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. Direct right ventricular puncture for hemodynamic evaluation of a mechanical tricuspid valve prosthesis: a new indication for an old procedure.

    Science.gov (United States)

    Gibson, M A; Carell, E S

    1997-11-01

    The advent of transvenous right heart catheterization has relegated direct transthoracic right ventricular puncture largely to the role of "interesting historical footnote." However, in the case of a right ventricle that is "protected" by a mechanical tricuspid valve prosthesis, direct right ventricular puncture represents a reasonable alternative for obtaining accurate hemodynamic information.

  4. Clinical observation of Ahmed glaucoma valve implantation for refractory glaucoma by directly puncturing the sclerotic tunnel

    Directory of Open Access Journals (Sweden)

    Zhi-Ke Xu

    2015-02-01

    Full Text Available AIM: To observe the clinic effects and complication of Ahmed glaucoma valve(AGVimplantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases(44 eyesof refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure(IOP, visual acuity, and complication of post-operation were contrasted with those of pre-operation. RESULTS:The success rate was 84.1%, the mean preoperative IOP in research group was 52.1±10.1mmHg, and the last follow up mean IOP was 15.6±6.9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber(4 eyes, choroidal detachment(3 eyes, drainage tube shift(1 eye, hyphema(6 eyes, drainage tube blockage(1 eye, expulsive choroidal hemorrhage(1 eye, and fiber wrap of drainage tray(5 eyes.CONCLUSION: AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. It avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. It is an effective procedure for refractory glaucoma.

  5. Juvenile nasopharyngeal angiofibroma with skull base invasion : intratumoral direct puncture embolization

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hye Young; Kim, Sun Yong; Suh, Jung Ho; Park, Kee Hyun [Ajou Univ., Suwon (Korea, Republic of). Coll. of Medicine

    1998-04-01

    The purpose of this study is to demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenile nasopharyngeal angiofibromas with skull base invasion. In nine cases of juvenile nasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed. Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. A glue-lipiodol mixture (1:1 -1:3) was injected slowly for 15 to 30 seconds under fluoroscopic control; the number of post-embolization angiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgically removed 3 to 7 days after embolization. Direct glue embolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. The technique could be used for other hypervascular lesions in the base of the skull or parapharyngeal space. (author). 19 refs., 1 tab., 2 figs.

  6. Juvenile nasopharyngeal angiofibroma with skull base invasion : intratumoral direct puncture embolization

    International Nuclear Information System (INIS)

    Shin, Hye Young; Kim, Sun Yong; Suh, Jung Ho; Park, Kee Hyun

    1998-01-01

    The purpose of this study is to demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenile nasopharyngeal angiofibromas with skull base invasion. In nine cases of juvenile nasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed. Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. A glue-lipiodol mixture (1:1 -1:3) was injected slowly for 15 to 30 seconds under fluoroscopic control; the number of post-embolization angiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgically removed 3 to 7 days after embolization. Direct glue embolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. The technique could be used for other hypervascular lesions in the base of the skull or parapharyngeal space. (author). 19 refs., 1 tab., 2 figs

  7. 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 %)

  8. Experimental study on venography with carbon dioxide by fine-needle direct-puncture of abdominal viscera

    International Nuclear Information System (INIS)

    Zhu Chi; Xu Changliang; Zhang Dezhi; Zheng Feiqun; Sheng Qiang; Zhang Xiuze; Xiong Zhuang; Yu Yongqiang

    2005-01-01

    Objective: To evaluate the feasibility and safety of CO 2 venography by fine-needle direct-puncture of abdominal viscera. Methods: Two healthy female pigs and two healthy female dogs were used in this study. Multi-point punctures of abdominal viscera including liver, spleen, kidney, pancreas, walls of small intestines, and uterus with 25-gauge needle were performed for CO 2 venography in all animals. Diagnostic image quality of the angiographic images was assessed by 3 independent observers. Results: Splenic-portal vein, hepatic vein, portal vein, renal vein and inferior vena cava, uterine vein and ovarian vein could be visualized by fine needle direct CO 2 injection into the related organic parenchyma, while draining vein of small intestines and pancreas could not be shown. Splenic-portal veins were revealed especially well with grade A of 87.5% (7/8) , grade B of 12.5% (1/8), and grade C of 0%. The image quality of hepatic veins were 81.8% (9/11), 18.2% (2/11), and 0% for grade A, B, and C, respectively. The portal veins were 77.8% (7/9), 22.2%(2/9), and 0% for grade A, B, and C, respectively. The renal vein and inferior vena cava were 38.5% (5/13), 61.5% (8/13), and 0% for grade A, B, and C respectively. The uterine veins and ovarian veins were 0%, 33.3% (2/6), and 66.7% (4/6) for grade A, B, and C, respectively. During the CO 2 angiographic procedure, vital signs remained stable in all animals. Conclusion: CO 2 venography with fine-needle direct-puncture of abdominal viscera, excluding small intestines and pancreas, is feasible and safe. (authors)

  9. In vitro bacterial cytotoxicity of CNTs: reactive oxygen species mediate cell damage edges over direct physical puncturing.

    Science.gov (United States)

    Rajavel, Krishnamoorthy; Gomathi, Rajkumar; Manian, Sellamuthu; Rajendra Kumar, Ramasamy Thangavelu

    2014-01-21

    Understanding the bacterial cytotoxicity of CNTs is important for a wide variety of applications in the biomedical, environmental, and health sectors. A majority of the earlier reports attributed the bactericidal cytotoxicity of CNTs to bacterial cell membrane damage by direct physical puncturing. Our results reveal that bacterial cell death via bacterial cell membrane damage is induced by reactive oxygen species (ROS) produced from CNTs and is not due to direct physical puncturing by CNTs. To understand the actual mechanism of bacterial killing, we elucidated the bacterial cytotoxicity of SWCNTs and MWCNTs against Gram-negative human pathogenic bacterial species Escherichia coli, Shigella sonnei, Klebsiella pneumoniae, and Pseudomonas aeruginosa and its amelioration upon functionalizing the CNTs with antioxidant tannic acid (TA). Interestingly, the bacterial cells treated with CNTs exhibited severe cell damage under laboratory (ambient) and sunlight irradiation conditions. However, CNTs showed no cytotoxicity to the bacterial cells when incubated in the dark. The quantitative assessments carried out by us made it explicit that CNTs are effective generators of ROS such as (1)O2, O2(•-), and (•)OH in an aqueous medium under both ambient and sunlight-irradiated conditions. Both naked and TA-functionalized CNTs showed negligible ROS production in the dark. Furthermore, strong correlations were obtained between ROS produced by CNTs and the bacterial cell mortality (with the correlation coefficient varying between 0.7618 and 0.9891) for all four tested pathogens. The absence of bactericidal cytotoxicity in both naked and functionalized CNTs in the dark reveals that the presence of ROS is the major factor responsible for the bactericidal action compared to direct physical puncturing. This understanding of the bactericidal activity of the irradiated CNTs, mediated through the generation of ROS, could be interesting for novel applications such as regulated ROS delivery

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Direct-puncture approach to the extraconal portion of the superior ophthalmic vein for carotid cavernous fistulae

    International Nuclear Information System (INIS)

    Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K.; Kan, S.

    2009-01-01

    The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)

  15. Direct analysis of radionuclides-96 samples simultaneously

    International Nuclear Information System (INIS)

    Kessler, M.J.

    1991-01-01

    Recently, there has been a tremendous interest in two areas of concern in nuclear counting and radioactivity waste disposal. The first is the reduction of radioactive waste, in particular the reduction in the amount of or the development of environmentally safe scintillation cocktails. The second is the development of a simple method of quantitating large numbers of samples (thousands/day) in a short period of time (minutes). These two areas of concern have been addressed with the development of the Matrix 96 direct beta counter. This new instrumental technique is capable of quantitating 96 samples simultaneously in the microplate format (8 x 12, 96 sample) on a solid support WITHOUT the use of any cocktails, vials, and is non-destructive to the sample. The use of this technique for the following biomedical applications, DNA dot blots, cell proliferation (3H thymidine), receptor binding, chromium cytotoxicity assays, and protein assays will be discussed in detail. The data from both the conventional beta and gamma counter will be correlated and compared to the new Matrix 96 direct beta counter. This new technique provides a convenient method of addressing the concerns of reducing radioactive waste and provides a method of quantitating a large number of samples, accurately in a short period of time (96 at a time)

  16. Use of the direct puncture technique in management of capillaro-venous malformations: case report

    Directory of Open Access Journals (Sweden)

    Tyagi Isha

    2002-03-01

    Full Text Available Abstract Background Preoperative devascularization of the capillaro-venous malformations located in the aero-digestive tract is important for surgeons, to minimize blood loss during surgical excision of malformations. Case presentation Here we present two cases of capillaro-venous malformation in which we could successfully achieve preoperative devascularization, by directly injecting n-butyl cyano acrylate into the capillaro-venous bed. This technique is relatively easy, safe and cheap, and can be carried out immediately before surgery.

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

    International Nuclear Information System (INIS)

    Chan, Gabriel; Quek, Lawrence Hwee Han; Tan, Glenn Leong Wei; Pua, Uei

    2016-01-01

    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.

  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. CT-guided puncture

    International Nuclear Information System (INIS)

    Noeldge, G.; Richter, G.M.; Grenacher, L.; Brado, M.; Kauffmann, G.W.

    1996-01-01

    Sonographic and CT-guided punctures allow the evaluation of suspected lesions in the head, thorax, abdomen, retroperitoneum and skeletal system. The size of the lesion to be evaluated determines the size and the diameter of the puncture needle. The quantity of the material obtained will be defined by the diameter of the needle, i.e. fine-needle biopsy is more adequate for cytological than for histological evaluation. Strict adherence to the indications and contraindications for puncture and painstaking performance of the procedure go a long why towards minimizing the complications. The advantage of CT-guided puncture, in contrast to an ultrasound-guided procedure, is visualization during the puncture procedure free from overshadowing. This permits punctures of lesions located deep in the thorax or the abdomen which are overshadowed by the lungs, by air in the small or large bowel or by bone structures. Moreover, this technique yields much more information about the tissues and organs surrounding the suspected lesion. This information is much more investigator-related with ultrasoundguided puncture. Therefore, the CT-guided puncture has become mandatory in the evaluation of suspected lesions. Moreover, using the same technique, percutaneous drainage of fluids in the interpleural space, abscesses in organs, hematomas, lymphoceles and urinomas; ablation of metastases; and sympathicolysis can be carried out. CT-guided puncture thus changes from a minimally invasive diagnostic procedure to a minimally invasive therapy. (orig./MG) [de

  20. 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.

  1. 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.

  2. 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

  3. Direct stent puncture technique for intraluminal stent recanalization in the superficial femoral and popliteal arteries in-stent occlusion: Outcomes from a prospective clinical analysis of diabetics with critical limb ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Palena, Luis Mariano, E-mail: marianopalena@hotmail.com; Manzi, Marco

    2013-07-15

    Purpose: To evaluate the efficacy and safety of “Direct Stent Puncture” technique for intraluminal stent recanalization in the femoro-popliteal segments. Methods and Materials: A cohort of diabetics who had symptomatic in-stent occlusion of the superficial femoral or popliteal arteries underwent endovascular recanalization. After antegrade failure, direct stent puncture technique was performed. The primary end-point was to efficacy assessment, intended as technical success and clinical improvement. The secondary end-point was safety assessment, intended as free of complication rate. Results: Fifty-four patients (37 men; 73.6 ± 8.5 years) underwent direct stent puncture technique, after several unsuccessful antegrade attempts to cross the occluded stent. Technical success for intraluminal stent recanalization was achieved in 53/54 (98.2%) of cases and failed in 1/54 (1.8%). Clinical improvement was obtained in 51/54 (94.4%) of cases, with regression of the clinical symptoms and improvement of the TcPO{sub 2}, from 3 ± 18 mmHg to 43 ± 11 mmHg after 15 days (p < 0.001). Free of complications rate was 92.5%. In 2/54 (3.7%) of cases distal embolization occurred, in 1/54 (1.9%) case a sudden vessel thrombosis was diagnosed after 12 hours and in 1/54 (1.9%) case hematoma at the stent puncture site was observed. Conclusions: Direct Stent Puncture technique is an efficacy and safety option for intraluminal stent recanalization in the femoro-popliteal segment in-stent occlusion.

  4. Puncture Wounds: First Aid

    Science.gov (United States)

    ... Skin problems. In: American Medical Association Handbook of First Aid and Emergency Care. New York, N.Y.: Random House; 2009. Jan. 12, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-puncture-wounds/basics/ART-20056665 . Mayo ...

  5. A New Navigation System of Renal Puncture for Endoscopic Combined Intrarenal Surgery: Real-time Virtual Sonography-guided Renal Access.

    Science.gov (United States)

    Hamamoto, Shuzo; Unno, Rei; Taguchi, Kazumi; Ando, Ryosuke; Hamakawa, Takashi; Naiki, Taku; Okada, Shinsuke; Inoue, Takaaki; Okada, Atsushi; Kohri, Kenjiro; Yasui, Takahiro

    2017-11-01

    To evaluate the clinical utility of a new navigation technique for percutaneous renal puncture using real-time virtual sonography (RVS) during endoscopic combined intrarenal surgery. Thirty consecutive patients who underwent endoscopic combined intrarenal surgery for renal calculi, between April 2014 and July 2015, were divided into the RVS-guided puncture (RVS; n = 15) group and the ultrasonography-guided puncture (US; n = 15) group. In the RVS group, renal puncture was repeated until precise piercing of a papilla was achieved under direct endoscopic vision, using the RVS system to synchronize the real-time US image with the preoperative computed tomography image. In the US group, renal puncture was performed under US guidance only. In both groups, 2 urologists worked simultaneously to fragment the renal calculi after inserting the miniature percutaneous tract. The mean sizes of the renal calculi in the RVS and the US group were 33.5 and 30.5 mm, respectively. A lower mean number of puncture attempts until renal access through the calyx was needed for the RVS compared with the US group (1.6 vs 3.4 times, respectively; P = .001). The RVS group had a lower mean postoperative hemoglobin decrease (0.93 vs 1.39 g/dL, respectively; P = .04), but with no between-group differences with regard to operative time, tubeless rate, and stone-free rate. None of the patients in the RVS group experienced postoperative complications of a Clavien score ≥2, with 3 patients experiencing such complications in the US group. RVS-guided renal puncture was effective, with a lower incidence of bleeding-related complications compared with US-guided puncture. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. 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

  7. The Tension and Puncture Properties of HDPE Geomembrane under the Corrosion of Leachate.

    Science.gov (United States)

    Xue, Qiang; Zhang, Qian; Li, Zhen-Ze; Xiao, Kai

    2013-09-17

    To investigate the gradual failure of high-density polyethylene (HDPE) geomembrane as a result of long-term corrosion, four dynamic corrosion tests were conducted at different temperatures and durations. By combining tension and puncture tests, we systematically studied the variation law of tension and puncture properties of the HDPE geomembrane under different corrosion conditions. Results showed that tension and puncture failure of the HDPE geomembrane was progressive, and tensile strength in the longitudinal grain direction was evidently better than that in the transverse direction. Punctures appeared shortly after puncture force reached the puncture strength. The tensile strength of geomembrane was in inversely proportional to the corrosion time, and the impact of corrosion was more obvious in the longitudinal direction than transverse direction. As corrosion time increased, puncture strength decreased and corresponding deformation increased. As with corrosion time, the increase of corrosion temperature induced the decrease of geomembrane tensile strength. Tensile and puncture strength were extremely sensitive to temperature. Overall, residual strength had a negative correlation with corrosion time or temperature. Elongation variation increased initially and then decreased with the increase in temperature. However, it did not show significant law with corrosion time. The reduction in puncture strength and the increase in puncture deformation had positive correlations with corrosion time or temperature. The geomembrane softened under corrosion condition. The conclusion may be applicable to the proper designing of the HDPE geomembrane in landfill barrier system.

  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. 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.)

  10. 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

  11. 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

  12. Lateral cervical puncture for cervical myelography

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Hae Young; Cha, Sang Hoon; Kim, Yoon Hwan; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1985-12-15

    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.

  13. Secondary tracheoesophageal puncture in-office using Seldinger technique.

    Science.gov (United States)

    Britt, Christopher J; Lippert, Dylan; Kammer, Rachael; Ford, Charles N; Dailey, Seth H; McCulloch, Timothy; Hartig, Gregory

    2014-05-01

    Evaluate the safety and efficacy of in-office secondary tracheoesophageal puncture (TEP) technique using transnasal esophagoscopy (TNE) and the Seldinger technique in conjunction with a cricothyroidotomy kit for placement. Case series with chart review. Academic medical center. A retrospective chart review was performed on 83 subjects who underwent in-office secondary TEP. Variables that were examined included disease site, staging, histologic diagnosis, extent of resection and reconstruction, chemoradiation, functional voice status (as assessed by speech pathologist in most recent note), and complications directly related to the procedure. Eighty-three individuals from our institution met our criteria for in-office secondary TEP from 2005 to August 2012. Of these, 97.6% (81/83) had no complications of TEP. The overall complication rate was 2.4% (2/83). Complications included bleeding from puncture site and closure of puncture site after dislodgement of prosthesis at the time of puncture. Fluent conversational speech was achieved in 69.9% of all patients (58/83), and an additional 19.3% (16/83) achieved functional/intelligible speech; of those, 3.6% (3/83) were unable to achieve fluent conversational speech due to anatomic defects from previous surgery. An in-office TEP can be safely performed using the Seldinger technique with direct visualization using TNE, despite the extent of resection or reconstruction, with functional speech outcomes comparable to other studies available in the literature.

  14. 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...

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

    International Nuclear Information System (INIS)

    Leswick, D.A.; Szkup, P.; Stoneham, G.W.

    2005-01-01

    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)

  16. 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.

  17. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy

    International Nuclear Information System (INIS)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-01-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct

  18. Technical Note: Thoracic duct embolization for treatment of chylothorax: A novel guidance technique for puncture using combined MRI and fluoroscopy.

    Science.gov (United States)

    Praveen, Alampath; Sreekumar, Karumathil Pullara; Nazar, Puthukudiyil Kader; Moorthy, Srikanth

    2012-04-01

    Thoracic duct embolization (TDE) is an established radiological interventional procedure for thoracic duct injuries. Traditionally, it is done under fluoroscopic guidance after opacifying the thoracic duct with bipedal lymphangiography. We describe our experience in usinga heavily T2W sequence for guiding thoracic duct puncture and direct injection of glue through the puncture needle without cannulating the duct.

  19. Simultaneous column chromatographic extraction and purification of abscisic acid in peanut plants for direct HPLC analysis.

    Science.gov (United States)

    Zhang, Ya-Wen; Fan, Wei-Wei; Li, Hui; Ni, He; Han, Han-Bing; Li, Hai-Hang

    2015-10-01

    Abscisic acid (ABA), a universal signaling molecule, plays important roles in regulating plant growth, development and stress responses. The low contents and complex components in plants make it difficult to be accurately analyzed. A novel one-step sample preparation method for ABA in plants was developed. Fresh peanut (Arachis hypogaea) plant materials were fixed by oven-drying, microwave drying, boiling or Carnoy's fixative, and loaded onto a mini-preparing column. After washed the impurities, ABA was eluted with a small amount of solvent. ABA in plant materials was completely extracted and purified in 2mL solution and directly analyzed by HPLC, with a 99.3% recovery rate. Multiple samples can be simultaneously prepared. Analyses using this method indicated that the endogenous ABA in oven-dried peanut leaves increased 20.2-fold from 1.01 to 20.37μgg(-1) dry weight within 12h and then decreased in 30% polyethylene glycol 6000 treated plants, and increased 3.34-fold from 0.85 to 2.84μgg(-1) dry weight in 5 days and then decreased in soil drought treated plants. The method combined the column chromatographic extraction and solid-phase separation technologies in one step and can completely extracted plant endogenous ABA in a purified and highly concentrated form for direct HPLC analysis. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. 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.

  1. Ultrasound assisted simultaneous reduction and direct functionalization of graphene oxide with thermal and cytotoxicity profile.

    Science.gov (United States)

    Maktedar, Shrikant S; Avashthi, Gopal; Singh, Man

    2017-01-01

    The new sonochemical approach for simultaneous reduction and direct functionalization of graphene oxide (GrO) has been developed. The GrO was functionalized with 2-Aminobenzoxazole (2-ABOZ) in twenty min with complete deletion of hazardous steps. The significance of ultrasound was exemplified with the comparative conventional methods. The newly prepared f-(2-ABOZ)GrO was extensively characterized with near edge X-ray absorption fine structure (NEXAFS) spectroscopy, 13 C solid state NMR, XPS, XRD, HRTEM, SAED, AFM, Raman, UV-vis, FTIR and TGA. The thermal stability of f-(2-ABOZ)GrO was confirmed with total percentage weight loss in TGA. The biological activity of f-(2-ABOZ)GrO was explored with MCF-7 and Vero cell lines. The inherent cytotoxicity was evaluated with SRB assay at 10, 20, 40 and 80μgmL -1 . The estimated cell viabilities were >78% with f-(2-ABOZ) GrO. A high cytocompatibility of f-(2-ABOZ)GrO was ensured with in vitro evaluation on living cell lines, and low toxicity of f-(2-ABOZ)GrO was confirmed its excellent biocompatibility. The morphological effect on Vero cell line evidently supports the formation of biocompatible f-(2-ABOZ)GrO. Therefore, f-(2-ABOZ)GrO was emerged as an advanced functional material for thermally stable biocompatible coatings. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Unilateral transpedicular percutaneous vertebroplasty using puncture simulation

    International Nuclear Information System (INIS)

    Kobayashi, Ken; Takizawa, Kenji; Koyama, Masamichi; Yoshimatsu, Misako; Sakaino, Shinjiro; Nakajima, Yasuo

    2006-01-01

    The aim of this study was to improve the accuracy of puncture to the median vertebral body using the unilateral transpedicular approach on percutaneous vertebroplasty (PVP). We have developed and evaluated a simple puncture simulation method based on the puncture angle determined by preoperative computed tomography (CT). Two groups were evaluated. The first (group A) comprised 23 patients (34 vertebral bodies) who had undergone PYP without preoperative puncture simulation before May 2004, and the second group (group B) comprised 24 patients (39 vertebral bodies) who had undergone preoperative puncture simulation and PVP after May 2004. CT in the prone position was performed, and the puncture angle on CT (PAC) via the vertebral arch pedicle targeting the anterior one-third median site of the vertebral body was determined. Puncture was performed by targeting the isocenter established on a fluoroscopic monitor based on the PAC. Determinations were made of the success rate (SR) of the median puncture of the vertebral body, the effect of treatment using the visual analogue score, and the overall procedural time between groups A and B. The SR was 56% (19/34 vertebral bodies) in group A, and 97% (37/38 vertebral bodies), including only one vertebral body in which it was difficult to perform the unilateral approach on CT images, in group B, with the difference being significant by Student's t-test (P<0.001). Among patients with available follow-up data, the unipedicular and bipedicular approaches achieved adequate pain relief with mean decreases in pain severity of 5.1±2.6 and 5.9±2.8 respectively. No significant differences in the treatment effect between the two groups was observed (P=0.811). The overall procedure time per puncture was shorten for the simulation group (36.0 min) than for group A (73.1 min), as shown by regression analysis. The preoperative PAC determination for PVP under fluoroscopy increased the completion rate of PVP by the unilateral transpedicular

  3. 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

  4. 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...... to whether the design of the videos impacts on subsequent performance. Objective: To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP). Design: 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...

  5. Higher-dimensional puncture initial data

    International Nuclear Information System (INIS)

    Zilhao, Miguel; Ansorg, Marcus; Cardoso, Vitor; Gualtieri, Leonardo; Herdeiro, Carlos; Sperhake, Ulrich; Witek, Helvi

    2011-01-01

    We calculate puncture initial data, corresponding to single and binary black holes with linear momenta, which solve the constraint equations of D-dimensional vacuum gravity. The data are generated by a modification of the pseudospectral code presented in [M. Ansorg, B. Bruegmann, and W. Tichy, Phys. Rev. D 70, 064011 (2004).] and made available as the TwoPunctures thorn inside the Cactus computational toolkit. As examples, we exhibit convergence plots, the violation of the Hamiltonian constraint as well as the initial data for D=4,5,6,7. These initial data are the starting point to perform high-energy collisions of black holes in D dimensions.

  6. 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  Direct calorimetry and indirect calorimetry gave similar estimates of energy expenditure. Energy expenditure was 10% lower in the prone position than in the supine position. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. 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)

  8. 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.

  9. 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.

  10. Direct liquid chromatography method for the simultaneous quantification of hydroxytyrosol and tyrosol in red wines.

    Science.gov (United States)

    Piñeiro, Zulema; Cantos-Villar, Emma; Palma, Miguel; Puertas, Belen

    2011-11-09

    A validated HPLC method with fluorescence detection for the simultaneous quantification of hydroxytyrosol and tyrosol in red wines is described. Detection conditions for both compounds were optimized (excitation at 279 and 278 and emission at 631 and 598 nm for hydroxytyrosol and tyrosol, respectively). The validation of the analytical method was based on selectivity, linearity, robustness, detection and quantification limits, repeatability, and recovery. The detection and quantification limits in red wines were set at 0.023 and 0.076 mg L(-1) for hydroxytyrosol and at 0.007 and 0.024 mg L(-1) for tyrosol determination, respectively. Precision values, both within-day and between-day (n = 5), remained below 3% for both compounds. In addition, a fractional factorial experimental design was developed to analyze the influence of six different conditions on analysis. The final optimized HPLC-fluorescence method allowed the analysis of 30 nonpretreated Spanish red wines to evaluate their hydroxytyrosol and tyrosol contents.

  11. Direct determination of free thyroxine in two simultaneous radioimmunoassays with different test principles

    International Nuclear Information System (INIS)

    Lohkamp, F.; Schmidt, M.

    1982-01-01

    Serum FT 4 was measured simultaneously by the commercial FT 4 kits of Amersham-Buchler and Corning Medical in 4 groups with defined thyroid function as follows: 57 euthroid subjects with and without goitre, 27 patients on T 4 supplementation. 12 subjects on oral contraceptives and 26 subclinically hyperthyroid patients. All patients underwent physical examination, thyroid scintigraphy and additional in-vitro tests (total thyroxine T 4 , total triiodothyronine T 3 and TRH/TSH assay). Both assays generally correlated well with the definded thyroid functional status except for the patients on oral contraceptives. Contrary to the FT 4 -test (Amersham-Buchler) in this group the FT 4 -test (Corning Medical) produced a significantly increased mean for FT 4 as compared to the euthyroid group thus indicating a probably insufficient compensation for high but not necessarily abnormal levels of TBG concentration. Using the FT 4 -assay (Amersham-Buchler) the normal range of FT 4 values of euthyroid subjects from the area of Bamberg with marked iodine deficiency agrees well with recently published results of a multicentre trial thus confirming the assumption of serum FT 4 not being strongly dependent on iodine intake. The results of the FT 4 -test (Corning) showed a wider scatter of normal ranges of FT 4 values for all groups and concomitantly reduced discrimination compared to the corresponding simultaneously obtained FT 4 -test (Amersham-Buchler) results. Though cost and time saving, the commercial radioimmunoassays will require further critical evaluation of normal range validity on larger populations of defined abnormalities will require further critical evaluation of normal range validity on larger populations of defined abnormalities of thyroid function to elucidate inherent deficiencies of the new FT 4 methods and of their diagnostic efficiency. (orig./MG) [de

  12. 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.

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

    DEFF Research Database (Denmark)

    Buchholz, Jörg; Mihai, Paul Glad

    2008-01-01

    B-SL direct sound level, NH-listeners showed a binaural suppression effect for delays smaller than 7-10 ms and a binaural enhancement effect for larger delays. When decreasing the direct sound level to 15 dB-SL, the only significant change observed was that the dichotic RMT increased for delays larger than...... expected from changed auditory filter bandwidth and audi-bility. However, the stimulus level-dependency of the auditory filters’ bandwidth was not reflected in the SRMT data....

  14. Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2015-06-15

    PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

  15. Optimization of the Contrast Mixture Ratio for Simultaneous Direct MR and CT Arthrography: an in Vitro Study

    International Nuclear Information System (INIS)

    Choi, Ja Young; Hong, Sung Hwan; Kim, Na Ra; Jun, Woo Sun; Moon, Sung Gyu; Kang, Heung Sik; Lee, Joon Woo; Choi, Jung Ah

    2008-01-01

    This study was designed to determine the optimal mixture ratio of gadolinium and iodinated contrast agent for simultaneous direct MR arthrography and CT arthrography. An in vitro study was performed utilizing mixtures of gadolinium at six different concentrations (0.625, 1.25, 2.5, 5.0, 10 and 20 mmol/L) and iodinated contrast agent at seven different concentrations (0, 12.5, 25, 37.5, 50, 75 and 92-99.9%). These mixtures were placed in tissue culture plates, and were then imaged with CT and MR (with T1-weighted sequences, proton-density sequences and T2-weighted sequences). CT numbers and signal intensities were measured. Pearson's correlation coefficients were used to assess the correlations between the gadolinium/iodinated contrast agent mixtures and the CT numbers/MR signal intensities. Scatter diagrams were plotted for all gadolinium/iodinated contrast agent combinations and two radiologists in consensus identified the mixtures that yielded the optimal CT numbers and MR signal intensities. The CT numbers showed significant correlation with iodinated contrast concentrations (r = 0.976, p < 0.001), whereas the signal intensities as measured on MR images showed a significant correlation with both gadolinium and iodinated contrast agent concentrations (r = -484 to -0.719, p < 0.001). A review of the CT and MR images, graphs, and scatter diagram of 42 combinations of the contrast agent showed that a concentration of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was the best combination for simultaneous CT and MR imaging. A mixture of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was found to be optimal for simultaneous direct MR arthrography and CT arthrography

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. Ballistic Puncture Self-Healing Polymeric Materials

    Science.gov (United States)

    Gordon, Keith L.; Siochi, Emilie J.; Yost, William T.; Bogert, Phil B.; Howell, Patricia A.; Cramer, K. Elliott; Burke, Eric R.

    2017-01-01

    Space exploration launch costs on the order of $10,000 per pound provide an incentive to seek ways to reduce structural mass while maintaining structural function to assure safety and reliability. Damage-tolerant structural systems provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to quickly heal following projectile penetration while retaining some structural function during the healing processes. Although there are materials known to possess this capability, they are typically not considered for structural applications. Current efforts use inexpensive experimental methods to inflict damage, after which analytical procedures are identified to verify that function is restored. Two candidate self-healing polymer materials for structural engineering systems are used to test these experimental methods.

  2. 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.

  3. 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

  4. Maass Cusp Forms on Singly Punctured Two-Torus

    International Nuclear Information System (INIS)

    Siddig, Abubaker Ahmed Mohamed; Shah, Nurisya Mohd; Zainuddin, Hishamuddin

    2009-01-01

    Quantum mechanical systems on punctured surfaces modeled by hyperbolic spaces can play an interesting role in exploring quantum chaos and in studying behaviour of future quantum nano-devices. The case of singly-punctured two-torus, for example, has been well-studied in the literature particularly for its scattering states. However, the bound states on the punctured torus given by Maass cusp forms are lesser known. In this note, we report on the algorithm of numerically computing these functions and we present ten lower-lying eigenvalues for each odd and even Maass cusp forms.

  5. Simultaneous Retrieval of Aerosol and Surface Optical Properties from Combined Airborne- and Ground-Based Direct and Diffuse Radiometric Measurements

    Science.gov (United States)

    Gatebe, C. K.; Dubovik, O.; King, M. D.; Sinyuk, A.

    2010-01-01

    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 m) 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.

  6. 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.

  7. 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.

  8. Punctures for theories of class S{sub Γ}

    Energy Technology Data Exchange (ETDEWEB)

    Heckman, Jonathan J. [Department of Physics, University of North Carolina,Chapel Hill, NC 27599 (United States); Jefferson, Patrick; Rudelius, Tom; Vafa, Cumrun [Jefferson Physical Laboratory, Harvard University,Cambridge, MA 02138 (United States)

    2017-03-31

    With the aim of understanding compactifications of 6D superconformal field theories to four dimensions, we study punctures for theories of class S{sub Γ}. The class S{sub Γ} theories arise from M5-branes probing ℂ{sup 2}/Γ, an ADE singularity. The resulting 4D theories descend from compactification on Riemann surfaces decorated with punctures. We show that for class S{sub Γ} theories, a puncture is specified by singular boundary conditions for fields in the 5D quiver gauge theory obtained from compactification of the 6D theory on a cylinder geometry. We determine general boundary conditions and study in detail solutions with first order poles. This yields a generalization of the Nahm pole data present for 1/2 BPS punctures for theories of class S. Focusing on specific algebraic structures, we show how the standard discussion of nilpotent orbits and its connection to representations of su(2) generalizes in this broader context.

  9. Lumbar puncture in patients using anticoagulants and antiplatelet agents

    Directory of Open Access Journals (Sweden)

    Renan Domingues

    2016-08-01

    Full Text Available ABSTRACT The use of anticoagulants and antiplatelet agents has largely increased. Diagnostic lumbar puncture in patients taking these drugs represents a challenge considering the opposing risks of bleeding and thrombotic complications. To date there are no controlled trials, specific guidelines, nor clear recommendations in this area. In the present review we make some recommendations about lumbar puncture in patients using these drugs. Our recommendations take into consideration the pharmacology of these drugs, the thrombotic risk according to the underlying disease, and the urgency in cerebrospinal fluid analysis. Evaluating such information and a rigorous monitoring of neurological symptoms after lumbar puncture are crucial to minimize the risk of hemorrhage associated neurological deficits. An individualized patient decision-making and an effective communication between the assistant physician and the responsible for conducting the lumbar puncture are essential to minimize potential risks.

  10. 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)

  11. Fuel rod puncturing and fission gas monitoring system examination techniques

    International Nuclear Information System (INIS)

    Song, Woong Sup

    1999-02-01

    Fission gas products accumulated in irradiated fuel rod is 1-2 cm 3 in CANDU and 40-50 cm 3 in PWR fuel rod. Fuel rod puncturing and fission gas monitoring system can be used for both CANDU and PWR fuel rod. This system comprises puncturing device located at in cell part and monitoring device located at out cell part. The system has computerized 9 modes and can calculate both void volume and mass volume only single puncturing. This report describes techniques and procedure for operating fuel rod puncturing and gas monitoring system which can be play an important role in successful operation of the devices. Results obtained from the analysis can give more influence over design for fuel rods. (Author). 6 refs., 9 figs

  12. Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

    Directory of Open Access Journals (Sweden)

    Salih Kalay

    2011-09-01

    Full Text Available Cerebral edema resulting in elevated intracranial pressure is a well-known complication of galactosemia. Lumbar puncture was performed for the diagnosis of clinically suspected bacterial meningitis. Herniation of cerebral tissue through the foramen magnum is not a common problem in neonatal intensive care units because of the open fontanelle in infants. We present the case of a 3-week-old infant with galactosemia who presented with signs of cerebellar herniation after lumbar puncture.

  13. Predisposing factors for peripheral intravenous puncture failure in children

    OpenAIRE

    Negri,Daniela Cavalcante de; Avelar,Ariane Ferreira Machado; Andreoni,Solange; Pedreira,Mavilde da Luz Gonçalvez

    2012-01-01

    OBJECTIVE: To identify predisposing factors for peripheral intravenous puncture failure in children. METHODS: Cross-sectional cohort study conducted with 335 children in a pediatric ward of a university hospital after approval of the ethics committee. The Wald Chi-squared, Prevalence Ratio (PR) and backward procedure (p≤0.05) tests were applied. RESULTS: Success of peripheral intravenous puncture was obtained in 300 (89.5%) children and failure in 35 (10.4%). The failure rates were sign...

  14. Plus- and minus-end directed microtubule motors bind simultaneously to herpes simplex virus capsids using different inner tegument structures.

    Directory of Open Access Journals (Sweden)

    Kerstin Radtke

    2010-07-01

    Full Text Available Many viruses depend on host microtubule motors to reach their destined intracellular location. Viral particles of neurotropic alphaherpesviruses such as herpes simplex virus 1 (HSV1 show bidirectional transport towards the cell center as well as the periphery, indicating that they utilize microtubule motors of opposing directionality. To understand the mechanisms of specific motor recruitment, it is necessary to characterize the molecular composition of such motile viral structures. We have generated HSV1 capsids with different surface features without impairing their overall architecture, and show that in a mammalian cell-free system the microtubule motors dynein and kinesin-1 and the dynein cofactor dynactin could interact directly with capsids independent of other host factors. The capsid composition and surface was analyzed with respect to 23 structural proteins that are potentially exposed to the cytosol during virus assembly or cell entry. Many of these proteins belong to the tegument, the hallmark of all herpesviruses located between the capsid and the viral envelope. Using immunoblots, quantitative mass spectrometry and quantitative immunoelectron microscopy, we show that capsids exposing inner tegument proteins such as pUS3, pUL36, pUL37, ICP0, pUL14, pUL16, and pUL21 recruited dynein, dynactin, kinesin-1 and kinesin-2. In contrast, neither untegumented capsids exposing VP5, VP26, pUL17 and pUL25 nor capsids covered by outer tegument proteins such as vhs, pUL11, ICP4, ICP34.5, VP11/12, VP13/14, VP16, VP22 or pUS11 bound microtubule motors. Our data suggest that HSV1 uses different structural features of the inner tegument to recruit dynein or kinesin-1. Individual capsids simultaneously accommodated motors of opposing directionality as well as several copies of the same motor. Thus, these associated motors either engage in a tug-of-war or their activities are coordinately regulated to achieve net transport either to the nucleus during

  15. 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)

  16. 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

  17. Neurocognitive Effects of Transcranial Direct Current Stimulation in Arithmetic Learning and Performance: A Simultaneous tDCS-fMRI Study.

    Science.gov (United States)

    Hauser, Tobias U; Rütsche, Bruno; Wurmitzer, Karoline; Brem, Silvia; Ruff, Christian C; Grabner, Roland H

    A small but increasing number of studies suggest that non-invasive brain stimulation by means of transcranial direct current stimulation (tDCS) can modulate arithmetic processes that are essential for higher-order mathematical skills and that are impaired in dyscalculic individuals. However, little is known about the neural mechanisms underlying such stimulation effects, and whether they are specific to cognitive processes involved in different arithmetic tasks. We addressed these questions by applying tDCS during simultaneous functional magnetic resonance imaging (fMRI) while participants were solving two types of complex subtraction problems: repeated problems, relying on arithmetic fact learning and problem-solving by fact retrieval, and novel problems, requiring calculation procedures. Twenty participants receiving left parietal anodal plus right frontal cathodal stimulation were compared with 20 participants in a sham condition. We found a strong cognitive and neural dissociation between repeated and novel problems. Repeated problems were solved more accurately and elicited increased activity in the bilateral angular gyri and medial plus lateral prefrontal cortices. Solving novel problems, in contrast, was accompanied by stronger activation in the bilateral intraparietal sulci and the dorsomedial prefrontal cortex. Most importantly, tDCS decreased the activation of the right inferior frontal cortex while solving novel (compared to repeated) problems, suggesting that the cathodal stimulation rendered this region unable to respond to the task-specific cognitive demand. The present study revealed that tDCS during arithmetic problem-solving can modulate the neural activity in proximity to the electrodes specifically when the current demands lead to an engagement of this area. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Direct multielement trace analyses of silicon carbide powders by spark ablation simultaneous inductively coupled plasma optical emission spectrometry

    International Nuclear Information System (INIS)

    Kiera, Arne F.; Schmidt-Lehr, Sebastian; Song, Ming; Bings, Nicolas H.; Broekaert, Jose A.C.

    2008-01-01

    A procedure for the direct analysis of silicon carbide powders (SiC) by simultaneous detection inductively coupled plasma optical emission spectrometry using a Spectro-CIROS TM spectrometer (CCD-ICP-OES) and a novel spark ablation system Spectro-SASSy (SA) as sample introduction technique is described. The sample preparation procedure for SA of non-conducting material is based on mixing the sample powders with a conducting matrix, in this case copper and briquetting pellets. Pressing time, pressure and mixing ratio are shown to be important parameters of the pelleting technique with respect to their mechanical stability for the reliability of the analysis results. A mixing ratio of 0.2 g +0.6 g for SiC and Cu, a pressure of 10 t cm -2 and a pressing time of 8 min have been found optimum. It has also been shown that the spark parameters selected are crucial for uniform volatilization. Electron probe micrographs of the burning spots and the analytical signal magnitude showed that a rather hard spark at 100 Hz was optimum. The determination of trace elements in silicon carbide powders is demonstrated using a calibration based on the addition of standard solutions. For Al, Ti, V, Mn and Fe detection limits in the lower μg g -1 range can be achieved. Internal standardization with Y in combination with the addition of standard solutions allows relative standard deviations in the range of 4 to 24% for concentration levels of the order of 3 to 350 μg g -1

  19. Direct multielement trace analyses of silicon carbide powders by spark ablation simultaneous inductively coupled plasma optical emission spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Kiera, Arne F.; Schmidt-Lehr, Sebastian; Song, Ming [Institute for Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, D-20146 Hamburg (Germany); Bings, Nicolas H. [Institute for Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, D-20146 Hamburg (Germany)], E-mail: bings@chemie.uni-hamburg.de; Broekaert, Jose A.C. [Institute for Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, D-20146 Hamburg (Germany)

    2008-02-15

    A procedure for the direct analysis of silicon carbide powders (SiC) by simultaneous detection inductively coupled plasma optical emission spectrometry using a Spectro-CIROS{sup TM} spectrometer (CCD-ICP-OES) and a novel spark ablation system Spectro-SASSy (SA) as sample introduction technique is described. The sample preparation procedure for SA of non-conducting material is based on mixing the sample powders with a conducting matrix, in this case copper and briquetting pellets. Pressing time, pressure and mixing ratio are shown to be important parameters of the pelleting technique with respect to their mechanical stability for the reliability of the analysis results. A mixing ratio of 0.2 g +0.6 g for SiC and Cu, a pressure of 10 t cm{sup -2} and a pressing time of 8 min have been found optimum. It has also been shown that the spark parameters selected are crucial for uniform volatilization. Electron probe micrographs of the burning spots and the analytical signal magnitude showed that a rather hard spark at 100 Hz was optimum. The determination of trace elements in silicon carbide powders is demonstrated using a calibration based on the addition of standard solutions. For Al, Ti, V, Mn and Fe detection limits in the lower {mu}g g{sup -1} range can be achieved. Internal standardization with Y in combination with the addition of standard solutions allows relative standard deviations in the range of 4 to 24% for concentration levels of the order of 3 to 350 {mu}g g{sup -1}.

  20. 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...

  1. 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)

  2. 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

  3. 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

  4. Needle puncture in rabbit functional spinal units alters rotational biomechanics.

    Science.gov (United States)

    Hartman, Robert A; Bell, Kevin M; Quan, Bichun; Nuzhao, Yao; Sowa, Gwendolyn A; Kang, James D

    2015-04-01

    An in vitro biomechanical study for rabbit lumbar functional spinal units (FSUs) using a robot-based spine testing system. To elucidate the effect of annular puncture with a 16 G needle on mechanical properties in flexion/extension, axial rotation, and lateral bending. Needle puncture of the intervertebral disk has been shown to alter mechanical properties of the disk in compression, torsion, and bending. The effect of needle puncture in FSUs, where intact spinal ligaments and facet joints may mitigate or amplify these changes in the disk, on spinal motion segment stability subject to physiological rotations remains unknown. Rabbit FSUs were tested using a robot testing system whose force/moment and position precision were assessed to demonstrate system capability. Flexibility testing methods were developed by load-to-failure testing in flexion/extension, axial rotation, and lateral bending. Subsequent testing methods were used to examine a 16 G needle disk puncture and No. 11 blade disk stab (positive control for mechanical disruption). Flexibility testing was used to assess segmental range-of-motion (degrees), neutral zone stiffness (N m/degrees) and width (degrees and N m), and elastic zone stiffness before and after annular injury. The robot-based system was capable of performing flexibility testing on FSUs-mean precision of force/moment measurements and robot system movements were elastic zone stiffness in flexion and lateral bending. These findings suggest that disk puncture and stab can destabilize FSUs in primary rotations.

  5. 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.

  6. 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

  7. 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.)

  8. Liouville theory and uniformization of four-punctured sphere

    Science.gov (United States)

    Hadasz, Leszek; Jaskólski, Zbigniew

    2006-08-01

    A few years ago Zamolodchikov and Zamolodchikov proposed an expression for the four-point classical Liouville action in terms of the three-point actions and the classical conformal block [Nucl. Phys. B 477, 577 (1996)]. In this paper we develop a method of calculating the uniformizing map and the uniformizing group from the classical Liouville action on n-punctured sphere and discuss the consequences of Zamolodchikovs conjecture for an explicit construction of the uniformizing map and the uniformizing group for the sphere with four punctures.

  9. 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.

  10. Recent Advances in Thermoplastic Puncture-Healing Polymers

    Science.gov (United States)

    Bogert, Philip B.; Working, Dennis C.; Wise, Kristopher E.; Smith, Janice Y.; Topping, Crystal C.; Britton, Sean M.; Bagby, Paul R.; Siochi, Emilie J.

    2010-01-01

    The motivation for this work is to develop self-healing polymeric materials to enable damage tolerant systems, and to tailor puncture healing for use temperatures and applications. This will be a benefit in environments and conditions where access for manual repair is limited or impossible, or where damage may not be detected.

  11. 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 ...

  12. Consensus guidelines for lumbar puncture in patients with neurological diseases

    NARCIS (Netherlands)

    S. Engelborghs (Sebastiaan); Niemantsverdriet, E. (Ellis); H. Struyfs (Hanne); K. Blennow (Kaj); Brouns, R. (Raf); M. Comabella (Manuel); I. Dujmovic (Irena); W.M. van der Flier (Wiesje); L. Frölich (Lutz); D. Galimberti (Daniela); S. Gnanapavan (Sharmilee); B. Hemmer` (Bernhard); E.I. Hoff (Erik I.); Hort, J. (Jakub); E. Iacobaeus (Ellen); M. Ingelsson (Martin); Jan de Jong, F. (Frank); Jonsson, M. (Michael); M. Khalil (Michael); J. Kuhle (Jens); A. Lleo (Alberto); A. De Mendonça (Alexandre); J.L. Molinuevo (José Luis); G. Nagels (Guy); C. Paquet (Claire); L. Parnetti; C.M.A.A. Roks (Gerwin); Rosa-Neto, P. (Pedro); P. Scheltens (Philip); C. Skarsgård (Constance); E. Stomrud (Erik); H. Tumani (Hayrettin); P. Visser (Pim); Wallin, A. (Anders); B. Winblad; H. Zetterberg (Henrik); F.H. Duits (Flora H.); C.E. Teunissen (Charlotte)

    2017-01-01

    textabstractIntroduction Cerebrospinal fluid collection by lumbar puncture (LP) is performed in the diagnostic workup of several neurological brain diseases. Reluctance to perform the procedure is among others due to a lack of standards and guidelines to minimize the risk of complications, such as

  13. 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...

  14. 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...

  15. Use of Lumbar Punctures in the Management of Ocular Syphilis.

    Science.gov (United States)

    Reekie, Ian; Reddy, Yaviche

    2018-01-01

    Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.

  16. 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.)

  17. Performance and complications of lumbar puncture in memory clinics : Results of the multicenter lumbar puncture feasibility study

    NARCIS (Netherlands)

    Duits, Flora H.; Martinez-Lage, Pablo; Paquet, Claire; Engelborghs, Sebastiaan; Lleo, Alberto; Hausner, Lucrezia; Molinuevo, Jose L.; Stomrud, Erik; Farotti, Lucia; Ramakers, Inez H. G. B.; Tsolaki, Magda; Skarsgard, Constance; Astrand, Ragnar; Wallin, Anders; Vyhnalek, Martin; Holmber-Clausen, Marie; Forlenza, Orestes V.; Ghezzi, Laura; Ingelsson, Martin; Hoff, Erik I.; Roks, C.M.A.A.; de Mendonca, Alexandre; Papma, Janne M.; Izagirre, Andrea; Taga, Mariko; Struyfs, Hanne; Alcolea, Daniel A.; Froelich, Lutz; Balasa, Mircea; Minthon, Lennart; Twisk, Jos W. R.; Persson, Staffan; Zetterberg, Henrik; van der Flier, Wiesje M.; Teunissen, Charlotte E.; Scheltens, Philip; Blennow, Kaj

    2016-01-01

    Introduction Lumbar puncture (LP) is increasingly performed in memory clinics. We investigated patient-acceptance of LP, incidence of and risk factors for post-LP complications in memory clinic populations. Methods We prospectively enrolled 3868 patients (50% women, age 66 ± 11 years, mini mental

  18. A real-time comparison between direct control, sequential pattern recognition control and simultaneous pattern recognition control using a Fitts' law style assessment procedure.

    Science.gov (United States)

    Wurth, Sophie M; Hargrove, Levi J

    2014-05-30

    Pattern recognition (PR) based strategies for the control of myoelectric upper limb prostheses are generally evaluated through offline classification accuracy, which is an admittedly useful metric, but insufficient to discuss functional performance in real time. Existing functional tests are extensive to set up and most fail to provide a challenging, objective framework to assess the strategy performance in real time. Nine able-bodied and two amputee subjects gave informed consent and participated in the local Institutional Review Board approved study. We designed a two-dimensional target acquisition task, based on the principles of Fitts' law for human motor control. Subjects were prompted to steer a cursor from the screen center of into a series of subsequently appearing targets of different difficulties. Three cursor control systems were tested, corresponding to three electromyography-based prosthetic control strategies: 1) amplitude-based direct control (the clinical standard of care), 2) sequential PR control, and 3) simultaneous PR control, allowing for a concurrent activation of two degrees of freedom (DOF). We computed throughput (bits/second), path efficiency (%), reaction time (second), and overshoot (%)) and used general linear models to assess significant differences between the strategies for each metric. We validated the proposed methodology by achieving very high coefficients of determination for Fitts' law. Both PR strategies significantly outperformed direct control in two-DOF targets and were more intuitive to operate. In one-DOF targets, the simultaneous approach was the least precise. The direct control was efficient in one-DOF targets but cumbersome to operate in two-DOF targets through a switch-depended sequential cursor control. We designed a test, capable of comprehensively describing prosthetic control strategies in real time. When implemented on control subjects, the test was able to capture statistically significant differences (p simultaneous

  19. 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.

  20. 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.

  1. 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

  2. Experience and nursing needs of school-age children undergoing lumbar puncture during the treatment of acute lymphoblastic leukaemia: a descriptive and qualitative study.

    Science.gov (United States)

    Xie, Anwei; Shan, Yuying; Niu, Mei E; Chen, Yi; Wang, Xiya

    2017-11-01

    To describe experiences and nursing needs of school-age Chinese children undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia. Lumbar puncture is an invasive procedure, causing psychological changes and physical discomfort in patients. In a previous study, it was proved that distraction intervention, such as music therapy, relieves pain and anxiety. There is limited evidence regarding the experience and needs of school-age children during lumbar puncture after being diagnosed with acute lymphoblastic leukaemia. To minimise their anxiety and pain during the procedure, it is important to collect information directly from these children. A descriptive qualitative research. Twenty-one school-age children with acute lymphoblastic leukaemia participated in semi-structured interviews at a Children's Hospital in China. Data were collected by an experienced and trained interviewer. Qualitative content analysis was chosen to describe experiences of children undergoing lumbar puncture. While undergoing lumbar puncture for the treatment of acute lymphoblastic leukaemia, school-age Chinese children experienced complex psychological feelings (fear, tension, helplessness, sadness and anxiety). They also experienced physical discomfort. They had multipolar needs, such as information, communication, respect, self-actualisation, environment and equipment. This study identified important areas that must be closely monitored by healthcare staff, performing lumbar puncture on acute lymphoblastic leukaemia children. Thus, a successful and smooth procedure can be performed on these patients, and their quality of life can be improved. The experiences described in this study contribute to a better understanding of the needs of acute lymphoblastic leukaemia children undergoing lumbar puncture. They also provide valuable information to professional medical care staff that develops future nursing assessments. © 2016 John Wiley & Sons Ltd.

  3. Triplanar correction of adolescent idiopathic scoliosis by asymmetrically shaped and simultaneously applied rods associated with direct vertebral rotation: clinical and radiological analysis of 36 patients.

    Science.gov (United States)

    Faldini, Cesare; Perna, Fabrizio; Geraci, Giuseppe; Pardo, Francesco; Mazzotti, Antonio; Pilla, Federico; Ruffilli, Alberto

    2018-04-17

    Aim of this study was to investigate the effectiveness of a new surgical corrective manoeuvre for adolescent idiopathic scoliosis (AIS) by asymmetrically shaped and simultaneously applied rods and in combination with direct vertebral rotation, to control both the triplanar deformity and the kyphosis apex location. We retrospectively reviewed 36 patients who undergo surgical treatment using simultaneous translation on two differently contoured rods, in combination with direct vertebral rotation. Patients were divided into three main groups according to the scoliotic curve type. The average follow-up was 1.8 years (range 1-3 years). Mean thoracic Cobb angle decreased from 64.6° to 17.0 (p < 0.05). Mean lumbar Cobb angle decreased from 54.9 to 13°. T5-T12 kyphosis values improved from 16.2 to 22.8° (p < 0.05). Apical vertebral rotation decreased from 25.3 to 9.7°. Mean total SRS-22 score values improved from 2.3 on pre-operative to 3.8 at the last available follow-up. Two major and two minor perioperative complications were recorded. Nor deformity progression or screw pull-out or non-union was recorded at the last available follow-up. The corrective manoeuvre using two differently contoured rods simultaneously in combination with direct vertebral rotation can provide a good triplanar deformity correction and improve patient's quality of life and self-image perception in mild-to-moderate AIS. Moreover, the described technique allows the positioning of the desired kyphosis apex at a different level from the scoliosis apex. This procedure allows a better sagittal contour restoration while maintaining a comparable amount of correction on the frontal and axial plane of the already available techniques. These slides can be retrieved under Electronic Supplementary Material.

  4. Designing on-demand education for simultaneous development of domain-specific and self-directed learning skills

    NARCIS (Netherlands)

    Taminiau, E.M.C.; Kester, L.; Corbalan Perez, G.; Spector, J.M.; Kirschner, P.A.; Merriënboer, J.J.G. van

    2015-01-01

    On-demand education enables individual learners to choose their learning pathways according to their own learning needs. They must use self-directed learning (SDL) skills involving self-assessment and task selection to determine appropriate pathways for learning. Learners who lack these skills must

  5. Designing on-demand education for simultaneous development of domain-specific and self-directed learning skills

    NARCIS (Netherlands)

    Taminiau, Bettine; Kester, Liesbeth; Corbalan, Gemma; Spector, J. Michael; Kirschner, Paul A.; Van Merriënboer, Jeroen

    2016-01-01

    On-demand education enables individual learners to choose their learning pathways according to their own learning needs. They must use self-directed learning (SDL) skills involving self-assessment and task selection to determine appropriate pathways for learning. Learners who lack these skills must

  6. 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.

  7. 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)

  8. 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.

  9. Pneumoperitoneum Caused by Air Leakage Through the Percutaneous Puncture Tract as a Complication of Rendezvous Technique: A Case Report

    Directory of Open Access Journals (Sweden)

    Chiao-Hsiung Chuang

    2008-11-01

    Full Text Available The rendezvous technique, combining percutaneous and endoscopic procedures, is a safe and effective method to achieve biliary cannulation if an endoscopic approach fails. The two procedures in this technique can be carried out simultaneously or in stages. A simultaneous approach is reported to be associated with fewer complications, and patients undergoing this approach can recover and be discharged more rapidly. Here, we report a complication of pneumoperitoneum in a patient who underwent percutaneous and endoscopic procedures simultaneously for the removal of a common bile duct stone. It was supposed that prolonged air insufflation during endoscopy forced intestinal air to track into the peritoneal cavity through the bile ducts and the puncture tract. Accordingly, a short wait before removing the percutaneous catheter to deflate the intestinal air will be helpful to avoid such a complication.

  10. A new hypothesis on the simultaneous direct and indirect proton pump mechanisms in NADH-quinone oxidoreductase (complex I).

    Science.gov (United States)

    Ohnishi, Tomoko; Nakamaru-Ogiso, Eiko; Ohnishi, S Tsuyoshi

    2010-10-08

    Recently, Sazanov's group reported the X-ray structure of whole complex I [Nature, 465, 441 (2010)], which presented a strong clue for a "piston-like" structure as a key element in an "indirect" proton pump. We have studied the NuoL subunit which has a high sequence similarity to Na(+)/H(+) antiporters, as do the NuoM and N subunits. We constructed 27 site-directed NuoL mutants. Our data suggest that the H(+)/e(-) stoichiometry seems to have decreased from (4H(+)/2e(-)) in the wild-type to approximately (3H(+)/2e(-)) in NuoL mutants. We propose a revised hypothesis that each of the "direct" and the "indirect" proton pumps transports 2H(+) per 2e(-). Copyright © 2010 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  11. The exchange algebra for Liouville theory on punctured Riemann sphere

    International Nuclear Information System (INIS)

    Shen Jianmin; Sheng Zhengmao

    1991-11-01

    We consider in this paper the classical Liouville field theory on the Riemann sphere with n punctures. In terms of the uniformization theorem of Riemann surface, we show explicitly the classical exchange algebra (CEA) for the chiral components of the Liouville fields. We find that the matrice which dominate the CEA is related to the symmetry of the Lie group SL(n) in a nontrivial manner with n>3. (author). 10 refs

  12. Cervical myelography via C1/C2 lateral puncture

    International Nuclear Information System (INIS)

    Grange, B.

    1981-01-01

    The use of the water soluble, tri-iodinated contrast medium, metrizamide, in cervical myelography via C1/C2 lateral puncture is described. Details of the tomographic apparatus and the technique employed are given. The advantages of water soluble myelography using metrizamide are overwhelming due to its miscibility with CSF, improved anatomical demonstration, radiographic visualisation and diagnostic accuracy and advantageous pharmacological properties with reduced toxicity. This technique provided successful diagnoses in a series of 104 patients. (U.K.)

  13. A case of subdural hematoma following lumbar puncture

    Directory of Open Access Journals (Sweden)

    Ramatharaknath Vemuri

    2017-01-01

    Full Text Available Lumbar puncture (LP is a frequent procedure done for administration of spinal anesthesia or for obtaining cerebrospinal fluid for analysis. The common complications of LP are pain at the local site and headache. Fortunately, the serious complications such as infections of central nervous system, brain stem herniation, and subdural hematoma are rare. We present a rare case of subdural hematoma following a LP.

  14. Liouville theory and uniformization of four-punctured sphere

    OpenAIRE

    Hadasz, Leszek; Jaskolski, Zbigniew

    2006-01-01

    Few years ago Zamolodchikov and Zamolodchikov proposed an expression for the 4-point classical Liouville action in terms of the 3-point actions and the classical conformal block. In this paper we develop a method of calculating the uniformizing map and the uniformizing group from the classical Liouville action on n-punctured sphere and discuss the consequences of Zamolodchikovs conjecture for an explicit construction of the uniformizing map and the uniformizing group for the sphere with four ...

  15. 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...

  16. CT guided percutaneous renal cysts puncture with ethanol therapy

    International Nuclear Information System (INIS)

    Zhang Xuezhe; Lu Yan; Wang Wu; Huang Zhengguo; Ren An

    2002-01-01

    Objective: To analyse our clinical experience with CT guided percutaneous renal cysts puncture and ethanol therapy. Methods: Five hundred and ten renal cysts in 445 patients were undergone CT guided percutaneous renal cysts puncture and ethanol therapy. Among the 445 cases, 385 cases had solitary renal cyst, 53 multiple renal cysts, and 7 polycystic kidneys. The renal cysts varied in size from 1.9 to 13.5 cm in diameter. The amount of aspirated fluid varied from 3 to 780 ml. A 18-21 gauge aspiration needles were used for all patients. A 25.0% cyst volume replacement with 99.7% ethanol was approved to be appropriate. Results: 427 renal cysts in 396 patients were followed up by computed tomographic (CT) or ultrasound for less than 3 months to more than one year duration. The curative effective rate and disappearance rate of the renal cystic cavity in solitary renal cysts were 97% and 82%, respectively. In multiple renal cysts, the corresponding values were 95% and 79%. In polycystic kidneys, the curative rate was 67%. The complications such as local abdominal pain (28 cases) and hematuria (four cases) were observed in this series. There were no fatal complications. Conclusions: CT guided percutaneous renal cyst puncture and ethanol therapy is an useful procedure for the treatment of solitary renal cysts and multiple renal cysts

  17. Rabbit models of cerebral vasospasm established with endovascular puncture

    International Nuclear Information System (INIS)

    Tu Jianfei; Liu Yizhi; Ji Jiansong; Zhao Zhongwei

    2008-01-01

    Objective: To investigate the method of endovascular puncture to establish rabbit models of cerebral vasospasm. Methods: New Zealand white rabbits were divided into 5 groups (12 h, 1 d, 2 d, 3 d and 7 d) randomly, and each group was separated into subarachnoid hemorrhage (SAH) subgroup (n=5) and control subgroup (n=2). cerebral vascular spasm (CVS) models were established after SAH with endovascular puncture. CT scans before and after operation were performed. The internal diameters and the wall thicknesses of posterior communicans artery (PcoA) and basilar artery (BA) were measured with HE stain after the animals were executed. Results: CVS model was successfully eastblished in 35 rabbits (SAH subgroup 25, control subgroup 10), resulting a successful rate of 48.61%. Compared with control subgroup, PcoA and BA showed shrinkage of internal diameters of 43.60% and 51.82% 12 h after SAH, respectively, and the shrinkage appeared as biphasic patterns until the 7th study day with another peaks of 29.32% and 45.19%, respectively. Conclusions: Endovascular puncture is an effective method to establish rabbit of CVS. The death rate of animals can be decreased with the asage of new interventional material and perfection for the details of operation. (authors)

  18. 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.

  19. A new cerebral vasospasm model established with endovascular puncture technique

    International Nuclear Information System (INIS)

    Tu Jianfei; Liu Yizhi; Ji Jiansong; Zhao Zhongwei

    2011-01-01

    Objective: To investigate the method of establishing cerebral vasospasm (CVS) models in rabbits by using endovascular puncture technique. Methods: Endovascular puncture procedure was performed in 78 New Zealand white rabbits to produce subarachnoid hemorrhage (SAH). The survival rabbits were randomly divided into seven groups (3 h, 12 h, 1 d, 2 d, 3 d, 7 d and 14 d), with five rabbits in each group for both study group (SAH group) and control group. Cerebral CT scanning was carried out in all rabbits both before and after the operation. The inner diameter and the thickness of vascular wall of both posterior communicating artery (PcoA) and basilar artery (BA) were determined after the animals were sacrificed, and the results were analyzed. Results: Of 78 experimental rabbits, CVS model was successfully established in 45, including 35 of SAH group and 10 control subgroup. The technical success rate was 57.7%. Twelve hours after the procedure, the inner diameter of PcoA and BA in SAH group was decreased by 45.6% and 52.3%, respectively, when compared with these in control group. The vascular narrowing showed biphasic changes, the inner diameter markedly decreased again at the 7th day when the decrease reached its peak to 31.2% and 48.6%, respectively. Conclusion: Endovascular puncture technique is an effective method to establish CVS models in rabbits. The death rate of experimental animals can be decreased if new interventional material is used and the manipulation is carefully performed. (authors)

  20. 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

  1. 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.

  2. 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

  3. High Definition Transcranial Direct Current Stimulation Induces Both Acute and Persistent Changes in Broadband Cortical Synchronization: a Simultaneous tDCS-EEG Study

    Science.gov (United States)

    Roy, Abhrajeet; Baxter, Bryan

    2014-01-01

    The goal of this study was to develop methods for simultaneously acquiring electrophysiological data during high definition transcranial direct current stimulation (tDCS) using high resolution electroencephalography (EEG). Previous studies have pointed to the after effects of tDCS on both motor and cognitive performance, and there appears to be potential for using tDCS in a variety of clinical applications. However, little is known about the real-time effects of tDCS on rhythmic cortical activity in humans due to the technical challenges of simultaneously obtaining electrophysiological data during ongoing stimulation. Furthermore, the mechanisms of action of tDCS in humans are not well understood. We have conducted a simultaneous tDCS-EEG study in a group of healthy human subjects. Significant acute and persistent changes in spontaneous neural activity and event related synchronization (ERS) were observed during and after the application of high definition tDCS over the left sensorimotor cortex. Both anodal and cathodal stimulation resulted in acute global changes in broadband cortical activity which were significantly different than the changes observed in response to sham stimulation. For the group of 8 subjects studied, broadband individual changes in spontaneous activity during stimulation were apparent both locally and globally. In addition, we found that high definition tDCS of the left sensorimotor cortex can induce significant ipsilateral and contralateral changes in event related desynchronization (ERD) and ERS during motor imagination following the end of the stimulation period. Overall, our results demonstrate the feasibility of acquiring high resolution EEG during high definition tDCS and provide evidence that tDCS in humans directly modulates rhythmic cortical synchronization during and after its administration. PMID:24956615

  4. ST-segment elevation and ventricular fibrillation shortly after transseptal puncture for left atrial catheter ablation

    Directory of Open Access Journals (Sweden)

    Daisuke Ishigaki, MD

    2013-10-01

    Full Text Available A 47-year-old man with drug-resistant paroxysmal atrial fibrillation underwent left atrial (LA catheter ablation. After sheaths were inserted into the LA using the Brockenbrough method, he complained of angina and developed ST-segment elevation in the II, III, aVF, V5, and V6 leads. Ventricular fibrillation (VF occurred followed by ventricular tachycardia. The VF was successfully treated with direct current shock. Coronary angiography with isosorbide dinitrate showed neither spasm nor embolism in the coronary artery. The chest pain disappeared after 6 min with resolution of the ST-segment elevation. A summarized review of ST-segment elevation associated with transseptal puncture disclosed that ST-segment elevation is often found in inferior leads (87.5%, while concomitant bradyarrhythmia has been reported in 43.8% of patients. Our patient is the first recorded case with potentially lethal tachyarrhythmia. Although ST-segment elevation and VF is a rare complication associated with transseptal puncture, awareness of this complication is important.

  5. 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)

  6. 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.

  7. 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

  8. The optical "Veress-needle"--initial puncture with a minioptic.

    Science.gov (United States)

    Schaller, G; Kuenkel, M; Manegold, B C

    1995-02-01

    Laparoscopic access is a necessary part of minimally invasive surgery. The double blind puncture with Veress-needle and trocar can cause lethal complications such as bowel injury, bleeding and gas-embolisation. Some authors have reported alternative techniques for laparoscopic abdominal access. Because no blind procedure can absolutely prevent injury, permanent visual control of perforated tissue layers as in open surgery should be achieved to prevent possible injury at an early stage. Previously described procedures could not fulfil all requirements to comply with this ideal, i.e. permanent visual control of abdominal wall penetration prior to establishment of pneumoperitoneum and trocar insertion without further possible damage. We designed a 2 mm fibreglass optic 250 mm in length that is inserted into a suitable cannula. Special construction allows rinsing through the cannula to clear the vision and to open spaces in the puncture track by water dissection. After incision of the skin, all layers of the abdominal wall can be visualised, including blood vessels and internal surfaces. Once the abdominal cavity is reached, the needle tip is retracted and a two-step dilation allows the trocar to be introduced via the puncture track. Only then does insufflation begin. The fibreglass optic-equipped safety needle was used for visually controlled access in 184 laparoscopic surgical procedures. After a period of training, all layers of the abdominal wall could be recognised exactly. In two patients with dense adhesions, perforation of the small bowel was diagnosed immediately by endoscopic viewing. The small injury needed no treatment, and the intended procedure was completed laparoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Reinvestigation of moving punctured black holes with a new code

    International Nuclear Information System (INIS)

    Cao Zhoujian; Yo Hweijang; Yu Juiping

    2008-01-01

    We report on our code, in which the moving puncture method is applied and an adaptive/fixed mesh refinement is implemented, and on its preliminary performance on black hole simulations. Based on the Baumgarte-Sharpiro-Shibata-Nakamura (BSSN) formulation, up-to-date gauge conditions and the modifications of the formulation are also implemented and tested. In this work, we present our primary results about the simulation of a single static black hole, of a moving single black hole, and of the head-on collision of a binary black hole system. For the static punctured black hole simulations, different modifications of the BSSN formulation are applied. It is demonstrated that both the currently used sets of modifications lead to a stable evolution. For cases of a moving punctured black hole with or without spin, we search for viable gauge conditions and study the effect of spin on the black hole evolution. Our results confirm previous results obtained by other research groups. In addition, we find a new gauge condition, which has not yet been adopted by any other researchers, which can also give stable and accurate black hole evolution calculations. We examine the performance of the code for the head-on collision of a binary black hole system, and the agreement of the gravitational waveform it produces with that obtained in other works. In order to understand qualitatively the influence of matter on the binary black hole collisions, we also investigate the same head-on collision scenarios but perturbed by a scalar field. The numerical simulations performed with this code not only give stable and accurate results that are consistent with the works by other numerical relativity groups, but also lead to the discovery of a new viable gauge condition, as well as clarify some ambiguities in the modification of the BSSN formulation. These results demonstrate that this code is reliable and ready to be used in the study of more realistic astrophysical scenarios and of numerical

  10. 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.

  11. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-07-01

    Full Text Available 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. Resumo: Apresentamos o caso clínico de uma paciente de 25 anos de idade, na qual uma técnica peridural foi realizada durante o trabalho de parto e posteriormente apresentou cefaleia com características de cefaleia pós-punção dural. Foi iniciado tratamento conservador e tampão de sangue peridural. Devido a ausência de melhora clínica e à mudança do componente postural da cefaleia, decidiu-se realizar um exame de imagem cerebral que demostrou a presença de hematoma subdural bilateral.A cefaleia pós-punção dural é relativamente frequente, mas a falta de resposta ao tratamento médico instaurado, assim como a mudança em suas características e a presença de foco neurológico, devem levantar a suspeita de presença de um hematoma subdural que, embora infrequente, pode chegar a ser devastador se não for diagnosticado e tratado oportunamente. Keywords: Accidental dural puncture, Epidural analgesia, Post-dural puncture headache, Subdural hematoma, Epidural blood patch, Palavras chave: Dura-Máter, Analgesia epidural, Cefaleia pós-punção dural, Hematoma subdural, Placa de sangue epidural

  12. New methodology for simultaneous volumetric and calorimetric measurements: Direct determination of {alpha}{sub p} and C{sub p} for liquids under pressure

    Energy Technology Data Exchange (ETDEWEB)

    Casas, L. M. [Departamento de Fisica Aplicada, Facultad de Ciencias Experimentales, Universidad de Vigo, Lagoas Marcosende s/n, 36310 Vigo (Spain); Plantier, F.; Bessieres, D. [Laboratoire de Thermodynamique et Energetique des Fluides Complexes-UMR 5150, Universite de Pau et des Pays de l' Adour, BP 1155, 64013 Pau (France)

    2009-12-15

    A new batch cell has been developed to measure simultaneously both isobaric thermal expansion and isobaric heat capacity from calorimetric measurements. The isobaric thermal expansion is directly proportional to the linear displacement of an inner flexible below and the heat capacity is calculated from the calorimetric signal. The apparatus used was a commercial Setaram C-80 calorimeter and together with this type of vessels can be operated up to 20 MPa and in the temperature range of 303.15-523.15 K, In this work, calibration was carried out using 1-hexanol and subsequently both thermophysical properties were determined for 3-pentanol, 3-ethyl-3-pentanol, and 1-octanol at atmospheric pressure, 5 and 10 MPa, and from 303.15 to 423.15 K in temperature. Finally experimental values were compared with the literature in order to validate this new methodology, which allows a very accurate determination of isobaric thermal expansion and isobaric heat capacity.

  13. Direct thermal desorption in the analysis of cheese volatiles by gas chromatography and gas chromatography-mass spectrometry: comparison with simultaneous distillation-extraction and dynamic headspace.

    Science.gov (United States)

    Valero, E; Sanz, J; Martínez-Castro, I

    2001-06-01

    Direct thermal desorption (DTD) has been used as a technique for extracting volatile components of cheese as a preliminary step to their gas chromatographic (GC) analysis. In this study, it is applied to different cheese varieties: Camembert, blue, Chaumes, and La Serena. Volatiles are also extracted using other techniques such as simultaneous distillation-extraction and dynamic headspace. Separation and identification of the cheese components are carried out by GC-mass spectrometry. Approximately 100 compounds are detected in the examined cheeses. The described results show that DTD is fast, simple, and easy to automate; requires only a small amount of sample (approximately 50 mg); and affords quantitative information about the main groups of compounds present in cheeses.

  14. 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.

  15. Efficiency comparison of 3 kinds of arterial puncture closing devices

    International Nuclear Information System (INIS)

    Feng Xiaodi; Jin Xian; Chen Yueguang; Xiao Hongbing; Yu Qiang; Chen Chengjun; Zhang Dadong

    2007-01-01

    Objective: To evaluate the efficiencies of arterial puncture closing devices (APCDs) including Angioseal, Perclose and Boomerang in patients undergone coronary angiography or percutaneous vascular interventions. Methods: 1497 patients underwent cardiac catheterization procedures were divided into manual compression group(639 cases) and APCDs closure group (576 cases with Angioseal, 151 cases Perclose and 11.3 cases of Boomerang). The times of maneuver, hemorrhage complication and other rare complications were assessed, recorded and compared. Results: The times for maneuver of standard manual compression group, Angioseal group, Perclose group and Boomerang group were (21.4±2.7) h, (3.5±2.3) h, (3.7± 2.6) h and (3.9±2.8) h respectively. The APCDs could obviously reduce bed rest time in comparing to that of manual compression. The rates of failure of the operations were 2.7%, 1.4%, 8.6% and 3.5% (P =0.006, P<0.001); and the rates of hemorrhage were 9.2%, 5.8%, 12.6% and 8.0% respectively for each of the four mentioned groups (P=0.005). Except the failure operations, the incidence of hemorrhage complications among the groups showed no significant differences. Conclusion: Application of APCDs to close the puncture site can significantly reduce the bed rest time, but not the incidence of hemorrhage complications. (authors)

  16. Simultaneous transcranial direct current stimulation (tDCS) and whole-head magnetoencephalography (MEG): assessing the impact of tDCS on slow cortical magnetic fields.

    Science.gov (United States)

    Garcia-Cossio, Eliana; Witkowski, Matthias; Robinson, Stephen E; Cohen, Leonardo G; Birbaumer, Niels; Soekadar, Surjo R

    2016-10-15

    Transcranial direct current stimulation (tDCS) can influence cognitive, affective or motor brain functions. Whereas previous imaging studies demonstrated widespread tDCS effects on brain metabolism, direct impact of tDCS on electric or magnetic source activity in task-related brain areas could not be confirmed due to the difficulty to record such activity simultaneously during tDCS. The aim of this proof-of-principal study was to demonstrate the feasibility of whole-head source localization and reconstruction of neuromagnetic brain activity during tDCS and to confirm the direct effect of tDCS on ongoing neuromagnetic activity in task-related brain areas. Here we show for the first time that tDCS has an immediate impact on slow cortical magnetic fields (SCF, 0-4Hz) of task-related areas that are identical with brain regions previously described in metabolic neuroimaging studies. 14 healthy volunteers performed a choice reaction time (RT) task while whole-head magnetoencephalography (MEG) was recorded. Task-related source-activity of SCFs was calculated using synthetic aperture magnetometry (SAM) in absence of stimulation and while anodal, cathodal or sham tDCS was delivered over the right primary motor cortex (M1). Source reconstruction revealed task-related SCF modulations in brain regions that precisely matched prior metabolic neuroimaging studies. Anodal and cathodal tDCS had a polarity-dependent impact on RT and SCF in primary sensorimotor and medial centro-parietal cortices. Combining tDCS and whole-head MEG is a powerful approach to investigate the direct effects of transcranial electric currents on ongoing neuromagnetic source activity, brain function and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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...

  2. Transforaminal Lumbar Puncture: An Alternative Technique in Patients with Challenging Access.

    Science.gov (United States)

    Nascene, D R; Ozutemiz, C; Estby, H; McKinney, A M; Rykken, J B

    2018-05-01

    Interlaminar lumbar puncture and cervical puncture may not be ideal in all circumstances. Recently, we have used a transforaminal approach in selected situations. Between May 2016 and December 2017, twenty-six transforaminal lumbar punctures were performed in 9 patients (25 CT-guided, 1 fluoroscopy-guided). Seven had spinal muscular atrophy and were referred for intrathecal nusinersen administration. In 2, CT myelography was performed via transforaminal lumbar puncture. The lumbar posterior elements were completely fused in 8, and there was an overlying abscess in 1. The L1-2 level was used in 2; the L2-3 level, in 10; the L3-4 level, in 12; and the L4-5 level, in 2 procedures. Post-lumbar puncture headache was observed on 4 occasions, which resolved without blood patching. One patient felt heat and pain at the injection site that resolved spontaneously within hours. One patient had radicular pain that resolved with conservative treatment. Transforaminal lumbar puncture may become an effective alternative to classic interlaminar lumbar puncture or cervical puncture. © 2018 by American Journal of Neuroradiology.

  3. 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

  4. 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

  5. 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 ...

  6. 40 CFR Table 3 to Subpart Xxxx of... - Emission Limits for Puncture Sealant Application Affected Sources

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Emission Limits for Puncture Sealant Application Affected Sources 3 Table 3 to Subpart XXXX of Part 63 Protection of Environment ENVIRONMENTAL... Manufacturing Pt. 63, Subpt. XXXX, Table 3 Table 3 to Subpart XXXX of Part 63—Emission Limits for Puncture...

  7. 40 CFR Table 4 to Subpart Xxxx of... - Operating Limits for Puncture Sealant Application Control Devices

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits for Puncture Sealant Application Control Devices 4 Table 4 to Subpart XXXX of Part 63 Protection of Environment ENVIRONMENTAL... Manufacturing Pt. 63, Subpt. XXXX, Table 4 Table 4 to Subpart XXXX of Part 63—Operating Limits for Puncture...

  8. Technological advances and changing indications for lumbar puncture in neurological disorders

    NARCIS (Netherlands)

    Costerus, Joost M.; Brouwer, Matthijs C.; van de Beek, Diederik

    2018-01-01

    Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal

  9. 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.

  10. 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®

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. Simultaneous determination of mercury and organic carbon in sediment and soils using a direct mercury analyzer based on thermal decomposition–atomic absorption spectrophotometry

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Jingjing [College of Chemical Engineering, Zhejiang University of Technology, No. 18 Chaowang Road, Hangzhou, Zhejiang 310032 (China); Chakravarty, Pragya [Department of Chemistry and Biochemistry, University of Mississippi, University, MS 38677 (United States); Davidson, Gregg R. [Department of Geology and Geological Engineering, University of Mississippi, University, MS 38677 (United States); Wren, Daniel G.; Locke, Martin A. [National Sedimentation Laboratory, United States Department of Agriculture, Agricultural Research Service, Oxford, MS 38655 (United States); Zhou, Ying, E-mail: yingzhou@zjut.edu.cn [College of Chemical Engineering, Zhejiang University of Technology, No. 18 Chaowang Road, Hangzhou, Zhejiang 310032 (China); Brown, Garry [Department of Chemistry and Biochemistry, University of Mississippi, University, MS 38677 (United States); Cizdziel, James V., E-mail: cizdziel@olemiss.edu [Department of Chemistry and Biochemistry, University of Mississippi, University, MS 38677 (United States)

    2015-04-29

    Graphical abstract: Comparison of LOI data obtained by a conventional method and by the DMA. The dark line represents a 1:1 ratio. - Highlights: • A direct mercury analyzer was used to estimate total organic carbon. • Mercury and organic carbon were measured in oxbow lake sediment cores. • Temporal and spatial deposition of Hg in the Mississippi Delta were evaluated. - Abstract: The purpose of this work was to study the feasibility of using a direct mercury analyzer (DMA) to simultaneously determine mercury (Hg) and organic matter content in sediment and soils. Organic carbon was estimated by re-weighing the sample boats post analysis to obtain loss-on-ignition (LOI) data. The DMA-LOI results were statistically similar (p < 0.05) to the conventional muffle furnace approach. A regression equation was developed to convert DMA-LOI data to total organic carbon (TOC), which varied between 0.2% and 13.0%. Thus, mercury analyzers based on combustion can provide accurate estimates of organic carbon content in non-calcareous sediment and soils; however, weight gain from moisture (post-analysis), measurement uncertainty, and sample representativeness should all be taken into account. Sediment cores from seasonal wetland and open water areas from six oxbow lakes in the Mississippi River alluvial flood plain were analyzed. Wetland sediments generally had higher levels of Hg than open water areas owing to a greater fraction of fine particles and higher levels of organic matter. Annual loading of Hg in open water areas was estimated at 4.3, 13.4, 19.2, 20.7, 129, and 135 ng cm{sup −2} yr{sup −1} for Beasley, Roundaway, Hampton, Washington, Wolf and Sky Lakes, respectively. Generally, the interval with the highest Hg flux was dated to the 1960s and 1970s.

  16. 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

  17. Direct electrodeposition of gold nanotube arrays of rough and porous wall by cyclic voltammetry and its applications of simultaneous determination of ascorbic acid and uric acid

    International Nuclear Information System (INIS)

    Yang Guangming; Li Ling; Jiang Jinhe; Yang Yunhui

    2012-01-01

    Gold nanotube arrays of rough and porous wall has been synthesized by direct electrodeposition with cyclic voltammetry utilizing anodic aluminum oxide template (AAO) and polycarbonate membrane (PC) during short time (only 3 min and 2 min, respectively). The mechanism of the direct electrodeposition of gold nanotube arrays by cyclic voltammetry (CV) has been discussed. The morphological characterizations of the gold nanotube arrays have been investigated by scanning electron microscopy (SEM). A simultaneous determination of ascorbic acid (AA) and uric acid (UA) by differential pulse voltammetry (DPV) was constructed by attaching gold nanotube arrays (using AAO) onto the surface of a glassy carbon electrode (GCE). The electrochemical behavior of AA and UA at this modified electrode has been studied by CV and differential pulse voltammetry (DPV). The sensor offers an excellent response for AA and UA and the linear response range for AA and UA were 1.02 × 10 −7 –5.23 × 10 −4 mol L −1 and 1.43 × 10 −7 –4.64 × 10 −4 mol L −1 , the detection limits were 1.12 × 10 −8 mol L −1 and 2.24 × 10 −8 mol L −1 , respectively. This sensor shows good regeneration, stability and selectivity and has been used for the determination of AA and UA in real human urine and serum samples with satisfied results. - Graphical abstract: The schematic diagram of formation of Au nanotube arrays (a) and the stepwise procedure of the sensor (b). Highlights: ► Gold nanotubes array has been synthesized by cyclic voltammetry. ► The mechanism of deposition of gold nanotube has been discussed. ► A determination of ascorbic acid and uric acid was constructed by gold array. ► A satisfied determination of samples can be obtained by this sensor.

  18. 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)

  19. 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)

  20. Can a combination of the conformal thin-sandwich and puncture methods yield binary black hole solutions in quasiequilibrium?

    International Nuclear Information System (INIS)

    Hannam, Mark D.; Evans, Charles R.; Cook, Gregory B.; Baumgarte, Thomas W.

    2003-01-01

    We consider combining two important methods for constructing quasiequilibrium initial data for binary black holes: the conformal thin-sandwich formalism and the puncture method. The former seeks to enforce stationarity in the conformal three-metric and the latter attempts to avoid internal boundaries, like minimal surfaces or apparent horizons. We show that these two methods make partially conflicting requirements on the boundary conditions that determine the time slices. In particular, it does not seem possible to construct slices that are quasistationary and that avoid physical singularities while simultaneously are connected by an everywhere positive lapse function, a condition which must be obtained if internal boundaries are to be avoided. Some relaxation of these conflicting requirements may yield a soluble system, but some of the advantages that were sought in combining these approaches will be lost

  1. 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.

  2. Direct electrodeposition of gold nanotube arrays of rough and porous wall by cyclic voltammetry and its applications of simultaneous determination of ascorbic acid and uric acid

    Energy Technology Data Exchange (ETDEWEB)

    Yang Guangming, E-mail: yangguangmingbs@126.com [Department of Resources and Environment, Baoshan University, Baoshan 678000 (China); Ling, Li [Department of Resources and Environment, Baoshan University, Baoshan 678000 (China); Jinhe, Jiang; Yunhui, Yang [College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650092 (China)

    2012-08-01

    Gold nanotube arrays of rough and porous wall has been synthesized by direct electrodeposition with cyclic voltammetry utilizing anodic aluminum oxide template (AAO) and polycarbonate membrane (PC) during short time (only 3 min and 2 min, respectively). The mechanism of the direct electrodeposition of gold nanotube arrays by cyclic voltammetry (CV) has been discussed. The morphological characterizations of the gold nanotube arrays have been investigated by scanning electron microscopy (SEM). A simultaneous determination of ascorbic acid (AA) and uric acid (UA) by differential pulse voltammetry (DPV) was constructed by attaching gold nanotube arrays (using AAO) onto the surface of a glassy carbon electrode (GCE). The electrochemical behavior of AA and UA at this modified electrode has been studied by CV and differential pulse voltammetry (DPV). The sensor offers an excellent response for AA and UA and the linear response range for AA and UA were 1.02 Multiplication-Sign 10{sup -7}-5.23 Multiplication-Sign 10{sup -4} mol L{sup -1} and 1.43 Multiplication-Sign 10{sup -7}-4.64 Multiplication-Sign 10{sup -4} mol L{sup -1}, the detection limits were 1.12 Multiplication-Sign 10{sup -8} mol L{sup -1} and 2.24 Multiplication-Sign 10{sup -8} mol L{sup -1}, respectively. This sensor shows good regeneration, stability and selectivity and has been used for the determination of AA and UA in real human urine and serum samples with satisfied results. - Graphical abstract: The schematic diagram of formation of Au nanotube arrays (a) and the stepwise procedure of the sensor (b). Highlights: Black-Right-Pointing-Pointer Gold nanotubes array has been synthesized by cyclic voltammetry. Black-Right-Pointing-Pointer The mechanism of deposition of gold nanotube has been discussed. Black-Right-Pointing-Pointer A determination of ascorbic acid and uric acid was constructed by gold array. Black-Right-Pointing-Pointer A satisfied determination of samples can be obtained by this sensor.

  3. Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

    Science.gov (United States)

    Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

    2018-06-01

    Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

  4. 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).

  5. 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.

  6. The training and learning process of transseptal puncture using a modified technique.

    Science.gov (United States)

    Yao, Yan; Ding, Ligang; Chen, Wensheng; Guo, Jun; Bao, Jingru; Shi, Rui; Huang, Wen; Zhang, Shu; Wong, Tom

    2013-12-01

    As the transseptal (TS) puncture has become an integral part of many types of cardiac interventional procedures, its technique that was initial reported for measurement of left atrial pressure in 1950s, continue to evolve. Our laboratory adopted a modified technique which uses only coronary sinus catheter as the landmark to accomplishing TS punctures under fluoroscopy. The aim of this study is prospectively to evaluate the training and learning process for TS puncture guided by this modified technique. Guided by the training protocol, TS puncture was performed in 120 consecutive patients by three trainees without previous personal experience in TS catheterization and one experienced trainer as a controller. We analysed the following parameters: one puncture success rate, total procedure time, fluoroscopic time, and radiation dose. The learning curve was analysed using curve-fitting methodology. The first attempt at TS crossing was successful in 74 (82%), a second attempt was successful in 11 (12%), and 5 patients failed to puncture the interatrial septal finally. The average starting process time was 4.1 ± 0.8 min, and the estimated mean learning plateau was 1.2 ± 0.2 min. The estimated mean learning rate for process time was 25 ± 3 cases. Important aspects of learning curve can be estimated by fitting inverse curves for TS puncture. The study demonstrated that this technique was a simple, safe, economic, and effective approach for learning of TS puncture. Base on the statistical analysis, approximately 29 TS punctures will be needed for trainee to pass the steepest area of learning curve.

  7. The closure device for the puncture point of femoral artery: an experiment in vitro

    International Nuclear Information System (INIS)

    Sun Jiantao; Zhang Junfeng; Wu Ke; Wang Yi

    2010-01-01

    Objective: To assess the blocking effects of a new-type closure device for the puncture point of femoral artery in vitro. Methods: An embolic colloidal substance with stable swelling value was embedded in an extracorporeal model which was used as an imitator of femoral artery blood flow velocity. Results: The embolization colloid was not displaced by the imitated blood flow lash, the embolic colloid was firmly attached to the puncture point and no fluid extravasation occurred. Conclusion: This new-type closure device for the puncture point of femoral artery is simple in structure and easy to manipulate with satisfactory blocking results. (authors)

  8. 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.

  9. 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

  10. Computation of Quantum Bound States on a Singly Punctured Two-Torus

    International Nuclear Information System (INIS)

    Kar-Tim Chan; Zainuddin Hishamuddin; Molladavoudi Saeid

    2013-01-01

    We study a quantum mechanical system on a singly punctured two-torus with bound states described by the Maass waveforms which are eigenfunctions of the hyperbolic Laplace—Beltrami operator. Since the discrete eigenvalues of the Maass cusp form are not known analytically, they are solved numerically using an adapted algorithm of Hejhal and Then to compute Maass cusp forms on the punctured two-torus. We report on the computational results of the lower lying eigenvalues for the punctured two-torus and find that they are doubly-degenerate. We also visualize the eigenstates of selected eigenvalues using GridMathematica

  11. Direct isolation of H1N2 recombinant virus from a throat swab of a patient simultaneously infected with H1N1 and H3N2 influenza A viruses.

    OpenAIRE

    Nishikawa, F; Sugiyama, T

    1983-01-01

    Two H1N2 recombinant viruses were isolated by a plaquing method from a throat swab of a patient who was simultaneously infected with H1N1 and H3N2 influenza viruses during the Tokyo epidemic of 1981. This is the first direct evidence that recombination of influenza viruses occurred in the human body.

  12. 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.

  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. Simultaneous radiochemotherapy

    International Nuclear Information System (INIS)

    Dunst, J.; Sauer, R.

    1993-01-01

    Simultaneous radiochemotherapy (RCT) means the simultaneous application of radiotherapy and chemotherapy. The major objective of this approach is the improvement of local control. On the cellular level, three types of interactions may be distinguished: Additivity, synergism, and sensibilization. The main type of interaction seems to be a simple additive effect. The clinical effect of a simultaneous chemotherapy depends mainly on the cytotoxic action of the drug itself and not on radiosensibilization. Therefore, effective chemotherapeutic drugs are to be delivered in cytotoxic dosages in RCT protocols. Compromises in radiotherapy as the main modality should be avoided. Recent clinical data have shown that simultaneous radiochemotherapy may yield heigh remission rates in a number of tumor entities (e.g. anal cancer, bladder cancer, head and neck cancer). This seems to improve local control as compared to radiotherapy alone. In some tumors (e.g. head and neck, esophagus), survival may be improved also. However, several questions require future detailed clinical trials. These questions include the value of simultaneous radiochemotherapy compared to optimal fractionation schemes, the clear definition of subgroups of patients with benefit by radiochemotherapy and the optimal dose intensity of cytotoxic drugs. (orig.) [de

  15. 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 ...

  16. 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.

  17. 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)

  18. 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)

  19. 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.

  20. 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.

  1. 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.

  2. Laparoscopic Removal of a Large Ovarian Mass Utilizing Planned Trocar Puncture

    OpenAIRE

    Stitely, Michael L.

    2012-01-01

    Background: Large cystic ovarian masses pose technical challenges to the laparoscopic surgeon. Removing large, potentially malignant specimens must be done with care to avoid the leakage of cyst fluid into the abdominal cavity. Case: We present the case of a large ovarian cystic mass treated laparoscopically with intentional trocar puncture of the mass to drain and remove the mass. Discussion: Large cystic ovarian masses can be removed laparoscopically with intentional trocar puncture of the ...

  3. 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.

  4. 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.

  5. Conformal blocks on a 2-sphere with indistinguishable punctures and implications on black hole entropy

    Directory of Open Access Journals (Sweden)

    Abhishek Majhi

    2016-11-01

    Full Text Available The dimensionality of the Hilbert space of a Chern–Simons theory on a 3-fold, in the presence of Wilson lines carrying spin representations, had been counted by using its link with the Wess–Zumino theory, with level k, on the 2-sphere with points (to be called punctures marked by the piercing of the corresponding Wilson lines and carrying the respective spin representations. It is shown, in the weak coupling (large k limit, the formula decouples into two characteristically distinct parts; one mimics the dimensionality of the Hilbert space of a collection of non-interacting spin systems and the other is an effective overall correction contributed by all the punctures. The exact formula yield from this counting has been shown earlier to have resulted from the consideration of the punctures to be distinguishable. We investigate the same counting problem by considering the punctures to be indistinguishable. Although the full formula remains undiscovered, nonetheless, we are able to impose the relevant statistics for indistinguishable punctures in the approximate formula resulting from the weak coupling limit. As an implication of this counting, in the context of its relation to that of black hole entropy calculation in quantum geometric approach, we are able to show that the logarithmic area correction, with a coefficient of −3/2, that results in this method of entropy calculation, in independent of whether the punctures are distinguishable or not.

  6. The effect of second-stage pushing and body mass index on postdural puncture headache.

    Science.gov (United States)

    Franz, Amber M; Jia, Shawn Y; Bahnson, Henry T; Goel, Akash; Habib, Ashraf S

    2017-02-01

    To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. Retrospective cohort. Obstetric ward and operating rooms at a university-affiliated hospital. One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014. Patients were categorized by pushing status and body mass index (kg/m 2 ): nonobese push, women who pushed during labor had increased risk of postdural puncture headache (odds ratio [OR], 2.1 [1.1-4.0]; P=.02), more days of headache (P=.02), and increased epidural blood patch placement (P=.02). Super obese patients were less likely to develop headache compared with nonobese (OR, 0.33 [0.13-0.85]; P=.02), obese (OR, 0.37 [0.14-0.98]; P=.045], and morbidly obese patients (OR, 0.20 [0.05-0.68]; Ppushing (OR, 0.57 [0.29-1.10]; P=.096) and super obesity (OR, 0.41 [0.16-1.02]; P=.056] were no longer significantly associated with reduced risk of postdural puncture headache. Parturients who did not push before delivery and parturients with body mass index ≥50kg/m 2 were less likely to develop postdural puncture headache in a univariate analysis. Similar trends were demonstrated in a multivariate model, but were no longer statistically significant. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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)

  8. Aortic intracardiac echocardiography-guided septal puncture during mitral valvuloplasty.

    Science.gov (United States)

    Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet Birhan

    2014-01-01

    Transoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 ± 9 years, 86% female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 ± 0.2 cm(2), and the mean left atrial volume index was 57.5 ± 12 mL/m(2). The mean size of the visualized septal length was 48 ± 5 mm by TEE, 51 ± 5 mm by aortic ICE, and 33 ± 6 mm by venous ICE. The Bland-Altman test indicated that the 95% limits of agreement for the measurement of septal diameter ranged from -11.0 to +5.9 mm (mean -2.5 mm) between TEE and aortic ICE, -2.8 to +33.5 mm (mean +15.3 mm) between TEE and venous ICE, and -36.6 to +0.8 mm (mean -17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and 'tenting effect' was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P < 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.

  9. 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)

  10. Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.

    Science.gov (United States)

    Ibrahim, Irwani; Yau, Ying Wei; Ong, Lizhen; Chan, Yiong Huak; Kuan, Win Sen

    2015-03-01

    Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample. © 2015 by the Society for Academic Emergency Medicine.

  11. The natural history of pedal puncture wounds in diabetics: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    East Jeffrey M

    2011-10-01

    Full Text Available Abstract Background Surgeons usually witness only the limb-threatening stages of infected, closed pedal puncture wounds in diabetics. Given that this catastrophic outcome often represents failure of conservative management of pre-infected wounds, some suggest consideration of invasive intervention (coring or laying-open for pre-infected wounds in hope of preventing contamination from evolving into infection, there being no evidence based guidelines. However, an invasive pre-emptive approach is only justifiable if the probability of progression to catastrophic infection is very high. Literature search revealed no prior studies on the natural history of closed pedal puncture wounds in diabetics. Methods A survey was conducted via an interviewer-administered questionnaire on 198 adult diabetics resident in the parish of St. James, Jamaica. The sample was selected using a purposive technique designed to mirror the social gradient and residential distribution of the target population and is twice the number needed to detect a prevalence of puncture wounds of 14% with a range of 7-21% in a random sample of the estimated adult diabetic population. Results The prevalence of a history of at least one closed pedal puncture wound since diagnosis of diabetes was 25.8% (CI; 19.6-31.9%. The only modifiable variable associated at the 5% level of significance with risk of pedal puncture wound, after adjustment by multivariable logistic regression, was site of interview/paying status, a variable substantially reflective of income more so than quality-of-care. Of 77 reported episodes of closed pedal puncture wound among 51 participants, 45.4% healed without medical intervention, 27.3% healed after non-surgical treatment by a doctor and 27.3% required surgical intervention ranging from debridement to below-knee amputation. Anesthetic foot (failure to feel the puncture and sole of the forefoot as site of puncture were the variables significantly associated with

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

    International Nuclear Information System (INIS)

    Hannerz, J.; Ericson, K.; Bro Skejoe, H.P.

    1999-01-01

    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.)

  13. Design of Rate-Compatible Parallel Concatenated Punctured Polar Codes for IR-HARQ Transmission Schemes

    Directory of Open Access Journals (Sweden)

    Jian Jiao

    2017-11-01

    Full Text Available In this paper, we propose a rate-compatible (RC parallel concatenated punctured polar (PCPP codes for incremental redundancy hybrid automatic repeat request (IR-HARQ transmission schemes, which can transmit multiple data blocks over a time-varying channel. The PCPP coding scheme can provide RC polar coding blocks in order to adapt to channel variations. First, we investigate an improved random puncturing (IRP pattern for the PCPP coding scheme due to the code-rate and block length limitations of conventional polar codes. The proposed IRP algorithm only select puncturing bits from the frozen bits set and keep the information bits unchanged during puncturing, which can improve 0.2–1 dB decoding performance more than the existing random puncturing (RP algorithm. Then, we develop a RC IR-HARQ transmission scheme based on PCPP codes. By analyzing the overhead of the previous successful decoded PCPP coding block in our IR-HARQ scheme, the optimal initial code-rate can be determined for each new PCPP coding block over time-varying channels. Simulation results show that the average number of transmissions is about 1.8 times for each PCPP coding block in our RC IR-HARQ scheme with a 2-level PCPP encoding construction, which can reduce half of the average number of transmissions than the existing RC polar coding schemes.

  14. Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance

    Directory of Open Access Journals (Sweden)

    Zolnierczyk P

    2015-05-01

    Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index – 38, congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic–therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations. Keywords: ovarian cyst puncture, hysteroscopy, ultrasound guided puncture, transfundal cyst puncture, vaginoscopy 

  15. Technological advances and changing indications for lumbar puncture in neurological disorders.

    Science.gov (United States)

    Costerus, Joost M; Brouwer, Matthijs C; van de Beek, Diederik

    2018-03-01

    Technological advances have changed the indications for and the way in which lumbar puncture is done. Suspected CNS infection remains the most common indication for lumbar puncture, but new molecular techniques have broadened CSF analysis indications, such as the determination of neuronal autoantibodies in autoimmune encephalitis. New screening techniques have increased sensitvity for pathogen detection and can be used to identify pathogens that were previously unknown to cause CNS infections. Evidence suggests that potential treatments for neurodegenerative diseases, such as Alzheimer's disease, will rely on early detection of the disease with the use of CSF biomarkers. In addition to being used as a diagnostic tool, lumbar puncture can also be used to administer intrathecal treatments as shown by studies of antisense oligonucleotides in patients with spinal muscular atrophy. Lumbar puncture is generally a safe procedure but complications can occur, ranging from minor (eg, back pain) to potentially devastating (eg, cerebral herniation). Evidence that an atraumatic needle tip design reduces complications of lumbar puncture is compelling, and reinforces the need to change clinical practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Simulation and training of lumbar punctures using haptic volume rendering and a 6DOF haptic device

    Science.gov (United States)

    Färber, Matthias; Heller, Julika; Handels, Heinz

    2007-03-01

    The lumbar puncture is performed by inserting a needle into the spinal chord of the patient to inject medicaments or to extract liquor. The training of this procedure is usually done on the patient guided by experienced supervisors. A virtual reality lumbar puncture simulator has been developed in order to minimize the training costs and the patient's risk. We use a haptic device with six degrees of freedom (6DOF) to feedback forces that resist needle insertion and rotation. An improved haptic volume rendering approach is used to calculate the forces. This approach makes use of label data of relevant structures like skin, bone, muscles or fat and original CT data that contributes information about image structures that can not be segmented. A real-time 3D visualization with optional stereo view shows the punctured region. 2D visualizations of orthogonal slices enable a detailed impression of the anatomical context. The input data consisting of CT and label data and surface models of relevant structures is defined in an XML file together with haptic rendering and visualization parameters. In a first evaluation the visible human male data has been used to generate a virtual training body. Several users with different medical experience tested the lumbar puncture trainer. The simulator gives a good haptic and visual impression of the needle insertion and the haptic volume rendering technique enables the feeling of unsegmented structures. Especially, the restriction of transversal needle movement together with rotation constraints enabled by the 6DOF device facilitate a realistic puncture simulation.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Simultaneous alcohol and cannabis expectancies predict simultaneous use

    Directory of Open Access Journals (Sweden)

    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. 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

  20. 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)

  1. 40 CFR 63.6000 - How do I conduct tests and procedures for puncture sealant application affected sources?

    Science.gov (United States)

    2010-07-01

    ... Tire Manufacturing Testing and Initial Compliance Requirements for Puncture Sealant Application... balances to demonstrate compliance, if the storage of materials, exhaust, or the wastewater from more than...

  2. 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.

  3. Experimental analysis of Kevlar modification for TRUPACT-I puncture panels

    International Nuclear Information System (INIS)

    Longenbaugh, R.S.; Joseph, B.J.

    1987-05-01

    The Kevlar Test Services was initiated to determine the maximum failure force and the energy-absorbing capability of puncture panels consisting of 16, 20, and 24 layers of 3000-denier 4 x 4 basket weave Kevlar-29, bonded to a 3.41 mm 304 annealed stainless steel puncture plate. Results of these tests were compared to the TRUPACT-1 Unit-0 drop test results to determine if the existing puncture panel configuration of TRUPACT-1 could be reduced. The data indicate for 24 layers of Kevlar, the panels failed at loads greater than those recorded in the TRUPACT-1, Unit 0 tests. Energy absorbed by the 24-layer Kevlar panels was 53% greater than that measured in the TRUPACT-1, Unit 0 test. Thermal performance of 20-layer Kevlar panels was measured in a conservative test environment and exceeded the design specifications

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Testing and analysis to determine the shell thickness required to prevent puncture

    International Nuclear Information System (INIS)

    Ammerman, D.J.; Radloff, H.D.; Eifert, E.J.

    1998-05-01

    Type B radioactive material packages are required to withstand a hypothetical puncture accident of a free fall from a height of one meter onto a 15 cm diameter mild steel puncture probe. For many packages it is desirable to have this accident event not result in puncture or tearing of the outer shell of the package. The wall thickness necessary to prevent this has historically been determined by test or the use of empirical relations. This technique generally results in overly conservative designs, but the degree of conservatism is uncertain. The use of modem finite element codes to determine package response to puncture accidents can result in designs that are both safe and economical. The work reported in this paper is aimed at developing a method to analytically determine the wall thickness required to prevent puncture. For designers and regulators to have confidence in this analytical method, however, it must be benchmarked against test results. A series of tests has been conducted with differing shell thicknesses, shell materials of mild steel and stainless steel, and shell backing materials of lead, foam, and air. The results of these tests have been compared with pre-test analytical predictions of the response obtained from the nonlinear transient dynamic finite element program PRONTO-2D. From this comparison it can be seen that the finite element method can accurately predict the response of packages to puncture accidents. This implies that an analytical technique based on the finite element method can be used to design packages having known response and margin of safety against tearing of the outer shell. In addition, the analytical technique can accurately predict the deformed shape of the package following the test. This may be important for subsequent calculations, such as external dose and heat input during a thermal event

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. Use of a Puncture Needle for Recanalization of an Occluded Right Subclavian Vein

    International Nuclear Information System (INIS)

    Gupta, Himanshu; Murphy, Timothy P.; Soares, Gregory M.

    1998-01-01

    We report a patient in whom we used a puncture needle to initiate percutaneous recanalization of a chronic occlusion of the junction between the right subclavian vein and the right brachiocephalic vein. Under fluoroscopic guidance, an 18-gauge needle was used to puncture the right subclavian vein. When contrast material injected through the needle confirmed intravascular location, the needle was advanced until it deflected and perforated an occlusion balloon target positioned within the right brachiocephalic vein. This technique may be useful in patients with central venous occlusions that are refractory to traversal using traditional catheter and guidewire techniques

  10. 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

  11. Laparoscopic Removal of a Large Ovarian Mass Utilizing Planned Trocar Puncture

    Science.gov (United States)

    2012-01-01

    Background: Large cystic ovarian masses pose technical challenges to the laparoscopic surgeon. Removing large, potentially malignant specimens must be done with care to avoid the leakage of cyst fluid into the abdominal cavity. Case: We present the case of a large ovarian cystic mass treated laparoscopically with intentional trocar puncture of the mass to drain and remove the mass. Discussion: Large cystic ovarian masses can be removed laparoscopically with intentional trocar puncture of the mass to facilitate removal without leakage of cyst fluid. PMID:22906344

  12. Simultaneous and Direct Determination of Vancomycin and Cephalexin in Human Plasma by Using HPLC-DAD Coupled with Second-Order Calibration Algorithms

    Directory of Open Access Journals (Sweden)

    Le-Qian Hu

    2012-01-01

    Full Text Available A simple, rapid, and sensitive method for the simultaneous determination of vancomycin and cephalexin in human plasma was developed by using HPLC-DAD with second-order calibration algorithms. Instead of a completely chromatographic separation, mathematical separation was performed by using two trilinear decomposition algorithms, that is, PARAFAC-alternative least squares (PARAFAC-ALSs and self-weight-alternative-trilinear-decomposition- (SWATLD- coupled high-performance liquid chromatography with DAD detection. The average recoveries attained from PARAFAC-ALS and SWATLD with the factor number of 4 (N=4 were 101±5% and 102±4% for vancomycin, and 96±3% and 97±3% for cephalexininde in real human samples, respectively. The statistical comparison between PARAFAC-ALS and SWATLD is demonstrated to be similar. The results indicated that the combination of HPLC-DAD detection with second-order calibration algorithms is a powerful tool to quantify the analytes of interest from overlapped chromatographic profiles for complex analysis of drugs in plasma.

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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

  15. Influence of repetitive finger puncturing on skin perfusion and capillary blood analysis in patients with diabetes mellitus

    NARCIS (Netherlands)

    de Graaff, J. C.; Hemmes, G. J.; Bruin, T.; Ubbink, D. T.; Michels, R. P.; Jacobs, M. J.; Sanders, G. T.

    1999-01-01

    Frequent puncturing of fingers to check blood glucose in patients with type 1 diabetes might alter skin perfusion and, hence, influence the representativeness of the blood sample. We investigated the influence of repetitive puncturing on skin microcirculatory perfusion using laser Doppler fluxmetry

  16. 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

  17. 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

  18. Ultrasound-guided, minimally invasive, percutaneous needle puncture treatment for tennis elbow.

    Science.gov (United States)

    Zhu, Jiaan; Hu, Bing; Xing, Chunyan; Li, Jia

    2008-10-01

    This report evaluates the efficacy of percutaneous needle puncture under sonographic guidance in treating lateral epicondylitis (tennis-elbow). Ultrasound-guided percutaneous needle puncture was performed on 76 patients who presented with persistent elbow pain. Under a local anesthetic and sonographic guidance, a needle was advanced into the calcification foci and the calcifications were mechanically fragmented. This was followed by a local injection of 25 mg prednisone acetate and 1% lidocaine. If no calcification was found then multiple punctures were performed followed by local injection of 25 mg prednisone acetate and 1% lidocaine. A visual analog scale (VAS) was used to evaluate the degree of pain pre-and posttreatment at 1 week to 24 weeks. Elbow function improvement and degree of self-satisfaction were also evaluated. Of the 76 patients, 55% were rated with excellent treatment outcome, 32% good, 11% average, and 3% poor. From 3 weeks posttreatment, VAS scores were significantly reduced compared with the pretreatment score (Ptennis elbow. Sonography can be used to accurately identify the puncture location and monitor changes.

  19. Gadolinium enhancement of spinal subdural collection on magnetic resonance imaging after lumbar puncture

    International Nuclear Information System (INIS)

    Teksam, Mehmet; Casey, Sean O.; McKinney, Alexander; Michel, Eduard; Truwit, Charles L.

    2003-01-01

    We report a 35-year-old male with an unusual contrast-enhancing sterile spinal subdural collection on magnetic resonance imaging (MRI), apparently occurring as a complication of lumbar puncture. Follow-up MRI after 4 weeks demonstrated spontaneous resolution of the collection without intervening treatment. (orig.)

  20. Quasiequilibrium states of black hole-neutron star binaries in the moving-puncture framework

    International Nuclear Information System (INIS)

    Kyutoku, Koutarou; Shibata, Masaru; Taniguchi, Keisuke

    2009-01-01

    General relativistic quasiequilibrium states of black hole-neutron star binaries are computed in the moving-puncture framework. We propose three conditions for determining the quasiequilibrium states and compare the numerical results with those obtained in the excision framework. We find that the results obtained in the moving-puncture framework agree with those in the excision framework and with those in the third post-Newtonian approximation for the cases that (i) the mass ratio of the binary is close to unity irrespective of the orbital separation, and (ii) the orbital separation is large enough (m 0 Ω 0 and Ω are the total mass and the orbital angular velocity, respectively) irrespective of the mass ratio. For m 0 Ω > or approx. 0.03, both of the results in the moving-puncture and excision frameworks deviate, more or less, from those in the third post-Newtonian approximation. Thus the numerical results do not provide a quasicircular state, rather they seem to have a non-negligible eccentricity of order 0.01-0.1. We show by numerical simulation that a method in the moving-puncture framework can provide approximately quasicircular states in which the eccentricity is by a factor of ∼2 smaller than those in quasiequilibrium given by other approaches.

  1. 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...

  2. Utility of the puncture of the radial artery in interventionist radiology

    International Nuclear Information System (INIS)

    Triana Rodriguez, Carlos Eduardo; Montes S, Mauricio; Barragan F, Jaime; Ucros Diaz Pablo; Ucros Diaz, Ignacio; Castillo, Luis Fernando

    1998-01-01

    We present the radial artery access, previous evaluation of collateral circulation with Allen's Test, as an alternative vascular access in patients with contraindications for femoral or axillary approaches. The radial artery puncture offers advantages, such as diminished bleeding and hematoma formation

  3. 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

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

    OpenAIRE

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

    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 pers...

  5. Simultaneous determination of glucose, triglycerides, urea, cholesterol, albumin and total protein in human plasma by Fourier transform infrared spectroscopy: direct clinical biochemistry without reagents.

    Science.gov (United States)

    Jessen, Torben E; Höskuldsson, Agnar T; Bjerrum, Poul J; Verder, Henrik; Sørensen, Lars; Bratholm, Palle S; Christensen, Bo; Jensen, Lene S; Jensen, Maria A B

    2014-09-01

    Direct measurement of chemical constituents in complex biologic matrices without the use of analyte specific reagents could be a step forward toward the simplification of clinical biochemistry. Problems related to reagents such as production errors, improper handling, and lot-to-lot variations would be eliminated as well as errors occurring during assay execution. We describe and validate a reagent free method for direct measurement of six analytes in human plasma based on Fourier-transform infrared spectroscopy (FTIR). Blood plasma is analyzed without any sample preparation. FTIR spectrum of the raw plasma is recorded in a sampling cuvette specially designed for measurement of aqueous solutions. For each analyte, a mathematical calibration process is performed by a stepwise selection of wavelengths giving the optimal least-squares correlation between the measured FTIR signal and the analyte concentration measured by conventional clinical reference methods. The developed calibration algorithms are subsequently evaluated for their capability to predict the concentration of the six analytes in blinded patient samples. The correlation between the six FTIR methods and corresponding reference methods were 0.87albumin and total protein in human plasma. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  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. 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.

  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. 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

  10. 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

  11. 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

  12. An analysis of a puncture wound case with medical intervention

    International Nuclear Information System (INIS)

    Bailey, B.R.; Eckerman, K.F.; Townsend, L.W.

    2003-01-01

    A worker noted a small wound to his thumb when leaving a work site that was undergoing decontamination because of past operations with plutonium (Pu) and americium (Am). Direct surveys of the wound site confirmed the presence of contamination. The chelating agent Ca-DTPA was administered via a nebulizer within an hour after discovery of the wound. External measurements were made of the wound site and wound dressings; 24-h urinary excretion data were collected periodically and the Pu and Am urine content was determined. Zn-DTPA was administered on three occasions. The ICRP Pu systemic model was modified to consider the enhanced urinary excretion following administration of the chelating agents. The analysis indicated that the wound resulted in an initial deposition of 400 Bq 238 Pu, 2240 Bq 239 / 240 Pu and 1060 Bq 241 Am. About 70% of the initial wound activity was removed by surgical procedures and less than 1% of the wound activity was removed by chelation therapy. This paper compares the observed urinary excretion data with that indicated by a simulation of the kinetics of the transfer from the wound site and the kinetics of the chelating agent and Pu. (author)

  13. 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.

  14. Technical measurement of small fission gas inventory in fuel rod with laser puncturing system

    International Nuclear Information System (INIS)

    Kim, Hee Moon; Kim, Sung Ryul; Lee, Byoung Oon; Yang, Yong Sik; Baek, Sang Ryul; Song, Ung Sup

    2012-01-01

    The fission gas release cause degradation of fuel rod. It influences fuel temperature and internal pressure due to low thermal conductivity. Therefore, fission gas released to internal void of fuel rod must be measured with burnup. To measure amount of fission gas, fuel rod must be punctured by a steel needle in a closed chamber. Ideal gas law(PV=nRT) is applied to obtain atomic concentration(mole). Steel needle type is good for large amount of fission gas such as commercial spent fuel rod. But, some cases with small fuel rig in research reactor for R/D program are not available to use needle type because of large chamber volume. The laser puncturing technique was developed to solve measurement of small amount of fission gas. This system was very rare equipment in other countries. Fine pressure gage and strong vacuum system were installed, and the chamber volume was reduced at least. Fiber laser was used for easy operation

  15. 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.

  16. Transfundal puncture of a large ovarian cyst with hysteroscopic and ultrasonographic guidance.

    Science.gov (United States)

    Zolnierczyk, Piotr; Cendrowski, Krzysztof; Sawicki, Wlodzimierz

    2015-01-01

    This paper describes the case of an 83-year-old patient with hypertension, diabetes, obesity (body mass index - 38), congestive heart failure, and history of cardiac surgery, who was referred for a diagnostic-therapeutic decompression of a large, symptomatic ovarian cyst. Due to anatomical conditions, the only safe way was a transfundal puncture under mini-hysteroscopic and ultrasound guidance. A puncture with aspiration of 300 mL of serous fluid from the cyst was performed without technical problems and complications. Cytology showed no cancer cells in the examined liquid. Relief from pain and compression discomfort was achieved in the patient. This case shows the possibility of combining ultrasound and minimally invasive diagnostic methods like hysteroscopy in selected clinical situations.

  17. 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...

  18. Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

    OpenAIRE

    Zahra Abbas Ali Madadi; Jalil Azimian; Farzaneh Falahatpishe; Mahmoud Alipour Heidari

    2017-01-01

    Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients. Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients ...

  19. Construction of Rate-Compatible LDPC Codes Utilizing Information Shortening and Parity Puncturing

    Directory of Open Access Journals (Sweden)

    Jones Christopher R

    2005-01-01

    Full Text Available This paper proposes a method for constructing rate-compatible low-density parity-check (LDPC codes. The construction considers the problem of optimizing a family of rate-compatible degree distributions as well as the placement of bipartite graph edges. A hybrid approach that combines information shortening and parity puncturing is proposed. Local graph conditioning techniques for the suppression of error floors are also included in the construction methodology.

  20. 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...

  1. Diagnostic Lumbar Puncture Among Children With Facial Palsy in a Lyme Disease Endemic Area.

    Science.gov (United States)

    Paydar-Darian, Niloufar; Kimia, Amir A; Lantos, Paul M; Fine, Andrew M; Gordon, Caroline D; Gordon, Catherine R; Landschaft, Assaf; Nigrovic, Lise E

    2017-06-01

    We identified 620 children with peripheral facial palsy of which 211 (34%) had Lyme disease. The 140 children who had a lumbar puncture performed were more likely to be hospitalized (73% LP performed vs 2% no LP) and to receive parenteral antibiotics (62% LP performed vs 6% no LP). © The Author 2016. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. 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

  3. Effect of needle puncture and electro-acupuncture on mucociliary clearance in anesthetized quails

    Directory of Open Access Journals (Sweden)

    Wang Tianshan

    2006-02-01

    Full Text Available Abstract Background Acupuncture therapy for obstructive respiratory diseases has been effectively used in clinical practice and the acupuncture points or acupoints of Zhongfu and Tiantu are commonly-used acupoints to treat patients with the diseases. Since the impaired mucociliary clearance is among the most important features of airway inflammation in most obstructive respiratory diseases, the effect of needle puncture and electro-acupuncture at the specific acupoints on tracheal mucociliary clearance was investigated in anesthetized quails. Methods Mucociliary transport velocity on tracheal mucosa was measured through observing the optimal pathway, and fucose and protein contents in tracheal lavages were determined with biochemical methods. In the therapeutic group, needle puncture or electro-acupuncture stimulation to the acupoints was applied without or with constant current output in 2 mA and at frequency of 100 Hz for 60 minutes. In the sham group, electro-acupuncture stimulation to Liangmen was applied. Results Our present experiments demonstrated that the electro-acupuncture stimulation to Zhongfu and Tiantu significantly increased tracheal mucociliary transport velocity and decreased the content of protein in the tracheal lavage, compared with the control group. Moreover, either needle puncture or electro-acupuncture stimulation to Zhongfu and Tiantu significantly reverted the human neutrophil elastase-induced decrease in tracheal mucociliary transport velocity and human neutrophil elastase -induced increase in the contents of fucose and protein in the tracheal lavage, compared with the control group. Conclusion These results suggest that either needle puncture or electro-acupuncture stimulation to the effective acupoints significantly improves both airway mucociliary clearance and the airway surface liquid and that the improvements maybe ascribed to both the special function of the points and the substantial stimulation of electricity.

  4. 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.

  5. Shanidar 3 Neandertal rib puncture wound and paleolithic weaponry.

    Science.gov (United States)

    Churchill, Steven E; Franciscus, Robert G; McKean-Peraza, Hilary A; Daniel, Julie A; Warren, Brittany R

    2009-08-01

    Since its discovery and initial description in the 1960s, the penetrating lesion to the left ninth rib of the Shanidar 3 Neandertal has been a focus for discussion about interpersonal violence and weapon technology in the Middle Paleolithic. Recent experimental studies using lithic points on animal targets suggest that aspects of weapon system dynamics can be inferred from the form of the bony lesions they produce. Thus, to better understand the circumstances surrounding the traumatic injury suffered by Shanidar 3, we conducted controlled stabbing experiments with replicas of Mousterian and Levallois points directed against the thoraces of pig carcasses. Stabs were conducted under both high and low kinetic energy conditions, in an effort to replicate the usual impact forces associated with thrusting spear vs. long-range projectile weapon systems, respectively. Analysis of the lesions produced in the pig ribs, along with examination of goat ribs subjected primarily to high kinetic energy stabs from an independent experiment, revealed consistent differences in damage patterns between the two conditions. In the case of Shanidar 3, the lack of major involvement of more than one rib, the lack of fracturing of the affected and adjacent ribs, and the lack of bony defects associated with the lesion (such as wastage, hinging, and radiating fracture lines) suggests that the weapon that wounded him was carrying relatively low kinetic energy. While accidental injury or attack with a thrusting spear or knife cannot absolutely be ruled out, the position, angulation, and morphology of the lesion is most consistent with injury by a low-mass, low-kinetic energy projectile weapon. Given the potential temporal overlap of Shanidar 3 with early modern humans in western Asia, and the possibility that the latter were armed with projectile weapon systems, this case carries more than simple paleoforensic interest.

  6. CT fluoroscopy-assisted puncture of thoracic and abdominal masses: a randomized trial.

    Science.gov (United States)

    Kirchner, Johannes; Kickuth, Ralph; Laufer, Ulf; Schilling, Esther Maria; Adams, Stephan; Liermann, Dieter

    2002-03-01

    We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CTF guidance realizes a time-saving but increases the radiation exposure dosage.

  7. 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®

  8. 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

  9. Clinical application of percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation under CT guidance

    International Nuclear Information System (INIS)

    Wang Linyou; Li Yuan; Shao Yangtong

    2004-01-01

    Objective: To evaluate the effect of the percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation. Methods: 75 cases of lumbar disc herniation with significant clinical signs were confirmed by CT scan. The technique of the percutaneous lumbar puncture led the needle to approach nerve root and injected medicine diffusing into extraduramater, and then relieved the symptom of sciatica. Results: The rate of success of percutaneous lumbar puncture guided by CT reached to 100%. After two weeks of follow-up, the symptom of pain was obviously improved and disappeared in 63.3% cases. There were 23.0% cases needed a second procedure, and no change was obsesved in 9.3% cases. Conclusions: The percutaneous lumbar puncture guided by CT to treat sciatica resulted from lumbar disc herniation is one of the safe, reliable, effective new methods with no complication. The long term effectiveness is still in need of investigation. (authors)

  10. Cerebral venous and sinus thrombosis with cerebrospinal fluid circulation block after the first methotrexate administration by lumbar puncture

    International Nuclear Information System (INIS)

    Bienfait, H.P.; Gijtenbeek, J.M.M.; Bent, M.J. van; Bruin, H.G. de; Voogt, P.J.; Pillay, M.

    2002-01-01

    We report a patient treated for small lymphocytic lymphoma/leukemia with cerebral venous and sinus thrombosis (CVST) after lumbar puncture with intrathecal administration of methotrexate (MTX). He also developed a cerebrospinal fluid flow block. This is the first report of an association between lumbar puncture and intrathecally administered MTX and the development of CVST. Intrathecal treatment in this patient was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously. (orig.)

  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. Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

    2015-10-15

    Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

  14. Validation of a novel cost effective easy to produce and durable in vitro model for kidney-puncture and PNL-Simulation.

    Science.gov (United States)

    Klein, Jan Thorsten; Rassweiler, Jens; Rassweiler-Seyfried, Marie-Claire Charlotte

    2018-03-29

    Nephrolithiasis is one of the most common diseases in urology. According to the EAU Guidelines, a percutaneous nephrolitholapaxy (PNL) is recommended when treating a kidney stone >2 cm. Nowadays PNL is performed even for smaller stones (PNL is the puncture of the planned site. PNL-novice surgeons need to practice this step in a safe environment with an ideal training model. We developed and evaluated a new, easy to produce, in-vitro model for the training of the freehand puncture of the kidney. Porcine kidneys with ureters were embedded in ballistic gel. Food coloring and preservative agent were added. We used the standard imaging modalities of X-ray and ultrasound to validate the training model. An additional new technique, the iPAD guided puncture, was evaluated. Five novices and three experts conducted 12 punctures for each imaging technique. Puncture time, radiation dose, and number of attempts to a successful puncture were measured. Mann-Whitney-U, Kruskal-Wallis, and U-Tests were used for statistical analyses. The sonographic guided puncture is slightly but not significantly faster than the fluoroscopic guided puncture and the iPAD assisted puncture. Similarly, the most experienced surgeon's time for a successful puncture was slightly less than that of the residents, and the experienced surgeons needed the least attempts to perform a successful puncture. In terms of radiation exposure, the residents had a significant reduction of radiation exposure compared to the experienced surgeons. The newly developed ballistic gel kidney-puncture model is a good training tool for a variety of kidney puncture techniques, with good content, construct, and face validity.

  15. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    International Nuclear Information System (INIS)

    Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young

    2006-01-01

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

  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. 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

  18. Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

    Science.gov (United States)

    Xu, Hong; Liu, Yang; Song, WenYe; Kan, ShunLi; Liu, FeiFei; Zhang, Di; Ning, GuangZhi; Feng, ShiQing

    2017-01-01

    Abstract Background: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle. Methods: We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data. Results: Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001). Conclusions: Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture. PMID:28383416

  19. Design of ACM system based on non-greedy punctured LDPC codes

    Science.gov (United States)

    Lu, Zijun; Jiang, Zihong; Zhou, Lin; He, Yucheng

    2017-08-01

    In this paper, an adaptive coded modulation (ACM) scheme based on rate-compatible LDPC (RC-LDPC) codes was designed. The RC-LDPC codes were constructed by a non-greedy puncturing method which showed good performance in high code rate region. Moreover, the incremental redundancy scheme of LDPC-based ACM system over AWGN channel was proposed. By this scheme, code rates vary from 2/3 to 5/6 and the complication of the ACM system is lowered. Simulations show that more and more obvious coding gain can be obtained by the proposed ACM system with higher throughput.

  20. Direct injection ion chromatography for the control of chlorinated drinking water: simultaneous estimation of nine haloacetic acids and quantitation of bromate, chlorite and chlorate along with the major inorganic anions.

    Science.gov (United States)

    Garcia-Villanova, Rafael J; Raposo Funcia, César; Oliveira Dantas Leite, M Vilani; Toruño Fonseca, Ivania M; Espinosa Nieto, Miguel; Espuelas India, Javier

    2014-09-01

    Most methods for the analysis of haloacetic acids published in recent years are based on ion chromatography with direct injection, employing a gradient elution with potassium hydroxide (KOH). This work reports the exploration of an alternative eluent, a buffer of sodium carbonate/sodium hydrogen carbonate, aimed at the simultaneous analysis of nine haloacetic acids along with bromate, chlorite and chlorate. The alternative of both a less alkaline eluent and a lower temperature of operation may prevent the partial decomposition of some of the haloacetic acids during the analytical process, especially the more vulnerable brominated ones. Gradient elution at temperature of 7 °C yielded the best results, with an acceptable separation of 17 analytes (which includes the major natural inorganic anions) and a good linearity. Precision ranges from 0.3 to 23.4 (% V.C.), and detection limits are within units of μg L⁻¹, except for tribromoacetic acid - somewhat high in comparison with those of the official methods. Nonetheless, with the basic instrumentation setup herein described, this method may be suitable for monitoring when the drinking water treatments are to be optimized. This is especially interesting for small communities or for developing/developed countries in which regulations on disinfection by-products others than trihalomethanes are being addressed.

  1. Effect of nebulizer/spray chamber interfaces on simultaneous, axial view inductively coupled plasma optical emission spectrometry for the direct determination of As and Se species separated by ion exchange high-performance liquid chromatography

    International Nuclear Information System (INIS)

    Gettar, Raquel T.; Smichowski, Patricia; Garavaglia, Ricardo N.; Farias, Silvia; Batistoni, Daniel A.

    2005-01-01

    Different nebulizer/expansion chamber combinations were evaluated to assess their performance for sample introduction in the direct coupling with an axial view inductively coupled plasma multielement spectrometer for on-line determination of As and Se species previously separated by ion exchange-high performance liquid chromatography. The column effluents were injected into the plasma without prior derivatization. The instrument operation software was adapted for data acquisition and processing to allow multi-wavelength recording of the transient chromatographic peaks. After optimization of the chromatographic operating conditions, separation of mixtures of inorganic As and Se species, and of inorganic and two organic As species (monomethylarsonic and dimethylarsinic acids), was achieved with excellent resolution. Species discrimination from mixtures of As and Se oxyanions was further improved by the simultaneous element detection at specific analytical wavelengths. Three nebulizers and three spray chambers, employed in seven combinations, were tested as interfaces. Concentric nebulizers associated to a glass cyclonic chamber appear most suitable regarding sensitivity and signal to noise ratio. Measured element detection limits (3 σ) were around 10 ng ml -1 for all the species considered, making the method a viable alternative to similar procedures that employ volatile hydride generation previous to sample injection into the plasma. Analytical recoveries both for inorganic and organic species ranged between 92 and 107%. The method was demonstrated to be apt for the analysis of surface waters potentially subjected to natural contamination with arsenic

  2. 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.

  3. [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.

  4. 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.

  5. Lumbar puncture requirement in acute hemiparesis: diagnosis of tuberculous meningitis after hemiparesis in a child.

    Science.gov (United States)

    Sahin, Sevim; Cansu, Ali; Kamaşak, Tülay; Eyüboğlu, İlker; Esenülkü, Gülnur; Ökten, Ayşenur

    2014-12-01

    Infections are an important acquired cause of cerebral arteriopathy. Tuberculous (TB) meningitis leading to infectious cerebral vasculopathy is a rare cause of acute hemiparesis. A 14-year-old male patient was examined after acute hemiparesis developing within 1 day. Neurological examination revealed total hemiplegia on the left side. Brain MRI findings showed bilateral focal T2-weighted signal hyperintensity in the subcortical and deep white matter regions. There were also areas of restricted diffusion in the right basal ganglia. Although the father had a history of pulmonary TB, the patient had not been given TB prophylaxis because of PPD negativity. At lumbar puncture, opening cerebrospinal fluid (CSF) pressure was 50 cm/H20, CSF protein 66.9 mg/dL, and glucose 54 mg/dL (concurrent blood glucose 93 mg/dL); 170 polymorphonuclear leukocytes per cubic millimeter were present in CSF. Following tests for TB, treatment was started immediately with four anti-TB drugs. TB PCR of CSF and acid-fast bacteria (AFB) staining in gastric aspirate were positive. At clinical follow-up, the patient was able to walk with support at the end of the first month. Various infectious agents have been reported as causes of cerebral vasculopathy. TB, which affects a significant number of patients worldwide, should be kept in mind in terms of cerebral vascular complications. Lumbar puncture is essential in order to diagnose TB meningitis.

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

    International Nuclear Information System (INIS)

    Issy, A.C.; Castania, V.; Castania, M.; Salmon, C.E.G.; Nogueira-Barbosa, M.H.; Bel, E. Del; Defino, H.L.A.

    2013-01-01

    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

  7. Equilibrium initial data for moving puncture simulations: the stationary 1 + log slicing

    International Nuclear Information System (INIS)

    Baumgarte, T W; Matera, K; Etienne, Z B; Liu, Y T; Shapiro, S L; Taniguchi, K; Murchadha, N O

    2009-01-01

    We discuss a 'stationary 1 + log' slicing condition for the construction of solutions to Einstein's constraint equations. For stationary spacetimes, these initial data give a stationary foliation when evolved with 'moving puncture' gauge conditions that are often used in black hole evolutions. The resulting slicing is time independent and agrees with the slicing generated by being dragged along a timelike Killing vector of the spacetime. When these initial data are evolved with moving puncture gauge conditions, numerical errors arising from coordinate evolution should be minimized. While these properties appear very promising, suggesting that this slicing condition should be an attractive alternative to, for example, maximal slicing, we demonstrate in this paper that solutions can be constructed only for a small class of problems. For binary black hole initial data, in particular, it is often assumed that there exists an approximate helical Killing vector that generates the binary's orbit. We show that 1 + log slices that are stationary with respect to such a helical Killing vector cannot be asymptotically flat, unless the spacetime possesses an additional axial Killing vector.

  8. Effectiveness of autologous epidural blood patch to relieve post dural puncture headache

    International Nuclear Information System (INIS)

    Iqbal, L.A.A.; Naqvi, E.H.

    2013-01-01

    Background: Post-dural puncture headache (PDPH) is a common problem in anaesthesia practice especially in obstetric anaesthesia. Autologous epidural blood patch (AEBP) is the main stay of treatment of PDPH when it is not relieved with conservative management. Objective: To describe the efficacy of AEBP in treatment of PDPH. Study Design: Prospective descriptive study. Setting and Duration: The study was conducted at departments of Anaesthesia and Intensive Care, Military Hospital, Rawalpindi and Combined Military Hospital, Malir, from July 2008 to July 2011. Methodology: All patients who received AEBP during study period secondary to PDPH were included. Up to 20 ml of autologous blood was injected in epidural space. Effectiveness of AEBP was judged by relief of symptom; any complications associated with AEBP i.e. backache and paresthesia were also noted. Data was interpreted as mean and percentages. Results: A total of 30 AEBP were performed during the study period in predominantly female patients (n=27) with mean age of 27.8 years. AEBP was performed after a mean 3.83 days of lumbar puncture. Complete relief was observed in 29 (96%) patients; one patient required a second patch. During the follow-up, 7 (23%) patients complained of backache and 2(6%) of paresthesias. conclusion: AEBP is an effective way of providing relief from PDPH. (author)

  9. X-ray targeting puncture collagenase chemonucleolysis combined with injection of medical ozone for the treatment of lumbar disc herniation

    International Nuclear Information System (INIS)

    Yao Lin; Zhu Genfa

    2011-01-01

    Objective: To evaluate the clinical value of X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone for lumbar disc herniation. Methods: One thousand and sixty-two cases of lumbar disc herniation accepted collagenase chemonucleolysis combined with injection of medical ozone targeted by X-ray. The therapeutic effects after operation were analyzed. Results: Of all the 1062 cases, the effective rate of X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone was 95.3% at 3 months, 92.3% at 12 months, and 91.2% at 24 months after operation. Conclusion: X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone is a simple and safe method for the lumbar disc herniation. It also had fewer adverse reactions and better therapeutic effects. (authors)

  10. 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.

  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. Cefalea secundaria a punción dural Headache as a result of dural puncture

    Directory of Open Access Journals (Sweden)

    Ariadna García Rodríguez

    2005-03-01

    Full Text Available Se realizó una revisión bibliográfica sobre cefalea pospunción en el Hospital "Abel Santamaría", de Pinar del Río, en el período comprendido de febrero a junio del 2004, con el objetivo de ampliar los conocimientos de los profesionales de la salud encargados de diagnosticar y tratar esta complicación. La cefalea secundaria a punción dural se debe al escape persistente de LCR (líquido cefalorraquídeo a través del desgarro hecho en la duramadre, causado por la penetración de la aguja; se presenta cuando el paciente adopta la posición erecta y se alivia con el decúbito, característica esta que de no aparecer debe hacer dudar el diagnóstico. La elección de un trocar fino para realizar la punción y la dirección del bisel paralelo a las fibras de la duramadre son los factores determinantes en la profilaxis de la cefalea. Aún existen controversias en cuanto a su tratamiento, pero si hay un consenso unido en que el parche de sangre epidural es el tratamiento definitivo de esta complicación.A review of the most updated literature on dural post-puncture headache was made at Abel Santamaría University Hospital in February - June 2004 aimed at spreading the awareness to health professionals at diagnosing and treating this condition. The headache secondary to dural puncture is caused by the persistent leakage of cerebrospinal fluid through the dura tear because of the needle insertion; it presents when the patient adopts the erect position and it alleviates with the supine position; if this characteristic is not present it may appear some doubts on diagnosis. The selection of a fine trocar for puncture and guiding the bevel parallel to the fibers of dura are the main factors for profilaxis of headache. Its treatment is controversial, but it does exist a consensus in that the epidural blood patch is the definitive treatment for this condition.

  13. Tezosentan reduces the microvascular filtration coefficient in isolated lungs from rats subjected to cecum ligation and puncture.

    Science.gov (United States)

    Kuklin, Vladimir; Sovershaev, Mikhail; Andreasen, Thomas; Skogen, Vegard; Ytrehus, Kirsti; Bjertnaes, Lars

    2005-01-01

    We recently demonstrated that the non-selective endothelin-1 (ET-1) receptor blocker tezosentan antagonizes ovine acute lung injury (ALI) following infusion of endotoxin or ET-1 by reducing the enhanced lung microvascular pressure, although we could not exclude the possibility of a simultaneous decline in microvascular permeability. In the present study, our aim was to find out if tezosentan reverses the rise in microvascular filtration coefficient (Kfc) in rat lungs that have been isolated and perfused 12 h after cecum ligation and puncture (CLP) or infusion of ET-1. Wistar rats (n = 42) were subjected to CLP. Postoperatively, rats were randomized to a CLP group (n = 7) and a CLP + tezosentan group (n = 7); the latter received tezosentan 30 mg/kg. A sham-operated group (n = 5) underwent laparotomy without CLP. Twelve hours postoperatively, the lungs were isolated and perfused with blood from similarly treated rats that also were used to assess plasma concentration of ET-1 and protein kinase Calpha (PKCalpha) in lung tissue. Additionally, isolated blood perfused lungs from healthy rats were randomized to a control group (n = 8), an ET-1 group (n = 7) subjected to pulmonary arterial injection of ET-1 10 nM, and an ET-1 + tezosentan group (n = 7) that received tezosentan 30 mg/kg. All lung preparations received papaverine 0.1 microg/kg added to the perfusate for vasoplegia. Pulmonary hemodynamic variables, Kfc and lung compliance (CL) were assessed. After CLP, the plasma concentration of ET-1 increased. Papaverine abolished the vasoconstrictor response to ET-1 and the pulmonary vascular pressures remained close to baseline throughout the experiments. Both CLP and injection of ET-1 caused significant changes in Kfc and CL that were prevented in tezosentan-treated rats. Compared to sham-operated animals, CLP increased the content of PKCalpha by 50% and 70% in the cytosolic and the membrane fractions of lung tissue homogenates, respectively. Tezosentan prevented the

  14. 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.

  15. 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.

  16. Evaluation of an antimicrobial surgical glove to inactivate live human immunodeficiency virus following simulated glove puncture.

    Science.gov (United States)

    Edmiston, Charles E; Zhou, S Steve; Hoerner, Pierre; Krikorian, Raffi; Krepel, Candace J; Lewis, Brian D; Brown, Kellie R; Rossi, Peter J; Graham, Mary Beth; Seabrook, Gary R

    2013-02-01

    Percutaneous injuries associated with cutting instruments, needles, and other sharps (eg, metallic meshes, bone fragments, etc) occur commonly during surgical procedures, exposing members of surgical teams to the risk for contamination by blood-borne pathogens. This study evaluated the efficacy of an innovative integrated antimicrobial glove to reduce transmission of the human immunodeficiency virus (HIV) following a simulated surgical-glove puncture injury. A pneumatically activated puncturing apparatus was used in a surgical-glove perforation model to evaluate the passage of live HIV-1 virus transferred via a contaminated blood-laden needle, using a reference (standard double-layer glove) and an antimicrobial benzalkonium chloride (BKC) surgical glove. The study used 2 experimental designs. In method A, 10 replicates were used in 2 cycles to compare the mean viral load following passage through standard and antimicrobial gloves. In method B, 10 replicates were pooled into 3 aliquots and were used to assess viral passage though standard and antimicrobial test gloves. In both methods, viral viability was assessed by observing the cytopathic effects in human lymphocytic C8166 T-cell tissue culture. Concurrent viral and cell culture viability controls were run in parallel with the experiment's studies. All controls involving tissue culture and viral viability were performed according to study design. Mean HIV viral loads (log(10)TCID(50)) were significantly reduced (P reduction (log reduction and percent viral reduction) of the HIV virus ranged from 1.96 to 2.4 and from 98.9% to 99.6%, respectively, following simulated surgical-glove perforation. Sharps injuries in the operating room pose a significant occupational risk for surgical practitioners. The findings of this study suggest that an innovative antimicrobial glove was effective at significantly (P < .01) reducing the risk for blood-borne virus transfer in a model of simulated glove perforation. Copyright

  17. Determination of Critical Conditions for Puncturing Almonds Using Coupled Response Surface Methodology and Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Mahmood Mahmoodi-Eshkaftaki

    2013-01-01

    Full Text Available In this study, the effect of seed moisture content, probe diameter and loading velocity (puncture conditions on some mechanical properties of almond kernel and peeled almond kernel is considered to model a relationship between the puncture conditions and rupture energy. Furthermore, distribution of the mechanical properties is determined. The main objective is to determine the critical values of mechanical properties significant for peeling machines. The response surface methodology was used to find the relationship between the input parameters and the output responses, and the fitness function was applied to measure the optimal values using the genetic algorithm. Two-parameter Weibull function was used to describe the distribution of mechanical properties. Based on the Weibull parameter values, i.e. shape parameter (β and scale parameter (η calculated for each property, the mechanical distribution variations were completely described and it was confirmed that the mechanical properties are rule governed, which makes the Weibull function suitable for estimating their distributions. The energy model estimated using response surface methodology shows that the mechanical properties relate exponentially to the moisture, and polynomially to the loading velocity and probe diameter, which enabled successful estimation of the rupture energy (R²=0.94. The genetic algorithm calculated the critical values of seed moisture, probe diameter, and loading velocity to be 18.11 % on dry mass basis, 0.79 mm, and 0.15 mm/min, respectively, and optimum rupture energy of 1.97·10-³ J. These conditions were used for comparison with new samples, where the rupture energy was experimentally measured to be 2.68 and 2.21·10-³ J for kernel and peeled kernel, respectively, which was nearly in agreement with our model results.

  18. 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.

  19. Opinion and Special Articles: Stress when performing the first lumbar puncture may compromise patient safety.

    Science.gov (United States)

    Henriksen, Mikael Johannes Vuokko; Wienecke, Troels; Kristiansen, Jesper; Park, Yoon Soo; Ringsted, Charlotte; Konge, Lars

    2018-05-22

    To quantify physician stress levels when performing lumbar puncture (LP) and explore operator stress effect on patient outcomes. This was a cross-sectional, multicenter study. Novices, intermediates, and experts in performing LP were recruited from 4 departments of neurology and emergency medicine. Stress was measured before and during performance of the LP using cognitive appraisal (CA), State-Trait Anxiety Inventory-Short (STAI-S) questionnaire, and the heart rate variability measure low frequency/high frequency index (LF/HF ratio). Patient-related outcomes were pain, confidence in the operator, and postdural puncture headache (PDPH). Forty-six physicians were included in the study: 22 novices, 12 intermediates, and 12 experts. Novices had the highest stress level and experts the lowest measured by cognitive appraisal and STAI-S before and during LP performance ( p < 0.001 for all comparisons). Novices had the highest sympathetic tonus indicated by the highest LF/HF ratio before ( p = 0.004) and during ( p = 0.056) LP performance. Physician stress level was not significantly related to patients' pain. However, there was a significant relationship between STAI-S during the procedure and patient confidence in the operator (regression coefficient = -0.034, p = 0.008). High physician heart rate during the procedure significantly increased the odds of PDPH (odds ratio = 1.17, p = 0.036). Novice stress levels were high before and during performance of LP. Stress was significantly related to patient confidence in the operator and risk of PDPH. Simulation-based training should be considered to reduce novice residents' stress levels and increase patient safety. © 2018 American Academy of Neurology.

  20. 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.

  1. J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system

    International Nuclear Information System (INIS)

    Hama, Yukihiro; Kusano, Shoichi; Makita, Kohzoh

    2004-01-01

    The aim of this study was to verify the feasibility of using a J-tipped guidewire as a target for puncture of the subclavian artery in the placement of a reservoir port and catheter system (RPCS). Twenty-five patients with various hepatic malignancies underwent percutaneous implantation of an RPCS through the left subclavian artery for regional chemotherapy. To successfully puncture the left subclavian artery, a J-tipped guidewire was used as a target with fluoroscopic guidance. Technical success and complication rates, and numbers of puncture failures, were retrospectively analyzed. Implantation of the RPCS was successful in all patients. Eight (32%) patients had minor complications and no patient had major complications. The number of puncture failures per patient was 0 to 1 (mean=0.32). The J-tipped guidewire is a safe and appropriate target for puncture of the subclavian artery in the placement of an RPCS. (orig.)

  2. 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...

  3. 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.

  4. Morphologic features of puncture sites after exoseal vascular closure device implantation: Changes on follow-up computed tomography

    International Nuclear Information System (INIS)

    Ryu, Hwa Seong; Jang, Joo Yeon; Kim, Tae Un; Lee, Jun Woo; Park, Jung Hwan; Choo, Ki Seok; Cho, Mong; Yoon, Ki Tae; Hong, Young Ki; Jeon, Ung Bae

    2017-01-01

    The study aimed to evaluate the morphologic changes in transarterial chemoembolization (TACE) puncture sites implanted with an ExoSeal vascular closure device (VCD) using follow-up computed tomography (CT). 16 patients who used ExoSeal VCD after TACE were enrolled. Using CT images, the diameters and anterior wall thicknesses of the puncture sites in the common femoral artery (CFA) were compared with those of the contralateral CFA before TACE, at 1 month after every TACE session, and at the final follow-up period. The rates of complications were also evaluated. There were no puncture- or VCD-related complications. Follow-up CT images of the CFA's of patients who used ExoSeal VCDs showed eccentric vascular wall thickening with soft-tissue densities considered to be hemostatic plugs. Final follow-up CT images (mean, 616 days; range, 95–1106 days) revealed partial or complete resorption of the hemostatic plugs. The CFA puncture site diameters did not differ statistically from those of the contralateral CFA on the final follow-up CT (p > 0.05), regardless of the number of VCDs used. Follow-up CT images of patients who used ExoSeal VCDs showed no significant vascular stenosis or significant vessel wall thickening

  5. Morphologic features of puncture sites after exoseal vascular closure device implantation: Changes on follow-up computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Hwa Seong; Jang, Joo Yeon; Kim, Tae Un; Lee, Jun Woo; Park, Jung Hwan; Choo, Ki Seok; Cho, Mong; Yoon, Ki Tae; Hong, Young Ki; Jeon, Ung Bae [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2017-05-15

    The study aimed to evaluate the morphologic changes in transarterial chemoembolization (TACE) puncture sites implanted with an ExoSeal vascular closure device (VCD) using follow-up computed tomography (CT). 16 patients who used ExoSeal VCD after TACE were enrolled. Using CT images, the diameters and anterior wall thicknesses of the puncture sites in the common femoral artery (CFA) were compared with those of the contralateral CFA before TACE, at 1 month after every TACE session, and at the final follow-up period. The rates of complications were also evaluated. There were no puncture- or VCD-related complications. Follow-up CT images of the CFA's of patients who used ExoSeal VCDs showed eccentric vascular wall thickening with soft-tissue densities considered to be hemostatic plugs. Final follow-up CT images (mean, 616 days; range, 95–1106 days) revealed partial or complete resorption of the hemostatic plugs. The CFA puncture site diameters did not differ statistically from those of the contralateral CFA on the final follow-up CT (p > 0.05), regardless of the number of VCDs used. Follow-up CT images of patients who used ExoSeal VCDs showed no significant vascular stenosis or significant vessel wall thickening.

  6. 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.

  7. 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.

  8. 40 CFR Table 14 to Subpart Xxxx of... - Continuous Compliance With the Emission Limitations for Puncture Sealant Application Affected...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Continuous Compliance With the Emission Limitations for Puncture Sealant Application Affected Sources 14 Table 14 to Subpart XXXX of Part 63... Hazardous Air Pollutants: Rubber Tire Manufacturing Pt. 63, Subpt. XXXX, Table 14 Table 14 to Subpart XXXX...

  9. 40 CFR Table 13 to Subpart Xxxx of... - Minimum Data for Continuous Compliance With the Emission Limitations for Puncture Sealant...

    Science.gov (United States)

    2010-07-01

    ... XXXX of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Standards for Hazardous Air Pollutants: Rubber Tire Manufacturing Pt. 63, Subpt. XXXX, Table 13 Table 13 to Subpart XXXX of Part 63—Minimum Data for Continuous Compliance With the Emission Limitations for Puncture...

  10. 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.

  11. 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.

  12. 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...

  13. 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

  14. 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.

  15. 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.

  16. Frequency of puncture holes in peritoneal dialysis catheters related to the beta cap adapter.

    Science.gov (United States)

    Ohashi, Yasushi; Kansal, Sheru; Schreiber, Martin

    2012-01-01

    Between November 2009 and September 2011, 12 patients (6 women, 6 men) undergoing continuous peritoneal dialysis (PD) or automated PD developed puncture-like holes in the PD catheter near the interface of the adapter with the superior aspect of the Silastic PD catheter The adapter is used to connect the PD catheter to the PD transfer set. Over the course of 23 months, the 12 patients presented to the PD unit with 19 separate instances of catheter holes, for an event rate of 0.23 holes per patient-year Data including socio-demographic information, PD modality, need for antibiotic treatment, event recurrence, infectious complications, and time from catheter placement were collected from patients whose catheters did and did not develop holes. We observed no differences between patients whose catheters developed holes and those whose catheters did not. The location of the individual holes suggested a relationship between the adapter and the catheter holes. The holes, which led to increased patient morbidity and costs, may be related to structural changes made in 2006 to the adapter.

  17. 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.

  18. Chronic Expanding Hematoma in the Popliteal Fossa after Pseudoaneurysm Surgery because of Nail Puncture

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz

    2014-01-01

    Full Text Available Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH. Magnetic resonance imaging (MRI is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery.

  19. 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

  20. 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

  1. Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

    Science.gov (United States)

    Wu, Jin; Jin, Tian; Wang, Hong; Li, Shi-Tong

    2016-01-01

    Background: The antagonistic actions of anticholinesterase drugs on non-depolarizing muscle relaxants are theoretically related to the activity of acetylcholinesterase (AChE) in the neuromuscular junction (NMJ). However, till date the changes of AChE activity in the NMJ during sepsis have not been directly investigated. We aimed to investigate the effects of sepsis on the antagonistic actions of neostigmine on rocuronium (Roc) and the underlying changes of AChE activity in the NMJ in a rat model of cecal ligation and puncture (CLP). Methods: A total of 28 male adult Sprague-Dawley rats were randomized to undergo a sham surgery (the sham group, n = 12) or CLP (the septic group, n = 16). After 24 h, the time-response curves of the antagonistic actions of 0.1 or 0.5 μmol/L of neostigmine on Roc (10 μmol/L)-depressed diaphragm twitch tension were measured. Meanwhile, the activity of AChE in the NMJ was detected using a modified Karnovsky and Roots method. The mRNA levels of the primary transcript and the type T transcript of AChE (AChET) in the diaphragm were determined by real-time reverse transcription-polymerase chain reaction. Results: Four of 16 rats in the septic group died within 24 h. The time-response curves of both two concentrations of neostigmine in the septic group showed significant upward shifts from those in the sham group (P < 0.001 for 0.1 μmol/L; P = 0.009 for 0.5 μmol/L). Meanwhile, the average optical density of AChE in the NMJ in the septic group was significantly lower than that in the sham group (0.517 ± 0.045 vs. 1.047 ± 0.087, P < 0.001). The AChE and AChET mRNA expression levels in the septic group were significantly lower than those in the sham group (P = 0.002 for AChE; P = 0.001 for AChET). Conclusions: Sepsis strengthened the antagonistic actions of neostigmine on Roc-depressed twitch tension of the diaphragm by inhibiting the activity of AChE in the NMJ. The reduced content of AChE might be one of the possible causes of the

  2. SIMULTANEOUS BCG AND SMALLPOX VACCINATION ON NEWBORN INFANTS

    Directory of Open Access Journals (Sweden)

    Abdul Rivai

    2012-09-01

    Full Text Available Telah dikemukakan anggapan-anggapan yang terdapat dewasa ini tentang vaksinasi BCG dan cacar secara simultan. Telah dilakukan vaksinasi BCG dan cacar secara simultan pada 729 neonati dengan freeze dried Smallpox vaccine buatan dari Bio Farma dan freeze dried BCG vaccine Tokyo. Pencacaran dilakukan secara multiple puncture dan bifurcated needle dengan suntikan BCG dengan jarum dan spuit khusus intracutan dengan dosis 0,1 ml. Tuberkulin test dilakukan dengan PPD dari Kopenhagen dengan kekuatan 2 TU 9 minggu setelah vaksinasi. Dari 741 bayi yang diikut sertakan dalam survey, 12 menolak, 3 bayi tidak dapat dilakukan pemeriksaan pertama, 35 bayi belum diperiksa, pemeriksaan pertama telah dilakukan pada 691 bayi. Dari 406 bayi yang seharusnya sudah diperiksa untuk pemeriksaan kedua, 23 dapat dilakukan karena tidak dapat dijumpai atau meninggal. Telah dikemukakan bahwa pencatatan alamat yang jelas dan lengkap serta kesungguhan dalam melakukan home visits sangat penting untuk berhasilnya penyelidikan semacam ini. Dari hasil-hasil yang didapatkan sampai sekarang telah dapat diambil kesimpulan sementara, bahwa vaksinasi BCG dan cacar secara simultan memberikan hasil yang memuaskan, juga bila dibandingkan dengan hasil-hasil penyelidikan diluar negeri take pada pencacaran 99.4 percent, test tuberkulin dengan PPD 2 TU 9 minggu setelah vaksinasi memberikan indurasi lebih dari 5 mm pada 99.75 percent dan tidak menimbulkan komplikasi-komplikasi. Pelaksanaan vaksinasi BCG dan cacar dapat dilakukan oleh tenaga paramedis yang telah mendapat latihan khusus dan diawasi oleh dokter yang kompeten. Dianjurkan untuk melakukan follow up pada bayi-bayi yang diikut sertakan dalam survey ini.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. Prospective Nonrandomized Trial of Manual Compression and Angio-Seal and Starclose Arterial Closure Devices in Common Femoral Punctures

    International Nuclear Information System (INIS)

    Ratnam, Lakshmi A.; Raja, Jowad; Munneke, Graham J.; Morgan, Robert A.; Belli, Anna-Maria

    2007-01-01

    We compared the use of manual compression and Angio-Seal and Starclose arterial closure devices to achieve hemostasis following common femoral artery (CFA) punctures in order to evaluate safety and efficacy. A prospective nonrandomized, single-center study was carried out on all patients undergoing CFA punctures over 1 year. Hemostasis was achieved using manual compression in 108 cases, Angio-Seal in 167 cases, and Starclose in 151 cases. Device-failure rates were low and not significantly different in the two groups (manual compression and closure devices; p = 0.8). There were significantly more Starclose (11.9%) patients compared to Angio-Seal (2.4%), with successful initial deployment subsequently requiring additional manual compression to achieve hemostasis (p < 0.0001). A significant number of very thin patients failed to achieve hemostasis (p = 0.014). Major complications were seen in 2.9% of Angio-Seal, 1.9% of Starclose, and 3.7% of manual compression patients, with no significant difference demonstrated; 4.7% of the major complications were seen in female patients compared to 1.3% in males (p = 0.0415). All three methods showed comparable safety and efficacy. Very thin patients are more likely to have failed hemostasis with the Starclose device, although this did not translate into an increased complication rate. There is a significant increased risk of major puncture-site complications in women with peripheral vascular disease

  11. [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.

  12. 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.

  13. Comparison the effect of lidocaine gel and inhalation of lavender aromatherapy on pain score of arteriovenous fistula puncture in hemodialysis patients

    OpenAIRE

    Abbaszadeh

    2015-01-01

    Introduction: patients undergoing hemodialysis repetitively experience pain and anxiety related to arterivenous fistula (AVF) punctures. Using of appropriate methods of pain relief in these patients is very important. The purpose of this study was to compare the effect of lidocaine gel and inhalation of lavender aromatherapy on pain intensity of arterivenous fistula puncture in hemodialysis patients. Methods: In this before and after clinical trial study, 40 hemodialysis patients were sele...

  14. 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.

  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. Thioredoxin-1 attenuates sepsis-induced cardiomyopathy after cecal ligation and puncture in mice.

    Science.gov (United States)

    Wilson, Rickesha L; Selvaraju, Vaithinathan; Lakshmanan, Rajesh; Thirunavukkarasu, Mahesh; Campbell, Jacob; McFadden, David W; Maulik, Nilanjana

    2017-12-01

    Sepsis is a leading cause of mortality among patients in intensive care units across the USA. Thioredoxin-1 (Trx-1) is an essential 12 kDa cytosolic protein that, apart from maintaining the cellular redox state, possesses multifunctional properties. In this study, we explored the possibility of controlling adverse myocardial depression by overexpression of Trx-1 in a mouse model of severe sepsis. Adult C57BL/6J and Trx-1 Tg/+ mice were divided into wild-type sham (WTS), wild-type cecal ligation and puncture (WTCLP), Trx-1 Tg/+ sham (Trx-1 Tg/+ S), and Trx-1 Tg/+ CLP groups. Cardiac function was evaluated before surgery, 6 and 24 hours after CLP surgery. Immunohistochemical and Western blot analysis were performed after 24 hours in heart tissue sections. Echocardiography analysis showed preserved cardiac function in the Trx-1 Tg/+ CLP group compared with the WTCLP group. Similarly, Western blot analysis revealed increased expression of Trx-1, heme oxygenase-1 (HO-1), survivin (an inhibitor of apoptosis [IAP] protein family), and decreased expression of thioredoxin-interacting protein (TXNIP), caspase-3, and 3- nitrotyrosine in the Trx-1 Tg/+ CLP group compared with the WTCLP group. Immunohistochemical analysis showed reduced 4-hydroxynonenal, apoptosis, and vascular leakage in the cardiac tissue of Trx-1 Tg/+ CLP mice compared with mice in the WTCLP group. Our results indicate that overexpression of Trx-1 attenuates cardiac dysfunction during CLP. The mechanism of action may involve reduction of oxidative stress, apoptosis, and vascular permeability through activation of Trx-1/HO-1 and anti-apoptotic protein survivin. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. 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.

  18. Interatrial septum thickness and difficulty with transseptal puncture during redo catheter ablation of atrial fibrillation.

    Science.gov (United States)

    Tomlinson, David R; Sabharwal, Nikant; Bashir, Yaver; Betts, Timothy R

    2008-12-01

    Patients undergoing catheter ablation for atrial fibrillation (AF) frequently require redo procedures, but there are no data reporting interatrial septum thickness (IAS) and difficulty during repeat transseptal puncture (TSP). Patients undergoing two separate AF ablation procedures had preprocedural fossa ovalis (FO) thickness measured using transesophageal echocardiography (TEE). "Difficult" TSP was defined by two observers as requiring excessive force, or conversion to TEE guidance. The study comprised 42 patients (37 male) with mean+/-SD age 55+/-9 years. Mean FO thickness was significantly greater at the time of redo TSP (2.2+/-1.6 mm vs 2.6+/-1.5 mm at redo, P=0.03); however, this finding was limited to those who underwent initial dual transseptal sheath procedures, FO thickness 2.0+/-1.5 mm and 2.5+/-1.4 mm for TEE 1 and 2, respectively (P=0.048). There was a trend for more frequent difficult redo TSP procedures, 7/42 (17%; 95% confidence interval [CI] 8-31) redo, versus 4/42 (10%; 95% CI 3-23) first TSP. On univariate analysis, FO thickness was not predictive of TSP difficulty; the only predictor of difficult redo TSP was diabetes. IAS thickness at the FO increased following catheter ablation of AF, yet on subgroup analysis this was limited to initial procedures utilizing dual transseptal sheaths. There was a trend toward more frequent difficulty during redo TSP, yet this was not associated with FO thickening. Diabetes may predispose to difficulty during redo TSP; this finding requires confirmation in a larger study population.

  19. Challenging the wisdom of puncture at the calyceal fornix in percutaneous nephrolithotripsy: feasibility and safety study with 137 patients operated via a non-calyceal percutaneous track.

    Science.gov (United States)

    Kyriazis, Iason; Kallidonis, Panagiotis; Vasilas, Marinos; Panagopoulos, Vasilios; Kamal, Wissam; Liatsikos, Evangelos

    2017-05-01

    To present our experience with a central, non-calyceal puncture protocol for percutaneous nephrolithotripsy (PCNL) in an attempt to challenge the opinion of worldwide adopted calyceal puncture as the less traumatic site of percutaneous entrance into the collecting system. During 2012, a total of 137 consecutive, unselected patients were subjected to PCNL in our department. Non-calyceal punctures were performed to all cases and followed by subsequent track dilations up to 30 Fr. Perioperative and postoperative data were prospectively collected and analyzed. Mean operative time (from skin puncture to nephrostomy tube placement) was 48 min. Patients with single, multiple and staghorn stones had primary stone-free rates of 89.2, 80.4 and 66.7 % after PCNL, respectively. The overall complication rate was 10.2 %, while bleeding complications were minimal. Only 4 patients (2.9 %) required blood transfusion. Five patients (3.6 %) had Clavien Grade IIIa complications requiring an intervention for their management and none Grade IV or V. Despite the absence of evidence that non-calyceal percutaneous tracts could be a risk factor for complications, the concept of calyceal puncture has been worldwide adopted by PCNL surgeons as the sole safe percutaneous entrance into the collective system. Based on our experience, other pathways than the worldwide recognized rule, calyceal puncture, are possible and probably not as dangerous as has been previously stated.

  20. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers

    2008-01-01

    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....... 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...... 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....

  1. The simultaneous boost technique

    International Nuclear Information System (INIS)

    Lebesque, J.V.; Keus, R.B.

    1991-01-01

    Simultaneous boost technique in radiotherapy consists of delivering the boost treatment (additional doses to reduced volumes) simultaneously with the basic (large-field) treatment for all treatment sessions. Both the dose per fraction delivered by basic-treatment fields and by boost-treatment fields have to be reduced to end up with the same total dose in boost volume as in the original schedule, where basic treatment preceded boost treatment. These dose reductions and corresponding weighting factors have been calculated using the linear-quadratic (LQ) model and the concept of Normalized Total Dose (NTD). Relative NTD distributions were computed to evaluate the dose distributions resulting for the simultaneous boost technique with respect to acute and late normal tissue damage and tumor control. For the example of treatment of prostate cancer the weighting factors were calculated on basis of NTD for late normal tissue damage. For treatment of oropharyngeal cancer NTD for acute and normal tissue damage was used to determine the weighting factors. In this last example a theoretical sparing of late normal tissue damage can be demonstrated. Another advantage of simultaneous boost technique is that megavoltage images of the large basic-treatment fields facilitates the determination of the position of the patient with respect to the small boost-treatment fields. (author). 42 refs., 8 figs

  2. Simultaneous orthogonal plane imaging.

    Science.gov (United States)

    Mickevicius, Nikolai J; Paulson, Eric S

    2017-11-01

    Intrafraction motion can result in a smearing of planned external beam radiation therapy dose distributions, resulting in an uncertainty in dose actually deposited in tissue. The purpose of this paper is to present a pulse sequence that is capable of imaging a moving target at a high frame rate in two orthogonal planes simultaneously for MR-guided radiotherapy. By balancing the zero gradient moment on all axes, slices in two orthogonal planes may be spatially encoded simultaneously. The orthogonal slice groups may be acquired with equal or nonequal echo times. A Cartesian spoiled gradient echo simultaneous orthogonal plane imaging (SOPI) sequence was tested in phantom and in vivo. Multiplexed SOPI acquisitions were performed in which two parallel slices were imaged along two orthogonal axes simultaneously. An autocalibrating phase-constrained 2D-SENSE-GRAPPA (generalized autocalibrating partially parallel acquisition) algorithm was implemented to reconstruct the multiplexed data. SOPI images without intraslice motion artifacts were reconstructed at a maximum frame rate of 8.16 Hz. The 2D-SENSE-GRAPPA reconstruction separated the parallel slices aliased along each orthogonal axis. The high spatiotemporal resolution provided by SOPI has the potential to be beneficial for intrafraction motion management during MR-guided radiation therapy or other MRI-guided interventions. Magn Reson Med 78:1700-1710, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  3. Basic characteristics of simultaneous color contrast revisited.

    Science.gov (United States)

    Ekroll, Vebjørn; Faul, Franz

    2012-10-01

    In this article, we present evidence supporting the hypothesis that the local mechanism of simultaneous color contrast is the same as the mechanism responsible for the crispening effect and the gamut expansion effect. A theoretically important corollary of this hypothesis is that the basic characteristics of simultaneous contrast are at odds with traditional laws. First, this hypothesis implies that the direction of the simultaneous contrast effect in color space is given by the vector from surround to target and not--as traditionally assumed--by the hue complementary to that of the surround. Second, it implies that the size of the simultaneous contrast effect depends on the difference between the target and surround colors in a way that challenges Kirschmann's fourth law. The widespread belief in the traditional laws, we argue, is due to the confounding influence of temporal adaptation.

  4. 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.

  5. 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 (pushing technique and primary brachial vein access is technically feasible and may represent an alternative to the conventional PICC placement technique, having low incidences of

  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. SIMULTANEOUS DIFFERENTIAL EQUATION COMPUTER

    Science.gov (United States)

    Collier, D.M.; Meeks, L.A.; Palmer, J.P.

    1960-05-10

    A description is given for an electronic simulator for a system of simultaneous differential equations, including nonlinear equations. As a specific example, a homogeneous nuclear reactor system including a reactor fluid, heat exchanger, and a steam boiler may be simulated, with the nonlinearity resulting from a consideration of temperature effects taken into account. The simulator includes three operational amplifiers, a multiplier, appropriate potential sources, and interconnecting R-C networks.

  8. 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.

  9. 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.

  10. 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.

  11. The effect of self-selected soothing music on fistula puncture-related pain in hemodialysis patients.

    Science.gov (United States)

    Shabandokht-Zarmi, Hosniyeh; Bagheri-Nesami, Masoumeh; Shorofi, Seyed Afshin; Mousavinasab, Seyed Nouraddin

    2017-11-01

    This study was intended to examine the effect of selective soothing music on fistula puncture-related pain in hemodialysis patients. This is a randomized clinical trial in which 114 participants were selected from two hemodialysis units by means of a non-random, convenience sampling method. The participants were then allocated in three groups of music (N = 38), headphone (N = 38), and control (N = 38). The fistula puncture-related pain was measured 1 min after venipuncture procedure in all three groups. The music group listened to their self-selected and preferred music 6 min before needle insertion into a fistula until the end of procedure. The headphone group wore a headphone alone without listening to music 6 min before needle insertion into a fistula until the end of procedure. The control group did not receive any intervention from the research team during needle insertion into a fistula. The pain intensity was measured immediately after the intervention in all three groups. This study showed a significant difference between the music and control groups, and the music and headphone groups in terms of the mean pain score after the intervention. However, the analysis did not indicate any significant difference between the headphone and control groups with regard to the mean pain score after the intervention. It is concluded that music can be used effectively for pain related to needle insertion into a fistula in hemodialysis patients. Future research should investigate the comparative effects of pharmacological and non-pharmacological interventions on fistula puncture-related pain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. 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)

  13. 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).

  14. 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

  15. 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.

  16. Quantitative analysis of disc degeneration using axial T2 mapping in a percutaneous annular puncture model in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Jee Won; Kim, Su Jin [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Heung Sik; Lee, Joon Woo [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Hong, Sung Hwan [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    To evaluate T2 relaxation time change using axial T2 mapping in a rabbit degenerated disc model and determine the most correlated variable with histologic score among T2 relaxation time, disc height index, and Pfirrmann grade. Degenerated disc model was made in 4 lumbar discs of 11 rabbits (n = 44) by percutaneous annular puncture with various severities of an injury. Lumbar spine lateral radiograph, MR T2 sagittal scan and MR axial T2 mapping were obtained at baseline and 2 weeks and 4 weeks after the injury in 7 rabbits and at baseline and 2 weeks, 4 weeks, and 6 weeks after the injury in 4 rabbits. Generalized estimating equations were used for a longitudinal analysis of changes in T2 relaxation time in degenerated disc model. T2 relaxation time, disc height index and Pfirrmann grade were correlated with the histologic scoring of disc degeneration using Spearman's rho test. There was a significant difference in T2 relaxation time between uninjured and injured discs after annular puncture. Progressive decrease in T2 relaxation time was observed in injured discs throughout the study period. Lower T2 relaxation time was observed in the more severely injured discs. T2 relaxation time showed the strongest inverse correlation with the histologic score among the variables investigated (r = -0.811, p < 0.001). T2 relaxation time measured with axial T2 mapping in degenerated discs is a potential method to assess disc degeneration.

  17. 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…

  18. Loudness estimation of simultaneous sources using beamforming

    DEFF Research Database (Denmark)

    Song, Woo-keun; Ellermeier, Wolfgang; Minnaar, Pauli

    2006-01-01

    An algorithm is proposed for estimating the loudness of several simultaneous sound sources by means of microphone-array beamforming. The algorithm is derived from two listening experiments in which the loudness of two simultaneous sounds (narrow-band noises with 1-kHz and 3.15-kHz center...... frequencies) was matched to a single sound (2-kHz narrow-band noise). The simultaneous sounds were presented from either one sound source or two spatially separated sources, whereas the single sound was presented from the frontal direction. The results indicate that overall loudness can be calculated...... by summing the loudnesses of the individual sources according to a simple psychophysical relationship....

  19. Classification of cryo electron microscopy images, noisy tomographic images recorded with unknown projection directions, by simultaneously estimating reconstructions and application to an assembly mutant of Cowpea Chlorotic Mottle Virus and portals of the bacteriophage P22

    Science.gov (United States)

    Lee, Junghoon; Zheng, Yili; Yin, Zhye; Doerschuk, Peter C.; Johnson, John E.

    2010-08-01

    Cryo electron microscopy is frequently used on biological specimens that show a mixture of different types of object. Because the electron beam rapidly destroys the specimen, the beam current is minimized which leads to noisy images (SNR substantially less than 1) and only one projection image per object (with an unknown projection direction) is collected. For situations where the objects can reasonably be described as coming from a finite set of classes, an approach based on joint maximum likelihood estimation of the reconstruction of each class and then use of the reconstructions to label the class of each image is described and demonstrated on two challenging problems: an assembly mutant of Cowpea Chlorotic Mottle Virus and portals of the bacteriophage P22.

  20. 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.

  1. Therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy on multiple renal calculi.

    Science.gov (United States)

    Cui, Zhenyu; Gao, Yanjun; Yang, Wenzeng; Zhao, Chunli; Ma, Tao; Shi, Xiaoqiang

    2018-01-01

    To evaluate the therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy (SMP) on multiple renal calculi. The clinical data of 46 patients with multiple renal calculi treated in Affiliated Hospital of Hebei University from October 2015 to September 2016 were retrospectively analyzed. There were 28 males and 18 females aged from 25 to 65 years old, with an average of 42.6. The stone diameters were 3.0-5.2 cm, (4.3 ± 0.8) cm on average. F4.8 visual puncture-assisted balloon expansion was used to establish a standard channel. After visible stones were removed through nephroscopy combined with ultrasound lithotripsy, the stones of other parts were treated through F4.8 visual puncture SMP with holmium laser. Indices such as the total time of channel establishment, surgical time, decreased value of hemoglobin, phase-I stone clearance rate and surgical complications were summarized. Single standard channel was successfully established in all cases with the assistance of F4.8 visual puncture, of whom 24 were combined with a single microchannel, 16 were combined with double microchannels, and six were combined with three microchannels. All patients were placed with nephrostomy tube which was not placed in the microchannels. Both F5 double J tubes were placed after surgery. The time for establishing a standard channel through F4.8 visual puncture was (6.8 ± 1.8) min, and that for establishing a single F4.8 visual puncture microchannel was (4.5 ± 0.9) min. The surgical time was (92 ± 15) min. The phase-I stone clearance rate was 91.3% (42/46), and the decreased value of hemoglobin was (12.21 ± 2.5) g/L. There were 8 cases of postoperative fever which was relieved after anti-inflammatory treatment. Four cases had 0.5-0.8 cm of stone residue in the lower calyx, and all stones were discharged one month after surgery by in vitro shock wave lithotripsy combined with position nephrolithotomy, without stone

  2. 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

  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. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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

    2018-01-01

    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. PMID:29479039

  10. Triangulating case-finding tools for patient safety surveillance: a cross-sectional case study of puncture/laceration.

    Science.gov (United States)

    Taylor, Jennifer A; Gerwin, Daniel; Morlock, Laura; Miller, Marlene R

    2011-12-01

    To evaluate the need for triangulating case-finding tools in patient safety surveillance. This study applied four case-finding tools to error-associated patient safety events to identify and characterise the spectrum of events captured by these tools, using puncture or laceration as an example for in-depth analysis. Retrospective hospital discharge data were collected for calendar year 2005 (n=48,418) from a large, urban medical centre in the USA. The study design was cross-sectional and used data linkage to identify the cases captured by each of four case-finding tools. Three case-finding tools (International Classification of Diseases external (E) and nature (N) of injury codes, Patient Safety Indicators (PSI)) were applied to the administrative discharge data to identify potential patient safety events. The fourth tool was Patient Safety Net, a web-based voluntary patient safety event reporting system. The degree of mutual exclusion among detection methods was substantial. For example, when linking puncture or laceration on unique identifiers, out of 447 potential events, 118 were identical between PSI and E-codes, 152 were identical between N-codes and E-codes and 188 were identical between PSI and N-codes. Only 100 events that were identified by PSI, E-codes and N-codes were identical. Triangulation of multiple tools through data linkage captures potential patient safety events most comprehensively. Existing detection tools target patient safety domains differently, and consequently capture different occurrences, necessitating the integration of data from a combination of tools to fully estimate the total burden.

  11. 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.

  12. 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...

  13. 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)

  14. 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.

  15. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

    2011-01-01

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  16. Effects of electron beam radiation on mechanical properties and on the resistance to punctures caused by Plodia interpunctella in cereal bar packaging

    International Nuclear Information System (INIS)

    Alves, Juliana N.; Moura, Esperidiana A.B.; Oliveira, Vitor M.; Potenza, Marcos R.; Arthur, Valter

    2009-01-01

    Plodia interpunctella is an important pest in stored products in the tropical and subtropical regions, infesting grains and flours. The adult of P. interpunctella is a small butterfly with about 15 - 20mm of spread and the female places separately of 100 the 400 eggs in groups on the grains whose hard incubation some days. This insect infesting diverse types of food packaging, 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 P. interpunctella in BOPPmet/BOPP structure, used commercially as cereal bar packaging, after electron beam irradiation. The material samples were irradiated up to 120 kGy using a 1.5 MeV electrostatic accelerator, at room temperature, in air, dose rate 11.22 kGy/s. Irradiation doses were measured using cellulose triacetate film dosimeters 'CTA-FTR-125' from Fuji Photo Film Co. Ltd. After irradiation the BOPPmet/BOPP samples were subjected to tests of puncture resistance by P. interpunctella, tensile tests and penetration resistance. The results showed significant decreases (p<0.05) in the original mechanical properties of the structures according to the radiation doses applied and effective resistance against punctures by P. interpunctella for irradiated and nonirradiated BOPPmet/BOPP samples. These results indicate that non-irradiated and irradiated BOPPmet/BOPP structure presents puncture resistance against P. interpunctella and that electron-beam irradiation, in conditions studied in this work, may turn the structure inappropriate for cereal bar packaging, due to high reduction its mechanical properties after irradiation. (author)

  17. Accuracy of the HumaSensplus point-of-care uric acid meter using capillary blood obtained by fingertip puncture.

    Science.gov (United States)

    Fabre, Stéphanie; Clerson, Pierre; Launay, Jean-Marie; Gautier, Jean-François; Vidal-Trecan, Tiphaine; Riveline, Jean-Pierre; Platt, Adam; Abrahamsson, Anna; Miner, Jeffrey N; Hughes, Glen; Richette, Pascal; Bardin, Thomas

    2018-05-02

    The uric acid (UA) level in patients with gout is a key factor in disease management and is typically measured in the laboratory using plasma samples obtained after venous puncture. This study aimed to assess the reliability of immediate UA measurement with capillary blood samples obtained by fingertip puncture with the HumaSens plus point-of-care meter. UA levels were measured using both the HumaSens plus meter in the clinic and the routine plasma UA method in the biochemistry laboratory of 238 consenting diabetic patients. HumaSens plus capillary and routine plasma UA measurements were compared by linear regression, Bland-Altman plots, intraclass correlation coefficient (ICC), and Lin's concordance coefficient. Values outside the dynamic range of the meter, low (LO) or high (HI), were analyzed separately. The best capillary UA thresholds for detecting hyperuricemia were determined by receiver operating characteristic (ROC) curves. The impact of potential confounding factors (demographic and biological parameters/treatments) was assessed. Capillary and routine plasma UA levels were compared to reference plasma UA measurements by liquid chromatography-mass spectrometry (LC-MS) for a subgroup of 67 patients. In total, 205 patients had capillary and routine plasma UA measurements available. ICC was 0.90 (95% confidence interval (CI) 0.87-0.92), Lin's coefficient was 0.91 (0.88-0.93), and the Bland-Altman plot showed good agreement over all tested values. Overall, 17 patients showed values outside the dynamic range. LO values were concordant with plasma values, but HI values were considered uninterpretable. Capillary UA thresholds of 299 and 340 μmol/l gave the best results for detecting hyperuricemia (corresponding to routine plasma UA thresholds of 300 and 360 μmol/l, respectively). No significant confounding factor was found among those tested, except for hematocrit; however, this had a negligible influence on the assay reliability. When capillary and routine

  18. P-Q simultaneous control scheme for SMES

    International Nuclear Information System (INIS)

    Tsuji, K.; Ise, T.; Murakami, Y.

    1981-01-01

    Superconducting magnetic energy storage (SMES) can be looked at as a control device as well as an effective energy storage device in power system applications. Thus far, active power control and reactive power control seem to have been treated separately. However, under some minor constraints, active (P) and reactive power (Q) may be controlled simultaneously and this capability is perhaps one of the most valuable characteristics of SMES in power system applications. In this brief paper, we examine the possibility of controlling active and reactive power simultaneously (henceforth we call it P-Q simultaneous control) and propose a direct digital control algorithm for the P-Q simultaneous control of SMES. Some simulation results are presented. In addition, a hierarchical control scheme for SMES at a load center is briefly discussed as an extension of P-Q simultaneous control presented in this paper

  19. Popliteal artery puncture in the assessment of patients with severe leg ischemia

    DEFF Research Database (Denmark)

    Agerskov, K; Faris, I; Tønnesen, K H

    1983-01-01

    Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation...... vessels and the popliteal ankle pressure difference. When the tiberoperoneal trunk or the trifurcation vessels were occluded or more than 50% of the lumen was stenosed, the pressure difference exceeded 10 mmHg in 30/40 limbs (75%). When three, two, or only one of the tibial vessels were patent......, the pressure difference exceeded 10 mmHg in 2/58 limbs (3%). One month following above knee femoropopliteal bypass (48 limbs), patients with a popliteal-ankle difference less than 10 mmHg obtained a significantly higher ankle pressure index (PI 0.86, range 0.56-1.20) (p less than 0.01) than those...

  20. 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...

  1. Clinical introduction of simultaneous radiohyperthermotherapy

    International Nuclear Information System (INIS)

    Kuroda, Masahiro; Asaumi, Junichi; Hiraki, Yoshio; Inamura, Keiji; Tahara, Seiji; Mimura, Seiichi; Mikami, Yasutaka; Kawasaki, Shoji.

    1992-01-01

    Simultaneous radiohyperthermotherapy (SRH) is a combined hyperthermia-radiation therapy in which radiation is given during heating. Mutual interference between the high energy radiotherapy system (Toshiba LMR-15A) and the 13.56 MHz capacitive heating system (Omron HEH-500C) was examined using phantoms prior to clinical trials. Phantoms were irradiated and heated simultaneously at right angles. The energy and flatness of irradiation were measured using films and were not affected by the heating system within the range of clinical use. The temperature increase was measured with a thermocouple thermometer, and the temperature distribution was determined by liquid crystal thermometer. The high energy radiotherapy system did not affect the heating device set power, the temperature increase and distribution during simultaneous treatment. This study clarified that these apparatuses work simultaneously without clinically significant mutual interference. SRH using these apparatuses can be safely applied to clinical study. (author)

  2. Outcomes of in vitro fertilization cycles among patients with polycystic ovary syndrome following ovarian puncture for in vitro maturation.

    Science.gov (United States)

    Lin, Jia; Wang, Peiyu; Zhao, Junzhao; Xiao, Shiquan; Yu, Rong; Jin, Congcong; Zhu, Ruru

    2016-12-01

    To investigate the effects of ovarian puncture for in vitro maturation (IVM) on subsequent in vitro fertilization (IVF) embryo transfer cycles in patients with polycystic ovary syndrome (PCOS). A retrospective study included data from patients admitted to the First Affiliated Hospital of Wenzhou Medical University, China, between January 1, 2008 and December 31, 2014. Patients with PCOS undergoing IVF cycles after having been treated with IVM unsuccessfully were included as the study group and an IVF-procedure data-matched control group of patients undergoing their first IVF cycles was included in a 1:4 ratio. Patients with reproductive anomalies were excluded. Endocrine-hormone levels and antral follicle counts were measured and fertilization-related outcomes were evaluated. There were 49 patients included in the study group and 196 included in the control group. Within the study group, basal luteal-hormone, testosterone, and antral follicle count levels were significantly lower following IVM treatment. The total gonadotropin dose was lower (Povarian hyper-stimulation syndrome (P=0.633). Previous IVM resulted in improved endocrine profiles and increased clinical-pregnancy rates among patients with PCOS undergoing IVF cycles. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Effect of venous dexamethasone, oral caffeine and acetaminophen on relative frequency and intensity of postdural puncture headache after spinal anesthesia.

    Science.gov (United States)

    Masoudifar, Mehrdad; Aghadavoudi, Omid; Adib, Sajjad

    2016-01-01

    Postdural puncture headache (PDPH) is a relatively common complication after regional anesthesia, especially in younger people, bothersome to patients and needs prophylaxis to prevent this complication. This study was conducted aiming to determine the preventive effect of dexamethasone plus caffeine and acetaminophen on relative frequency and intensity of PDPH after spinal anesthesia. In a clinical trial study, 90 candidates for the lower extremities orthopedic elective operation were divided into two groups of 45 individuals each. Intervention group received the compound of 500 mg acetaminophen +65 mg oral caffeine +8 mg venous dexamethasone an hour before spinal blocking, and the control group received placebo tablets + a dexamethasone equivalent volume of venous normal saline. The level of postoperative headache at the time of entrance to recovery and discharge, 6, 12, 24, 48, and 72 h postoperatively were measured based on Visual Analog Scale criterion in the two groups and then compared with each other. During the study, 24 patients in the control group and 17 patients in the intervention group were afflicted with headache; however, with no significant difference (P = 0.14). Total frequency of headache incidence was 35 times in the control group and 27 times in the intervention group (P = 0.32). Though the taking of acetaminophen + caffeine + dexamethasone is associated with a decrease in headache intensity and duration and decrease in PDPH incidence, compared with placebo, however, no essentially and statistically significant effect was produced.

  4. Variation in lumbar punctures for early onset neonatal sepsis: a nationally representative serial cross-sectional analysis, 2003-2009

    Directory of Open Access Journals (Sweden)

    Patrick Stephen W

    2012-08-01

    Full Text Available Abstract Background Whether lumbar punctures (LPs should be performed routinely for term newborns suspected of having early onset neonatal sepsis (EONS is subject to debate. It is unclear whether variations in performance of LPs for EONS may be associated with patient, hospital, insurance or regional factors. Our objective was to identify characteristics associated with the practice of performing LPs for suspected EONS in a nationally representative sample. Methods Utilizing data from the 2003, 2006 and 2009 Kids’ Inpatient Database (KID compiled by the Agency for Healthcare Research and Quality, we examined the frequency and characteristics of term, normal-birth weight newborns receiving an LP for EONS. Survey-weighting was applied for national estimates and used in chi squared and multivariable regression analysis. Results In 2009, there were 13,694 discharges for term newborns that underwent LPs for apparent EONS. Newborns having LPs performed were more likely to be covered by Medicaid vs. private insurance (51.9 vs. 45.1 percent; p Conclusions We found pronounced variation in LPs performed for EONS, even when adjusting for clinical conditions that would prompt LPs. These findings indicate practice variations in newborn care that merit further examination and explanation.

  5. Diagnosing diseases of the thyroid gland by means of scintiscanning and puncture cytology taking into consideration the nodular goitre

    International Nuclear Information System (INIS)

    Eitel, M.

    1981-01-01

    This paper contains the results of scintigraphical and puncture-cytological examinations carried out during an observation period of appr. 3 years on 548 patients with goiters from the Upper-Bavarien endemis region. In total, we had 484 thyroid gland scintigrams which showed 335 uninodular, 71 multinodular, and 78 diffuse goiters. The 335 solitary nodular goiters were allocated 278 cold, 36 warm, and 18 hot nodes; in three cases, the scintigram could not be assessed due to exogenous iodine contamination. In the 71 multinodular goiters, we found 118 cold, 28 warm, and 9 hot nodes. Cytological findings were established in 548 patients. In 484 cases, the findings were negative, in 19 cases suspicious, and in 17 cases positive. The efficiency of cytological diagnosis of malignant tumours can be stated to be 87.5%. The rate of falsely negative smears was 12.5%; cytologically, in 10.9% of the preparations falsely suspicious diagnoses were established, and in 1.6% the diagnoses were falsely positive. (orig./MG) [de

  6. 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.

  7. 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.

  8. 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.

  9. Simultaneous viscous-inviscid coupling via transpiration

    International Nuclear Information System (INIS)

    Yiu, K.F.C.; Giles, M.B.

    1995-01-01

    In viscous-inviscid coupling analysis, the direct coupling technique and the inverse coupling technique are commonly adopted. However, stability and convergence of the algorithms derived are usually very unsatisfactory. Here, by using the transpiration technique to simulate the effect of the displacement thickness, a new simultaneous coupling method is derived. The integral boundary layer equations and the full potential equation are chosen to be the viscous-inviscid coupled system. After discretization, the Newton-Raphson technique is proposed to solve the coupled nonlinear system. Several numerical results are used to demonstrate the accuracy and efficiency of the proposed method. 15 refs., 23 figs

  10. Accuracy and feasibility of frameless stereotactic and robot-assisted CT-based puncture in interventional radiology. A comparative phantom study

    International Nuclear Information System (INIS)

    Stoffner, R.; Widmann, G.; Bale, R.; Augschoell, C.; Boehler, D.

    2009-01-01

    Purpose: To compare the accuracy of frameless stereotactic and robot-assisted puncture in vitro based on computed tomography (CT) imaging with a slice thickness of 1, 3, and 5 mm. Materials and Methods: 300 punctures were carried out with help of the Atlas aiming device guided by the optical navigation system Stealth Station TREONplus and 150 punctures were guided by the robotic assistance system Innomotion. Conically shaped rods were punctured with Kirschner wires. The accuracy was evaluated on the basis of control CTs by measuring the Euclidean distance between the wire tip and target and the normal distance between the target and wire. Results: With the Stealth Station a mean Euclidean distance of 1.94±0.912, 2.2±1.136, and 2.74±1.166 mm at a slice thickness of 1, 3 and 5 mm, respectively, was reached. The mean normal distance was 1.64±0.919, 1.84±1.189, and 2.48±1.196 mm, respectively. The Innomotion system resulted in a mean Euclidean distance of 1.69±0.772, 1.91±0.673, and 2.30±0.881 mm, respectively, while the mean normal distance was (1.42±0.78), 1.60±0.733, and 1.98±1.002 mm, respectively. A statistical significance between accuracies with both systems with 1 mm and 3 mm slices could not be detected (p > 0.05). At a slice thickness of 5 mm, the robot was significantly more accurate, but not as accurate as when using thinner slices (p < 0.05). The procedure time is longer for the Innomotion system (∝30 vs. ∝18 min), and the practicability is higher with the Stealth Station. (orig.)

  11. Intra-operative cerebrospinal fluid sampling versus post-operative lumbar puncture for detection of leptomeningeal disease in malignant paediatric brain tumours.

    Directory of Open Access Journals (Sweden)

    Sharon Y Y Low

    Full Text Available Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD. From a clinical perspective, the key aim of the study was for affected paediatric patients to avoid an additional procedure of a lumbar puncture, often performed under anaesthesia after neurosurgical intervention.This is single-institution, retrospective study of paediatric patients diagnosed with malignant brain tumours. Its main aim was to compare cytological data from CSF collected at the time of surgery versus data from an interval lumbar puncture. In addition, MRI imaging of the same cohort of patients was examined for leptomeningeal disease and corroborated against CSF tumour cytology findings.Thirty patients are recruited for this study. Data analysis demonstrates a statistically significant association between our intra-operative CSF and LP sampling. Furthermore, our results also show for significant correlation between evidence of leptomeningeal disease on MRI findings versus intra-operative CSF positivity for tumour cells.Although this is a retrospective study with a limited population, our data concurs with potential to avoid an additional procedure for the paediatric patient diagnosed with a malignant brain tumour.

  12. 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)

  13. 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

  14. A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures.

    Science.gov (United States)

    Oliveira-Santos, Thiago; Klaeser, Bernd; Weitzel, Thilo; Krause, Thomas; Nolte, Lutz-Peter; Peterhans, Matthias; Weber, Stefan

    2011-01-01

    Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well

  15. 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

  16. 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.

  17. Customization of the voice prosthesis to prevent leakage from the enlarged tracheoesophageal puncture: results of a prospective trial.

    Science.gov (United States)

    Lewin, Jan S; Hutcheson, Katherine A; Barringer, Denise A; Croegaert, Lindsay E; Lisec, Asher; Chambers, Mark S

    2012-08-01

    Customization of the tracheoesophageal (TE) voice prosthesis (VP) is often preferred over surgical closure to prevent aspiration around the VP in laryngectomized patients with an enlarged tracheoesophageal puncture (TEP), but it has not been thoroughly evaluated. Single-institution prospective trial. A prospective trial was conducted to evaluate the effectiveness of a customized VP with the addition of an enlarged tracheal and/or esophageal collar in patients with leakage around an enlarged TEP. Absence of leakage around the VP after placement defined immediate effectiveness. Long-term success was defined by the prevention of adverse events related to leakage during the study period. Events that defined failure included: permanent gastrostomy dependence, aspiration pneumonia, and/or surgical TEP closure. Twenty-one patients with enlarged TEP were enrolled (2003-2006). Insertion of a customized VP was unsuccessful in one patient; 145 customizations were performed in the remaining 20 patients (median, 3.5 customizations) during the trial period. Of the customizations, 77% (112/145) prevented leakage immediately after VP insertion. The most common adverse event was dislodgement of the prosthesis (11%) or the collar alone (7%) in 18% (26/145) of customized VP placements. Six patients who died of disease were not evaluable for long-term outcomes. Long-term success was achieved in 80% (12/15) of evaluable patients who avoided permanent gastrostomy, aspiration pneumonia, and surgical TEP closure. Prosthetic customization offers an effective method to prevent leakage around the VP in many patients with an enlarged TEP, thereby preserving TE voice while avoiding surgical closure in this high-risk population. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  18. 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.

  19. Cryptococcal meningitis management in Tanzania with strict schedule of serial lumber punctures using intravenous tubing sets: an operational research study.

    Science.gov (United States)

    Meda, John; Kalluvya, Samuel; Downs, Jennifer A; Chofle, Awilly A; Seni, Jeremiah; Kidenya, Benson; Fitzgerald, Daniel W; Peck, Robert N

    2014-06-01

    Cryptococcal meningitis (CM) has a mortality rate of ∼70% among HIV-infected adults in low-income countries. Controlling intracranial pressure (ICP) is essential in CM, but it is difficult in low-income countries because manometers and practical ICP management protocols are lacking. As part of a continuous quality improvement project, our Tanzanian hospital initiated a new protocol for ICP management for CM. All adult inpatients with CM are included in a prospective patient registry. At the time of analysis, this registry included data from 2 years before the initiation of this new ICP management protocol and for a 9-month period after. ICP was measured at baseline and at days 3, 7, and 14 by both manometer and intravenous (IV) tubing set. All patients were given IV fluconazole according to Tanzanian treatment guidelines and were followed until 30 days after admission. Among adult inpatients with CM, 32 of 35 patients (91%) had elevated ICP on admission. Cerebrospinal fluid pressure measurements using the improvised IV tubing set demonstrated excellent agreement (r = 0.96) with manometer measurements. Compared with historical controls, the new ICP management protocol was associated with a significant reduction in 30-day mortality (16/35 [46%] vs. 48/64 [75%] in historical controls; hazard ratio = 2.1 [95% CI: 1.1 to 3.8]; P = 0.018]. Increased ICP is almost universal among HIV-infected adults admitted with CM in Tanzania. Intensive ICP management with a strict schedule of serial lumbar punctures reduced in-hospital mortality compared with historical controls. ICP measurement with IV tubing sets may be a good alternative in resource-limited health facilities where manometers are not available.

  20. 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.

  1. Anterior stromal puncture with staining: A modified technique for preoperative reference corneal marking for toric lenses and its retrospective analyses

    Directory of Open Access Journals (Sweden)

    Sahil Bhandari

    2016-01-01

    Full Text Available Introduction: Toric intraocular lenses (IOLs are an effective way of compensating preexisting corneal astigmatism during cataract surgery. To achieve success, it is imperative to align the toric IOLs in desired position and preoperative reference marking is one among the three important steps for accurate alignment. To make the marking procedure simpler and effective, we have modified the conventional three-step slit lamp-based technique. Materials and Methods: Patient is seated in front of the slit lamp and asked to keep the chin over chin rest. A 26-gauge bent needle with tip stained by sterile blue ink marker is used to make anterior stromal puncture (ASP at the edges of horizontal 180° axis near the limbus. Results: A total of 58 eyes were retrospectively evaluated. Mean (+/-SD IOL deviation on day 1 and day 30 was 5.7 ± 6.5° and 4.7 ± 5.6°, respectively. Median IOL misalignment on day 1 and day 30 was 3°. Redialing of IOL was required in 2 (3.4% eyes only, all of which were performed within 1 week of surgery. In total, 2 (3.7% eyes had a residual astigmatism of − 0.5 Dcyl and − 1.0 Dcyl, respectively. Conclusion: ASP is an effective technique for reference marking, technically simpler and can be practiced by most of the surgeons. It avoids the necessity of high-end sophisticated machinery and gives a better platform for the reference corneal marking along with the benefit of reproducibility and simplicity.

  2. Determination of fission gas release of spent nuclear fuel in puncturing test and in leaching experiments under anoxic conditions

    Energy Technology Data Exchange (ETDEWEB)

    González-Robles, E., E-mail: ernesto.gonzalez-robles@kit.edu [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany); Metz, V. [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany); Wegen, D.H. [European Commission, Joint Research Centre, Institute for Transuranium Elements (JRC-ITU), P.O. Box 2340, 76125, Karlsruhe (Germany); Herm, M. [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany); Papaioannou, D. [European Commission, Joint Research Centre, Institute for Transuranium Elements (JRC-ITU), P.O. Box 2340, 76125, Karlsruhe (Germany); Bohnert, E. [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany); Gretter, R. [European Commission, Joint Research Centre, Institute for Transuranium Elements (JRC-ITU), P.O. Box 2340, 76125, Karlsruhe (Germany); Müller, N. [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany); Nasyrow, R.; Weerd, W. de; Wiss, T. [European Commission, Joint Research Centre, Institute for Transuranium Elements (JRC-ITU), P.O. Box 2340, 76125, Karlsruhe (Germany); Kienzler, B. [Karlsruhe Institute of Technology, Institute for Nuclear Waste Disposal (KIT-INE), P.O. Box 3640, D-76021, Karlsruhe (Germany)

    2016-10-15

    During reactor operation the fission gases Kr and Xe are formed within the UO{sub 2} matrix of nuclear fuel. Their quantification is important to evaluate their impact on critical parameters regarding the fuel behaviour during irradiation and (long-term) interim storage, such as internal pressure of the fuel rod and fuel swelling. Moreover the content of Kr and Xe in the plenum of a fuel rod and their content in the UO{sub 2} fuel itself are widely used as indicators for the release properties of {sup 129}I, {sup 137}Cs, and other safety relevant radionuclides with respect to final disposal of spent nuclear fuel. The present study deals with the fission gas release from spent nuclear fuel exposed to simulated groundwater in comparison with the fission gas previously released to the fuel rod plenum during irradiation in reactor. In a unique approach we determined both the Kr and Xe inventories in the plenum by means of a puncturing test and in leaching experiments with a cladded fuel pellet and fuel fragments in bicarbonate water under 3.2 bar H{sub 2} overpressure. The fractional inventory of the fission gases released during irradiation into the plenum was (8.3 ± 0.9) %. The fraction of inventory of fission gases released during the leaching experiments was (17 ± 2) % after 333 days of leaching of the cladded pellet and (25 ± 2) % after 447 days of leaching of the fuel fragments, respectively. The relatively high release of fission gases in the experiment with fuel fragments was caused by the increased accessibility of water to the Kr and Xe occluded in the fuel.

  3. Murine Pancreatic Cancer Alters T Cell Activation and Apoptosis and Worsens Survival After Cecal Ligation and Puncture.

    Science.gov (United States)

    Lyons, John D; Chen, Ching-Wen; Liang, Zhe; Zhang, Wenxiao; Chihade, Deena B; Burd, Eileen M; Farris, Alton B; Ford, Mandy L; Coopersmith, Craig

    2018-06-08

    Patients with cancer who develop sepsis have a markedly higher mortality than patients who were healthy prior to the onset of sepsis. Potential mechanisms underlying this difference have previously been examined in two preclinical models of cancer followed by sepsis. Both pancreatic cancer/pneumonia and lung cancer/cecal ligation and puncture (CLP) increase murine mortality, associated with alterations in lymphocyte apoptosis and intestinal integrity. However, pancreatic cancer/pneumonia decreases lymphocyte apoptosis and increases gut apoptosis while lung cancer/CLP increases lymphocyte apoptosis and decreases intestinal proliferation. These results cannot distinguish the individual roles of cancer versus sepsis since different models of each were used. We therefore created a new cancer/sepsis model to standardize each variable. Mice were injected with a pancreatic cancer cell line and three weeks later cancer mice and healthy mice were subjected to CLP. Cancer septic mice had a significantly higher 10-day mortality than previously healthy septic mice. Cancer septic mice had increased CD4 T cells and CD8 T cells, associated with decreased CD4 T cell apoptosis 24 hours after CLP. Further, splenic CD8+ T cell activation was decreased in cancer septic mice. In contrast, no differences were noted in intestinal apoptosis, proliferation or permeability, nor were changes noted in local bacterial burden, renal, liver or pulmonary injury. Cancer septic mice thus have consistently reduced survival compared to previously healthy septic mice, independent of the cancer or sepsis model utilized. Changes in lymphocyte apoptosis are common to cancer model and independent of sepsis model whereas gut apoptosis is common to sepsis model and independent of cancer model. The host response to the combination of cancer and sepsis is dependent, at least in part, on both chronic co-morbidity and acute illness.

  4. 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

  5. Simultaneous PET and MR imaging

    International Nuclear Information System (INIS)

    Yiping Shao; Cherry, Simon R.; Meadors, Ken; Siegel, Stefan; Silverman, Robert W.; Farahani, Keyvan; Marsden, Paul K.

    1997-01-01

    We have developed a prototype PET detector which is compatible with a clinical MRI system to provide simultaneous PET and MR imaging. This single-slice PET system consists of 48 2x2x10mm 3 LSO crystals in a 38 mm diameter ring configuration that can be placed inside the receiver coil of the MRI system, coupled to three multi-channel photomultipliers housed outside the main magnetic field via 4 m long and 2 mm diameter optical fibres. The PET system exhibits 2 mm spatial resolution, 41% energy resolution at 511 keV and 20 ns timing resolution. Simultaneous PET and MR phantom images were successfully acquired. (author)

  6. 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…

  7. Simultaneous engineering; Simultaneous Engineering bei der Entwicklung der Motorenbaureihen

    Energy Technology Data Exchange (ETDEWEB)

    Reifenscheid, O. [Entwicklung Kommerzielle Motoren, MTU, Friedrichshafen (Germany)

    1997-10-01

    At a time when the German industry is faced with world-wide competition and the recent recession has not been fully overcome, the subject of simultaneous engineering is very popular. A series of punch words such as Lean Management, TQM, (Total Quality Management), Lean Production, KVP, Kaizen, Value Management, etc. are considered as synonyms for strategies by which product development is to be made more efficient and production more economical, faster and more flexible. In this respect the co-ordination between market, company the human element, procedure and structure play a major role. The present paper describes Simultaneous Enginering (SE) from the standpoint of the research engineer; provides information regarding the degree of implementation of SE at MTU and presents some of the author`s personal thoughts and experiences for discussion. (orig.)

  8. Cuts and puncture wounds

    Science.gov (United States)

    ... 2014:chap 34. Simon BC, Hern HG. Wound management principles. In: Walls RM, Hockberger RS, Gausche-Hill M, eds, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 9th ed. Philadelphia, PA: Elsevier Saunders; 2018:chap ...

  9. The Punctured Plane

    Indian Academy of Sciences (India)

    in the 'analysis' on these spaces. The main theme of this article is to illustrate how topology governs analysis. Most of you are probably familiar with analysis, another name for calculus. At its core are the fundamental concepts of limits, differentiation and integration of functions on R, and more generally Rn. What is topology ...

  10. Preferences for Simultaneous Polydrug Use:

    DEFF Research Database (Denmark)

    Østergaard, Jeanette; Østergaard, Stine Vernstrøm; Fletcher, Adam

    2016-01-01

    among those reporting drug use, according to sociodemographics, alcohol intake, frequency of intoxication, and smoking. Illicit drug use was more prevalent among young adults in England than Denmark. The difference was smallest for cannabis use: Lifetime cannabis use is 66% in England and 58% in Denmark......Cross-national surveys of young adults’ simultaneous polydrug use (SPU) are rare, as measuring polydrug use requires multiple questions capturing the timing, sequence, and dosage of mixing drugs. This study proposes a new way of measuring SPU by examining how preferences for simultaneous polydrug...... use (PSPU) vary among club/bar-goers in two European countries, Denmark and England, typically cited as exemplars of the normalization of illegal drug use. The study considers the utility of the normalization thesis for understanding preferences for polydrug use in the European nighttime economy...

  11. 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 ...

  12. Simultaneous spatio-temporal focusing for tissue manipulation

    Directory of Open Access Journals (Sweden)

    Squier J.

    2013-11-01

    Full Text Available Simultaneous spatiotemporal focusing (SSTF is applied to lens tissue and compared directly with standard femtosecond micromachining of the tissue at the same numerical aperture. Third harmonic generation imaging is used for spatio-temporal characterization of the processing conditions obtained with both a standard and SSTF focus.

  13. 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...

  14. 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 <5 cm hematomas (6.6%) not necessitating treatment. In this prospective study, Starclose SE® VCD was safe and effective for 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.

  15. Myelography in achondroplasia: value of a lateral C1-2 puncture and non-ionic, water-soluble contrast medium

    International Nuclear Information System (INIS)

    Suss, R.A.; Udvarhelyi, G.B.; Wang, H.; Kumar, A.J.; Zinreich, S.J.; Rosenbaum, A.E.

    1983-01-01

    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

  16. 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

  17. Clinical introduction of simultaneous radiohyperthermotherapy

    International Nuclear Information System (INIS)

    Kuroda, Masahiro; Makihata, Eiichi; Asaumi, Junichi; Hiraki, Yoshio; Inamura, Keiji; Tahara, Seiji; Mimura, Seiichi; Mikami, Yasutaka; Kawasaki, Shoji.

    1992-01-01

    Simultaneous radiohyperthermotherapy (SRH) is a combined hyperthermia-radiation therapy in which radiation is given during heating. An in vitro study was performed on NIH3T3 cells using 60 Co γ-ray for irradiation and a water bath for heat treatment. The thermal enhancement ratio increased after simultaneous treatment compared to sequential treatment with heating for 90 min at 43degC and irradiation. Simultaneous treatment was more cytotoxic than sequential treatment with heating for 20 min at 45degC and irradiation of 6 Gy. A clinical trial was performed on a 57-year-old female with post-operative recurrence of rectal carcinoma. This is the first reported clinical case treated with true SRH in which external irradiation was administered during mid RF capacitive heating. Twelve SRH treatments were performed on the recurrent lesion at a frequency of twice a week for six weeks using the high energy radiotherapy system (Toshiba LMR-15A) and the 13.56MHz capacitive heating system (Omron HEH-500C). Average temperature at the time of irradiation in mid heating was 41.1degC. The patient received 60 Gy in 30 fractions over six weeks. There was a dramatic reduction in pain after treatment. The tumor marker CEA level decreased after treatment. On CT images taken after treatment, the tumor site became a low density area which indicated necrosis. There were no side effects encountered. These results suggest that further clinical study of SRH should be performed to clarify its advantages. (author)

  18. 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.

  19. 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.

  20. Sequential versus simultaneous market delineation

    DEFF Research Database (Denmark)

    Haldrup, Niels; Møllgaard, Peter; Kastberg Nielsen, Claus

    2005-01-01

    and geographical markets. Using a unique data setfor prices of Norwegian and Scottish salmon, we propose a methodologyfor simultaneous market delineation and we demonstrate that comparedto a sequential approach conclusions will be reversed.JEL: C3, K21, L41, Q22Keywords: Relevant market, econometric delineation......Delineation of the relevant market forms a pivotal part of most antitrustcases. The standard approach is sequential. First the product marketis delineated, then the geographical market is defined. Demand andsupply substitution in both the product dimension and the geographicaldimension...

  1. 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.

  2. 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.

  3. Effects caused by the spinal administration of ketamine S (+) 5% with no preservatives, using a single puncture, and located on the spinal cord and meninges in rabbits.

    Science.gov (United States)

    Lima Filho, José Admirço; Fin, Natalia Castro; Valerini, Felipe Gilberto; Machado, Vania Maria; Marques, Mariangela Ester; Miot, Hélio; Lima, Lais Helena Navarro E; Ganen, Eliana Marisa

    2014-07-01

    To evaluate the effect of ketamine S (+) 5% with no preservatives and administered as a subarachnoid single puncture on the spinal cord and meninges of rabbits. Twenty young adult female rabbits, each weighing 3500-5000 g and having a spine length between 34 and 38 cm, were divided by lot into two groups (G): 0.9% saline in G1 and ketamine S (+) 5% in G2, by volume of 5 μg per cm column (0.18 mL). After intravenous anaesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance, and a random solution was injected. The animals remained in captivity for 21 days under medical observation and were sacrificed by decapitation. The lumbosacral spinal cord portion was removed for immunohistochemistry to assess the glial fibrillary acidic protein (GFAP), and histology was assessed using hematoxylin and eosin (HE) stain. No histological lesions were found in the nervous tissue (roots and cord) or meninges in either group. The ketamine S (+) 5% unpreserved triggered no neurological or histological lesions in the spinal cord or meninges of rabbits.

  4. 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.

  5. Simultaneous and Sequential Feature Negative Discriminations: Elemental Learning and Occasion Setting in Human Pavlovian Conditioning

    Science.gov (United States)

    Baeyens, Frank; Vervliet, Bram; Vansteenwegen, Debora; Beckers, Tom; Hermans, Dirk; Eelen, Paul

    2004-01-01

    Using a conditioned suppression task, we investigated simultaneous (XA-/A+) vs. sequential (X [right arrow] A-/A+) Feature Negative (FN) discrimination learning in humans. We expected the simultaneous discrimination to result in X (or alternatively the XA configuration) becoming an inhibitor acting directly on the US, and the sequential…

  6. Automated Story Direction and Intelligent Tutoring: Towards a Unifying Architecture

    National Research Council Canada - National Science Library

    Riedl, Mark; Lane, H. Chad; Hill, Randall; Swartout, William

    2006-01-01

    .... Our goal is to build training simulations that cultivate compelling storylines while simultaneously maintaining a pedagogical presence by incorporating both automated story direction and intelligent...

  7. Simultaneous seeing measurements at Atacama

    Science.gov (United States)

    Uraguchi, Fumihiro; Motohara, Kentaro; Doi, Mamoru; Takato, Naruhisa; Miyashita, Akihiko; Tanabe, Toshihiko; Oyabu, Shinki; Soyano, Takao

    2004-10-01

    Institute of Astronomy, University of Tokyo is now planning to build a 6.5-m optical-infrared telescope in Atacama, Chile. This project is called "Univ. Tokyo Atacama Observatory (TAO)", and the site evaluation is now under way. As a part of this evaluation process, we started an investigation to compare the astronomical seeing at Atacama with that at Mauna Kea. Here, we report preliminary results of seeing measurements at several sites in Atacama, carried out on October 2003. In order to separate the temporal and site-to-site variation of the seeing, we used two sets of Differential Image Motion Monitors (DIMMs), each of which has two pairs of 7.4 cm sub-apertures with 20.5 cm separation. Three sites were investigated; the point near the TAO weather station (4,950m), the summit of Cello Chico (5,150m) and the point at 5,430m altitude on Cello Toco. Simultaneous measurements were carried out for three half nights out of four half nights measurements. Although the amount of our data is very limited, the results suggest following: 1) Seeing becomes better and more stable as time passing to midnight (eg. From 0."7 to 0."4 at V-band). 2) Higher altitude sites show better seeing than lower altitude sites.

  8. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles.

    Science.gov (United States)

    Shaikh, Jan Muhammad; Memon, Amna; Memon, Muhammad Ali; Khan, Majida

    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. Liaquat University Hospital Hyderabad from October 2005 to December 2006. 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.

  9. 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)

  10. Concepts of Simultaneity From Antiquity to Einstein and beyond

    International Nuclear Information System (INIS)

    Muller, F A

    2007-01-01

    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 relation in terms of the structure of Minkowski space

  11. 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

  12. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    While many books on direct democracy have a regional or national approach, or simply focus on one of the many mechanisms associated with direct democracy, this Handbook delves into a global comparison of direct democracy mechanisms, including referendums, citizens' initiatives, agenda initiatives...... learned. In addition, the uniquely comprehensive world survey outlines direct democracy provisions in 214 countries and territories and indicates which, if any, of these provisions are used by each country or territory at both the national and sub-national levels. Furthermore, the world survey includes...

  13. 5 CFR 1651.11 - Simultaneous death.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Simultaneous death. 1651.11 Section 1651.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD DEATH BENEFITS § 1651.11 Simultaneous death. If a beneficiary dies at the same time as the participant, the beneficiary will be treated...

  14. 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

  15. Directing 101.

    Science.gov (United States)

    Pintoff, Ernest

    Providing an introduction to anyone considering directing as a field of study or career, this book takes a broad look at the process of directing and encourages students and professionals alike to look outside of the movie industry for inspiration. Chapters in the book discuss selecting and acquiring material; budgeting and financing; casting and…

  16. 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

  17. 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

  18. Results of simultaneous and sequential pediatric liver and kidney transplantation.

    Science.gov (United States)

    Rogers, J; Bueno, J; Shapiro, R; Scantlebury, V; Mazariegos, G; Fung, J; Reyes, J

    2001-11-27

    (86%) of seven sequentially transplanted kidneys developed acute cellular rejection compared with only two (25%) of eight simultaneously transplanted kidneys (P<0.04). Simultaneously transplanted kidneys were less likely to develop rejection than sequentially transplanted kidneys in this series. This did not have any bearing on patient or graft survival rates. Mortality correlated directly with the severity of United Network of Organ Sharing status at the time of kidney transplantation. Candidates for simultaneous or sequential LTx/KTx should be prioritized based on medical stability to optimize distribution of scarce renal allografts.

  19. 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.

  20. [Administration of vaccine against myxomatosis using live MXT by means of external ear puncture with a special needle].

    Science.gov (United States)

    Cupera, Z; Krupka, V; Jiran, E

    1982-01-01

    A new application method was developed and tested for the immunoprophylaxis of rabbits against myxomatosis using a live MXT vaccine. This new application method--injection of the ear with a special double needle--is very simple and easy. Its use enables a five-fold increase in vaccination doses as compared with subcutaneous application while the amount of vaccine remains the same. In laboratory this method with the MXT vaccine secured a 98.2% protection of the vaccinated animals. One vaccination dose contains 18.1 to 37.2 PD50. Eleven months from a single vaccination by injecting the ear, 83% of the rabbits still remained protected against experimental infection. With the use of the new application method of injecting the ear with the special double needle, the live MXT vaccine against myxomatosis in rabbits represents an effective, easily practicable and economically advantageous direction in the immunoprophylaxis of rabbits against myxomatosis.

  1. Simultaneous estimation of experimental and material parameters

    CSIR Research Space (South Africa)

    Jansen van Rensburg, GJ

    2012-07-01

    Full Text Available to the experimental data. An inverse analysis is performed that determines material properties and boundary conditions simultaneously. This idea is investigated using virtual experimental data. The virtual experimental data is obtained by performing a finite element...

  2. Simultaneous invention and the patent law

    DEFF Research Database (Denmark)

    Howells, John

    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...... 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...... 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....

  3. Optimization of bioethanol production from simultaneous ...

    African Journals Online (AJOL)

    ADOWIE PERE

    fermentation of pineapple peels using Saccharomyces cerevisiae ... ABSTRACT: In this study, bioethanol production from the simultaneous ... in turn has resulted in the need to find a source of ... fruit in the world after Banana and Citrus and.

  4. Directed polymers versus directed percolation

    Science.gov (United States)

    Halpin-Healy, Timothy

    1998-10-01

    Universality plays a central role within the rubric of modern statistical mechanics, wherein an insightful continuum formulation rises above irrelevant microscopic details, capturing essential scaling behaviors. Nevertheless, occasions do arise where the lattice or another discrete aspect can constitute a formidable legacy. Directed polymers in random media, along with its close sibling, directed percolation, provide an intriguing case in point. Indeed, the deep blood relation between these two models may have sabotaged past efforts to fully characterize the Kardar-Parisi-Zhang universality class, to which the directed polymer belongs.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Alterations in audiovisual simultaneity perception in amblyopia

    OpenAIRE

    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...

  11. Control functions in nonseparable simultaneous equations models

    OpenAIRE

    Blundell, R.; Matzkin, R. L.

    2014-01-01

    The control function approach (Heckman and Robb (1985)) in a system of linear simultaneous equations provides a convenient procedure to estimate one of the functions in the system using reduced form residuals from the other functions as additional regressors. The conditions on the structural system under which this procedure can be used in nonlinear and nonparametric simultaneous equations has thus far been unknown. In this paper, we define a new property of functions called control function ...

  12. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    Energy Technology Data Exchange (ETDEWEB)

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua [University Hospital, University of Cologne, Department of Radiology, Cologne (Germany); Pfister, Roman [University Hospital, University of Cologne, Department of Internal Medicine III, Cologne (Germany); Deppe, Antje-Christin [University Hospital, University of Cologne, Department of Cardiothoracic Surgery, Cologne (Germany); Matoussevitch, Vladimir [University Hospital, University of Cologne, Department of Vascular Surgery, Cologne (Germany)

    2014-06-15

    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.)

  13. 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.)

  14. Magnetic resonance findings associated with intracranial hypotension. A report of three cases occurring after lumbar puncture; Hallazgos por RM en el sindrome de hipotension intracraneal. A proposito de tres casos tras puncion lumbar

    Energy Technology Data Exchange (ETDEWEB)

    Galan, J. [Hospital General Yague (Spain); Vuelta, R. V. [Hospital de Txagorritxu. Vitoria (Spain); Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain)

    1999-07-01

    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.

  15. 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.

  16. 彩超引导肾穿刺在肾积水引流中的应用价值%Color Dopplar Ultrasound Guidance of Hydronephrosis Puncture Drainage the ApplicationValue

    Institute of Scientific and Technical Information of China (English)

    于立江; 王希路; 张颖

    2014-01-01

    Objective:To explore the colour dopplar ultrasound guide hydronephrosis puncture of the drainage application value .Meth-ods:Retrospective analysis of 22 cases in hydronephrosis with colour dopplar ultrasound to exceed guided puncture , placed the tube .Re-sults:22 cases are all drainage success , of hydronephrosis ease and all did not appear serious complications .Conclusion:Colour dopplar ultrasound can reveal organization structure and vascular distribution of hydronephrosis under puncture point , and improve the success rate and security .%目的:探讨彩超引导在肾积水穿刺引流中的应用价值。方法:回顾性分析22例肾积水患者在彩超引导下穿刺,放置引流管。结果:22例患者均引流成功,肾积水缓解均未出现严重并发症。结论:彩超可以明确肾积水穿刺点下的组织结构及血管分布,提高了穿刺成功率和安全性。

  17. 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

  18. 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.

  19. Alterations in audiovisual simultaneity perception in amblyopia.

    Directory of Open Access Journals (Sweden)

    Michael D Richards

    Full Text Available 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.

  20. 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)

  1. Neurodegenerative evidence in mice brains with cecal ligation and puncture-induced sepsis: preventive effect of the free radical scavenger edaravone.

    Directory of Open Access Journals (Sweden)

    Hiroki Yokoo

    Full Text Available Sepsis is a major clinical challenge and septic encephalopathy is its nasty complication. The pathogenesis and underlying mechanisms of septic encephalopathy are not well understood. This study sought to fully characterize sepsis-associated biochemical and histopathological changes in brains of mice after cecal ligation and puncture, regarded as a highly clinically relevant animal model of polymicrobial sepsis. Real-time PCR analysis showed that gene expression levels of proinflammatory cytokines, including tumor necrosis factor-α and interleukin-1β, were significantly up-regulated in brain tissues from septic mice, but to a much lesser extent when compared with those in peripheral tissues such as lungs. Blood-brain barrier (BBB permeability was significantly increased in septic mice, as determined by the measurement of sodium fluorescein and Evans blue content. Sepsis resulted in increases in NADPH oxidase activity and expression of p47(phox and p67(phox and up-regulation of inducible nitric oxide (NO synthase in brains, indicating that superoxide, produced by NADPH oxidase, reacts with NO to form peroxynitrite, that maybe lead to the loss of BBB integrity. Light and electron microscopic examination of septic mouse brain showed serious neuronal degeneration, as indicated by hyperchromatic, shrunken, pyknotic, and electron-dense neurons. These histopathological changes were prevented by treatment with the free radical scavenger edaravone. Together, these results suggest that sepsis can lead to rapid neurodegenerative changes in brains via free radical species production and possibly subsequent injury to the BBB. We may also provide a potentially useful therapeutic tool for treating septic encephalopathy.

  2. Appreciation of CT-negative, lumbar puncture-positive subarachnoid haemorrhage: risk factors for presence of aneurysms and diagnostic yield of imaging.

    Science.gov (United States)

    Bakker, Nicolaas A; Groen, Rob J M; Foumani, Mahrouz; Uyttenboogaart, Maarten; Eshghi, Omid S; Metzemaekers, Jan D M; Luijckx, Gert Jan; Van Dijk, J Marc C

    2014-08-01

    Patients without a subarachnoid haemorrhage (SAH) on brain CT scan (CT-negative), but a lumbar puncture (LP)-proven SAH, are a challenging patient category. The optimal diagnostic approach is still a matter of debate. Also, there is little knowledge on the probability of finding an underlying vascular lesion. In this observational study, a consecutive cohort of 94 patients with CT-negative, LP-positive SAH was prospectively collected between 1998 and 2013. The yield of diagnostic modalities as well as patient outcome was studied. In addition, risk factors for the presence of a vascular lesion were analysed. In 40 patients (43%), an intracranial vascular abnormality was detected: 37 aneurysms and three arterial dissections. Female gender was significantly associated with detection of a vascular lesion. Time between ictus and diagnosis of SAH was not associated with the presence of vascular pathology. Overall, 99% of patients had a modified Rankin Score of 0-2 after a median follow-up of 72 months. The yield of additional digital subtraction angiography in patients with a negative CT angiography was zero. In this study, the chance of finding a vascular lesion in a patient with CT-negative, LP-positive SAH was 43%, underlining the need for an adequate diagnostic workup. In general, the patient outcome was favourable. Female gender was found to be predictive for detecting a vascular lesion. In contrast with previous reports, the interval between ictus and LP was not associated with the presence of an aneurysm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Cecal ligation and puncture followed by methicillin-resistant Staphylococcus aureus 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

    2012-01-01

    Mortality in the intensive care unit frequently results from the synergistic effect of two temporally distinct infections. This study examined the pathophysiology of a new model of intra-abdominal sepsis followed by methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Mice underwent cecal ligation and puncture (CLP) or sham laparotomy followed 3 days later by an intratracheal injection of MRSA or saline. Both CLP/saline and sham/MRSA mice had 100% survival, whereas animals with CLP followed by MRSA pneumonia had 67% 7-day survival. Animals subjected to CLP/MRSA had increased bronchoalveolar lavage concentrations of MRSA compared with sham/MRSA animals. Animals subjected to sham/MRSA pneumonia had increased bronchoalveolar lavage levels of interleukin 6 (IL-6), tumor necrosis factor α, and granulocyte colony-stimulating factor compared with those given intratracheal saline, whereas 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 with those subjected to sham laparotomy, whereas 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 with 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.

  4. 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.

  5. Devascularization of Head and Neck Paragangliomas by Direct Percutaneous Embolization

    International Nuclear Information System (INIS)

    Ozyer, Umut; Harman, Ali; Yildirim, Erkan; Aytekin, Cuneyt; Akay, Tankut Hakki; Boyvat, Fatih

    2010-01-01

    Preoperative transarterial embolization of head and neck paragangliomas using particulate agents has proven beneficial for decreasing intraoperative blood loss. However, the procedure is often incomplete owing to extensive vascular structure and arteriovenous shunts. We report our experience with embolization of these lesions by means of direct puncture and intratumoral injection of n-butyl cyanoacrylate (NBCA) or Onyx. Ten patients aged 32-82 years who were referred for preoperative embolization of seven carotid body tumors and three jugular paragangliomas were retrospectively analyzed. Intratumoral injections were primarily performed in four cases with multiple small-caliber arterial feeders and adjunctive to transarterial embolization in six cases with incomplete devascularization. Punctures were performed under ultrasound and injections were performed under roadmap fluoroscopic guidance. Detailed angiographies were performed before and after embolization procedures. Control angiograms showed complete or near-complete devascularization in all tumors. Three tumors with multiple small-caliber arterial feeders were treated with primary NBCA injections. One tumor necessitated transarterial embolization after primary injection of Onyx. Six tumors showed regional vascularization from the vasa vasorum or small-caliber branches of the external carotid artery following the transarterial approach. These regions were embolized with NBCA injections. No technical or clinical complications related to embolization procedures occurred. All except one of the tumors were surgically removed following embolization. In conclusion, preoperative devascularization with percutaneous direct injection of NBCA or Onyx is feasible, safe, and effective in head and neck paragangliomas with multiple small-caliber arterial feeders and in cases of incomplete devascularization following transarterial embolization.

  6. Direct Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Austern, N. [University of Pittsburgh, Pittsburgh, PA (United States)

    1963-01-15

    In order to give a unified presentation of one point of view, these lectures are devoted only to a detailed development of the standard theories of direct reactions, starting from basic principles. Discussion is given of the present status of the theories, of the techniques used for practical calculation, and of possible future developments. The direct interaction (DI) aspects of a reaction are those which involve only a few of the many degrees of freedom of a nucleus. In fact the minimum number of degrees of freedom which must be involved in a reaction are those required to describe the initial and final channels, and DI studies typically consider these degrees of freedom and no others. Because of this simplicity DI theories may be worked out in painstaking detail. DI processes concern only part of the wave function for a problem. The other part involves complicated excitations of many degrees of freedom, and gives the compound nucleus (CN) effects. While it is extremely interesting to learn how to separate DI and CN effects in an orderly manner, if they are both present in a reaction, no suitable method has yet been found. Instead, current work stresses the kinds of reactions and the kinds of final states in which DI effects dominate and in which CN effects may almost be forgotten. The DI cross-sections which are studied are often extremely large, comparable to elastic scattering cross-sections. (author)

  7. Focusing on Concepts by Covering Them Simultaneously

    Science.gov (United States)

    Shwartz, Pete

    2017-01-01

    "Parallel" pedagogy covers the four mechanics concepts of momentum, energy, forces, and kinematics simultaneously instead of building each concept on an understanding of the previous one. Course content is delivered through interactive videos, allowing class time for group work and student-centered activities. We start with simple…

  8. Bilateral empyema thoracis treated simultaneously with video ...

    African Journals Online (AJOL)

    Keywords: bilateral empyema, children, pneumonia, simultaneous ... Department of Pediatric Surgery, J.J. Hospital and Grant Medical College, ... occurrence of an acute inflammatory reaction. ... specific organism has been associated with the patients of ... 8 Santos Jw. Community-acquired staphylococcal pneumonia.

  9. 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 ...

  10. Simultaneous measurement of non-commuting observables

    NARCIS (Netherlands)

    Allahverdyan, A.E.; Balian, R.; Nieuwenhuizen, T.M.

    2010-01-01

    A dynamical model of a quantum measurement process is introduced, where the tested system S, a spin 1/2, is simultaneously coupled with two apparatuses A and A'. Alone, A would measure the component (s) over cap (z) whereas A' alone would measure (s) over cap (x). The apparatus A simulates an Ising

  11. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  12. Simultaneous determination of isoniazid and pyrazinamide in ...

    African Journals Online (AJOL)

    Finally, 20 µL was injected into the HPLC system. HPLC analysis ... The method was accurate, and relative error ... Keywords: HPLC, Isoniazid, Pyrazinamide, Plasma, Simultaneous analysis. Tropical ... work, we describe a new HPLC method with UV ... pooled human plasma. ..... License, which permits unrestricted use,.

  13. Development of Three Methods for Simultaneous Quantitative ...

    African Journals Online (AJOL)

    Development of Three Methods for Simultaneous Quantitative Determination of Chlorpheniramine Maleate and Dexamethasone in the Presence of Parabens in ... Tropical Journal of Pharmaceutical Research ... Results: All the proposed methods were successfully applied to the analysis of raw materials and dosage form.

  14. Simultaneous scheduling of machines and mobile robots

    DEFF Research Database (Denmark)

    Dang, Vinh Quang; Nielsen, Izabela Ewa

    2013-01-01

    This paper deals with the problem of simultaneously scheduling machines and a number of autonomous mobile robots in a flexible manufacturing system (FMS). Besides capability of transporting materials between machines, the considered mobile robots are different from other material handling devices...

  15. Simultaneous adsorption and biodegradation of synthetic melanoidin

    African Journals Online (AJOL)

    Being an antioxidant, melanoidin removal through purely biodegradation has been inadequate. Consequently, in the current study, simultaneous adsorption and biodegradation (SAB) was employed in a stirred tank system to remove melanoidin from synthetic wastewater. Mixed microbial consortium was immobilized onto ...

  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. Influence of simultaneous infestations of Prostephanus truncatus ...

    African Journals Online (AJOL)

    The specific objective was to determine the number of the insect pests at F1 and F2 and the grain weight losses caused by the simultaneous pests\\' infestations of shelled maize in the search for a control strategy. The results showed a change in adult insect numbers from F1 to F2. During single infestation the change in P.

  18. 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 ...

  19. 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 ...

  20. Mutiple simultaneous event model for radiation carcinogenesis

    International Nuclear Information System (INIS)

    Baum, J.W.

    1979-01-01

    Theoretical Radiobiology and Risk Estimates includes reports on: Multiple Simultaneous Event Model for Radiation Carcinogenesis; Cancer Risk Estimates and Neutron RBE Based on Human Exposures; A Rationale for Nonlinear Dose Response Functions of Power Greater or Less Than One; and Rationale for One Double Event in Model for Radiation Carcinogenesis

  1. Simultaneous embedding: edge orderings, relative positions, cutvertices

    NARCIS (Netherlands)

    Bläsius, T.; Karrer, A.; Rutter, I.

    A simultaneous embedding (with fixed edges) of two graphs (Formula presented.) and (Formula presented.) with common graph (Formula presented.) is a pair of planar drawings of (Formula presented.) and (Formula presented.) that coincide on G. It is an open question whether there is a polynomial-time

  2. Simultaneous Determination of Ciprofloxacin and Tinidazole in ...

    African Journals Online (AJOL)

    Purpose: To develop a simple, sensitive and specific liquid chromatographic method with PDA detection for the simultaneous estimation of ciprofloxacin and tinidazole in tablet dosage form. Methods: Separation was achieved with an Agilent XDB C18, 250 × 4.60 mm 5 μ column, low pressure gradient mode with a ambient ...

  3. Simultaneous Multi-Element Electrothermal Atomic Absorption ...

    African Journals Online (AJOL)

    width of transmittance profile 120 pm, a linear CCD array attached to a PC and a tube atomizer furnished with a carbon fibre collector. In the experiments simultaneous determination of 18 elements was performed in the mixed solutions at the mg ...

  4. Future direction of direct writing

    Science.gov (United States)

    Kim, Nam-Soo; Han, Kenneth N.

    2010-11-01

    Direct write technology using special inks consisting of finely dispersed metal nanoparticles in liquid is receiving an undivided attention in recent years for its wide range of applicability in modern electronic industry. The application of this technology covers radio frequency identification-tag (RFID-tag), flexible-electronics, organic light emitting diodes (OLED) display, e-paper, antenna, bumpers used in flip-chip, underfilling, frit, miniresistance applications and biological uses, artificial dental applications and many more. In this paper, the authors have reviewed various direct write technologies on the market and discussed their advantages and shortfalls. Emphasis has given on microdispensing deposition write (MDDW), maskless mesoscale materials deposition (M3D), and ink-jet technologies. All of these technologies allow printing various patterns without employing a mask or a resist with an enhanced speed with the aid of computer. MDDW and M3D are capable of drawing patterns in three-dimension and MDDW, in particular, is capable of writing nanoinks with high viscosity. However, it is still far away for direct write to be fully implemented in the commercial arena. One of the hurdles to overcome is in manufacturing conductive inks which are chemically and physically stable, capable of drawing patterns with acceptable conductivity, and also capable of drawing patterns with acceptable adhesiveness with the substrates. The authors have briefly discussed problems involved in manufacturing nanometal inks to be used in various writing devices. There are numerous factors to be considered in manufacturing such inks. They are reducing agents, concentrations, oxidation, compact ability allowing good conductivity, and stability in suspension.

  5. Seasonal incidence of lameness and risk factors associated with thin soles, white line disease, ulcers, and sole punctures in dairy cattle.

    Science.gov (United States)

    Sanders, A H; Shearer, J K; De Vries, A

    2009-07-01

    Lameness is a multifactorial condition with many causes. In this study, cow lifetime records were used to quantify the incidence of specific lameness-causing lesions and investigate factors associated with those lesions. Of primary interest were the effects of seasonality and the effects of thin soles (TS). Thin sole-induced toe ulcers (TSTU) occurring adjacent to the white line in the apical portion of the weight-bearing surface were distinguished from white line disease (WLD) occurring in the region of the abaxial heel sole junction. Sole (SU), heel (HU), and toe (TU) ulcers; TS; sole punctures (SP); leg injuries (INJ); and other (OTH) lesions (e.g., infectious diseases, laminitis, unclassified hemorrhage) were also considered. Data were collected from May 2004 through October 2007 and included records for 4,915 cows of which 1,861 had at least one recorded lameness event. Of these, 20% were TSTU, 20% OTH, 16% SU, 13% TS, 10% WLD, 8% HU, 6% INJ, 4% SP, and 2% TU. Annual incidence risk for lameness was 49.1%. Overall incidence rate for lameness was 1.41/1,000 cow-days, and rates for all lesions were highest in the summer. As parity increased, so did incidence rates for TS, SU, WLD, HU, and INJ. For TS, TSTU, and WLD, incidence rates were lowest in early lactation (16 to 60 DIM), whereas for SU, HU, TU, incidence rates were highest in mid lactation (61 to 150 DIM). Cox proportional hazard models for TS, TSTU, WLD, SU, HU, TU, and SP included age and year of first calving and milk production capacity. Prior/concurrent lameness events, season, parity, and stage of lactation were included as time-dependent effects. Prior/concurrent TS increased the hazard for all other lesions, particularly TSTU, and HU. Having any other prior claw lesion also increased the hazard for all lesions. Hazard was highest in summer for all lesions except TU. Stage of lactation was a significant effect in hazard of TSTU, which was lowest in mid lactation (61 to 150 DIM).

  6. Retrospective analysis of clinical efficacy of protocol-based management of postdural puncture headache in patients undergoing cesarean section under spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Zainab Salim Said Al Amri

    2017-01-01

    Full Text Available Despite advances in needle size and design, postdural puncture headache (PDPH still remains a significant cause of morbidity in parturients receiving spinal anesthesia. Several treatment options have been suggested to treat PDPH ranging from bed rest, rehydration, and analgesics to epidural blood patch. At our institution, we adhere to a strict protocol for managing PDPH wherein adrenocorticotrophic hormone (ACTH is one of the treatment steps in cases of unrelieved PDPH. We carried out a 1-year retrospective analysis to note the efficacy of ACTH in managing PDPH in patients undergoing spinal anesthesia for cesarean section. All patients with PDPH were followed up for at least 2 months after being discharged from the hospital to note recurrence, if any. Data revealed that a total of 614 patients received spinal anesthesia during this period using a 25- or 26-G Quincke needle with the patient in the sitting position using a midline approach. Totally 31 patients developed PDPH and all patients reported their headache spontaneously. As per protocol, if the PDPH did not resolve or lessen in intensity with bed rest and simple analgesics (paracetamol, diclofenac or tramadol alone, or in combination over the first 24 h, two injections of ACTH (1.5 μg/kg in 500 ml saline intravenous over 30 min were administered 12 h apart. No further injections of ACTH were administered. If any treatment modality demonstrated relief or attenuation in PDPH, the patient was observed for the next 2 days. If there was no further improvement, next step of the protocol using epidural blood patch was adopted. Of these 614 patients, 31 developed PDPH giving an incidence of 5.04%. The first line of conservative treatment with bed rests and simple analgesics was successful in relieving or alleviating PDPH in 20 patients (64.5% within 24 h. About 11 patients (35.5% went on to receive ACTH as the second conservative line of management. In 10 of these 11 patients (90.9%, PDPH

  7. Gene deletion of P-Selectin and ICAM-1 does not inhibit neutrophil infiltration into peritoneal cavity following cecal ligation-puncture

    Directory of Open Access Journals (Sweden)

    Hess Karen

    2004-07-01

    Full Text Available Abstract Background Neutrophil infiltration is one of the critical cellular components of an inflammatory response during peritonitis. The adhesion molecules, P-selectin and intercellular adhesion molecule (ICAM-1, mediate neutrophil-endothelial cell interactions and the subsequent neutrophil transendothelial migration during the inflammatory response. Despite very strong preclinical data, recent clinical trials failed to show a protective effect of anti-adhesion therapy, suggesting that the length of injury might be a critical factor in neutrophil infiltration. Therefore, the objective of this study was to determine the role of P-selectin and ICAM-1 in neutrophil infiltration into the peritoneal cavity during early and late phases of peritonitis. Methods Peritonitis was induced in both male wild-type and P-selectin/ICAM-1 double deficient (P/I null mice by cecal ligation-puncture (CLP. Peripheral blood and peritoneal lavage were collected at 6 and 24 hours after CLP. The total leukocyte and neutrophil contents were determined, and neutrophils were identified with the aid of in situ immunohistochemical staining. Comparisons between groups were made by applying ANOVA and student t-test analysis. Results CLP induced a severe inflammatory response associated with a significant leukopenia in both wild-type and P/I null mice. Additionally, CLP caused a significant neutrophil infiltration into the peritoneal cavity that was detected in both groups of mice. However, neutrophil infiltration in the P/I null mice at 6 hours of CLP was significantly lower than the corresponding wild-type mice, which reached a similar magnitude at 24 hours of CLP. In contrast, in peritonitis induced by intraperitoneal inoculation of 2% glycogen, no significant difference in neutrophil infiltration was observed between the P/I null and wild-type mice at 6 hours of peritonitis. Conclusions The data suggest that alternative adhesion pathway(s independent of P-selectin and ICAM

  8. Simultaneous optimization of photons and electrons for mixed beam radiotherapy.

    Science.gov (United States)

    Mueller, S; Fix, M K; Joosten, A; Henzen, D; Frei, D; Volken, W; Kueng, R; Aebersold, D M; Stampanoni, M F M; Manser, P

    2017-06-26

    The aim of this work is to develop and investigate an inverse treatment planning process (TPP) for mixed beam radiotherapy (MBRT) capable of performing simultaneous optimization of photon and electron apertures. A simulated annealing based direct aperture optimization (DAO) is implemented to perform simultaneous optimization of photon and electron apertures, both shaped with the photon multileaf collimator (pMLC). Validated beam models are used as input for Monte Carlo dose calculations. Consideration of photon pMLC transmission during DAO and a weight re-optimization of the apertures after deliverable dose calculation are utilized to efficiently reduce the differences between optimized and deliverable dose distributions. The TPP for MBRT is evaluated for an academic situation with a superficial and an enlarged PTV in the depth, a left chest wall case including the internal mammary chain and a squamous cell carcinoma case. Deliverable dose distributions of MBRT plans are compared to those of modulated electron radiotherapy (MERT), photon IMRT and if available to those of clinical VMAT plans. The generated MBRT plans dosimetrically outperform the MERT, photon IMRT and VMAT plans for all investigated situations. For the clinical cases of the left chest wall and the squamous cell carcinoma, the MBRT plans cover the PTV similarly or more homogeneously than the VMAT plans, while OARs are spared considerably better with average reductions of the mean dose to parallel OARs and D 2% to serial OARs by 54% and 26%, respectively. Moreover, the low dose bath expressed as V 10% to normal tissue is substantially reduced by up to 45% compared to the VMAT plans. A TPP for MBRT including simultaneous optimization is successfully implemented and the dosimetric superiority of MBRT plans over MERT, photon IMRT and VMAT plans is demonstrated for academic and clinical situations including superficial targets with and without deep-seated part.

  9. Bayesian calibration of simultaneity in audiovisual temporal order judgments.

    Directory of Open Access Journals (Sweden)

    Shinya Yamamoto

    Full Text Available After repeated exposures to two successive audiovisual stimuli presented in one frequent order, participants eventually perceive a pair separated by some lag time in the same order as occurring simultaneously (lag adaptation. In contrast, we previously found that perceptual changes occurred in the opposite direction in response to tactile stimuli, conforming to bayesian integration theory (bayesian calibration. We further showed, in theory, that the effect of bayesian calibration cannot be observed when the lag adaptation was fully operational. This led to the hypothesis that bayesian calibration affects judgments regarding the order of audiovisual stimuli, but that this effect is concealed behind the lag adaptation mechanism. In the present study, we showed that lag adaptation is pitch-insensitive using two sounds at 1046 and 1480 Hz. This enabled us to cancel lag adaptation by associating one pitch with sound-first stimuli and the other with light-first stimuli. When we presented each type of stimulus (high- or low-tone in a different block, the point of simultaneity shifted to "sound-first" for the pitch associated with sound-first stimuli, and to "light-first" for the pitch associated with light-first stimuli. These results are consistent with lag adaptation. In contrast, when we delivered each type of stimulus in a randomized order, the point of simultaneity shifted to "light-first" for the pitch associated with sound-first stimuli, and to "sound-first" for the pitch associated with light-first stimuli. The results clearly show that bayesian calibration is pitch-specific and is at work behind pitch-insensitive lag adaptation during temporal order judgment of audiovisual stimuli.

  10. Simultaneous resonant x-ray diffraction measurement of polarization inversion and lattice strain in polycrystalline ferroelectrics

    DEFF Research Database (Denmark)

    Gorfman, S.; Simons, Hugh; Iamsasri, T.

    2016-01-01

    and strain in ferroelectrics is an ongoing challenge that so far has obscured its fundamental behaviour. By utilizing small intensity differences between Friedel pairs due to resonant scattering, we demonstrate a time-resolved X-ray diffraction technique for directly and simultaneously measuring both lattice...

  11. Mating rate influences female reproductive investment in a simultaneous hermaphrodite, Lymnaea stagnalis.

    NARCIS (Netherlands)

    Hoffer, J.N.A.; Schwegler, D.; Ellers, J.; Koene, J.M.

    2012-01-01

    Multiple mating often imposes direct fitness costs on females but can provide indirect benefits such as enhanced genetic diversity and offspring quality. The costs and benefits of multiple mating have been investigated extensively in separate-sex species but less so in simultaneous hermaphrodites,

  12. Upper GI examinations in older premature infants with persistent apnea: Correlation with simultaneous cardiorespiratory monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Itani, Y.; Niitsu, N.; Oono, T.; Fujioka, M.; Nishimura, G.

    1988-09-01

    Upper gastrointestinal examinations with simultaneous cardiorespiratory monitoring were performed in 39 older premature infants with persistent apnea. Swallowing incoordination was documented to be causatively related to persistent apnea in such infants, especially with feeding. Direct relationship between apnea and gastroesophageal reflux was not documented in this study.

  13. Simultaneous Multiple-Location Separation Control

    Science.gov (United States)

    Greenblatt, David (Inventor)

    2009-01-01

    A method of controlling a shear layer for a fluid dynamic body introduces first periodic disturbances into the fluid medium at a first flow separation location. Simultaneously, second periodic disturbances are introduced into the fluid medium at a second flow separation location. A phase difference between the first and second periodic disturbances is adjusted to control flow separation of the shear layer as the fluid medium moves over the fluid dynamic body.

  14. Simultaneous Determination of Amlodipine and Valsartan

    OpenAIRE

    Mohamed, Nashwah Gadallah

    2011-01-01

    A spectrophotometric method was developed for simultaneous determination of amlodipine (Aml) and valsartan (Val) without previous separation. In this method amlodipine in methanolic solution was determined using zero order UV spectrophotometry by measuring its absorbency at 360.5 nm without any interference from valsartan. Valsartan spectrum in zero order is totally overlapped with that of amlodipine. First, second and third derivative could not resolve the overlapped peaks. The first derivat...

  15. Freeform object design and simultaneous manufacturing

    Science.gov (United States)

    Zhang, Wei; Zhang, Weihan; Lin, Heng; Leu, Ming C.

    2003-04-01

    Today's product design, especially the consuming product design, focuses more and more on individuation, originality, and the time to market. One way to meet these challenges is using the interactive and creationary product design methods and rapid prototyping/rapid tooling. This paper presents a novel Freeform Object Design and Simultaneous Manufacturing (FODSM) method that combines the natural interaction feature in the design phase and simultaneous manufacturing feature in the prototyping phase. The natural interactive three-dimensional design environment is achieved by adopting virtual reality technology. The geometry of the designed object is defined through the process of "virtual sculpting" during which the designer can touch and visualize the designed object and can hear the virtual manufacturing environment noise. During the designing process, the computer records the sculpting trajectories and automatically translates them into NC codes so as to simultaneously machine the designed part. The paper introduced the principle, implementation process, and key techniques of the new method, and compared it with other popular rapid prototyping methods.

  16. Simultaneous CT and SPECT tomography using CZT detectors

    Science.gov (United States)

    Paulus, Michael J.; Sari-Sarraf, Hamed; Simpson, Michael L.; Britton, Jr., Charles L.

    2002-01-01

    A method for simultaneous transmission x-ray computed tomography (CT) and single photon emission tomography (SPECT) comprises the steps of: injecting a subject with a tracer compound tagged with a .gamma.-ray emitting nuclide; directing an x-ray source toward the subject; rotating the x-ray source around the subject; emitting x-rays during the rotating step; rotating a cadmium zinc telluride (CZT) two-sided detector on an opposite side of the subject from the source; simultaneously detecting the position and energy of each pulsed x-ray and each emitted .gamma.-ray captured by the CZT detector; recording data for each position and each energy of each the captured x-ray and .gamma.-ray; and, creating CT and SPECT images from the recorded data. The transmitted energy levels of the x-rays lower are biased lower than energy levels of the .gamma.-rays. The x-ray source is operated in a continuous mode. The method can be implemented at ambient temperatures.

  17. Paper Skin Multisensory Platform for Simultaneous Environmental Monitoring

    KAUST Repository

    Nassar, Joanna M.

    2016-02-19

    Human skin and hair can simultaneously feel pressure, temperature, humidity, strain, and flow—great inspirations for applications such as artificial skins for burn and acid victims, robotics, and vehicular technology. Previous efforts in this direction use sophisticated materials or processes. Chemically functionalized, inkjet printed or vacuum-technology-processed papers albeit cheap have shown limited functionalities. Thus, performance and/or functionalities per cost have been limited. Here, a scalable “garage” fabrication approach is shown using off-the-shelf inexpensive household elements such as aluminum foil, scotch tapes, sticky-notes, napkins, and sponges to build “paper skin” with simultaneous real-time sensing capability of pressure, temperature, humidity, proximity, pH, and flow. Enabling the basic principles of porosity, adsorption, and dimensions of these materials, a fully functioning distributed sensor network platform is reported, which, for the first time, can sense the vitals of its carrier (body temperature, blood pressure, heart rate, and skin hydration) and the surrounding environment.

  18. Simultaneous Mean and Covariance Correction Filter for Orbit Estimation.

    Science.gov (United States)

    Wang, Xiaoxu; Pan, Quan; Ding, Zhengtao; Ma, Zhengya

    2018-05-05

    This paper proposes a novel filtering design, from a viewpoint of identification instead of the conventional nonlinear estimation schemes (NESs), to improve the performance of orbit state estimation for a space target. First, a nonlinear perturbation is viewed or modeled as an unknown input (UI) coupled with the orbit state, to avoid the intractable nonlinear perturbation integral (INPI) required by NESs. Then, a simultaneous mean and covariance correction filter (SMCCF), based on a two-stage expectation maximization (EM) framework, is proposed to simply and analytically fit or identify the first two moments (FTM) of the perturbation (viewed as UI), instead of directly computing such the INPI in NESs. Orbit estimation performance is greatly improved by utilizing the fit UI-FTM to simultaneously correct the state estimation and its covariance. Third, depending on whether enough information is mined, SMCCF should outperform existing NESs or the standard identification algorithms (which view the UI as a constant independent of the state and only utilize the identified UI-mean to correct the state estimation, regardless of its covariance), since it further incorporates the useful covariance information in addition to the mean of the UI. Finally, our simulations demonstrate the superior performance of SMCCF via an orbit estimation example.

  19. Freehand direct arthrography of the shoulder using near real-time guidance in an open 1.0-T MRI scanner

    Energy Technology Data Exchange (ETDEWEB)

    Wybranski, Christian [University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne (Germany); Adamchic, Ilya; Ricke, Jens; Fischbach, Frank; Fischbach, Katharina [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine, Magdeburg (Germany); Roehl, Friedrich-Wilhelm [Otto-von-Guericke University Medical School, Institute of Biometry and Medical Informatics, Magdeburg (Germany)

    2017-01-15

    To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique. An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA. Technical success rate and duration of MRI-guided FDSA of the expert and the residents were compared. The residents' learning curves were assessed. The occurrence of extra-articular deposition and leakage of contrast media from the puncture site and the subsequent impairment of image interpretation were retrospectively analyzed. Overall technical success was 97.5 %. The expert needed overall fewer puncture needle readjustments and was faster at puncture needle positioning (p < 0.01). The learning curve of the residents, however, was steep. They leveled with the performance of the expert after ∼ 15 interventions. With a minimal amount of training all steps of MRI-guided FDSA can be performed in ≤10 min. Magnetic resonance-guided FDSA in an open 1.0-T MRI scanner can be performed with high technical success in a reasonably short amount of time. Only a short learning curve is necessary to achieve expert level. (orig.)

  20. Simultaneous optimization of sequential IMRT plans

    International Nuclear Information System (INIS)

    Popple, Richard A.; Prellop, Perri B.; Spencer, Sharon A.; Santos, Jennifer F. de los; Duan, Jun; Fiveash, John B.; Brezovich, Ivan A.

    2005-01-01

    Radiotherapy often comprises two phases, in which irradiation of a volume at risk for microscopic disease is followed by a sequential dose escalation to a smaller volume either at a higher risk for microscopic disease or containing only gross disease. This technique is difficult to implement with intensity modulated radiotherapy, as the tolerance doses of critical structures must be respected over the sum of the two plans. Techniques that include an integrated boost have been proposed to address this problem. However, clinical experience with such techniques is limited, and many clinicians are uncomfortable prescribing nonconventional fractionation schemes. To solve this problem, we developed an optimization technique that simultaneously generates sequential initial and boost IMRT plans. We have developed an optimization tool that uses a commercial treatment planning system (TPS) and a high level programming language for technical computing. The tool uses the TPS to calculate the dose deposition coefficients (DDCs) for optimization. The DDCs were imported into external software and the treatment ports duplicated to create the boost plan. The initial, boost, and tolerance doses were specified and used to construct cost functions. The initial and boost plans were optimized simultaneously using a gradient search technique. Following optimization, the fluence maps were exported to the TPS for dose calculation. Seven patients treated using sequential techniques were selected from our clinical database. The initial and boost plans used to treat these patients were developed independently of each other by dividing the tolerance doses proportionally between the initial and boost plans and then iteratively optimizing the plans until a summation that met the treatment goals was obtained. We used the simultaneous optimization technique to generate plans that met the original planning goals. The coverage of the initial and boost target volumes in the simultaneously optimized

  1. Cost-effectiveness of simultaneous versus sequential surgery in head and neck reconstruction.

    Science.gov (United States)

    Wong, Kevin K; Enepekides, Danny J; Higgins, Kevin M

    2011-02-01

    To determine whether simultaneous (ablation and reconstruction overlaps by two teams) head and neck reconstruction is cost effective compared to sequentially (ablation followed by reconstruction) performed surgery. Case-controlled study. Tertiary care hospital. Oncology patients undergoing free flap reconstruction of the head and neck. A match paired comparison study was performed with a retrospective chart review examining the total time of surgery for sequential and simultaneous surgery. Nine patients were selected for both the sequential and simultaneous groups. Sequential head and neck reconstruction patients were pair matched with patients who had undergone similar oncologic ablative or reconstructive procedures performed in a simultaneous fashion. A detailed cost analysis using the microcosting method was then undertaken looking at the direct costs of the surgeons, anesthesiologist, operating room, and nursing. On average, simultaneous surgery required 3 hours 15 minutes less operating time, leading to a cost savings of approximately $1200/case when compared to sequential surgery. This represents approximately a 15% reduction in the cost of the entire operation. Simultaneous head and neck reconstruction is more cost effective when compared to sequential surgery.

  2. Simultaneous penile-vaginal intercourse orgasm is associated with satisfaction (sexual, life, partnership, and mental health).

    Science.gov (United States)

    Brody, Stuart; Weiss, Petr

    2011-03-01

    Previous multivariate research found that satisfaction was associated positively with frequency of specifically penile-vaginal intercourse (PVI; as opposed to other sexual activities) as well as with vaginal orgasm. The contribution to satisfaction of simultaneous orgasm produced by PVI merited direct examination in a large representative sample. To examine the associations of aspects of satisfaction (sexual, life, own mental health, partner relationship) with consistency of simultaneous orgasm produced by PVI (as well as with PVI frequency and vaginal orgasm consistency). A representative sample of Czechs (N = 1,570) aged 35-65 years completed a survey on aspects of satisfaction, PVI frequency, vaginal orgasm consistency, and consistency of simultaneous orgasm produced by PVI (the latter being a specially timed version of vaginal orgasm for women). Analysis of variance of satisfaction components (LiSat scale items) from age and the sexual behaviors. For both sexes, all aspects of satisfaction were associated with simultaneous PVI orgasm consistency and with PVI frequency (except female life satisfaction). All aspects of satisfaction were also associated with vaginal orgasm consistency. Multivariate analyses indicated that PVI frequency and simultaneous orgasm consistency make independent contributions to the aspects of satisfaction for both sexes. For both sexes, PVI frequency and simultaneous orgasm produced by PVI (as well as vaginal orgasm for women) are associated with greater life, sexual, partnership, and mental health satisfaction. Greater support for these specific aspects of sexual activity is warranted. © 2010 International Society for Sexual Medicine.

  3. Relations between the simultaneous and sequential transfer of two nucleons

    International Nuclear Information System (INIS)

    Satchler, G.R.

    1982-01-01

    The transfer of two nucleons between projectile and target in a direct or peripheral reaction such as (p,t) or ( 16 O, 14 C) may occur in one-step or two-steps. These we refer to as simultaneous and sequential transfers, respectively. In the former, the interaction acts once and both nucleons are transferred. In the latter, the interaction acts once to transfer one nucleon, the system then propagates in one or more intermediate states and is followed by a second action of the interaction to transfer the second nucleon. This process may be symbolized for the above examples as (p,d;d,t) and ( 16 O, 15 N; 15 N, 14 C), implying the intermediate formation of a deuteron or the nucleus 15 N. (Of course, the intermediate system may exist in more than one state of excitation). For simplicity, the (t,p) reaction is chosen to illustrate the theory

  4. Truss topology optimization with simultaneous analysis and design

    Science.gov (United States)

    Sankaranarayanan, S.; Haftka, Raphael T.; Kapania, Rakesh K.

    1992-01-01

    Strategies for topology optimization of trusses for minimum weight subject to stress and displacement constraints by Simultaneous Analysis and Design (SAND) are considered. The ground structure approach is used. A penalty function formulation of SAND is compared with an augmented Lagrangian formulation. The efficiency of SAND in handling combinations of general constraints is tested. A strategy for obtaining an optimal topology by minimizing the compliance of the truss is compared with a direct weight minimization solution to satisfy stress and displacement constraints. It is shown that for some problems, starting from the ground structure and using SAND is better than starting from a minimum compliance topology design and optimizing only the cross sections for minimum weight under stress and displacement constraints. A member elimination strategy to save CPU time is discussed.

  5. Electrokinetic Supercapacitor for Simultaneous Harvesting and Storage of Mechanical Energy.

    Science.gov (United States)

    Yang, Peihua; Qu, Xiaopeng; Liu, Kang; Duan, Jiangjiang; Li, Jia; Chen, Qian; Xue, Guobin; Xie, Wenke; Xu, Zhimou; Zhou, Jun

    2018-03-07

    Energy harvesting and storage are two distinct processes that are generally achieved using two separated parts based on different physical and chemical principles. Here we report a self-charging electrokinetic supercapacitor that directly couples the energy harvesting and storage processes into one device. The device consists of two identical carbon nanotube/titanium electrodes, separated by a piece of anodic aluminum oxide nanochannels membrane. Pressure-driven electrolyte flow through the nanochannels generates streaming potential, which can be used to charge the capacitive electrodes, accomplishing simultaneous energy generation and storage. The device stores electric charge density of 0.4 mC cm -2 after fully charging under pressure of 2.5 bar. This work may offer a train of thought for the development of a new type of energy unit for self-powered systems.

  6. Simultaneous observation of chemomechanical coupling of a molecular motor.

    Science.gov (United States)

    Nishizaka, Takayuki; Hasimoto, Yuh; Masaike, Tomoko

    2011-01-01

    F(1)-ATPase is the smallest rotary molecular motor ever found. Unidirectional rotation of the γ-shaft is driven by precisely coordinated sequential ATP hydrolysis reactions in three catalytic sites arranged 120° apart in the cylinder. Single-molecule observation allows us to directly watch the rotation of the shaft using micron-sized plastic beads. Additionally, an advanced version of "total internal reflection fluorescence microscope (TIRFM)" enables us to detect binding and release of energy currency through fluorescently labeled ATP. In this chapter, we describe how to set up the system for simultaneous observation of these two critical events. This specialized optical setup is applicable to a variety of research, not only molecular motors but also other single-molecule topics.

  7. Relations between the simultaneous and sequential transfer of two nucleons

    International Nuclear Information System (INIS)

    Satchler, G.R.

    1982-01-01

    The transfer of two nucleons between projectile and target in a direct or peripheral reaction such as (p,t) or ( 16 O, 14 C) may occur in one-step or two-steps. These we refer to as simultaneous and sequential transfers, respectively. In the former, the interaction acts once and both nucleons are transferred. In the latter, the interaction acts once to transfer one nucleon, the system then propagates in one or more intermediate states and is followed by a second action of the interaction to transfer the second nucleon. This process may be symbolized for the examples as (p,d; d,t) and ( 16 O, 15 N; 15 N, 14 C), implying the intermediate formation of a deuteron or the nucleus 15 N. In terms of a perturbation theory expansion, such as the distorted-wave Born series, simultaneous transfer is possible in first order while sequential transfer requires second order. The nuclear forces are predominantly two-body in character; hence, in first-order only one of the two nucleons experiences an interaction. The possibility of finding that the other nucleon has also transferred arises only because its state within the projectile is not orthogonal to the state in the target into which it transfers. In the two-step process each nucleon is transferred under the direct influence of an interaction with the target. The one-step and two-step amplitudes are frequently comparable in magnitude for light-ion reactions while the two-step may dominate in reactions with heavy ions. Our purpose here is to gain some insight into the relationship between the two amplitudes by using a simple approximate form of the theory. For simplicity, we shall discuss a light-ion reaction and, to be specific, we choose the (t,p) reaction (or the inverse (p,t) reaction)

  8. Transfer of learned perception of sensorimotor simultaneity.

    Science.gov (United States)

    Pesavento, Michael J; Schlag, John

    2006-10-01

    Synchronizing a motor response to a predictable sensory stimulus, like a periodic flash or click, relies on feedback (somesthetic, auditory, visual, or other) from the motor response. Practically, this results in a small (<50 ms) asynchrony in which the motor response leads the sensory event. Here we show that the perceived simultaneity in a coincidence-anticipation task (line crossing) is affected by changing the perceived simultaneity in a different task (pacing). In the pace task, human subjects were instructed to press a key in perfect synchrony with a red square flashed every second. In training sessions, feedback was provided by flashing a blue square with each key press, below the red square. There were two types of training pace sessions: one in which the feedback was provided with no delay, the other (adapting), in which the feedback was progressively delayed (up to 100 ms). Subjects' asynchrony was unchanged in the first case, but it was significantly increased in the pace task with delay. In the coincidence-anticipation task, a horizontally moving vertical bar crossed a vertical line in the middle of a screen. Subjects were instructed to press a key exactly when the bar crossed the line. They were given no feedback on their performance. Asynchrony on the line-crossing task was tested after the training pace task with feedback. We found that this asynchrony to be significantly increased even though there never was any feedback on the coincidence-anticipation task itself. Subjects were not aware that their sensorimotor asynchrony had been lengthened (sometimes doubled). We conclude that perception of simultaneity in a sensorimotor task is learned. If this perception is caused by coincidence of signals in the brain, the timing of these signals depends on something-acquired by experience-more adaptable than physiological latencies.

  9. Einstein Synchronisation and the Conventionality of Simultaneity

    OpenAIRE

    Mladen Domazet

    2006-01-01

    Despite a broad-range title the paper settles for the related issue of whether the Special Theory of Relativity (STR) necessarily advocates the demise of an ontological difference between past and future events, between past and future in general. In the jargon of H. Stein: are we forced, within the framework of the STR, to choose only between ‘solipsism’ and ‘determinism’ exclusively? A special emphasis is placed on the role that the conventionality of simultaneity plays in the STR with rega...

  10. Principles of Simultaneous PET/MR Imaging.

    Science.gov (United States)

    Catana, Ciprian

    2017-05-01

    Combined PET/MR imaging scanners capable of acquiring simultaneously the complementary information provided by the 2 imaging modalities are now available for human use. After addressing the hardware challenges for integrating the 2 imaging modalities, most of the efforts in the field have focused on developing MR-based attenuation correction methods for neurologic and whole-body applications, implementing approaches for improving one modality by using the data provided by the other and exploring research and clinical applications that could benefit from the synergistic use of the multimodal data. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Simultaneous neutron and gamma spectrum adjustment

    International Nuclear Information System (INIS)

    Remec, I.

    1996-01-01

    The spectrum adjustment procedure was extended to simultaneous neutron and gamma spectrum adjustment, and the feasibility of this technique is demonstrated in the analysis of HFIR dosimetry experiments. Conditions in which gamma rays may contribute considerably to radiation damage in steels are discussed. Beryllium helium accumulation fluence monitors (HAFMs) were found to be good monitors in gamma fields of intensities high enough to contribute to steel embrittlement. Use of 237 Np, 238 U, and 9 Be HAFM as gamma dosimeters is proposed for high-dose irradiations in high-energy, high-intensity gamma fields

  12. Method and apparatus for simultaneous spectroelectrochemical analysis

    Science.gov (United States)

    Chatterjee, Sayandev; Bryan, Samuel A; Schroll, Cynthia A; Heineman, William R

    2013-11-19

    An apparatus and method of simultaneous spectroelectrochemical analysis is disclosed. A transparent surface is provided. An analyte solution on the transparent surface is contacted with a working electrode and at least one other electrode. Light from a light source is focused on either a surface of the working electrode or the analyte solution. The light reflected from either the surface of the working electrode or the analyte solution is detected. The potential of the working electrode is adjusted, and spectroscopic changes of the analyte solution that occur with changes in thermodynamic potentials are monitored.

  13. Attenuation correction using simultaneous emission - transmission tomography

    International Nuclear Information System (INIS)

    Ljubenov, V.; Marinkovic, P.

    1998-01-01

    In order to reduce degrading influence of attenuation on SPECT image quality, possibility for correction, based on simultaneous emission / transmission measurements, is discussed. Numerical photon transport simulations through the phantom and acquisition of of tomographic projections are performed by using Monte Carlo code MCNP-4A. Amount of contamination in transmission data due to photon Compton scattering for emission energy window is specially analyzed and appropriate spatial depending 'noise / signal' factors for three different external sources, applied with Tc-99m, are determined (author)

  14. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Examination, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds.

    Science.gov (United States)

    Carpenter, Christopher R; Hussain, Adnan M; Ward, Michael J; Zipfel, Gregory J; Fowler, Susan; Pines, Jesse M; Sivilotti, Marco L A

    2016-09-01

    Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. The objective was to perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP). PubMed, Embase, Scopus, and research meeting abstracts were searched up to June 2015 for studies of emergency department patients with acute headache clinically concerning for spontaneous SAH. QUADAS-2 was used to assess study quality and, when appropriate, meta-analysis was conducted using random effects models. Outcomes were sensitivity, specificity, and positive (LR+) and negative (LR-) likelihood ratios. To identify test and treatment thresholds, we employed the Pauker-Kassirer method with Bernstein test indication curves using the summary estimates of diagnostic accuracy. A total of 5,022 publications were identified, of which 122 underwent full-text review; 22 studies were included (average SAH prevalence = 7.5%). Diagnostic studies differed in assessment of history and physical examination findings, CT technology, analytical techniques used to identify xanthochromia, and criterion standards for SAH. Study quality by QUADAS-2 was variable; however, most had a relatively low risk of biases. A history of neck pain (LR+ = 4.1; 95% confidence interval [CI] = 2.2 to 7.6) and neck stiffness on physical examination (LR+ = 6.6; 95% CI = 4.0 to 11.0) were the individual findings most strongly associated with SAH. Combinations of findings may rule out SAH, yet promising clinical decision rules await external validation. Noncontrast cranial CT within 6 hours of headache onset accurately ruled in (LR+ = 230; 95

  15. Concurrent Alzheimer's pathology in patients with clinical normal pressure hydrocephalus: correlation of high-volume lumbar puncture results, cortical brain biopsies, and outcomes.

    Science.gov (United States)

    Pomeraniec, I Jonathan; Bond, Aaron E; Lopes, M Beatriz; Jane, John A

    2016-02-01

    Normal pressure hydrocephalus (NPH) remains most often a clinical diagnosis and has been widely considered responsive to the placement of a cerebrospinal fluid (CSF) shunt. The high incidence of patients with Alzheimer's disease (AD) with NPH symptoms leads to poorer outcomes than would be expected in patients with NPH alone. This article reviews a series of patients operated on for presumed NPH in whom preoperative high-volume lumbar puncture (HVLP) and intraoperative cortical brain biopsies were performed. The data derived from these procedures were then used to understand the incidence of AD in patients presenting with NPH symptoms and to analyze the efficacy of HVLP in patients with NPH and patients with concurrent AD (NPH+AD). A review of the outcomes of shunt surgery is provided. The cases of all patients who underwent placement of a CSF shunt for NPH from 1998 to 2013 at the University of Virginia by the senior author were retrospectively reviewed. Patients who underwent HVLP and patients who underwent cortical brain biopsies were stratified based on the biopsy results into an NPH-only group and an NPH+AD group. The HVLP results and outcomes were then compared in these 2 groups. From 1998 to 2013, 142 patients underwent shunt operations because of a preoperative clinical diagnosis of NPH. Of the patients with a shunt who had a diagnosis of NPH, 105 (74%) received HVLPs. Of 142 shunt-treated patients with NPH, 27 (19%) were determined to have concomitant Alzheimer's pathology based on histopathological findings at the time of shunting. Patients who underwent repeat biopsies had an initial positive outcome. After they clinically deteriorated, they underwent repeat biopsies during shunt interrogation, and 13% of the repeat biopsies demonstrated Alzheimer's pathology. Improvements in gait and cognition did not reach significance between the NPH and NPH+AD groups. In total, 105 patients underwent HVLP before shunt placement. In the NPH cohort, 44.6% of patients

  16. Focus : Évaluation de la protection contre l'endommagement des géomembranes en polyéthylène haute densité Evaluation of HDPE geomembranes protection against puncturing

    Directory of Open Access Journals (Sweden)

    CROISSANT, Didier ; TOUZE-FOLTZ, Nathalie

    2012-08-01

    Full Text Available En fond d'installation de stockage des déchets, les géomembranes constituant la barrière d'étanchéité sont soumises à des sollicitations pouvant endommager leur fonctionnement. Pour éviter le risque de perforation et de fuite, un géotextile de protection est généralement mis en place. Focus sur les tests de performance de plusieurs types de géotextiles et premières recommandations quant aux caractéristiques minimales à respecter pour éviter l'endommagement.Geotextiles are used in the constitution of landfill lining systems in order to protect the geomembrane against puncturing effects during installation of the granular drainage layer, then during the life of the landfill site, in relation with the weight of waste. The objective of this paper is to evaluate the performance of nonwoven needlepunched geotextiles having an average mass per unit area equal to 1000 g/m² in protecting geomembrane, bases on static puncture tests performed in 1m diameter cells. Those tests were previously developed by Aufrère et al. (2009. Recommendations are given in the following as regards the length of fibers, the elasticity modulus, the masse per unit area and the thickness of the geotextile depending on the nature of granular material used.

  17. Estimating individual listeners’ auditory-filter bandwidth in simultaneous and non-simultaneous masking

    DEFF Research Database (Denmark)

    Buchholz, Jörg; Caminade, Sabine; Strelcyk, Olaf

    2010-01-01

    Frequency selectivity in the human auditory system is often measured using simultaneous masking of tones presented in notched noise. Based on such masking data, the equivalent rectangular bandwidth (ERB) of the auditory filters can be derived by applying the power spectrum model of masking....... Considering bandwidth estimates from previous studies based on forward masking, only average data across a number of subjects have been considered. The present study is concerned with bandwidth estimates in simultaneous and forward masking in individual normal-hearing subjects. In order to investigate...... the reliability of the individual estimates, a statistical resampling method is applied. It is demonstrated that a rather large set of experimental data is required to reliably estimate auditory filter bandwidth, particularly in the case of simultaneous masking. The poor overall reliability of the filter...

  18. Orthognathic Surgery and Rhinoplasty: Simultaneous or Staged?

    Science.gov (United States)

    Sun, Alexander H; Steinbacher, Derek M

    2018-02-01

    Orthognathic surgery can significantly impact the nasolabial envelope, and at times requires an adjunctive rhinoplasty. The purpose of this study was to evaluate nasal morphology in orthognathic patients, focusing on predictive variables, and the need for and timing of definitive rhinoplasty. Based on these data, an algorithm for the implementation of adjunctive rhinoplasty is proposed. A review of cases over a 3-year period was completed. Information regarding demographic, diagnostic, and operative details; nasal morphology; and use of rhinoplasty was compiled. Three-dimensional images were used to quantify anatomical variables. Over 589 patients were reviewed during this period. Of these, 163 fulfilled inclusion criteria for this study. The mean age was 23.3 years. In total, 41.7 percent of orthognathic cases underwent adjunctive rhinoplasty. Of these, 82.4 percent were staged and 17.6 percent were simultaneous. The average time between staged procedures was 208 days. When simultaneous, 16.7 percent of the orthognathic procedures had significant maxillary movement (advancement >4 to 5 mm, impaction >2 mm, alar base excisions); in comparison, 92.9 percent of staged cases had significant maxillary movement (p orthognathic surgery. The authors present an algorithm to extensively treat the nasomaxillofacial relationship using orthognathic surgery alone, orthognathic surgery in concert with rhinoplasty, or orthognathic surgery followed by staged rhinoplasty.

  19. Simultaneity Analysis In A Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Malović Miodrag

    2015-06-01

    Full Text Available An original wireless sensor network for vibration measurements was designed. Its primary purpose is modal analysis of vibrations of large structures. A number of experiments have been performed to evaluate the system, with special emphasis on the influence of different effects on simultaneity of data acquired from remote nodes, which is essential for modal analysis. One of the issues is that quartz crystal oscillators, which provide time reading on the devices, are optimized for use in the room temperature and exhibit significant frequency variations if operated outside the 20–30°C range. Although much research was performed to optimize algorithms of synchronization in wireless networks, the subject of temperature fluctuations was not investigated and discussed in proportion to its significance. This paper describes methods used to evaluate data simultaneity and some algorithms suitable for its improvement in small to intermediate size ad-hoc wireless sensor networks exposed to varying temperatures often present in on-site civil engineering measurements.

  20. Further Investigations on Simultaneous Ultrasonic Coal Flotation

    Directory of Open Access Journals (Sweden)

    Safak Gokhan Ozkan

    2017-09-01

    Full Text Available This study investigates the flotation performance of a representative hard coal slime sample (d80 particle size of minus 0.2 mm obtained from the Prosper-Haniel coal preparation plant located in Bottrop, Germany. Flotation was carried out with a newly designed flotation cell refurbished from an old ultrasonic cleaning bath (2.5 L volume equipped with a single frequency (35 kHz and two different power levels (80–160 W and a sub-aeration-type flotation machine operating at a stable impeller speed (1200 rpm and air rate (2.5 L/min. The reagent combination for conventional and simultaneous ultrasonic coal flotation tests was Ekofol-440 at variable dosages (40–300 g/t with controlling water temperature (20–25 °C at natural pH (6.5–7.0. The batch coal flotation results were analyzed by comparing the combustible recovery (% and separation efficiency (% values, taking mass yield and ash concentrations of the froths and tailings into account. It was found that simultaneous ultrasonic coal flotation increased yield and recovery values of the floated products with lower ash values than the conventional flotation despite using similar reagent dosages. Furthermore, particle size distribution of the ultrasonically treated and untreated coals was measured. Finely distributed coal particles seemed to be agglomerated during the ultrasonic treatment, while ash-forming slimes were removed by hydrodynamic cavitation.