeshima, Tatsuhide; Kanno, Atsushi; Masamune, Atsushi; Hayashi, Hiroki; Hongo, Seiji; Yoshida, Naoki; Nakano, Eriko; Miura, Shin; Hamada, Shin; Kikuta, Kazuhiro; Kume, Kiyoshi; Hirota, Morihisa; Unno, Michiaki; Shimosegawa, Tooru

    2017-01-01

    Pancreaticojejunostomy stricture (PJS) is a late complication of pancreaticoduodenectomy. The endoscopic treatment of PJS is very challenging due to the difficulty of locating the small anastomotic site and passing the stricture using a guidewire. We herein report two cases of severe PJS. These patients could not be treated using only double-balloon endoscopy or endoscopic ultrasound-guided puncture of the main pancreatic duct because of severe stenosis at the anastomotic site. However, we could treat them by the rendezvous technique using the rigid part of the guidewire to penetrate PJS. This method was useful and safe for treating severe PJS. PMID:29151507

  15. Optimizing Residents' Performance of Lumbar Puncture: An RCT Comparing the Effect of Preparatory Interventions on Performance and Self-Confidence.

    Science.gov (United States)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Thagesen, Helle; Jacobsen, Rikke Borre Vita; Subhi, Yousif; Brydges, Ryan; Ringsted, Charlotte; Konge, Lars

    2018-02-01

    Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given to whether the design of the videos impacts on subsequent performance. To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP). Randomized controlled trial in which participants were randomly assigned to one of three interventions as preparation for performing lumbar puncture: 1) goal- and learner-centered video (GLV) presenting procedure-specific process goals and learner-centered information; 2) traditional video (TV) providing expert-driven content, but no process goals; and 3) written text (WT) with illustrations. Participants were PGY-1 doctors without LP experience. After the preparatory intervention, participants performed an LP in a simulated setting with a standardized patient and an assistant. Two content experts, blinded to participant group allocation, assessed video recordings of the performance using the Lumbar Puncture Assessment Tool (LumPAT) and an overall global rating. Participants rated their self-confidence immediately prior to performing the procedure. The primary outcome was the difference in LumPAT scores among groups. A total of 110 PGY-1 doctors were included. Results demonstrated significant differences in LumPAT mean scores among the three groups: GLV, 42.8; TV, 40.6; WT, 38.1 (p = 0.01). The global rating scores were highest in the GLV group (p = 0.026). Self-confidence scores differed significantly among the three groups (p = 0.003), with the TV group scoring the highest. There were no significant correlations between self-confidence scores and performance scores in any of the groups. A video designed with procedure-specific process goals and learner-centered information

  16. Peripartum Isolated Cortical Vein Thrombosis in a Mother with Postdural Puncture Headache Treated with an Epidural Blood Patch

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    Etienne Laverse

    2013-01-01

    Full Text Available A 32-year-old woman presented with low pressure headache 3 days after delivery of her baby. An assessment of postdural puncture headache was made. This was initially treated with analgesia, caffeine, and fluids for the presumed cerebrospinal fluid (CSF leak. The woman was readmitted two days after her hospital discharge with generalised seizures. A brain scan showed features of intracranial hypotension, and she was treated for CSF leak using an epidural blood patch. Her symptoms worsened and three days later, she developed a left homonymous quadrantanopia. An MRI scan confirmed a right parietal haematoma with evidence of isolated cortical vein thrombosis (ICVT.

  17. Use of EchoNavigator, a novel echocardiography-fluoroscopy overlay system, for transseptal puncture and left atrial appendage occlusion.

    Science.gov (United States)

    Gafoor, Sameer; Schulz, Philipp; Heuer, Luisa; Matic, Predrag; Franke, Jennifer; Bertog, Stefan; Reinartz, Markus; Vaskelyte, Laura; Hofmann, Ilona; Sievert, Horst

    2015-04-01

    Structural heart disease requires a coordinated effort to join echocardiographic and fluoroscopic data. Various methods have been used, including echocardiography, CT, and MRI. We report on the use of EchoNavigator (Philips Inc., Amsterdam, Netherlands), a novel echocardiographic-fluoroscopic fusion system. This new system allows real-time integration and marking of important structures that track on fluoroscopy even with movement of the C-arm. In this article, we describe potential uses for this system in respect to transseptal puncture and left atrial appendage closure. © 2015, Wiley Periodicals, Inc.

  18. Significant Improvement of Puncture Accuracy and Fluoroscopy Reduction in Percutaneous Transforaminal Endoscopic Discectomy With Novel Lumbar Location System: Preliminary Report of Prospective Hello Study.

    Science.gov (United States)

    Fan, Guoxin; Guan, Xiaofei; Zhang, Hailong; Wu, Xinbo; Gu, Xin; Gu, Guangfei; Fan, Yunshan; He, Shisheng

    2015-12-01

    Prospective nonrandomized control study.The study aimed to investigate the implication of the HE's Lumbar LOcation (HELLO) system in improving the puncture accuracy and reducing fluoroscopy in percutaneous transforaminal endoscopic discectomy (PTED).Percutaneous transforaminal endoscopic discectomy is one of the most popular minimally invasive spine surgeries that heavily depend on repeated fluoroscopy. Increased fluoroscopy will induce higher radiation exposure to surgeons and patients. Accurate puncture in PTED can be achieved by accurate preoperative location and definite trajectory.The HELLO system mainly consists of self-made surface locator and puncture-assisted device. The surface locator was used to identify the exact puncture target and the puncture-assisted device was used to optimize the puncture trajectory. Patients who had single L4/5 or L5/S1 lumbar intervertebral disc herniation and underwent PTED were included the study. Patients receiving the HELLO system were assigned in Group A, and those taking conventional method were assigned in Group B. Study primary endpoint was puncture times and fluoroscopic times, and the secondary endpoint was location time and operation time.A total of 62 patients who received PTED were included in this study. The average age was 45.35 ± 8.70 years in Group A and 46.61 ± 7.84 years in Group B (P = 0.552). There were no significant differences in gender, body mass index, conservative time, and surgical segment between the 2 groups (P > 0.05). The puncture times were 1.19 ± 0.48 in Group A and 6.03 ± 1.87 in Group B (P HELLO system is accurate preoperative location and definite trajectory. This preliminary report indicated that the HELLO system significantly improves the puncture accuracy of PTED and reduces the fluoroscopic times, preoperative location time, as well as operation time. (ChiCTR-ICR-15006730).

  19. A New Ultrasound-Guided Puncture Device with Augmented Degrees of Performance Freedom and Ability to Attach to Most Convex Probes

    International Nuclear Information System (INIS)

    Jung, Sung Il; Son, Kyu Ri; Kim, Young Jun; Jeon, Hae Jeong; Park, Sang Woo; Cho, Jeong Yeon; Kim, Seung Hyup

    2008-01-01

    To evaluate the performance of a newly-designed ultrasound (US)-guided puncture device. A newly-designed US-guided puncture device was composed of a guide segment and an attachable segment. The guide segment allowed the needle to be placed in the plane of US view with a maximal degree of freedom, and the attachable segment was designed to attach to most convex US probes. Six operators punctured 144 targets in phantoms using either the new device (n = 72) or free-hand technique (n = 72). The number of required needle passages and the necessary procedure times were compared between the two groups. The number of required needle passages and the necessary procedure time were significantly reduced in five operators when the newly-designed US-guided puncture device was used (p < 0.05). A newly-designed US-guided puncture device, which allows for a maximal degree of freedom in needle placement and can attach to most convex US probes, showed good performance in our study

  20. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  1. 3D Non-destructive Imaging of Punctures in Polyethylene Composite Armor by THz Time Domain Spectroscopy

    Science.gov (United States)

    Palka, N.; Panowicz, R.; Ospald, F.; Beigang, R.

    2015-08-01

    An ultra-high molecular weight polyethylene composite sample totally punctured by a projectile was examined by THz TDS raster scanning method in reflection configuration. The scanning results correctly match the distribution of delaminations inside the sample, which was proven with cross-sectional and frontal views after waterjet cutting. For further analysis, a signal-processing algorithm based on the deconvolution method was developed and the modified reference signal was used to reduce disturbances. The complex refractive index of the sample was determined by transmission TDS technique and was later used for the simulation of pulse propagation by the finite difference time domain method. These simulations verified the correctness of the proposed method and showed its constraints. Using the proposed algorithm, the ambiguous raw THz image was converted into a binary 3D image of the sample, which consists only of two areas: sample—polyethylene and delamination—air. As a result, a clear image of the distribution of delaminations with their spatial extent was obtained which can be used for further comparative analysis. The limitation of the proposed method is that parts of the central area of the puncture cannot be analyzed because tilted layers deflect the incident signal.

  2. Study of the damage rate caused by intervertebral foramen type inside and outside and the pass of the intervertebral DRG RF puncture way.

    Science.gov (United States)

    Sun, Jiashu; Zhang, Haitao

    2014-09-01

    This paper was to analyze and contrast the damage rate on the thoracic segment different position of the dorsal root ganglion(dorsal root ganglion, DRG) caused by different puncture path in radiofrequency ablation, thus the best RF target way for the thoracic segment of different types of DRG was confirmed. According to the difference of puncture and ablation damage way, 14 segmental spinal specimens were randomly divided into three groups, and then conducted DRG radiofrequency damage on percutaneous puncture path according to the type of DRG position.The damage effect of different puncture path by the judgment standard of the result of pathology analyzed. The experiment showed that RF damage of group A were 72.58 ± 18.88%, 54.16 ± 24.84% and 32.85 ± 28.11%; that of group B were 771.86 ± 15.15% and 72.02 ± 17.86%, 57.14 ± 18.02% and 52.47 ± 20.64%, 68.75 ± 14.63% and 71.78 ± 16.00%; and that of group C were 82.46 ± 14.10%, 81.53 ± 11.81% and 80.83 ± 13.33%. It was concluded that the singleness of DRG puncture route is one of the important reasons for the poor thoracic segments DRG radiofrequency (RF) ablation effect. While according to the type of DRG different positions with double joint puncture path can significantly improve the rate of DRG RF damage.

  3. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    Directory of Open Access Journals (Sweden)

    Radeleff Boris

    2008-10-01

    Full Text Available Abstract Background Totally Implantable Access Ports (TIAP are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single-center, expertise based randomized, controlled superiority trial to compare two different TIAP implantation techniques. 100 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective implantation of a TIAP under local anesthesia who signed the informed consent will be included. The primary endpoint is the primary success rate of the randomized technique. Control Intervention: Venae Sectio will be employed to insert a TIAP by a surgeon; Experimental intervention: Punction of V. Subclavia will be used to place a TIAP by a radiologist. Duration of study: Approximately 10 months, follow up time: 90 days. Organisation/Responsibility The PORTAS 2 – Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The Center of Clinical Trials at the Department of Surgery, University Hospital Heidelberg is responsible for design and conduct of the trial including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI, University of Heidelberg. Trial Registration The trial is registered at ClinicalTrials.gov (NCT00600444.

  4. Utilizing the Flipped Classroom, Simulation-Based Mastery Learning and Group Learning to Teach and Evaluate Lumbar Puncture Skills

    Directory of Open Access Journals (Sweden)

    Amanda Crichlow

    2018-01-01

    Full Text Available Audience: This lumbar puncture curriculum was developed and implemented to educate and evaluate incoming intern Emergency Medicine (EM residents. This curriculum can also be used to educate and evaluate senior medical students and senior residents. Introduction: Procedural competency is an important component of healthcare education. With the implementation of milestones, the need for valid assessment tools to determine procedural competency has increased. Simulation-based mastery learning (SBML with the incorporation of deliberate practice has been shown to be an effective way to teach and evaluate procedural skills.1-8 These studies, however, highlight one of the major barriers to successful integration of SBML into existing medical curricula: they require a significant investment of time. One reason for this is the performance of the pre-test evaluation of the learners’ procedure skills prior to commencement of training. Although necessary for research endeavors to evaluate curricula effectiveness, the need for pre-testing specifically on studies where the goal of the curricula is procedural competency, as measured by learners’ performance on the post-testing, has not been described. Consequently, we decided a more effective use of limited time was to allow our learners the opportunity for deliberate practice and conducting the post-test. Since the ultimate goal of our educational endeavors is to ensure that our learners achieve defined standards of performance, evaluation of their performance prior to training may not be necessary. Another reason for the significant time investment for SBML curricula is the utilization of individualized instruction with one facilitator providing corrective feedback to one learner. Although Cohen et al. reference the use of groups of learners for procedure training9, it is not explicitly delineated how the group instruction is conducted. In other disciplines, training team protocols such as dyad training

  5. Simultaneous multislice (SMS) imaging techniques

    NARCIS (Netherlands)

    Barth, M.; Breuer, F.; Koopmans, P.J.; Norris, David Gordon; Poser, B.A.

    2016-01-01

    Simultaneous multislice imaging (SMS) using parallel image reconstruction has rapidly advanced to become a major imaging technique. The primary benefit is an acceleration in data acquisition that is equal to the number of simultaneously excited slices. Unlike in-plane parallel imaging this can have

  6. Simultaneous Lipschitz extensions

    International Nuclear Information System (INIS)

    Brudnyi, A Yu; Brudnyi, Yu A

    2005-01-01

    This paper is devoted to a study of a new bi-Lipschitz invariant λ(M) of metric spaces M. Finiteness of this quantity means that the Lipschitz functions on any subset of M can be linearly extended to functions on M with Lipschitz constants increased by the factor λ(M). It is shown that λ(M) is finite for some important classes of metric spaces, including metric trees of any cardinality, groups of polynomial growth, hyperbolic groups in the Gromov sense, certain classes of Riemannian manifolds of bounded geometry, and finite direct sums of any combinations of these objects. On the other hand, an example is given of a two-dimensional Riemannian manifold M of bounded geometry with λ(M)=∞

  7. Painful procedures in children with cancer: comparison of moderate sedation and general anesthesia for lumbar puncture and bone marrow aspiration.

    Science.gov (United States)

    Iannalfi, Alberto; Bernini, Gabriella; Caprilli, Simona; Lippi, Alma; Tucci, Fabio; Messeri, Andrea

    2005-12-01

    The study was conducted to compare moderate sedation (MS) with general anesthesia (GA) in the management of frequently performed lumbar puncture or bone marrow aspiration (BMA) during the treatment of childhood cancer. The MS (14 patients for 30 procedures) was managed by non-anesthesiologists (combined nitrous oxide-midazolam +/- non-pharmacological techniques). The GA was managed by anesthesiologists (17 patients for 30 procedures). A neutral observer recorded side effects, use of sedative antagonists, recovery time, oncologist's evaluation, procedure behaviors check list (PBCL); subjective perceptions during the procedure with a questionnaire administered to children (>6 years) and their parents; drugs costs and professional resources. P-values compliance and cost-effectiveness as it relies on the contribution of non-pharmacological techniques. 2005 Wiley-Liss, Inc.

  8. Fine needle puncture (FNP) for pre- and post-operative studies of femoro-crural vacular reconstructions

    International Nuclear Information System (INIS)

    Hofmann-Preiss, K.; Reichler, B.; Aichinger, U.; Schweiger, H.

    1990-01-01

    During two years we performed 199 pre- and postoperative angiograms on 99 patients with femoro-crural reconstruction. 133 of these were by FNP. In 4.2% of postoperative FNPs (fully anticoagulated patients), there was significant bleeding from the puncture or the operative scar. It was not necessary to reoperate on any bypasses and there were no late complications. As regards the demonstration of the calf vessels, FNP proved itself superior as a pre- and postoperative method. Because of the rapidity of the method, the small amount of contrast required and the minimal trauma, FNP is the method of choice for pre- and postoperative studies of the calf vessels for femoro-crural reconstructions. (orig.) [de

  9. RS3PE Syndrome with Iliopsoas Bursitis Distinguished from an Iliopsoas Abscess Using a CT-guided Puncture.

    Science.gov (United States)

    Fukui, Shoichi; Iwamoto, Naoki; Tsuji, Sosuke; Umeda, Masataka; Nishino, Ayako; Nakashima, Yoshikazu; Suzuki, Takahisa; Horai, Yoshiro; Koga, Tomohiro; Kawashiri, Shin-ya; Ichinose, Kunihiro; Hirai, Yasuko; Tamai, Mami; Nakamura, Hideki; Origuchi, Tomoki; Kawakami, Atsushi

    2015-01-01

    A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly disappeared following treatment. Clinicians should be aware that iliopsoas bursitis may resemble an iliopsoas abscess. As a result, it is important to make an accurate differential diagnosis.

  10. Structural evaluation of the Shippingport Reactor Pressure Vessel and Neutron Shield Tank package for impact and puncture loads

    International Nuclear Information System (INIS)

    Fischer, L.E.; Chou, C.K.; Lo, T.; Schwartz, M.W.

    1988-06-01

    A structural evaluation of Shippingport Reactor Pressure Vessel and Neutron Shield Tank package for impact and puncture loads under the normal and hypothetical accident conditions of 10 CFR 71 was performed. Component performance criteria for the Shippingport package and the corresponding structural acceptance criteria for these components were developed based on a review of the package geometry, the planned transport environment, and the external radiation standards and dispersal limits of 10 CFR 71. The evaluation was performed using structural analysis methods. A demonstration combining simplified model tests and nonlinear finite element analyses was made to substantiate the structural analysis methods used to evaluate the Shippingport package. The package was analyzed and the results indicate that the package meets external radiation standards and release limits of 10 CFR 71. 13 refs., 50 figs., 19 tabs

  11. Effects of a new device to guide venous puncture in elderly critically ill patients: results of a pilot randomized study.

    Science.gov (United States)

    Fumagalli, Stefano; Torricelli, Gionatan; Massi, Marta; Calvani, Silvia; Boni, Serena; Roberts, Anna T; Accarigi, Elisabetta; Manetti, Stefania; Marchionni, Niccolò

    2017-04-01

    Novel devices based on the emission of near-infrared electromagnetic radiation (NIR) have been developed to minimize venous puncture failures. These instruments produce an "augmented reality" image, in which subcutaneous veins are depicted on a LCD display. We compared the new technique with standard venipuncture in a population of elderly patients. Patients admitted in Intensive Care Unit were randomized to standard or to NIR assisted procedure. In the 103 enrolled patients (age 74 ± 12 years; standard venipuncture-N = 56; NIR-N = 47), no differences were found in procedure length, number of attempts, and referred pain. With NIR there was a lower incidence of hematomas and fewer anxiety and depressive symptoms. The use of the novel NIR-based device is safer and more psychologically tolerable, and it is not associated to an increase of procedure length or number of attempts.

  12. Music and 25% glucose for preterm babies during the pre-procedure for arterial puncture: facial mimics emphasis

    Directory of Open Access Journals (Sweden)

    Maria Vera Lúcia Moreira Leitão Cardoso

    2016-06-01

    Full Text Available We aimed to describe and quantify facial mimic movements of preterm babies during music and 25% glucose interventions at the pre-procedure for arterial puncture. A randomized controlled trial involving 48 videos of preterm attended in a public neonatal unit, in Fortaleza – Ceará. We collected data from footage analyses during the pre-procedure. Babies heard a lullaby song for 10 minutes in the experimental group; we administered 25% glucose in the control group at the end of the eighth minute, matching a total of 10 minutes of observation. We assessed the frequency of facial expressions: cry, sneeze, yawn, frown the forehead, focused sight, vague sight, sleeping and head movement. Statistically significant variable for the control group: vague sight (p=0.001 at the two last minutes of observation. We concluded that there was no association between most of facial movements and the studied interventions, except for a vague sight in the control group.

  13. Propagation of a linear wave created by a spatially localized perturbation in a regular lattice and punctured Lagrangian manifolds

    Science.gov (United States)

    Dobrokhotov, S. Yu.; Nazaikinskii, V. E.

    2017-01-01

    The following results are obtained for the Cauchy problem with localized initial data for the crystal lattice vibration equations with continuous and discrete time: (i) the asymptotics of the solution is determined by Lagrangian manifolds with singularities ("punctured" Lagrangian manifolds); (ii) Maslov's canonical operator is defined on such manifolds as a modification of a new representation recently obtained for the canonical operator by the present authors together with A. I. Shafarevich (Dokl. Ross. Akad. Nauk 46 (6), 641-644 (2016)); (iii) the projection of the Lagrangian manifold onto the configuration plane specifies a bounded oscillation region, whose boundary (which is naturally referred to as the leading edge front) is determined by the Hamiltonians corresponding to the limit wave equations; (iv) the leading edge front is a special caustic, which possibly contains stronger focal points. These observations, together with earlier results, lead to efficient formulas for the wave field in a neighborhood of the leading edge front.

  14. Punciones repetidas de la arteria radial para cateterismo cardíaco Repeated radial artery puncture for cardiac catheterization

    Directory of Open Access Journals (Sweden)

    Eduardo Magariños

    2007-06-01

    Full Text Available La punción percutánea de la arteria radial para la realización de procedimientos por cateterismo ha ganado aceptación debido a una eficacia similar a la obtenida con el acceso femoral. En el presente trabajo evaluamos los resultados obtenidos con la punción repetida de esta arteria. En un total de 182 accesos radiales se realizaron 17 punciones repetidas, y mediante ellas, 20 procedimientos (9 coronariografías y 11 angioplastias. Se obtuvo éxito del acceso en 15 punciones repetidas (88.2% y éxito del procedimiento en todos los casos cuando logramos éxito del acceso. Si bien el grupo es pequeño es suficiente para mostrar que la punción repetida de la arteria radial es factible y permite una alta tasa de éxito de los procedimientos con una disminución ostensible de las complicaciones locales.The radial artery approach for percutaneous cardiac interventions has gained worldwide acceptance due to the similar results obtained by the femoral artery access. In this paper, we report our experience with repeated puncture of the radial artery. One hundred and eighty two radial artery access procedures were performed, in 17 interventions the puncture was repeated once or twice, with a total of 20 therapeutic catheterizations (9 coronary angiographies, 11 angioplasties. There was no therapeutic failure through the radial approach but, we successfully gained access in 88.2% (15/17 of the re-interventions cases. Although an experience with a low number of cases, we had a very high successful therapeutic rate, and also a remarkable lowering of local complications, this shows the feasibility and potential of this technique.

  15. Febrile response induced by cecal ligation and puncture (CLP) in rats: involvement of prostaglandin E2 and cytokines.

    Science.gov (United States)

    Figueiredo, Maria José; Soares, Denis Melo; Soares, Denis de Melo; Martins, Juliano Manvailer; Machado, Renes de Resende; Sorgi, Carlos Arterio; Faccioli, Lucia Helena; Melo, Miriam Cristina Contin de; de Melo, Miriam Cristina Contin; Malvar, David do Carmo; Souza, Glória E P

    2012-05-01

    The purpose of the present study was to better understand the events involved in the febrile response induced by cecal ligation and puncture (CLP), a complex infectious process. To this end, we conducted in vivo experiments in rats examining (1) fever development, (2) bacterial number in the infection focus and in blood, (3) peripheral and hypothalamic synthesis of cytokines, (4) hypothalamic and cerebrospinal fluid (CSF) synthesis of prostaglandin E(2) (PGE(2)), (5) the effect of anti-IL-6 antibody on fever, and (6) the effect of celecoxib on fever and hypothalamic synthesis of PGE(2) after CLP induction. We found that CLP promotes fever and animal death depending on the number of punctures. The peak of CLP-induced fever overlapped with the maximal increase in the number of bacteria in the infectious focus and blood, which occurred at 6 and 12 h. The peak of the febrile response also coincided with increased amounts of interleukin (IL)-1β, IL-6 and IL-10 in the peritoneal exudate and serum; IL-6 in the hypothalamus and PGE(2) in the CSF and predominantly in the hypothalamus. Moreover, intracerebroventricularly injected anti-IL-6 antibody reduced the febrile response while celecoxib reduced the fever and PGE(2) amount in the hypothalamus induced by CLP. Tumor necrosis factor (TNF)-α peaked at 3 h at all sites studied. Conversely, IL-10 concentration decreased in the hypothalamus. These findings show that the peak of CLP-induced fever is accompanied by an increase of bacteria in peritoneal fluid (local infection) and blood; local synthesis of pyrogenic (IL-1β, IL-6) and antipyretic (IL-10) cytokines and central production of IL-6 and PGE(2), suggesting that these last are the central mediators of this response.

  16. Concomitant Intracranial and Lumbar Chronic Subdural Hematoma Treated by Fluoroscopic Guided Lumbar Puncture: A Case Report and Literature Review.

    Science.gov (United States)

    Ichinose, Daisuke; Tochigi, Satoru; Tanaka, Toshihide; Suzuki, Tomoya; Takei, Jun; Hatano, Keisuke; Kajiwara, Ikki; Maruyama, Fumiaki; Sakamoto, Hiroki; Hasegawa, Yuzuru; Tani, Satoshi; Murayama, Yuichi

    2018-02-23

    A 40-year-old man presented with a severe headache, lower back pain, and lower abdominal pain 1 month after a head injury caused by falling. Computed tomography (CT) of the head demonstrated bilateral chronic subdural hematoma (CSDH) with a significant amount in the left frontoparietal region. At the same time, magnetic resonance imaging (MRI) of the lumbar spine also revealed CSDH from L2 to S1 level. A simple drainage for the intracranial CSDH on the left side was performed. Postoperatively, the headache was improved; however, the lower back and abdominal pain persisted. Aspiration of the liquefied spinal subdural hematoma was performed by a lumbar puncture under fluoroscopic guidance. The clinical symptoms were dramatically improved postoperatively. Concomitant intracranial and spinal CSDH is considerably rare so only 23 cases including the present case have been reported in the literature so far. The etiology and therapeutic strategy were discussed with a review of the literature. Therapeutic strategy is not established for these two concomitant lesions. Conservative follow-up was chosen for 14 cases, resulting in a favorable clinical outcome. Although surgical evacuation of lumbosacral CSDH was performed in seven cases, an alteration of cerebrospinal fluid (CSF) pressure following spinal surgery should be reminded because of the intracranial lesion. Since CSDH is well liquefied in both intracranial and spinal lesion, a less invasive approach is recommended not only for an intracranial lesion but also for spinal lesion. Fluoroscopic-guided lumbar puncture for lumbosacral CSDH following burr hole surgery for intracranial CSDH could be a recommended strategy.

  17. Percutaneous evacuation of diffuse pulmonary interstitial emphysema by lung puncture in a baby with extremely low birth weight: a case report

    Directory of Open Access Journals (Sweden)

    Watanabe Masahiro

    2012-09-01

    Full Text Available Abstract Introduction Pulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs. Therapeutic lung puncture is a treatment option for severe pulmonary interstitial emphysema but has a limited use in babies with extremely low birth weight. We present a case of pulmonary interstitial emphysema in a Japanese baby (1-day-old boy with extremely low birth weight. The emphysema was successfully decompressed by therapeutic lung puncture performed with a trocar catheter. Case presentation The baby was born with a weight of 420g, which, to the best of our knowledge, is the lowest reported birth weight among babies with pulmonary interstitial emphysema. A chest X-ray on postnatal day 2 revealed pulmonary interstitial emphysema, which gradually progressed to diffuse pseudocystic changes. His condition became life-threatening despite the use of high-frequency oscillatory ventilation and lateral decubitus positioning. We evacuated the pulmonary interstitial emphysema by lung puncture with a trocar catheter to avoid respiratory and cardiovascular collapse. This resulted in adequate evacuation of the emphysema and a dramatic improvement in his clinical condition. Conclusions Therapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema. This treatment option may be broadly applicable, especially in an emergency situation.

  18. CT-Guided Superior Vena Cava Puncture: A Solution to Re-Establishing Access in Haemodialysis-Related Central Venous Occlusion Refractory to Conventional Endovascular Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Khalifa, Mohamed, E-mail: mkhalifa@nhs.net; Patel, Neeral R., E-mail: neeral.patel06@gmail.com; Moser, Steven, E-mail: steven.moser@imperial.nhs.uk [Hammersmith Hospital, Department of Radiology, Imperial College Healthcare NHS Trust (United Kingdom)

    2016-04-15

    PurposeThe purpose of this technical note is to demonstrate the novel use of CT-guided superior vena cava (SVC) puncture and subsequent tunnelled haemodialysis (HD) line placement in end-stage renal failure (ESRF) patients with central venous obstruction refractory to conventional percutaneous venoplasty (PTV) and wire transgression, thereby allowing resumption of HD.MethodsThree successive ESRF patients underwent CT-guided SVC puncture with subsequent tract recanalisation. Ultrasound-guided puncture of the right internal jugular vein was performed, the needle advanced to the patent SVC under CT guidance, with subsequent insertion of a stabilisation guidewire. Following appropriate tract angioplasty, twin-tunnelled HD catheters were inserted and HD resumed.ResultsNo immediate complications were identified. There was resumption of HD in all three patients with a 100 % success rate. One patient’s HD catheter remained in use for 2 years post-procedure, and another remains functional 1 year to the present day. One patient died 2 weeks after the procedure due to pancreatitis-related abdominal sepsis unrelated to the Tesio lines.ConclusionCT-guided SVC puncture and tunnelled HD line insertion in HD-related central venous occlusion (CVO) refractory to conventional recanalisation options can be performed safely, requires no extra equipment and lies within the skill set and resources of most interventional radiology departments involved in the management of HD patients.

  19. Treatment with 24 h-delayed normo- and hyperbaric oxygenation in severe sepsis induced by cecal ligation and puncture in rats

    DEFF Research Database (Denmark)

    Bærnthsen, Nina Falcon; Hansen, Marco Bo; Wahl, Anna Mygind

    2017-01-01

    uncertain. We investigated the effects of 24 h delayed normobaric oxygen (NBO2) and HBO2treatment on the endogenous production of the inflammatory markers interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10, and on mortality in rats with cecal ligation and puncture (CLP) induced sepsis. Method...

  20. Evaluation of the effects of electron-beam irradiation on the puncture resistance by Lasioderma serricorne in flexible packaging of granola

    International Nuclear Information System (INIS)

    Oliveira, Vitor M.; Alves, Juliana N.; Nogueira, Beatriz R.; Moura, Esperidiana A.B.; Ortiz, Angel V.; Potenza, Marcos R.

    2009-01-01

    Lasioderma serricorne is a beetle that infests stored and industrialized dry foods such as cereal bars, granola, flour and pasta, amongst others, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by L. serricorne in BOPP/PP structure, used commercially as granola packaging after electron-beam irradiation. The irradiations were performed using a 1.5 MeV electron beam accelerator, dose rate of 11.22 kGy/s, at room temperature in presence of air, doses up to 120 kGy. After irradiation the BOPP/PP samples were subjected to tests of puncture resistance by L. serricorne, tensile strength, friction coefficient, penetration and seal strength. Results showed decreases in the original mechanical properties of the structure according to the radiation doses applied and effective resistance against punctures by L. serricorne (p<0.05). The results indicate that the irradiated and non-irradiated BOPP/PP structure, in the conditions studied in this work, is resistant against L. serricorne, however the decreases observed in the mechanical properties of the irradiated structure may turn it inappropriate for packaging granola. (author)

  1. Evaluation of the effects of electron-beam irradiation on the puncture resistance by Lasioderma serricorne in flexible packaging of granola

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Vitor M.; Alves, Juliana N.; Nogueira, Beatriz R.; Moura, Esperidiana A.B., E-mail: vmiranda@ipen.b, E-mail: julianaabc@ig.com.b, E-mail: bia.ribnog@gmail.co, E-mail: eabmoura@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Ortiz, Angel V., E-mail: angel.ortiz@unipacnet.com.b [UNIPAC Embalagens Ltda., Sao Paulo, SP (Brazil); Potenza, Marcos R., E-mail: potenza@biologico.sp.gov.b [Instituto Biologico de Sao Paulo/APTA, Sao Paulo, SP (Brazil)

    2009-07-01

    Lasioderma serricorne is a beetle that infests stored and industrialized dry foods such as cereal bars, granola, flour and pasta, amongst others, depreciating the products and causing economic losses. It is therefore critical for these products a packaging that presents, in addition to good mechanical, barrier and machinability properties, a good resistance to puncture by insects, in order to prevent the contact and spread of pests in the packaged food. This study evaluates the changes on mechanical properties and puncture resistance by L. serricorne in BOPP/PP structure, used commercially as granola packaging after electron-beam irradiation. The irradiations were performed using a 1.5 MeV electron beam accelerator, dose rate of 11.22 kGy/s, at room temperature in presence of air, doses up to 120 kGy. After irradiation the BOPP/PP samples were subjected to tests of puncture resistance by L. serricorne, tensile strength, friction coefficient, penetration and seal strength. Results showed decreases in the original mechanical properties of the structure according to the radiation doses applied and effective resistance against punctures by L. serricorne (p<0.05). The results indicate that the irradiated and non-irradiated BOPP/PP structure, in the conditions studied in this work, is resistant against L. serricorne, however the decreases observed in the mechanical properties of the irradiated structure may turn it inappropriate for packaging granola. (author)

  2. Bulletin of International Simultaneous Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The publication of the Bulletin of International Simultaneous Observations, began July 1, 1875, with daily maps added in 1877. It was published for distribution...

  3. Simultaneous distribution of AC and DC power

    Science.gov (United States)

    Polese, Luigi Gentile

    2015-09-15

    A system and method for the transport and distribution of both AC (alternating current) power and DC (direct current) power over wiring infrastructure normally used for distributing AC power only, for example, residential and/or commercial buildings' electrical wires is disclosed and taught. The system and method permits the combining of AC and DC power sources and the simultaneous distribution of the resulting power over the same wiring. At the utilization site a complementary device permits the separation of the DC power from the AC power and their reconstruction, for use in conventional AC-only and DC-only devices.

  4. Simultaneous surgeries in a split forward surgical team: a case study.

    Science.gov (United States)

    Vanfosson, Christopher A; Seery, Jason M

    2011-12-01

    The 541st Forward Surgical Team performed split-based operations, with one site in the city of Pol-e-Khumri. One evening, the 10-person team received two pediatric patients simultaneously and conducted simultaneous surgeries. The 3-year-old female sustained severe injuries to bilateral lower extremities and a puncture wound to her right forearm. The 13-year-old sustained fragmentary wounds to her left hand, left foot, right medial calf, and evisceration to her left lower quadrant. The patients presented in extremis after being taken to a civilian hospital initially, spending approximately 1.5 hours receiving no resuscitative therapy. The 3-year-old underwent amputations of bilateral lower extremities and a fasciotomy of the right forearm. The 13-year-old survived an exploratory laparotomy and irrigation and debridement of intra-abdominal wounds. The successful completion of simultaneous surgeries, by a split forward surgical team at a remote location, for two critically ill patients is possible. It should not become the standard of care. Prior planning made this occurrence feasible and safer, but such situations put the patients at risk for complications.

  5. Protective Effects of Huang-Lian-Jie-Du-Tang against Polymicrobial Sepsis Induced by Cecal Ligation and Puncture in Rats

    Directory of Open Access Journals (Sweden)

    Yufen Wei

    2013-01-01

    Full Text Available Huang-Lian-Jie-Du-Tang (HLJDT is a traditional formula that has long been used for treatment of inflammatory diseases in Traditional Chinese Medicine. In this study, we examined its protective effect against sepsis in an experimental septic model induced by cecal ligation and puncture (CLP in rats. The results demonstrated that prophylactic administration of HLJDT protected rats from CLP-induced lethality and ameliorated CLP-induced liver and lung injury. HLJDT treatment suppressed the production of proinflammatory cytokines, including TNF-α, IL-1, IL-6, and IL-17A, indicating HLJDT could limit excessive inflammatory responses in septic condition. In addition, HLJDT facilitated bacterial clearance by increasing phagocytic activities of peritoneal macrophages. Furthermore, HLJDT treatment reversed CLP-induced suppression of IFN-γ expression and blocked CLP-induced increase in IL-4 expression in spleens of rats at 24 h after CLP, indicating that HLJDT could reverse the shift from Th1 to Th2 response and promote Th1/Th2 balance toward Th1 predominance in septic rats. Moreover, HLJDT also inhibited the expression of IL-17A and ROR-γt in spleens of septic rats, indicating HLJDT is able to inhibit Th17 activation in septic condition. In conclusion, the present study demonstrated the protective effects of HLJDT against sepsis and highlighted the potential of HLJDT as a medication for septic patients.

  6. A novel technique of axillary vein puncture involving peripherally inserted central venous catheters for a small basilic vein.

    Science.gov (United States)

    Saijo, Fumito; Odaka, Yoshinobu; Mutoh, Mitsuhisa; Katayose, Yu; Tokumura, Hiromi

    2018-03-01

    Peripherally inserted central venous catheters are some of the most useful devices for vascular access used globally. Peripherally inserted central venous catheters have a low rate of fatal mechanical complications when compared to non-tunnel central venous catheters. However, as peripherally inserted central venous catheter access requires a smaller vein, there is a high risk of thrombosis. The axillary vein (confluence of the basilic and brachial veins) can serve as an access for cannulation. Moreover, as this vein is larger than the basilic or brachial vein, it might be a superior option for preventing thrombosis. The risk of catheter-related bloodstream infection should be considered when the puncture site is at the axillary fossa. The aim of this study was to present our new protocol involving peripherally inserted central venous catheters (non-tunneled/tunneled) and a tunneling technique and assess its feasibility and safety for improving cannulation and preventing thrombosis and infection. The study included 20 patients. The axillary vein in the upper arm was used for peripherally inserted central venous catheters in patients with a small-diameter basilic vein (venous catheter. The observed catheter duration was 645 days (median ± standard deviation, 26 ± 22.22 days). Catheterization was successful in all cases, however, two accidental dislodgements were identified. No fatal or serious complications were observed after catheterization. Our new protocol for axillary peripherally inserted central venous catheters/tunneled axillary peripherally inserted central venous catheters use for a small-diameter basilic vein is safe and feasible.

  7. Epinecidin-1 protects mice from LPS-induced endotoxemia and cecal ligation and puncture-induced polymicrobial sepsis.

    Science.gov (United States)

    Su, Bor-Chyuan; Huang, Han-Ning; Lin, Tai-Wen; Hsiao, Chwan-Deng; Chen, Jyh-Yih

    2017-12-01

    The antimicrobial peptide, epinecidin-1 (Epi), was identified from Epinephelus coioides and may have clinical application for treating sepsis. Epi has been shown to ameliorate antibiotic-resistant bacteria-induced sepsis in mice, but further evaluation in mixed-flora models and a description of the protective mechanisms are essential to establish this peptide as a potential therapeutic. Therefore, we first tested the protective effects of Epi against polymicrobial sepsis-induced bactericidal infection, inflammation and lung injury that result from cecal ligation and puncture in mice. Furthermore, since lipopolysaccharide (LPS) is a key inducer of inflammation during bacterial infection and sepsis, we also tested the LPS-antagonizing activity and related mechanisms of Epi-mediated protection in mice with LPS-induced endotoxemia and LPS-treated Raw264.7 mouse macrophage cells. Epi rescued mice from both polymicrobial sepsis and endotoxemia after delayed administration and suppressed both lung and systemic inflammatory responses, while attenuating lung injury and diminishing bacterial load. In vitro studies revealed that Epi suppressed LPS-induced inflammatory cytokine production. Mechanistically, Epi disrupted the interaction between LPS and LPS binding protein, competed with LPS for binding on the cell surface, and inhibited Toll-like receptor 4 endocytosis, resulting in inhibition of LPS-induced reactive oxygen species/p38/Akt/NF-κB signaling and subsequent cytokine production. Overall, our results demonstrate that Epi is a promising therapeutic agent for endotoxemia and polymicrobial sepsis. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Ursolic acid improves survival and attenuates lung injury in septic rats induced by cecal ligation and puncture.

    Science.gov (United States)

    Hu, Zhansheng; Gu, Zhilong; Sun, Meina; Zhang, Ke; Gao, Penghui; Yang, Qinwu; Yuan, Yuan

    2015-04-01

    Sepsis is characterized as a systemic inflammatory response syndrome during infection, which can result in multiple organ dysfunction and death. Ursolic acid (UA), a pentacyclic triterpene acid, has been reported to have potent anti-inflammatory and antioxidant properties. The aim of this study was to detect the possible protective effects of UA on sepsis-evoked acute lung injury. A rat model of sepsis induced by cecal ligation and puncture (CLP) was used. Rats were injected intraperitoneally with UA (10 mg/kg) after CLP, and then the survival was determined twice a day for 4 d. The protective effects of UA on CLP-induced acute lung injury were assayed at 24 h after CLP. The results revealed that UA treatment markedly improved the survival of septic rats, and attenuated CLP-induced lung injury, including reduction of lung wet/dry weight ratio, infiltration of leukocytes and proteins, myeloperoxidase activity, and malondialdehyde content. In addition, UA significantly decreased the serum levels of tumor necrosis factor-α, interleukin-6, and interleukin-1β, inhibited the expression of inducible nitric oxide synthase and cyclooxygenase-2 in the lung, which are involved in the productions of nitric oxide and prostaglandin E2. These findings indicate that UA exerts protective effects on CLP-induced septic rats. UA may be a potential therapeutic agent against sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Tracheobronchial puncture-site nodular reaction (TPNR following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA: Systematic review of case reports

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2017-01-01

    Full Text Available Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA is a minimally invasive and efficacious diagnostic modality for lung cancer staging and evaluation of undiagnosed mediastinal lymphadenopathy. Procedure-related complications are uncommon. We herein report an infrequently described phenomenon following EBUS-TBNA in which two patients developed nodular granulation tissue at the tracheobronchial puncture site. On systematic review, we found description of such phenomena by terminologies such as endobronchial inflammatory polyp, granuloma, and endobronchial mass. The endobronchial inflammatory polyp has been one of the most commonly used terminologies for these; but in most cases, the classical features of an inflammatory polyp are lacking. We propose the term, tracheobronchial puncture-site nodular reaction (TPNR with further classification into granulomatous and nongranulomatous subtypes, for standardized reporting of such reactions following transbronchial needle aspiration procedures. Knowledge of this entity and standardized nomenclature shall help in better characterization of the outcomes and risk factors for the occurrence of these reactions.

  10. Use of the profunda femoris to facilitate closure of an antegrade puncture with the StarClose device after proximal SFA angioplasty.

    Science.gov (United States)

    Yeung-Ngok-Kao, Susan; Fisher, Robert Kendall; Williams, Robin Edward Thomas; Jackson, Ralph; Rose, John; Macdonald, Sumaira

    2006-08-01

    To report a novel technique for safely closing antegrade common femoral artery (CFA) punctures using the StarClose device after proximal superficial femoral artery (SFA) angioplasty. The vessel locator of the StarClose device should not be deployed within a recently dilated vessel, so after proximal SFA angioplasty, the sheath is withdrawn into the CFA. A second guidewire is inserted into the profunda femoris artery followed by insertion of the StarClose sheath. The vessel locator is deployed in the profunda main stem and withdrawn into the CFA until resistance is felt, indicating apposition to the luminal aspect of the vessel wall. The device is subsequently deployed according to the manufacturer's instructions. Use of profunda femoris artery allows safe closure of the CFA using the StarClose device following antegrade puncture for proximal SFA angioplasty.

  11. Tracheobronchial puncture-site nodular reaction (TPNR) following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): Systematic review of case reports

    Science.gov (United States)

    Madan, Karan; Tiwari, Pavan; Arava, Sudheer; Hadda, Vijay; Mohan, Anant; Guleria, Randeep

    2017-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and efficacious diagnostic modality for lung cancer staging and evaluation of undiagnosed mediastinal lymphadenopathy. Procedure-related complications are uncommon. We herein report an infrequently described phenomenon following EBUS-TBNA in which two patients developed nodular granulation tissue at the tracheobronchial puncture site. On systematic review, we found description of such phenomena by terminologies such as endobronchial inflammatory polyp, granuloma, and endobronchial mass. The endobronchial inflammatory polyp has been one of the most commonly used terminologies for these; but in most cases, the classical features of an inflammatory polyp are lacking. We propose the term, tracheobronchial puncture-site nodular reaction (TPNR) with further classification into granulomatous and nongranulomatous subtypes, for standardized reporting of such reactions following transbronchial needle aspiration procedures. Knowledge of this entity and standardized nomenclature shall help in better characterization of the outcomes and risk factors for the occurrence of these reactions. PMID:29098999

  12. Envisioning Curriculum as Six Simultaneities

    Science.gov (United States)

    Hussain, Hanin; Conner, Lindsey; Mayo, Elaine

    2014-01-01

    This paper uses the discourse of complexity thinking to envision curriculum as six partial and coupled facets that exist simultaneously: curriculum as structure, curriculum as process, curriculum as content, curriculum as teaching, curriculum as learning and curriculum as activity. Such a curriculum is emergent and self-organising. It is emergent…

  13. SIMULTANEOUS SEPARATION AND PRECONCENTRATION OF ...

    African Journals Online (AJOL)

    In this work, a simple, rapid, selective, sensitive and economical method has been developed for the simultaneous separation and preconcentration of trace amounts of copper, nickel, cadmium, and zinc in aqueous medium using XAD-4 resins that were modified with 2-(5-bromo-2-pyridylazo)-5-diethylaminophenol ...

  14. Experimental simulation of simultaneous vision.

    Science.gov (United States)

    de Gracia, Pablo; Dorronsoro, Carlos; Sánchez-González, Álvaro; Sawides, Lucie; Marcos, Susana

    2013-01-17

    To present and validate a prototype of an optical instrument that allows experimental simulation of pure bifocal vision. To evaluate the influence of different power additions on image contrast and visual acuity. The instrument provides the eye with two superimposed images, aligned and with the same magnification, but with different defocus states. Subjects looking through the instrument are able to experience pure simultaneous vision, with adjustable refractive correction and addition power. The instrument is used to investigate the impact of the amount of addition of an ideal bifocal simultaneous vision correction, both on image contrast and on visual performance. the instrument is validated through computer simulations of the letter contrast and by equivalent optical experiments with an artificial eye (camera). Visual acuity (VA) was measured in four subjects (AGE: 34.3 ± 3.4 years; spherical error: -2.1 ± 2.7 diopters [D]) for low and high contrast letters and different amounts of addition. The largest degradation in contrast and visual acuity (∼25%) occurred for additions around ±2 D, while additions of ±4 D produced lower degradation (14%). Low additions (1-2 D) result in lower VA than high additions (3-4 D). A simultaneous vision instrument is an excellent tool to simulate bifocal vision and to gain understanding of multifocal solutions for presbyopia. Simultaneous vision induces a pattern of visual performance degradation, which is well predicted by the degradation found in image quality. Neural effects, claimed to be crucial in the patients' tolerance of simultaneous vision, can be therefore compared with pure optical effects.

  15. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

    Directory of Open Access Journals (Sweden)

    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  16. Under X-ray guidance stent implantation through retrograde popliteal artery puncturing for the treatment of superficial femoral artery occlusion: the initial results in nine cases

    International Nuclear Information System (INIS)

    He Xu; Gu Jianping; Lou Wensheng; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao; Xu Ke

    2011-01-01

    Objective: To discuss the application of retrograde popliteal artery puncturing under X-ray guidance in the interventional therapy for superficial femoral artery occlusion. Methods: Retrograde popliteal artery puncturing under X-ray guidance was carried out in nine patients with long-segment occlusion of superficial femoral artery as antegrade recanalization via femoral artery approach had failed in them. After retrograde route was successfully established, the balloon dilation and subsequent stent placement for occluded vessel were performed. Results: The technical success was obtained in all patients. The occluded superficial femoral arteries were reopened and the symptoms of intermittent claudication disappeared. No serious complications such as injuries of adjacent nerves or vessels occurred. The ankle-brachial index (ABI) increased from preoperative (0.38±0.13) to postoperative (0.92±0.11) with the difference being statistically significant (P<0.01). A follow-up period lasting for 2-16 months was conducted. Eleven months after the treatment, intermittent claudication recurred in one case, and CT angiography showed that the distal part of the stent was narrowed. The symptoms were improved after percutaneous transcatheter angioplasty was performed again. Conclusion: Retrograde popliteal artery puncturing under X-ray guidance is an effective and safe technique for the treatment of superficial femoral artery long-segment occlusion with stent placement, especially for patients in whom antegrade recanalization via femoral artery approach fails. (authors)

  17. Simultaneous selection for yield and ratooning ability in sugarcane ...

    African Journals Online (AJOL)

    During sugarcane breeding, indirect selection for pest resistance and direct selection for high ratoon yields increases ratooning ability. The objective of this study was to describe the simultaneous screening of genotypes for yield and ratooning ability in sugarcane breeding trials using analysis of covariance. Data for cane ...

  18. Simultaneous Determination of Bisphenol A and Bisphenol S in ...

    African Journals Online (AJOL)

    NICO

    2014-08-08

    Aug 8, 2014 ... A simplified method based on ratio derivative ultraviolet spectrometry for simultaneous determination of bisphenol A (BPA) and bisphenol S (BPS) in environmental water is presented. The method provides a direct analysis of the samples without tedious sample preparation. In this method, the overlapping ...

  19. The First Simultaneous Microlensing Observations by Two Space telescopes

    DEFF Research Database (Denmark)

    Shvartzvald, Y.; Li, Z.; Udalski, A.

    2016-01-01

    Simultaneous observations of microlensing events from multiple locations allow for the breaking of degeneracies between the physical properties of the lensing system, specifically by exploring different regions of the lens plane and by directly measuring the “microlens parallax.” We report the di...

  20. Simultaneous Determination of Metals in Coal with Low-Resolution ...

    African Journals Online (AJOL)

    The setup including low-resolution spectrometer with the charge-coupled device (CCD) detector, continuum radiation source and filter furnace (FF) atomizer was employed for direct simultaneous determination of Al, Fe, Mg, Cu and Mn in coal slurry. In the FF, sample vapour entered absorption volume by filtering through ...

  1. Acute kidney injury and inflammatory response of sepsis following cecal ligation and puncture in D-galactose-induced aging rats

    Directory of Open Access Journals (Sweden)

    Liu C

    2017-03-01

    Full Text Available Chao Liu,1,* Jie Hu,1,* Zhi Mao,1,* Hongjun Kang,1 Hui Liu,1 Wanlei Fu,2 Yangfan Lv,2 Feihu Zhou1 1Department of Critical Care Medicine, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China; 2Department of Pathology, Xinqiao Hospital, Third Military Medical University, Chongqing, People’s Republic of China *These authors contributed equally to this work Background: Recently, the D-galactose (D-gal-induced mimetic aging rat model has been widely used in studies of age-associated diseases, which have shown that chronic D-gal exposure induces premature aging similar to natural aging in rats. With the increasing rate of sepsis in the geriatric population, an easy-access animal model for preclinical studies of elderly sepsis is urgently needed. This study investigates whether a sepsis model that is established in D-gal-induced aging rats can serve as a suitable model for preclinical studies of elderly patients with sepsis.Objective: To investigate the acute kidney injury (AKI and inflammatory response of sepsis following cecal ligation and puncture (CLP in D-gal-induced aging rats.Methods: Twelve-week-old male Sprague Dawley rats were divided into low-dose D-gal (L D-gal, 125 mg/kg/d, high-dose D-gal (H D-gal, 500 mg/kg/d, and control groups. After daily subcutaneous injection of D-gal for 6 weeks, the CLP method was used to establish a sepsis model.Results: The mortality was 73.3%, 40%, and 33.3% in the H D-gal, L D-gal, and control groups, respectively. Blood urea nitrogen, creatinine, plasma neutrophil gelatinase-associated lipocalin, interleukin-6, interleukin-10, and tumor necrosis factor-α were markedly increased in the H D-gal group after establishment of the sepsis model (H D-gal vs control, P<0.05 at 12 h and 24 h post-CLP. The rate of severe AKI (RIFLE-F at 24 h post-CLP was 43% for both the control and L D-gal groups and 80% for the H D-gal group.Conclusion: High-dose-D-gal-induced aging rats are

  2. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  3. Cecal ligation and puncture followed by MRSA pneumonia increases mortality in mice and blunts production of local and systemic cytokines

    Science.gov (United States)

    Jung, Enjae; Perrone, Erin E.; Liang, Zhe; Breed, Elise R.; Dominguez, Jessica A.; Clark, Andrew T.; Fox, Amy C.; Dunne, W. Michael; Burd, Eileen M.; Farris, Alton B.; Hotchkiss, Richard S.; Coopersmith, Craig M.

    2011-01-01

    Mortality in the ICU frequently results from the synergistic effect of two temporally-distinct infections. This study examined the pathophysiology of a new model of intraabdominal sepsis followed by methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Mice underwent cecal ligation and puncture (CLP) or sham laparotomy followed three days later by an intratracheal injection of MRSA or saline. Both CLP/saline and sham/MRSA mice had 100% survival while animals with CLP followed by MRSA pneumonia had 67% seven-day survival. Animals subjected to CLP/MRSA had increased bronchoalveolar lavage (BAL) concentrations of MRSA compared to sham/MRSA animals. Animals subjected to sham/MRSA pneumonia had increased BAL levels of IL-6, TNF-α, and G-CSF compared to those given intratracheal saline while CLP/MRSA mice had a blunted local inflammatory response with markedly decreased cytokine levels. Similarly, animals subjected to CLP/saline had increased peritoneal lavage levels of IL-6 and IL-1β compared to those subjected to sham laparotomy while this response was blunted in CLP/MRSA mice. Systemic cytokines were upregulated in both CLP/saline and sham/MRSA mice, and this was blunted by the combination of CLP/MRSA. In contrast, no synergistic effect on pneumonia severity, white blood cell count or lymphocyte apoptosis was identified in CLP/MRSA mice compared to animals with either insult in isolation. These results indicate that a clinically relevant model of CLP followed by MRSA pneumonia causes higher mortality than could have been predicted from studying either infection in isolation, and this was associated with a blunted local (pulmonary and peritoneal) and systemic inflammatory response and decreased ability to clear infection. PMID:21937950

  4. Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture.

    Science.gov (United States)

    Kessler, David; Pusic, Martin; Chang, Todd P; Fein, Daniel M; Grossman, Devin; Mehta, Renuka; White, Marjorie; Jang, Jaewon; Whitfill, Travis; Auerbach, Marc

    2015-05-01

    Simulation-based skill trainings are common; however, optimal instructional designs that improve outcomes are not well specified. We explored the impact of just-in-time and just-in-place training (JIPT) on interns' infant lumbar puncture (LP) success. This prospective study enrolled pediatric and emergency medicine interns from 2009 to 2012 at 34 centers. Two distinct instructional design strategies were compared. Cohort A (2009-2010) completed simulation-based training at commencement of internship, receiving individually coached practice on the LP simulator until achieving a predefined mastery performance standard. Cohort B (2010-2012) had the same training plus JIPT sessions immediately before their first clinical LP. Main outcome was LP success, defined as obtaining fluid with first needle insertion and <1000 red blood cells per high-power field. Process measures included use of analgesia, early stylet removal, and overall attempts. A total of 436 first infant LPs were analyzed. The LP success rate in cohort A was 35% (13/37), compared with 38% (152/399) in cohort B (95% confidence interval for difference [CI diff], -15% to +18%). Cohort B exhibited greater analgesia use (68% vs 19%; 95% CI diff, 33% to 59%), early stylet removal (69% vs 54%; 95% CI diff, 0% to 32%), and lower mean number of attempts (1.4 ± 0.6 vs 2.1 ± 1.6, P < .01) compared with cohort A. Across multiple institutions, intern success rates with infant LP are poor. Despite improving process measures, adding JIPT to training bundles did not improve success rate. More research is needed on optimal instructional design strategies for infant LP. Copyright © 2015 by the American Academy of Pediatrics.

  5. The Conversion of a Peer Teaching Course in the Puncture of Peripheral Veins for Medical Students into an Interprofessional Course

    Directory of Open Access Journals (Sweden)

    Brem, Beate Gabriele

    2016-04-01

    Full Text Available Objective: There is a great interest on both a national and international level in promoting cooperation between different occupational groups within the healthcare professions through interprofessional education (IPE , , . Within this project, a peer teaching course on the puncture of peripheral veins was therefore converted from a course for medical students into an IPE learning unit. Students from different occupational groups were to learn within the context of this course, according to the definition from the World Health Organisation (WHO, with and from each other . Project description: This course constituted a small group class in the peer teaching format. The didactic principle was based on the idea that the students were to practice the respective practical skills in pairs and give each other reciprocal feedback. Together with the Department for Health at the Bern University of Applied Sciences (BUAS and the Bern Center of Higher Education of Nusing (BCHEN, the course, which was conducted by the Institute of Medical Education at the University of Bern (IME, was converted into a voluntary IPE pilot project. Students from all three institutions were represented in terms of participants as well as tutors. Results: The course was evaluated very positively by participants, peer tutors and the participating institutions. By means of an OSCE, it could be proven that the course content had been successfully imparted. On the basis of these results, it was determined that the course should be compulsory in the future for students at all three institutions. Discussion: The evaluation results show the successful conversion of the course into an IPE format within the context of the pilot project. The interactive format of the course created the prerequisite that the students from different professional groups learned with and from each other in actuality, and did not just study the same objectives at the same time as with multiprofessional learning

  6. A prospective controlled study: Minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Tang Yuping

    2011-06-01

    Full Text Available Abstract Background Spontaneous intracerebral hemorrhage (ICH is a devastating form of stroke with the high mortality twofold to sixfold higher than that for ischemic stroke. But the treatment of haematomas within the basal ganglia continues to be a matter of debate among neurologists and neurosurgeons. The purpose of this study is to judge the clinical value of minimally invasive stereotactic puncture therapy (MISPT on acute ICH. Methods A prospective controlled study was undertaken. The clinical trial was in compliance with the WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. According to the enrollment criterion, there were 168 acute ICH cases analyzed, of which 90 cases were performed by MISPT ( MISPT group, MG and 78 cases by Conventional craniotomy (CC group, CG, by means of compare of Glasgow Coma Scale(GCS score, postoperative complications(PC and rebleeding incidence(RI, moreover, long-term outcome of 1 year postoperation judged by Glasgow Outcome Scale (GOS, Barthel Index (BI, modified Rankin Scale (mRS and case fatality(CF. Results MG patients showed obvious amelioration in GCS score compared with that of CG. The total incidence of PC in MG decreased obviously compared with that of CG. The incidences of rebleeding in MG and CG were 10.0% and 15.4% respectively. There was no obvious difference between CFs of MG and CG. For three parameters representing long-term outcome, the GOS, BI and mRS in MG were ameliorated significantly than that of CG. Conclusion These data suggested that the advantage of MISPT was displayed in minute trauma and safety, and seemed to be feasible and to had a trend towards improved long-term outcome. Trial Registration The Australian New Zealand Clinical Trials Registry (ANZCTR, the registration number:ACTRN12610000945022.

  7. A prospective controlled study: Minimally invasive stereotactic puncture therapy versus conventional craniotomy in the treatment of acute intracerebral hemorrhage

    Science.gov (United States)

    2011-01-01

    Background Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with the high mortality twofold to sixfold higher than that for ischemic stroke. But the treatment of haematomas within the basal ganglia continues to be a matter of debate among neurologists and neurosurgeons. The purpose of this study is to judge the clinical value of minimally invasive stereotactic puncture therapy (MISPT) on acute ICH. Methods A prospective controlled study was undertaken. The clinical trial was in compliance with the WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. According to the enrollment criterion, there were 168 acute ICH cases analyzed, of which 90 cases were performed by MISPT ( MISPT group, MG) and 78 cases by Conventional craniotomy (CC group, CG), by means of compare of Glasgow Coma Scale(GCS) score, postoperative complications(PC) and rebleeding incidence(RI), moreover, long-term outcome of 1 year postoperation judged by Glasgow Outcome Scale (GOS), Barthel Index (BI), modified Rankin Scale (mRS) and case fatality(CF). Results MG patients showed obvious amelioration in GCS score compared with that of CG. The total incidence of PC in MG decreased obviously compared with that of CG. The incidences of rebleeding in MG and CG were 10.0% and 15.4% respectively. There was no obvious difference between CFs of MG and CG. For three parameters representing long-term outcome, the GOS, BI and mRS in MG were ameliorated significantly than that of CG. Conclusion These data suggested that the advantage of MISPT was displayed in minute trauma and safety, and seemed to be feasible and to had a trend towards improved long-term outcome. Trial Registration The Australian New Zealand Clinical Trials Registry (ANZCTR), the registration number:ACTRN12610000945022. PMID:21699716

  8. Three complications of Pair (puncture, aspiration, injection, reaspiration) in one case: Recurrent hemobilia, cyst infection and pneumonia.

    Science.gov (United States)

    Sevinç, B; Karahan, Ö; Bakdik, S; Aksoy, N; Eryilmaz, M A

    2015-01-01

    With the appropriate indications, puncture, aspiration, injection and reaspiration (PAIR) is the most effective minimal invasive method used in the treatment of hydatic cysts. Hemobilia is the hemorrhagia in bile ducts in consequence of any reason. In literature there is no case with hemobilia because of PAIR. This is the first case with recurrent hemobilia, infection in cyst cavity and pneumonia because of PAIR. A 66 years old female patient was admitted to hospital with complaints of abdominal pain, hematemesis and melaena. She gave the history of PAIR for two hydatic cysts. At physical examination, there were jaundice, tenderness at right subcostal area and melaena at rectal digital examination. Hemobilia was detected by abdominal ultrasonography and magnetic resonance cholangiopancreaticography (MRCP). An endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic sphincterotomy were performed. The patient was discharged after 6 days hospital stay. One day after the discharge the patient was admitted to hospital with the same complaints again. Performing ERCP and balloon extraction, the hematoma filling the common bile duct was removed. After the patient was hemodynamically stable for 3 days, she was discharged from the hospital. A week after that the patient was admitted to hospital with the clinical findings of infected hydatic cyst and pneumonia. The patient was treated medically with mechanical ventilation support for 8 days. It should not be underestimated that, there can be serious complications of PAIR like hemobilia. Therefore, PAIR should be performed only in centers having appropriate medical and surgical facilities. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Shorter Duration of Post-Operative Antibiotics for Cecal Ligation and Puncture Does Not Increase Inflammation or Mortality.

    Directory of Open Access Journals (Sweden)

    Kendra N Iskander

    Full Text Available Antimicrobial therapy for sepsis has beneficial effects, but prolonged use fosters emergence of resistant microorganisms, increases cost, and secondary infections. We tested whether 3 days versus 5 days of antibiotics in the murine model of cecal ligation and puncture (CLP negatively influences outcomes. Following CLP mice were randomized to receive the antibiotic imipenem-cilastatin (25mg/kg in dextrose 5% in Lactated Ringer's solution every 12 hours for either three or five days. Serial monitoring over 28 days included body weight, temperature, pulse oximetry, and facial vein sampling for hematological analysis and glucose. A separate group of mice were euthanized on post-CLP day 5 to measure cytokines and peritoneal bacterial counts. The first study examined no antimicrobial therapy and demonstrated that antibiotics significantly improved survival compared to fluids only (p = 0.004. We next tested imipenem-cilastatin therapy for 3 days versus 5 days. Body weight, temperature, glucose, and pulse oximetry measurements remained generally consistent between both groups as did the hematological profile. Pro-inflammatory plasma cytokines were comparable between both groups for IL-6, IL-1β, MIP-2 and anti-inflammatory cytokines IL-10, and TNF SRI. At 5 days post-CLP, i.e. 2 days after the termination of antibiotics in the 3 day group, there were no differences in the number of peritoneal bacteria. Importantly, shortening the course of antibiotics by 40% (from 5 days to 3 days did not decrease survival. Our results indicate that reducing the duration of broad-spectrum antibiotics in murine sepsis did not increase inflammation or mortality.

  10. Cuts and puncture wounds

    Science.gov (United States)

    Lammers RL, Smith ZE. Principles of wound management. In: Roberts JR, Hedges JR, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine . 5th ed. Philadelphia, PA. Elsevier Saunders; 2014:chap ...

  11. The Punctured Plane

    Indian Academy of Sciences (India)

    The basic objects that topol- ogy studies are called topological spaces, i.e. sets which have ... For example, all the objects listed in the first para- graph are topological spaces. Once this is done, it is easy to ..... for all t E [0,1]. Henceforth, we shall always assume that. X is a path connected open subset of R2, i.e. givenany two.

  12. Multiple Puncture Tuberculin Reactions

    African Journals Online (AJOL)

    munity;' the most important test employed in human and veterinary medicine;' and an essential tool in the ultimate eradication of tuberculosis" In countries with a serious tuberculosis problem, prevention with BCG vaccine, and isoniazid chemotherapy for healthy infected subjects, are of great importance; and it is necessary ...

  13. The Punctured Plane

    Indian Academy of Sciences (India)

    tween metric spaces. You may be aware that it has to do with Mobius strips, Klein bottles, doughnuts, knots and the like. To make a very crude definition, the objective of .... vector field. GENERAL I ARTICLE all over X. The (also smooth) function * -~ is called the curl of v, and denoted curl v. The discussion above shows.

  14. A critique of current developments in simultaneous localization and mapping

    Directory of Open Access Journals (Sweden)

    Shoudong Huang

    2016-10-01

    Full Text Available The number of research publications dealing with the simultaneous localization and mapping problem has grown significantly over the past 15 years. Many fundamental and practical aspects of simultaneous localization and mapping have been addressed, and some efficient algorithms and practical solutions have been demonstrated. The aim of this paper is to provide a critical review of current theoretical understanding of the fundamental properties of the SLAM problem, such as observability, convergence, achievable accuracy and consistency. Recent research outcomes associated with these topics are briefly discussed together with potential future research directions.

  15. Simultaneous tracking and activity recognition

    DEFF Research Database (Denmark)

    Manfredotti, Cristina Elena; Fleet, David J.; Hamilton, Howard J.

    2011-01-01

    Many tracking problems involve several distinct objects interacting with each other. We develop a framework that takes into account interactions between objects allowing the recognition of complex activities. In contrast to classic approaches that consider distinct phases of tracking and activity...... recognition, our framework performs these two tasks simultaneously. In particular, we adopt a Bayesian standpoint where the system maintains a joint distribution of the positions, the interactions and the possible activities. This turns out to be advantegeous, as information about the ongoing activities can...

  16. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  17. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  18. Simultaneous beta and gamma spectroscopy

    Science.gov (United States)

    Farsoni, Abdollah T.; Hamby, David M.

    2010-03-23

    A phoswich radiation detector for simultaneous spectroscopy of beta rays and gamma rays includes three scintillators with different decay time characteristics. Two of the three scintillators are used for beta detection and the third scintillator is used for gamma detection. A pulse induced by an interaction of radiation with the detector is digitally analyzed to classify the type of event as beta, gamma, or unknown. A pulse is classified as a beta event if the pulse originated from just the first scintillator alone or from just the first and the second scintillator. A pulse from just the third scintillator is recorded as gamma event. Other pulses are rejected as unknown events.

  19. Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients.

    Science.gov (United States)

    Spiliopoulos, Stavros; Kitrou, Panagiotis; Christeas, Nikolaos; Karnabatidis, Dimitris

    2016-01-01

    Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head. This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month. Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.

  20. Simultaneous multislice (SMS) imaging techniques.

    Science.gov (United States)

    Barth, Markus; Breuer, Felix; Koopmans, Peter J; Norris, David G; Poser, Benedikt A

    2016-01-01

    Simultaneous multislice imaging (SMS) using parallel image reconstruction has rapidly advanced to become a major imaging technique. The primary benefit is an acceleration in data acquisition that is equal to the number of simultaneously excited slices. Unlike in-plane parallel imaging this can have only a marginal intrinsic signal-to-noise ratio penalty, and the full acceleration is attainable at fixed echo time, as is required for many echo planar imaging applications. Furthermore, for some implementations SMS techniques can reduce radiofrequency (RF) power deposition. In this review the current state of the art of SMS imaging is presented. In the Introduction, a historical overview is given of the history of SMS excitation in MRI. The following section on RF pulses gives both the theoretical background and practical application. The section on encoding and reconstruction shows how the collapsed multislice images can be disentangled by means of the transmitter pulse phase, gradient pulses, and most importantly using multichannel receiver coils. The relationship between classic parallel imaging techniques and SMS reconstruction methods is explored. The subsequent section describes the practical implementation, including the acquisition of reference data, and slice cross-talk. Published applications of SMS imaging are then reviewed, and the article concludes with an outlook and perspective of SMS imaging. © 2015 Wiley Periodicals, Inc.

  1. Simultaneous bilateral primary spontaneous pneumothorax

    Directory of Open Access Journals (Sweden)

    Arife Zeybek

    2014-04-01

    Full Text Available Simultaneous bilateral primary pneumothorax is a very rare (1.6 / 100,000 and life-threatening condition. Clinical presentation may vary from mild dyspnea to tension pneumothorax. It may be milder particularly in younger patients, but more severe in patients with advanced age, and tube thoracostomy is a life preserver in the latter group. Since mortality and recurrence rates following tube thoracostomy are high, endoscopic approaches to bilateral hemithorax have been reported in literature. Apical wedge resection and pleural procedures are recommended in video thoracoscopy or mini thoracotomy even if no bulla and/or bleb are detected. Bilateral surgical interventions and additional pleural procedures are associated with increased rate of post-operative complications and longer postoperative hospital-stays. As a first-line approach, the surgical method toward any side of lung with air leakage following a previous tube thoracostomy is considered less invasive, especially in younger patients. Here, we present a case of simultaneous bilateral primary spontaneous pneumothorax (SBPSP in a 21-year old male with no history of smoking and chronic pulmonary disease. A unilateral surgical intervention was performed, and no recurrence was observed during 5-year follow up.

  2. Profile cytological tests, sensibility and specificity of fine needle puncture into skin and subcutaneous samples in dogs.

    Directory of Open Access Journals (Sweden)

    Arlinda Flores Coleto

    2016-09-01

    Full Text Available ABSTRACT. Coleto A.F., Moreira T. de A., Gundim L.F., Silva S. de A., de Castro M. de R., Bandarra M. de B. & Medeiros-Ronchi A.A. [Profile cytological tests, sensibility and specificity of fine needle puncture into skin and subcutaneous samples in dogs.] Perfil de exames citológicos, sensibilidade e especificidade da punção por agulha fina para amostras cutâneas e subcutâneas em cães. Revista Brasileira de Medicina Veterinária, 38(3:311-315, 2016. Programa de Pós-Graduação em Ciências Veterinárias, Universidade Federal de Uberlândia, Rua Ceará s/n - Bloco 2D, Sala 3, Campus Umuarama, Uberlândia, MG 38400- 902, Brasil. E-mail: arlindacoleto@hotmail.com The cytology has been routinely used in veterinary clinic and has a good correlation with histological examination. The objective was to conduct a retrospective study of cytological examinations in the period of six years and then calculate accuracy, sensitivity and specificity of cytology examination for neoplasms in cutaneous and subcutaneous samples collected by PAF (fine needle punction in dogs, using histology as golden pattern. The canine species was the most common in 92.2% (736/798. The PAF was the most used technique in 84.0% (814/968. The most frequent samples were from the Cutaneous System in 36.1% (344/951. There was 67.0% (36/53 agreement between the exams. The sensitivity of cytology in the diagnosis of neoplasms was 77% (moderate and specificity of 12.5% (low, and the PPV 83% and NPV 9.0%. Cytology is the most commonly test used in cutaneous and subcutaneous lesions in dogs and the PAF is the most used technique. The examination is recommended as a screening method because of its high sensitivity.

  3. Hypertonic Saline Solution Drives Neutrophil from Bystander Organ to Infectious Site in Polymicrobial Sepsis: A Cecal Ligation and Puncture Model

    Science.gov (United States)

    Theobaldo, Mariana Cardillo; Llimona, Flavia; Petroni, Ricardo Costa; Rios, Ester Correia Sarmento; Velasco, Irineu Tadeu; Soriano, Francisco Garcia

    2013-01-01

    The effects of hypertonic saline solution (HSS) have been shown in several animal models of ischemia and shock. Literature has shown potential benefits of HSS modulating inflammatory response after sepsis in an animal model. We studied the HSS effects in sepsis through cecal ligation and puncture (CLP) in Balb-C mice. Groups studied: 1- CLP without treatment (CLP-C); 2- CLP treated with normal saline solution NaCl 0.9% – 34 ml/Kg (CLP-S); 3- CLP treated with HSS NaCl 7.5% – 4 ml/Kg (CLP-H); and 4- group (Basal) without no CLP or treatment. Volume infusion was always applied 30 min after CLP. Lung and peritoneal lavage were harvested after 6h and 24h of CLP to analyze cytokines amount, oxide nitric, lipid peroxidation and neutrophil infiltration. Neutrophil infiltration, ICAM-1, CXCR-2, and CXCL-1 in lung were reduced by HSS (CLP-H) compared to CLP-C or CLP-S. Neutrophil in peritoneal lavage was increased in 24h with HSS (CLP-H) compared to CLP and CLP-S. Peritoneal CXCR-2 was increased in CLP-C and CLP-S but presented a lower increase with HSS (CLP-H) after 6 hours. GRK-2 presented difference among the groups at 24 h, showing a profile similar to neutrophil infiltration. Pro-inflammatory cytokines (TNF-α and IL-6) were reduced by HSS treatment; CLP-S increased TNF-α. IL-10 was increased in lung tissue by the HSS treatment. The oxidative stress (TBARS and nitric oxide biochemistry markers) was reduced with HSS. Animal survival was 33.3% in CLP-C group, 46.6% in CLP-S group and 60% in the CLP-H group after the sixth day. The HSS protects the animal against sepsis. Our results suggest that the volume replacement modulate pro and anti-inflammatory mediators of an inflammatory response, but HSS presented a more effective and potent effect. PMID:24069301

  4. Comparison of the Effects of Hegu Point Ice Massage and 2% Lidocaine Gel on Arteriovenous Fistula Puncture-Related Pain in Hemodialysis Patients: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Vajihe Arab

    2017-06-01

    Full Text Available Introduction: There is a paucity of information on the effects of Hegu point ice massage and 2% lidocaine gel on fistula puncture-related pain in hemodialysis patients. The aim of the present research was compare the two methods in terms of their effectiveness. Methods: This study is a randomized controlled trial. Seventy hemodialysis patients were divided into two groups. The fistula puncture-related pain in the two groups was measured in the first session of hemodialysis without any intervention. During a hemodialysis session, 2% lidocaine gel was applied on the patient’s arteriovenous fistula site in one group. Also, for the other group, an ice cube was used to massage on the Hegu point in the hand without fistula in the other hemodialysis session. The pain score was recorded, using the Visual Analogue Scale. The data were analyzed using SPSS ver.13. Results: No significant differences were observed in the mean pain scores of the two groups in the preintervention phase. The comparison of the pain score before and after interventions of the lidocaine gel and ice massage groups was found to bear significant differences. Moreover, the comparison of the mean changes of the pain score before and after the intervention of the Hegu point ice massage groups revealed a further reduction for Hegu point than of lidocaine gel groups. Conclusion: Lidocaine gel and Hegu point ice massage affect the intensity of fistula puncture related pain in hemodialysis patients. Given the higher effectiveness of Hegu point ice massage, this method is recommended to be used for fast and safe pain reduction in hemodialysis patients.

  5. On Teaching the Lack of Simultaneity

    Science.gov (United States)

    Huggins, Elisha R.

    1975-01-01

    Describes a lecture demonstration that has been effective in teaching the concept of the lack of simultaneity in introductory physics courses. The demonstration experiment can be used for studying the relationship between simultaneity and causality and as a conceptual device for analyzing the lack of simultaneity in special relativity thought…

  6. Myelography in achondroplasia: value of a lateral C1-2 puncture and non-ionic, water-soluble contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Suss, R.A.; Udvarhelyi, G.B.; Wang, H.; Kumar, A.J.; Zinreich, S.J.; Rosenbaum, A.E.

    1983-10-01

    Because of technical difficulties and diagnostic limitations encountered with other myelographic techniques in patients with achondroplasia, the authors employed a lateral C1-2 puncture and non-ionic, water-soluble contrast medium in 18 achondroplastic patients with spinal compression (21 procedures). This technique proved most appropriate for identifying the upper limit of degenerative osteophytes causing exacerbation of congenital spinal stenosis, which is crucial in planning decompressive surgery. A potentially important additional finding was the presence of degenerative lower cervical spine disease in the majority of patients. There were no serious complications. The authors recommend this technique as safe and effective in achondroplastic patients with severe congenital spinal stenosis.

  7. Impact of femoral artery puncture using digital subtraction angiography and road mapping on vascular and bleeding complications after transfemoral transcatheter aortic valve implantation.

    Science.gov (United States)

    El-Mawardy, Mohamed; Schwarz, Bettina; Landt, Martin; Sulimov, Dmitriy; Kebernik, Julia; Allali, Abdelhakim; Becker, Bjoern; Toelg, Ralph; Richardt, Gert; Abdel-Wahab, Mohamed

    2017-01-20

    The use of large-diameter sheaths carries the risk of significant vascular and bleeding complications after transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to assess the impact of a modified femoral artery puncture technique using digital subtraction angiography (DSA) and road mapping during transfemoral TAVI on periprocedural vascular and bleeding events. This is a retrospective analysis of transfemoral TAVI patients included in a prospective institutional database. The modified femoral artery puncture technique using DSA-derived road mapping guidance was introduced in October 2012. Before the introduction of this technique, vascular puncture was acquired based on an integration of angiographic data, the bony iliofemoral landmarks and a radiopaque object. Consecutive patients who underwent TAVI with the road mapping technique (RM group, n=160) were compared with consecutive patients who underwent TAVI without road mapping (control group, n=160) prior to its introduction. A standardised strategy of periprocedural anticoagulation was adopted in both groups as well as the use of a single suture-based closure device. All endpoints were defined according to the VARC-2 criteria for event definition. The mean age in the RM group was 80±7.7 years compared to 81±5.9 years in the control group (p=0.19), and females were equally distributed between both groups (63.1% vs. 58.1%, p=0.36). The baseline logistic EuroSCORE was 20.7±14.4% vs. 24.9±15.2% in the RM and control group, respectively (p=0.01). Notably, sheath size was significantly larger in the RM compared to the control group due to the more frequent use of the 20 Fr sheath (23.8% vs. 1.8%, proad map group but did not reach statistical significance (8.1% vs. 13.8%, p=0.1). Other forms of vascular and bleeding complications as well as all-cause mortality were comparable in both groups. A modified femoral artery puncture technique using DSA and road mapping was associated

  8. Simultaneous analysis of uranium and nitrate

    Energy Technology Data Exchange (ETDEWEB)

    Bostick, D.T.

    1978-04-01

    A direct spectrophotometric method has been developed for the determination of 20 to 200 g/l of uranium in the presence of 3 to 5 M nitric acid. A dual-wavelength analysis is used to eliminate the enhancing effect of nitrate ion on the uranium visible spectra. The precision and accuracy of the simultaneous analysis of uranium and nitrate were compared using combinations of the four uranium wavelength maxima, occurring at 426, 416, 403 and 359 nm. Calculations based on 426 and 416 nm data yielded the most accurate results. The calculated relative standard deviation of uranium and nitrate concentrations was 5.4 percent and 15.5 percent, respectively. The photometric procedure is slightly affected by temperature; an increase of one degree centigrade results in a 0.2 g/l overestimation of uranium concentration. Because the method is non-destructive, it is directly applicable to the continuous in-line analysis of dissolved uranium in aqueous fuel reprocessing streams.

  9. Delayed Treatment with Sodium Hydrosulfide Improves Regional Blood Flow and Alleviates Cecal Ligation and Puncture (CLP)-Induced Septic Shock.

    Science.gov (United States)

    Ahmad, Akbar; Druzhyna, Nadiya; Szabo, Csaba

    2016-08-01

    Cecal ligation and puncture (CLP)-induced sepsis is a serious medical condition, caused by a severe systemic infection resulting in a systemic inflammatory response. Recent studies have suggested the therapeutic potential of donors of hydrogen sulfide (H2S), a novel endogenous gasotransmitter and biological mediator in various diseases. The aim of the present study was to assess the effect of H2S supplementation in sepsis, with special reference to its effect on the modulation of regional blood flow. We infused sodium hydrosulfide (NaHS), a compound that produces H2S in aqueous solution (1, 3, or 10 mg/kg/h, for 1 h at each dose level) in control rats or rats 24 h after CLP, and measured blood flow using fluorescent microspheres. In normal control animals, NaHS induced a characteristic redistribution of blood flow, and reduced cardiac, hepatic, and renal blood flow in a dose-dependent fashion. In contrast, in rats subjected to CLP, cardiac, hepatic, and renal blood flow was significantly reduced; infusion of NaHS (1 mg/kg/h and 3 mg/kg/h) significantly increased organ blood flow. In other words, the effect of H2S on regional blood flow is dependent on the status of the animals (i.e., a decrease in blood flow in normal controls, but an increase in blood flow in CLP). We have also evaluated the effect of delayed treatment with NaHS on organ dysfunction and the inflammatory response by treating the animals with NaHS (3 mg/kg) intraperitoneally (i.p.) at 24 h after the start of the CLP procedure; plasma levels of various cytokines and tissue indicators of inflammatory cell infiltration and oxidative stress were measured 6 h later. After 24 h of CLP, glomerular function was significantly impaired, as evidenced by markedly increased (over 4-fold over baseline) blood urea nitrogen and creatinine levels; this increase was also significantly reduced by treatment with NaHS. NaHS also attenuated the CLP-induced increases in malondialdehyde levels (an index of

  10. Simultaneous two-photon excitation of photodynamic therapy agents

    Energy Technology Data Exchange (ETDEWEB)

    Wachter, E.A.; Fisher, W.G. [Oak Ridge National Lab., TN (United States)]|[Photogen, Inc., Knoxville, TN (United States); Partridge, W.P. [Oak Ridge National Lab., TN (United States); Dees, H.C. [Photogen, Inc., Knoxville, TN (United States); Petersen, M.G. [Univ. of Tennessee, Knoxville, TN (United States). College of Veterinary Medicine

    1998-01-01

    The spectroscopic and photochemical properties of several photosensitive compounds are compared using conventional single-photon excitation (SPE) and simultaneous two-photon excitation (TPE). TPE is achieved using a mode-locked titanium:sapphire laser, the near infrared output of which allows direct promotion of non-resonant TPE. Excitation spectra and excited state properties of both type 1 and type 2 photodynamic therapy (PDT) agents are examined.

  11. Interaction and coalescence of multiple simultaneous and non-simultaneous blast waves

    Science.gov (United States)

    Qiu, S.; Eliasson, V.

    2016-05-01

    Interaction of multiple blast waves can be used to direct energy toward a target while simultaneously reducing collateral damage away from the target area. In this paper, simulations of multiple point source explosives were performed and the resulting shock interaction and coalescence behavior were explored. Three to ten munitions were placed concentrically around the target, and conditions at the target area were monitored and compared to those obtained using a single munition. For each simulation, the energy summed over all munitions was kept constant, while the radial distances between target and munitions and the munition initiation times were varied. Each munition was modeled as a point source explosion. The resulting blast wave propagation and shock front coalescence were solved using the inviscid Euler equations of gas dynamics on overlapping grids employing a finite difference scheme. Results show that multiple munitions can be beneficial for creating extreme conditions at the intended target area; over 20 times higher peak pressure is obtained for ten simultaneous munitions compared to a single munition. Moreover, peak pressure at a point away from the target area is reduced by more than a factor of three.

  12. Concepts of Simultaneity From Antiquity to Einstein and beyond

    Energy Technology Data Exchange (ETDEWEB)

    Muller, F A [Dept. of Physics and Astronomy, Institute for the History and Foundations of Science, Utrecht University, Utrecht University P.O Box 80125, 3508 TC Utrecht (Netherlands)

    2007-10-05

    point is that when we replace the messengers by rays of light, we obtain one of Einstein's signalling methods to synchronise distant clocks. The next two chapters (4 and 5) lead us to through the rise of classical physics; the rest of the book (more than a third, 10 chapters) is devoted to the 20th Century and enacts on the stage of Relativity. In the by far longest chapter 7, Jammer traces Einstein's thinking about simultaneity from his epoch-making paper 'Zur Elektrodynamik der bewegten Koerper' (1905), which founded his Special Theory of Relativity, through every of his subsequent writings; this surprisingly reveals various subtle and important differences, such as that Einstein's method of 1911 uses no clocks at all to determine distant simultaneity but only measuring rods. Another thing we learn is that in 1917 Einstein realised that his synchronisation procedure is not an empirical determination of distant simultaneity but a stipulation, or a convention, because it assumes that the speed of light travelling in opposite directions is the same (isotropy of space), and the 'two-way velocity of light' cannot be determined empirically without presupposing that distant simultaneity has been determined antecedently. This conventionality thesis is usually ascribed to the philosopher Hans Reichenbach, who expounded it in his famous Philosophie der Raum-Zeit-Lehre (1928)-Einstein reviewed and admired this book. The conventionality thesis has proved difficult to swallow for many physicists and philosophers alike. Frequently some physicist proposes an experiment supposed to confute the conventionality thesis; but these proposals, no matter how ingenious, never survive scrutiny. Jammer devotes no less than three chapters to the enormous amount of literature on this topic. A seminal result concerning the conventionality thesis is the philosopher David Malament's proof of the theorem that the implicity definability of the simultaneity

  13. Directed homology

    DEFF Research Database (Denmark)

    Fahrenberg, Uli

    2004-01-01

    We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata.......We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata....

  14. Can neural machine translation do simultaneous translation?

    OpenAIRE

    Cho, Kyunghyun; Esipova, Masha

    2016-01-01

    We investigate the potential of attention-based neural machine translation in simultaneous translation. We introduce a novel decoding algorithm, called simultaneous greedy decoding, that allows an existing neural machine translation model to begin translating before a full source sentence is received. This approach is unique from previous works on simultaneous translation in that segmentation and translation are done jointly to maximize the translation quality and that translating each segmen...

  15. Simultaneous bilateral-knee MR imaging.

    Science.gov (United States)

    Kogan, Feliks; Levine, Evan; Chaudhari, Akshay S; Monu, Uchechukwuka D; Epperson, Kevin; Oei, Edwin H G; Gold, Garry E; Hargreaves, Brian A

    2017-12-17

    To demonstrate and evaluate the scan time and quantitative accuracy of simultaneous bilateral-knee imaging compared with single-knee acquisitions. Hardware modifications and safety testing was performed to enable MR imaging with two 16-channel flexible coil arrays. Noise covariance and sensitivity-encoding g-factor maps for the dual-coil-array configuration were computed to evaluate coil cross-talk and noise amplification. Ten healthy volunteers were imaged on a 3T MRI scanner with both dual-coil-array bilateral-knee and single-coil-array single-knee configurations. Two experienced musculoskeletal radiologists compared the relative image quality between blinded image pairs acquired with each configuration. Differences in T 2 relaxation time measurements between dual-coil-array and single-coil-array acquisitions were compared with the standard repeatability of single-coil-array measurements using a Bland-Altman analysis. The mean g-factors for the dual-coil-array configuration were low for accelerations up to 6 in the right-left direction, and minimal cross-talk was observed between the two coil arrays. Image quality ratings of various joint tissues showed no difference in 89% (95% confidence interval: 85-93%) of rated image pairs, with only small differences ("slightly better" or "slightly worse") in image quality observed. The T 2 relaxation time measurements between the dual-coil-array configuration and the single-coil configuration showed similar limits of agreement and concordance correlation coefficients (limits of agreement: -0.93 to 1.99 ms; CCC: 0.97 (95% confidence interval: 0.96-0.98)), to the repeatability of single-coil-array measurements (limits of agreement: -2.07 to 1.96 ms; CCC: 0.97 (95% confidence interval: 0.95-0.98)). A bilateral coil-array setup can image both knees simultaneously in similar scan times as conventional unilateral knee scans, with comparable image quality and quantitative accuracy. This has the potential to improve the value of

  16. Effects of Auditory Information on Self-Motion Perception during Simultaneous Presentation of Visual Shearing Motion

    Directory of Open Access Journals (Sweden)

    Shigehito eTanahashi

    2015-06-01

    Full Text Available Recent studies have found that self-motion perception induced by simultaneous presentation of visual and auditory motion is facilitated when the directions of visual and auditory motion stimuli are identical. They did not, however, examine possible contributions of auditory motion information for determining direction of self-motion perception. To examine this, a visual stimulus projected on a hemisphere screen and an auditory stimulus presented through headphones were presented separately or simultaneously, depending on experimental conditions. The participant continuously indicated the direction and strength of self-motion during the 130-s experimental trial. When the visual stimulus with a horizontal shearing rotation and the auditory stimulus with a horizontal one-directional rotation were presented simultaneously, the duration and strength of self-motion perceived in the opposite direction of the auditory rotation stimulus were significantly longer and stronger than those perceived in the same direction of the auditory rotation stimulus. However, the auditory stimulus alone could not sufficiently induce self-motion perception, and if it did, its direction was not consistent within each experimental trial. We concluded that auditory motion information can determine perceived direction of self-motion during simultaneous presentation of visual and auditory motion information, at least when visual stimuli moved in opposing directions (around the yaw-axis. We speculate that the contribution of auditory information depends on the plausibility and information balance of visual and auditory information.

  17. Effects of auditory information on self-motion perception during simultaneous presentation of visual shearing motion

    Science.gov (United States)

    Tanahashi, Shigehito; Ashihara, Kaoru; Ujike, Hiroyasu

    2015-01-01

    Recent studies have found that self-motion perception induced by simultaneous presentation of visual and auditory motion is facilitated when the directions of visual and auditory motion stimuli are identical. They did not, however, examine possible contributions of auditory motion information for determining direction of self-motion perception. To examine this, a visual stimulus projected on a hemisphere screen and an auditory stimulus presented through headphones were presented separately or simultaneously, depending on experimental conditions. The participant continuously indicated the direction and strength of self-motion during the 130-s experimental trial. When the visual stimulus with a horizontal shearing rotation and the auditory stimulus with a horizontal one-directional rotation were presented simultaneously, the duration and strength of self-motion perceived in the opposite direction of the auditory rotation stimulus were significantly longer and stronger than those perceived in the same direction of the auditory rotation stimulus. However, the auditory stimulus alone could not sufficiently induce self-motion perception, and if it did, its direction was not consistent within each experimental trial. We concluded that auditory motion information can determine perceived direction of self-motion during simultaneous presentation of visual and auditory motion information, at least when visual stimuli moved in opposing directions (around the yaw-axis). We speculate that the contribution of auditory information depends on the plausibility and information balance of visual and auditory information. PMID:26113828

  18. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25G quince, 27G quince and 27G whitacre spinal needles

    International Nuclear Information System (INIS)

    Shaikh, J.M.; Memon, M.; Khan, M.

    2008-01-01

    To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used. (author)

  19. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    of direct democracy mechanisms in specific contexts. These country case studies allow for in depth discussion of particular issues, including signature collection and voter participation, campaign financing, media coverage, national variations in the usage of direct democracy procedures and national lessons...

  20. Simultaneity as an Invariant Equivalence Relation

    Science.gov (United States)

    Mamone-Capria, Marco

    2012-11-01

    This paper deals with the concept of simultaneity in classical and relativistic physics as construed in terms of group-invariant equivalence relations. A full examination of Newton, Galilei and Poincaré invariant equivalence relations in ℝ4 is presented, which provides alternative proofs, additions and occasionally corrections of results in the literature, including Malament's theorem and some of its variants. It is argued that the interpretation of simultaneity as an invariant equivalence relation, although interesting for its own sake, does not cut in the debate concerning the conventionality of simultaneity in special relativity.

  1. Advance Directives

    Science.gov (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma ... about advance directives. Two well-known ones are: Aging With Dignity Aging with Dignity is a national ...

  2. Direct evidence of hybodont shark predation on Late Jurassic ammonites

    Science.gov (United States)

    Vullo, Romain

    2011-06-01

    Sharks are known to have been ammonoid predators, as indicated by analysis of bite marks or coprolite contents. However, body fossil associations attesting to this predator-prey relationship have never been described so far. Here, I report a unique finding from the Late Jurassic of western France: a complete specimen of the Kimmeridgian ammonite Orthaspidoceras bearing one tooth of the hybodont shark Planohybodus. Some possible tooth puncture marks are also observed. This is the first direct evidence of such a trophic link between these two major Mesozoic groups, allowing an accurate identification of both organisms. Although Planohybodus displays a tearing-type dentition generally assumed to have been especially adapted for large unshelled prey, our discovery clearly shows that this shark was also able to attack robust ammonites such as aspidoceratids. The direct evidence presented here provides new insights into the Mesozoic marine ecosystem food webs.

  3. Direct Heat

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.

    1990-01-01

    Potential resources and applications of earth heat in the form of geothermal energy are large. United States direct uses amount to 2,100 MWt thermal and worldwide 8,850 MWt above a reference temperature of 35 degrees Celsius. Space and district heating are the major direct uses of geothermal energy. Equipment employed in direct use projects is of standard manufacture and includes downhole and circulation pumps, transmission and distribution pipelines, heat exchangers and convectors, heat pumps and chillers. Direct uses of earth heat discussed are space and district heating, greenhouse heating and fish farming, process and industrial applications. The economic feasibility of direct use projects is governed by site specific factors such as location of user and resource, resource quality, system load factor and load density, as well as financing. Examples are presented of district heating in Klamath Falls, and Elko. Further developments of direct uses of geothermal energy will depend on matching user needs to the resource, and improving load factors and load density.

  4. Simultaneous invention and the patent law

    DEFF Research Database (Denmark)

    Howells, John; Katznelson, Ron D

    is typical of important pioneer inventions in both survey evidence and alleged illustrative cases of simultaneous invention. We show this in the cases of Edison, the Wright brothers, the Selden automobile patent vis a vis Ford, Watt and the steam engine. We then point out that patent law inherently ensures...... inventions they often find this to challenge the idea that patent law (which rewards only the first inventor with exclusive rights) is needed to encourage invention and innovation. We review the empirical evidence alleged to show that simultaneous invention is prevalent for important inventions. In general...... that patent protection is not extended to near simultaneous inventions. There remain a number of simultaneous inventions discovered through interference proceedings but we find the number too small to mount a serious challenge to the general operation of patent law....

  5. DIRECT KICKS IN BOXING

    Directory of Open Access Journals (Sweden)

    Izet Kahrović

    2009-11-01

    Full Text Available Hit directly, giving any impact maximum muscle strength is skill, and it is neces- sary to the exercise and learning to make it perfect. Training begins with oral statement, so that students get to know with the techni- que that works. After oral exposure, it is necessary to create a good notion on technology that is adopted. The best way for the creation of good notion is a good demonstration. In direct training kicks in the box, you need patience and gradualness and there- fore uses a large number of additional exercises. In their work with beginners, in the first class, individual elements of technology, and also direct blow, it is necessary to separate the parts and run them on multiple commands, to later come to the confluence in one command. Direct wounds, with left and right hand, can be run from the towns, on the head and body, from the movement, to step forward, step back and step aside, the remedy to the left and right side. Left direct is taking out from a running protrusion hands, but kick, which is a pro- duct of the system, ankle-knee-pelvis and shoulder forward horizontaly. Set at the time of stripes, body weight over the left leg. Right direct from the place, starting ekscentrical reflecsive impuls of a extensor muscle in ankle, knee and joint of a hip.This kind of a sud- den movement is running simultaneously with the rotation of the body around vertical (longitudinal axis, with the transfer body weight on the left leg. Further movement to the hand which serves as a lever, which is transmitted through the power stroke

  6. Review on Non-directional Direct Dark Matter Searches

    Science.gov (United States)

    Censier, B.

    2012-02-01

    An overview of non-directional direct detection methods is given. The currently leading experiments for spin independent WIMPs interactions are using simultaneous measurement of two quantities for event-by-event background discrimination in cryogenic bolometers and noble gas like xenon. Besides these, several interesting techniques have been developped, each having a specific advantage concerning e.g. energy threshold lowering or strong immunity to ionizing radiations background. Technologies used and most recent results about spin-dependent and spin-independent cases are presented.

  7. Direct marketing

    Directory of Open Access Journals (Sweden)

    Čičić Muris

    2002-01-01

    Full Text Available Direct Marketing (DM is usually treated as unworthy activity, with actions at the edge of legality and activities minded cheating. Despite obvious problems regarding ethics and privacy threat, DM with its size, importance and role in a concept of integrated marketing communication deserves respect and sufficient analysis and review

  8. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: is it Necessary to Use Local Anesthesia for the Application of One Needle Puncture?

    International Nuclear Information System (INIS)

    Kim, Dong Wook; Rho, Myung Ho; Kim, Ki Nam

    2009-01-01

    This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was

  9. Diminished responsiveness to dobutamine as an inotrope in mice with cecal ligation and puncture-induced sepsis: attribution to phosphodiesterase 4 upregulation.

    Science.gov (United States)

    Sakai, Mari; Suzuki, Tokiko; Tomita, Kengo; Yamashita, Shigeyuki; Palikhe, Sailesh; Hattori, Kohshi; Yoshimura, Naoki; Matsuda, Naoyuki; Hattori, Yuichi

    2017-06-01

    Dobutamine has been used in septic shock for many years as an only inotrope, but its benefit has been questioned. We weighed the effects of dobutamine and milrinone as inotropes in mice with cecal ligation and puncture (CLP)-induced polymicrobial sepsis. CLP-induced septic mice exhibited significant cardiac inflammation, as indicated by greatly increased mRNAs of proinflammatory cytokines and robust infiltration of inflammatory cells in the ventricular myocardium. Elevations of plasma cardiac troponin-I showed cardiac injury in CLP mice. Noninvasive echocardiographic assessment of cardiac function revealed that despite preserved left ventricular function in the presence of fluid replacement, the dobutamine inotropic response was significantly impaired in CLP mice compared with sham-operated controls. By contrast, milrinone exerted inotropic effects in sham-operated and CLP mice in an equally effective manner. Surface expression levels of β 1 -adrenoceptors and α-subunits of three main G protein families in the myocardium were unaffected by CLP-induced sepsis. Plasma cAMP levels were significantly elevated in both sham-operated and CLP mice in response to milrinone but only in sham-operated controls in response to dobutamine. Of phosphodiesterase (PDE) isoforms, PDE4D, but not PDE3A, both of which are responsible for cardiac cAMP hydrolysis, was significantly upregulated in CLP mouse myocardium. We define a novel mechanism for the impaired responsiveness to dobutamine as an inotrope in sepsis, and understanding the role of PDE4D in modulating cardiac functional responsiveness in sepsis may open the potential of a PDE4D-targeted therapeutic option in septic patients with low cardiac output who have a need for inotropic support. NEW & NOTEWORTHY Advisability of the usefulness of dobutamine in septic shock management is limited. Here, we reveal that the effect of dobutamine as a positive inotrope is impaired in mice with cecal ligation and puncture-induced sepsis

  10. Alterations in audiovisual simultaneity perception in amblyopia.

    Science.gov (United States)

    Richards, Michael D; Goltz, Herbert C; Wong, Agnes M F

    2017-01-01

    Amblyopia is a developmental visual impairment that is increasingly recognized to affect higher-level perceptual and multisensory processes. To further investigate the audiovisual (AV) perceptual impairments associated with this condition, we characterized the temporal interval in which asynchronous auditory and visual stimuli are perceived as simultaneous 50% of the time (i.e., the AV simultaneity window). Adults with unilateral amblyopia (n = 17) and visually normal controls (n = 17) judged the simultaneity of a flash and a click presented with both eyes viewing. The signal onset asynchrony (SOA) varied from 0 ms to 450 ms for auditory-lead and visual-lead conditions. A subset of participants with amblyopia (n = 6) was tested monocularly. Compared to the control group, the auditory-lead side of the AV simultaneity window was widened by 48 ms (36%; p = 0.002), whereas that of the visual-lead side was widened by 86 ms (37%; p = 0.02). The overall mean window width was 500 ms, compared to 366 ms among controls (37% wider; p = 0.002). Among participants with amblyopia, the simultaneity window parameters were unchanged by viewing condition, but subgroup analysis revealed differential effects on the parameters by amblyopia severity, etiology, and foveal suppression status. Possible mechanisms to explain these findings include visual temporal uncertainty, interocular perceptual latency asymmetry, and disruption of normal developmental tuning of sensitivity to audiovisual asynchrony.

  11. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    International Nuclear Information System (INIS)

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua; Pfister, Roman; Deppe, Antje-Christin; Matoussevitch, Vladimir

    2014-01-01

    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  12. Direct ELISA.

    Science.gov (United States)

    Lin, Alice V

    2015-01-01

    First described by Engvall and Perlmann, the enzyme-linked immunosorbent assay (ELISA) is a rapid and sensitive method for detection and quantitation of an antigen using an enzyme-labeled antibody. Besides routine laboratory usage, ELISA has been utilized in medical field and food industry as diagnostic and quality control tools. Traditionally performed in 96-well or 384-well polystyrene plates, the technology has expanded to other platforms with increase in automation. Depending on the antigen epitope and availability of specific antibody, there are variations in ELISA setup. The four basic formats are direct, indirect, sandwich, and competitive ELISAs. Direct ELISA is the simplest format requiring an antigen and an enzyme-conjugated antibody specific to the antigen. This chapter describes the individual steps for detection of a plate-bound antigen using a horseradish peroxidase (HRP)-conjugated antibody and luminol-based enhanced chemiluminescence (ECL) substrate. The methodological approach to optimize the assay by chessboard titration is also provided.

  13. Multichannel simultaneous magnetic induction measurement system (MUSIMITOS)

    International Nuclear Information System (INIS)

    Steffen, Matthias; Leonhardt, Steffen; Heimann, Konrad; Bernstein, Nina

    2008-01-01

    Non-contact heart and lung activity monitoring would be a desirable supplement to conventional monitoring techniques. Based on the potential of non-contact magnetic induction measurements, requirements for an adequate monitoring system were estimated. This formed the basis for the development of the presented extendable multichannel simultaneous magnetic induction measurement system (MUSIMITOS). Special focus was given to the dynamic behaviour and simultaneous multichannel measurements, so that the system allows for up to 14 receiver coils working simultaneously at 6 excitation frequencies. Moreover, a real-time software concept for online signal processing visualization in combination with a fast software demodulation is presented. Finally, first steps towards a clinical application are pointed out and technical performance as well as first in vivo measurements are presented. This paper covers some aspects previously presented in Steffen and Leonhardt (2007 Proc. 13th Int. Conf. on Electrical Bioimpedance and the 8th Conf. on Electrical Impedance Tomography, Graz 2007)

  14. Speech Rehabilitation For 10 Alaryngeal Patients Using Tracheoesophageal Puncture And Prosthesis Insertion In Amir Alam And Imam Khomeini Hospitals 2002-2003

    Directory of Open Access Journals (Sweden)

    M.T. Khorsi Ashtiani

    2006-05-01

    Full Text Available Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation. Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003; were included in this study. Prosthesis insertion in 4 patients is primary and in 6 patients is secondary; and all patients are men. Results: The age of patients was between 50 to 70. 90% of patients had history of cigarette smoking and 10% of them had history of drinking alcohol. Salivary leakage was seen in 30% of patients that was improved with conservative management. Fluency of speech in 30% of patients and intelligibility of speech & voice quality in 40% of patients is good. Conclusion: We could conclude that TEP has less complication & better speech results of other vocal rehabilitation methods. Carefully selection of patients & size of prosthesis has important role in results of TEP.

  15. Translocation dynamics of Pu(NO3)4 and PuO2 from puncture wounds to lymph nodes and major organs of beagles

    International Nuclear Information System (INIS)

    Bistline, R.W.; Lebel, J.L.; Dagle, G.E.

    1976-01-01

    The translocation dynamics of plutonium and americium from simulated puncture wounds in the paws of beagle dogs following contamination with Pu(NO 3 ) 4 and high-fired PuO 2 was studied. Fractions of initial implant transported to the first major lymph node and to major body organs were measured with in vivo counting equipment and by radiochemical analysis of tissue material collected at necropsy. Samples were obtained from serial necropsies ranging from 2 weeks to 1 year after implant. The difference in lymph node and organ-accumulation dynamics between the two chemical forms and the effects of diethylenetriaminepentaacetate (DTPA) chelation treatment are presented. Active mechanisms to transport plutonium to and from the lymph system appear to exist. Equations for buildup in the lymph nodes and organs are included. The data suggest a buildup in the lymph node to a maximum, followed by a long negative slope, and a possible dose-rate effect from Pu(NO 3 ) 4 in lymph nodes

  16. Pomegranate protects liver against cecal ligation and puncture-induced oxidative stress and inflammation in rats through TLR4/NF-κB pathway inhibition.

    Science.gov (United States)

    Makled, Mirhan N; El-Awady, Mohammed S; Abdelaziz, Rania R; Atwan, Nadia; Guns, Emma T; Gameil, Nariman M; Shehab El-Din, Ahmed B; Ammar, Elsayed M

    2016-04-01

    Acute liver injury secondary to sepsis is a major challenge in intensive care unit. This study was designed to investigate potential protective effects of pomegranate against sepsis-induced acute liver injury in rats and possible underlying mechanisms. Pomegranate was orally given (800mg/kg/day) for two weeks before sepsis induction by cecal ligation and puncture (CLP). Pomegranate improved survival and attenuated liver inflammatory response, likely related to downregulation of mRNA expression of toll like recptor-4, reduced nuclear translocation and DNA binding activity of proinflammatory transcription factor NF-κB subunit p65, decreased mRNA and protein expression of tumor necrosis factor-alpha and reduction in myeloperoxidase activity and mRNA expression. Pomegranate also decreased CLP-induced oxidative stress as reflected by decreased malondialdehyde content, and increased reduced glutathione level and superoxide dismutase activity. These results confirm the antiinflammatory and antioxidant effects of pomegranate in CLP-induced acute liver injury mediated through inhibiting TLR4/NF-κB pathway, lipid peroxidation and neutrophil infiltration. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Comparison of the efficacy of epidural autologous blood patch in the treatment of spontaneous intracranial hypotension and post-dural puncture headache

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sung Hyun; Lee, Jon Woo; Lee, Geun Young; Lee, Eu Gene; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2014-04-15

    To evaluate and compare the effectiveness of fluoroscopy-guided epidural blood patch (EBP) in patients with post-dural puncture headache (PDPH) and spontaneous intracranial hypotension (SIH). Between August 2012 and September 2013, 16 patients (12 with PDPH, 4 with SIH; 5 males, 11 females; age range 19-58 years, mean age 32.8 years) who underwent EBP in the Department of Radiology were included in this study. Pain relief within three days after EBP was evaluated based on medical record and classified on a 3-level scale: complete relief; incomplete relief; and failure. Recurrence is defined as aggravated postural headache after three days. We evaluated and compared treatment outcome between PDPH and SIH, using Fisher's exact test (considered as significant when p < 0.05). In 12 PDPH patients, the EBP provided complete relief in 5 patients (41.7%), and incomplete relief in 7 patients (58.3%). In 4 SIH patients, the EBP provided complete relief in 1 patient (25%), and incomplete relief in 3 patients (75%). There was no significant difference (p = 0.511) of pain relief rate between PDPH and SIH. There was recurrence in 5 patients with PDPH and 1 patient with SIH. Five PDPH patients were retreated by EBP with incomplete relief. Fluoroscopy-guided EBP provides effective treatment of postural headache for both SIH and PDPH patients.

  18. Comparison of the efficacy of epidural autologous blood patch in the treatment of spontaneous intracranial hypotension and post-dural puncture headache

    International Nuclear Information System (INIS)

    Yoon, Sung Hyun; Lee, Jon Woo; Lee, Geun Young; Lee, Eu Gene; Kang, Heung Sik

    2014-01-01

    To evaluate and compare the effectiveness of fluoroscopy-guided epidural blood patch (EBP) in patients with post-dural puncture headache (PDPH) and spontaneous intracranial hypotension (SIH). Between August 2012 and September 2013, 16 patients (12 with PDPH, 4 with SIH; 5 males, 11 females; age range 19-58 years, mean age 32.8 years) who underwent EBP in the Department of Radiology were included in this study. Pain relief within three days after EBP was evaluated based on medical record and classified on a 3-level scale: complete relief; incomplete relief; and failure. Recurrence is defined as aggravated postural headache after three days. We evaluated and compared treatment outcome between PDPH and SIH, using Fisher's exact test (considered as significant when p < 0.05). In 12 PDPH patients, the EBP provided complete relief in 5 patients (41.7%), and incomplete relief in 7 patients (58.3%). In 4 SIH patients, the EBP provided complete relief in 1 patient (25%), and incomplete relief in 3 patients (75%). There was no significant difference (p = 0.511) of pain relief rate between PDPH and SIH. There was recurrence in 5 patients with PDPH and 1 patient with SIH. Five PDPH patients were retreated by EBP with incomplete relief. Fluoroscopy-guided EBP provides effective treatment of postural headache for both SIH and PDPH patients.

  19. Impact of apoptotic adipose-derived mesenchymal stem cells on attenuating organ damage and reducing mortality in rat sepsis syndrome induced by cecal puncture and ligation.

    Science.gov (United States)

    Chang, Chia-Lo; Leu, Steve; Sung, Hsin-Ching; Zhen, Yen-Yi; Cho, Chung-Lung; Chen, Angela; Tsai, Tzu-Hsien; Chung, Sheng-Ying; Chai, Han-Tan; Sun, Cheuk-Kwan; Yen, Chia-Hung; Yip, Hon-Kan

    2012-12-07

    We tested whether apoptotic adipose-derived mesenchymal stem cells (A-ADMSCs) were superior to healthy (H)-ADMSCs at attenuating organ damage and mortality in sepsis syndrome following cecal ligation and puncture (CLP). Adult male rats were categorized into group 1 (sham control), group 2 (CLP), group 3 [CLP + H-ADMSC administered 0.5, 6, and 18 h after CLP], group 4 [CLP + A-ADMSC administered as per group 3]. Circulating peak TNF-α level, at 6 h, was highest in groups 2 and 3, and higher in group 4 than group 1 (p HO-1, NQO-1) showed an opposite way of Bcl-2; these patterns were reversed for group 4 (all p < 0.001). Mortality was highest in group 3 and higher in group 2 than group 4 than group 1 (all p < 0.001). A-ADMSC therapy protected major organs from damage and improved prognosis in rats with sepsis syndrome.

  20. Actual vs optimal fetal hematocrit measured with punctures of cord blood in utero: Relationship with umbilical artery resistance.

    Science.gov (United States)

    Brun, Jean-Frédéric; Boulot, Pierre; Varlet-Marie, Emmanuelle

    2016-01-01

    Physiological studies on fetal blood in narrow glass tubes have suggested that fetal optimal hematocrit (hct) might be as high as 60%. A theoretical 'ideal' hct can also be predicted with a theoretical curve of hematocrit/viscosity (h/η) ratio vs hct constructed with Quemada's model. We used the database of one of our previous papers on fetal hemorheology to reinterpret its results with this concept. A series of 28 intrauterine cord punctures (between 19 and 33 weeks gestation) with doppler measurements of resistance in umbilical arteries was studied. The theoretical 'optimal hematocrit' was well correlated to actual (r = 0.857, p hematocrit (r = 0.407, p hematocrit, suggesting that the discrepancy between ideal and actual may reflect an adaptative decrease aiming at reducing vascular resistance. These findings indicate that prediction of ideal hematocrit with Quemada's equation makes sense in fetal blood, and suggest that a 'viscoregulatory mechanism' maintains hematocrit below this theoretical value in order to avoid excess vascular resistance.

  1. A novel simultaneous streak and framing camera without principle errors

    Science.gov (United States)

    Jingzhen, L.; Fengshan, S.; Ningwen, L.; Xiangdong, G.; Bin, H.; Qingyang, W.; Hongyi, C.; Yi, C.; Xiaowei, L.

    2018-02-01

    A novel simultaneous streak and framing camera with continuous access, the perfect information of which is far more important for the exact interpretation and precise evaluation of many detonation events and shockwave phenomena, has been developed. The camera with the maximum imaging frequency of 2 × 106 fps and the maximum scanning velocity of 16.3 mm/μs has fine imaging properties which are the eigen resolution of over 40 lp/mm in the temporal direction and over 60 lp/mm in the spatial direction and the framing frequency principle error of zero for framing record, and the maximum time resolving power of 8 ns and the scanning velocity nonuniformity of 0.136%~-0.277% for streak record. The test data have verified the performance of the camera quantitatively. This camera, simultaneously gained frames and streak with parallax-free and identical time base, is characterized by the plane optical system at oblique incidence different from space system, the innovative camera obscura without principle errors, and the high velocity motor driven beryllium-like rotating mirror, made of high strength aluminum alloy with cellular lateral structure. Experiments demonstrate that the camera is very useful and reliable to take high quality pictures of the detonation events.

  2. Simultaneous wireless electrophysiological and neurochemical monitoring

    Science.gov (United States)

    Murari, Kartikeya; Mollazadeh, Mohsen; Thakor, Nitish; Cauwenberghs, Gert

    2008-08-01

    Information processing and propagation in the central nervous system is mostly electrical in nature. At synapses, electrical signals cause the release of neurotransmitters like dopamine, glutamate etc., that are sensed by post-synaptic neurons resulting in signal propagation or inhibition. It can be very informative to monitor electrical and neurochemical signals simultaneously to understand the mechanisms underlying normal or abnormal brain function. We present an integrated system for the simultaneous wireless acquisition of neurophysiological and neurochemical activity. Applications of the system to neuroscience include monitoring EEG and glutamate in rat somatosensory cortex following global ischemia.

  3. Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.

    LENUS (Irish Health Repository)

    Halpenny, Darragh

    2013-06-05

    OBJECTIVES: Failed lumbar puncture (LP) is a common indication for referral for radiologically guided LP. This study aims to evaluate what percentage of the hospital population would fail an LP using a standard 9-cm needle because of obesity and a skin to subarachnoid space distance greater than 9 cm. METHODS: Images of 402 consecutive patients undergoing computed tomography of the abdomen and pelvis were reviewed. Skin to subarachnoid space distance was calculated using sagittal images. A survey was conducted among junior hospital doctors to assess their experience of performing lumbar puncture in obese patients. RESULTS: Four hundred patients were included. Fifty-five patients (13.8 %) had a skin to subarachnoid space distance greater than 9 cm. Intra-abdominal fat, subcutaneous fat and abdominal girth correlated with distance between the skin and subarachnoid space. Among junior doctors, 68.3 % (n = 41) reported LP failure on an obese patient; 78.4 % (n = 47) were unaware of the existence of a longer needle and 13.3 % (n = 8) had experience using a longer needle. CONCLUSIONS: A significant proportion of the hospital population will fail LP with a standard length spinal needle. Selecting a longer needle may be sufficient to successfully complete LP in obese patients. KEY POINTS : • Lumbar puncture failure commonly leads to referral for an image-guided procedure • Standard lumbar puncture may fail in 13.8 % of patients due to obesity • 78.4 % of trainee doctors are unaware of the existence of longer spinal-needles • Using longer spinal needles may allow successful LP in obese patients.

  4. Optimal random perturbations for stochastic approximation using a simultaneous perturbation gradient approximation

    DEFF Research Database (Denmark)

    Sadegh, Payman; Spall, J. C.

    1998-01-01

    The simultaneous perturbation stochastic approximation (SPSA) algorithm has attracted considerable attention for challenging optimization problems where it is difficult or impossible to obtain a direct gradient of the objective (say, loss) function. The approach is based on a highly efficient...... simultaneous perturbation approximation to the gradient based on loss function measurements. SPSA is based on picking a simultaneous perturbation (random) vector in a Monte Carlo fashion as part of generating the approximation to the gradient. This paper derives the optimal distribution for the Monte Carlo...... process. The objective is to minimize the mean square error of the estimate. The authors also consider maximization of the likelihood that the estimate be confined within a bounded symmetric region of the true parameter. The optimal distribution for the components of the simultaneous perturbation vector...

  5. Optimal random perturbations for stochastic approximation using a simultaneous perturbation gradient approximation

    DEFF Research Database (Denmark)

    Sadegh, Payman; Spall, J. C.

    1997-01-01

    The simultaneous perturbation stochastic approximation (SPSA) algorithm has recently attracted considerable attention for optimization problems where it is difficult or impossible to obtain a direct gradient of the objective (say, loss) function. The approach is based on a highly efficient...... simultaneous perturbation approximation to the gradient based on loss function measurements. SPSA is based on picking a simultaneous perturbation (random) vector in a Monte Carlo fashion as part of generating the approximation to the gradient. This paper derives the optimal distribution for the Monte Carlo...... process. The objective is to minimize the mean square error of the estimate. We also consider maximization of the likelihood that the estimate be confined within a bounded symmetric region of the true parameter. The optimal distribution for the components of the simultaneous perturbation vector is found...

  6. Simultaneous determination of naproxen, ibuprofen and diclofenac ...

    African Journals Online (AJOL)

    Simultaneous determination of naproxen, ibuprofen and diclofenac in wastewater using solid-phase extraction with high performance liquid chromatography. ... The instrument quantification limits obtained were 0.1 μg·L-1, for naproxen and 0.4 μg·L-1 for both ibuprofen and diclofenac. The detected concentrations for ...

  7. Optimization of bioethanol production from simultaneous ...

    African Journals Online (AJOL)

    In this study, bioethanol production from the simultaneous saccharification and fermentation (SSF) of pineapple peels using cellulase and Saccharomyces cerevisiae was investigated. A three-factor Box-behnken design (BBD) and response surface methodology (RSM) were employed to study the effect of broth pH (2-6), ...

  8. Scaling in ANOVA-simultaneous component analysis

    NARCIS (Netherlands)

    Timmerman, M.E; Hoefsloot, H.C.J.; Smilde, A.K.; Ceulemans, E.

    2015-01-01

    In omics research often high-dimensional data is collected according to an experimental design. Typically, the manipulations involved yield differential effects on subsets of variables. An effective approach to identify those effects is ANOVA-simultaneous component analysis (ASCA), which combines

  9. influence of simultaneous infestations of prostephanus truncatus ...

    African Journals Online (AJOL)

    significant differences in the percentage change of adult insect numbers between single and simultaneous infestations at P< 0.01. Further, the grain ... complete development over a wide range of temperatures, 270C to 320C and between ... Aging, sexing and conditioning P. truncatus and S. zeamais. Adults were removed ...

  10. Simultaneous estimation of earthquake source parameters and ...

    Indian Academy of Sciences (India)

    stress drop values are quite large compared to the other similar size Indian intraplate earthquakes, which can be attributed ... Earthquake source parameters; crustal Q-value; simultaneous inversion; S-wave spectra; aftershocks. J. Earth Syst. Sci. ...... 28 1339–1342. Lee W H K and Valdes C M 1985 HYP071PC: A personal.

  11. Simultaneous Visual Discrimination in Asian Elephants

    Science.gov (United States)

    Nissani, Moti; Hoefler-Nissani, Donna; Lay, U. Tin; Htun, U. Wan

    2005-01-01

    Two experiments explored the behavior of 20 Asian elephants ("Elephas aximus") in simultaneous visual discrimination tasks. In Experiment 1, 7 Burmese logging elephants acquired a white+/black- discrimination, reaching criterion in a mean of 2.6 sessions and 117 discrete trials, whereas 4 elephants acquired a black+/white- discrimination in 5.3…

  12. Simultaneous Multi-Element Electrothermal Atomic Absorption ...

    African Journals Online (AJOL)

    NICO

    Simultaneous Multi-Element Electrothermal Atomic. Absorption Determination Using a Low Resolution CCD. Spectrometer and Continuum Light Source: The Concept and Methodology. Dimitri A. Katskov* and G. Eunice Khanye. Department of Chemistry and Physics, Tshwane University of Technology, Pretoria, 0001 South ...

  13. Reproductive strategies of a simultaneous hermaphrodite

    NARCIS (Netherlands)

    Nakadera, Y.

    2014-01-01

    Reproductive strategies in a simultaneous hermaphrodite All the extant organisms are the consequence of reproduction by ancestors. This fact naturally invokes the urge to know how organisms managed to reproduce. Therefore, I studied reproductive strategy, which is defined as a set of (behavioural,

  14. Simultaneous Quantification of Paracetamol and Meloxicam in ...

    African Journals Online (AJOL)

    Purpose: To develop and validate a simple, rapid and inexpensive RP-HPLC method for the simultaneous estimation of paracetamol and meloxicam in tablets. Methods: For the analysis of the drugs, chromatographic analysis was performed on XTerra symmetry C18 column (100 × 4.6 mm, 5 μ particle size) with mobile ...

  15. Simultaneous Estimation of Sitagliptin and Metformin in ...

    African Journals Online (AJOL)

    A rapid, simple, specific and precise high-performance thin-layer chromatography (HPTLC) method was developed for the simultaneous estimation of sitagliptin (STG) and metformin (MET) content in a fixed dose pharmaceutical formulation and also in bulk drug. In the developed method, aluminium backed silica gel 60 ...

  16. Simultaneous approximation in scales of Banach spaces

    International Nuclear Information System (INIS)

    Bramble, J.H.; Scott, R.

    1978-01-01

    The problem of verifying optimal approximation simultaneously in different norms in a Banach scale is reduced to verification of optimal approximation in the highest order norm. The basic tool used is the Banach space interpolation method developed by Lions and Peetre. Applications are given to several problems arising in the theory of finite element methods

  17. Simultaneous determination of isoniazid and pyrazinamide in ...

    African Journals Online (AJOL)

    Purpose: To develop and validate a new high performance liquid chromatographic (HPLC) method for the simultaneous determination of isoniazid (INH) and pyrazinamide (PZA) in plasma. Methods: A 150 μL aliquot of plasma was mixed with 75 μL of 10 % trichloroacetic acid containing 100 mg/L of acetanilide as the ...

  18. Simultaneous Determination of Mutagenicity and Toxicity of ...

    African Journals Online (AJOL)

    A demonstration of cytotoxicity is required (measurement of cell number, culture confluency and inhibition of mitotic index) for in vitro cytogenetic assays. The study therefore investigated whether delayed cytotoxicity can be used to simultaneously predict mutagenicity and cytotoxicty. Chinese hamster lung cells were ...

  19. Simultaneous Quantification of Paracetamol and Meloxicam in ...

    African Journals Online (AJOL)

    Erah

    Purpose: To develop and validate a simple, rapid and inexpensive RP-HPLC method for the simultaneous estimation of paracetamol and meloxicam in tablets. Methods: For the analysis of the drugs, chromatographic analysis was performed on XTerra symmetry. C18 column (100 × 4.6 mm, 5 µ particle size) with mobile ...

  20. Simultaneous Determination of Seven Constituents in Herbal ...

    African Journals Online (AJOL)

    Simultaneous Determination of Seven Constituents in Herbal Prescription Jaeumganghwa-Tang Using HPLC-PDA. CS Seo, JH Kim, HK Shin. Abstract. A simple and accurate high-performance liquid chromatographic method was applied to the quantitative analysis of seven components of the traditional herbal prescription ...