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Sample records for duct injury correlation

  1. Financial Aspects of Bile Duct Injuries.

    Science.gov (United States)

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

    2017-11-04

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

  2. The experimental study of radiation injury on bile duct and liver tissue

    International Nuclear Information System (INIS)

    Cao Guiwen; Wang Bin; Sun Yequan; Shao Xueye; Ning Houfa; Sui Shouguang; Wang Xiuchun; Bai Xuming

    2007-01-01

    Objective: To investigate the safety, acceptance and the effective extent of 192 Ir-internal irradiation, providing theoretical guidelines for HC. Methods: Sixteen male healthy hybrid dogs enrolled in the experiment were divided into 4 groups of 4 each. The brachytherapy applicator was introduced from gall bladder into the convergence of cystic duct with common hepatic duct during the operation and a small chip of 1 cm 3 liver tissue was cut off and taken for control later on. The animals in group A-D were irradiated by 192 Ir-internal irradiation with 30 Gy, 40 Gy, 50 Gy arid 60 Gy at the correlative dose points respectively. Animals were put to death after 10 days subsequently, with sampling specimens obtained from radiation cystic duct and the in between liver tissue with the distant cystic duct. The radiation injury of the cystic duct and liver tissue near bile ducts were observed and studied by light microscope and transmission election microscope. Results: By the limit of the safest endurance dose(50 Gy) of Bile duct, unreversed injury of the nuclei of liver cells occurred at 0 to 15 mm from bile duct revealed by transmission electron microscope and light microscope. The whole biliary duct wall would be undergone necrosis with irradiation dose over 60 Gy. Conclusions: Normal bile duct possesses good endurance to 192 Ir-internal irradiation. Within the safest endurance limit of 50 Gy the effective irradiation field could reach 15 mm from the involved bile duct. (authors)

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

    African Journals Online (AJOL)

    2012-07-05

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

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

    NARCIS (Netherlands)

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

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

  5. Improvement in the management of bile duct injuries?

    NARCIS (Netherlands)

    Keulemans, Y. C.; Bergman, J. J.; de Wit, L. T.; Rauws, E. A.; Huibregtse, K.; Tytgat, G. N.; Gouma, D. J.

    1998-01-01

    BACKGROUND: Previous studies have suggested that improvements in diagnostic workup and treatment of bile duct injuries (BDI) sustained during laparoscopic cholecystectomy can be expected as experience increases with the laparoscopic procedure. Many published articles reported that early diagnosis,

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

    International Nuclear Information System (INIS)

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

    2005-01-01

    Objective: To evaluate the incidence, risk factors , and clinical course of bile duct injury after transcatheter arterial chemoembolization (TACE) for treatment of hepatic malignancy. Methods: A total of 1240 consecutive patients with hepatic malignancies underwent 2680 TACE procedures. None of these patients were found to have any radiographic evidence of biliary abnormalities pre-TACE. Eighteen patients developed bile duct injuries at 3 weeks to 3 months after TACE. A retrospective review of medical records and imaging studies were carried out to evaluate the occurrence of TACE-induced bile duct injury, the clinical outcome, and the statistical significance of potential predisposing factors. Results: The TACE-induced bile duct injuries occurred in 13 of 148 patients with liver metastatic tumors (8.8%), 5 of 1092 patients with HCC (0.5%). Biliary injuries, including focal (n=4) and multiple intrahepatic bile duct dilatation (n=8), and cystic lesion or biloma (n=6), were identified on the follow-up imaging studies after TACE. Three patients with multiple bile duct injuries had mild jaundice at the presentation, two of them responded well to the conservative treatment, one died of irreversible deterioration of liver function at 2 weeks after the onset of jaundice. Four patients with a large biloma had associated serious bacterial infections; 3 of which were treated with percutaneous catheter drainage and antibiotics, 2 of them died of purulent peritonitis due to rupture of the cystic lesions and 1 cured with antibiotic. The remaining 11 patients were asymptomatic. The mortality related to the biliary injury occurred in 3 patients (16.7%). The incidences of bile duct injury were higher in patients with metastatic tumors in non-cirrhotic livers than in patients with hepatocellular carcinoma associated with cirrhosis (P<0.01), higher in patient with hypovascular lesions (P<0.01), and higher in patients using an emulsion of lipiodol-platinum for selective embolization

  7. Causes and Prevention of Laparoscopic Bile Duct Injuries

    Science.gov (United States)

    Way, Lawrence W.; Stewart, Lygia; Gantert, Walter; Liu, Kingsway; Lee, Crystine M.; Whang, Karen; Hunter, John G.

    2003-01-01

    Objective To apply human performance concepts in an attempt to understand the causes of and prevent laparoscopic bile duct injury. Summary Background Data Powerful conceptual advances have been made in understanding the nature and limits of human performance. Applying these findings in high-risk activities, such as commercial aviation, has allowed the work environment to be restructured to substantially reduce human error. Methods The authors analyzed 252 laparoscopic bile duct injuries according to the principles of the cognitive science of visual perception, judgment, and human error. The injury distribution was class I, 7%; class II, 22%; class III, 61%; and class IV, 10%. The data included operative radiographs, clinical records, and 22 videotapes of original operations. Results The primary cause of error in 97% of cases was a visual perceptual illusion. Faults in technical skill were present in only 3% of injuries. Knowledge and judgment errors were contributory but not primary. Sixty-four injuries (25%) were recognized at the index operation; the surgeon identified the problem early enough to limit the injury in only 15 (6%). In class III injuries the common duct, erroneously believed to be the cystic duct, was deliberately cut. This stemmed from an illusion of object form due to a specific uncommon configuration of the structures and the heuristic nature (unconscious assumptions) of human visual perception. The videotapes showed the persuasiveness of the illusion, and many operative reports described the operation as routine. Class II injuries resulted from a dissection too close to the common hepatic duct. Fundamentally an illusion, it was contributed to in some instances by working too deep in the triangle of Calot. Conclusions These data show that errors leading to laparoscopic bile duct injuries stem principally from misperception, not errors of skill, knowledge, or judgment. The misperception was so compelling that in most cases the surgeon did not

  8. Parotid duct injury secondary to shark bite injury: Repair with a Crawford stent

    Directory of Open Access Journals (Sweden)

    Mallory Highstein

    2016-12-01

    Conclusion: Clinicians should have a high level of suspicion for parotid duct injury in a patient presenting with injury to the face, particularly with laceration type injuries. Our patient had a unique injury that required a novel Crawford stent repair over traditional silicone catheters.

  9. Reconstruction of major bile duct injuries after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Holte, Kathrine; Bardram, Linda; Wettergren, André

    2010-01-01

    Bile duct injury (BDI) after cholecystectomy remains a serious complication with major implications for patient outcome. For most major BDIs, the recommended method of repair is a hepaticojejunostomy (HJ). We conducted a retrospective review aiming to examine the perioperative and the long...

  10. Percutaneous management of bile duct injury after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Islim, F.; Ors, S.; Salik, A.; Guven, K.; Yanar, F.; Alis, H.

    2012-01-01

    Full text: Introduction: The risk of bile duct injury after laparoscopic cholecystectomy is higher than open cholecystectomy. Objective: To discuss the importance of minimally invasive treatment options in the management of bile duct injuries after laparoscopic cholecystectomy and to present our approach in the management. Materials and methods: Management of 25 patients with symptomatic bile duct injury after laparoscopic cholecystectomy was retrospectively evaluated. Percutaneous collection drainage, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and percutaneous biliary drainage were performed for the management of the patients. Results: Mean age of the patients (15 women, 10 men) was 55. Either ultrasonography or computed tomography guided percutaneous drainage was performed in 13 patients. 9 of them completely recovered only with percutaneous drainage. In 4 of them ERCP was performed because of high drainage volume. In 9 of the patients with jaundice and high bilirubin levels ERCP was performed as the first option. And 3 patients were reoperated because of acute abdomen signs. ERCP, MRCP and PTC revealed type A in 7, type E2 in 3, type E3 in 3 and type E4 in 1 of the patients according to Strasberg classification. Conclusion: Presenting symptoms of the patients with symptomatic bile duct injury are useful in the determination of the treatment option.

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

    African Journals Online (AJOL)

    2012-07-05

    Jul 5, 2012 ... Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of ... Mansarovar Dental College Hospital and Research Centre,. Kolar Road ... A 42-year-old male patient presented to maxillofacial .... catheter, catgut suture, and pediatric intravascular cannula.

  12. Role of cholangiocyte bile Acid transporters in large bile duct injury after rat liver transplantation.

    Science.gov (United States)

    Cheng, Long; Zhao, Lijin; Li, Dajiang; Liu, Zipei; Chen, Geng; Tian, Feng; Li, Xiaowu; Wang, Shuguang

    2010-07-27

    The pathogenesis of nonanastomotic strictures with a patent hepatic artery remains to be investigated. This study focuses on the role of cholangiocyte bile acid transporters in bile duct injury after liver transplantation. Sprague-Dawley rats were divided into three groups (n=20 for each): the sham-operated group (Sham), the transplant group with 1-hr donor liver cold preservation (CP-1h), and the transplant group with 12-hr donor liver cold preservation (CP-12h). Bile was collected for biochemical analysis. The histopathologic evaluation of bile duct injury was performed and the cholangiocyte bile acid transporters apical sodium-dependent bile acid transporter (ASBT), ileal lipid binding protein (ILBP), and Ostalpha/Ostbeta were investigated. RESULTS.: The immunohistochemical assay suggested that ASBT and ILBP were expressed exclusively on large bile duct epithelial cells, whereas Ostalpha and Ostbeta were expressed on both small and large bile ducts. Western blot and quantitative polymerase chain reaction analysis showed that the expression levels of these transporters dramatically decreased after transplantation. It took seven to 14 days for ILBP, Ostalpha, and Ostbeta to recover, whereas ASBT recovered within 3 days and even reached a peak above the normal level seven days after operation. In the CP-12h group, the ratios of the ASBT/ILBP, ASBT/Ostalpha and ASBT/Ostbeta expression levels were correlated with the injury severity scores of large but not small bile ducts. The results suggest that the unparallel alteration of cholangiocyte bile acid transporters may play a potential role in large bile duct injury after liver transplantation with prolonged donor liver preservation.

  13. Delayed rearterialization unlikely leads to nonanastomotic stricture but causes temporary injury on bile duct after liver transplantation.

    Science.gov (United States)

    Liu, Yang; Wang, Jiazhong; Yang, Peng; Lu, Hongwei; Lu, Le; Wang, Jinlong; Li, Hua; Duan, Yanxia; Wang, Jun; Li, Yiming

    2015-03-01

    Nonanastomotic strictures (NAS) are common biliary complications after liver transplantation (LT). Delayed rearterialization induces biliary injury in several hours. However, whether this injury can be prolonged remains unknown. The correlation of this injury with NAS occurrence remains obscure. Different delayed rearterialization times were compared using a porcine LT model. Morphological and functional changes in bile canaliculus were evaluated by transmission electron microscopy and real-time PCR. Immunohistochemistry and TUNEL were performed to validate intrahepatic bile duct injury. Three months after LT was performed, biliary duct stricture was determined by cholangiography; the tissue of common bile duct was detected by real-time PCR. Bile canaliculi were impaired in early postoperative stage and then exacerbated as delayed rearterialization time was prolonged. Nevertheless, damaged bile canaliculi could fully recover in subsequent months. TNF-α and TGF-β expressions and apoptosis cell ratio increased in the intrahepatic bile duct only during early postoperative period in a time-dependent manner. No abnormality was observed by cholangiography and common bile duct examination after 3 months. Delayed rearterialization caused temporary injury to bile canaliculi and intrahepatic bile duct in a time-dependent manner. Injury could be fully treated in succeeding months. Solo delayed rearterialization cannot induce NAS after LT. © 2014 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

  14. Acute Cholangitis After Bilioenteric Anastomosis for Bile Duct Injuries.

    Science.gov (United States)

    Ortiz-Brizuela, Edgar; Sifuentes-Osornio, José; Manzur-Sandoval, Daniel; Terán-Ellis, Santiago Mier Y; Ponce-de-León, Sergio; Torres-González, Pedro; Mercado, Miguel Ángel

    2017-10-01

    The study aims to describe the clinical features, microbiology, and associated factors of acute cholangitis (AC) after bilioenteric anastomosis (BEA) for biliary duct injury (BDI). Additionally, we assessed the performance of the Tokyo Guidelines 2013 (TG13) recommendations in these patients. We conducted a case-control study of 524 adults with a history of BEA for BDI from January 2000 to January 2014. A propensity score adjustment was performed for the analysis of the independent role of the main factors identified during the univariate logistic regression procedure. We identified 117 episodes of AC in 70 patients; 51.3% were definitive AC according to the TG13 diagnostic criteria, and 39.3% did not fulfill the imaging criteria of AC. A history of post-operative biliary complications (OR 2.55, 95% CI 1.38-4.70) and the bile duct confluence preservation (OR 0.46, 95% CI 0.24-0.87) were associated with AC. Eighty-nine percent of the microorganisms were Enterobacteriaceae; of them, 28% were extended spectrum β-lactamase (ESBL) producers. AC is a common complication after BEA and must be suspected even in the absence of imaging findings, particulary in patients with a history of post-operative biliary complications, and/or without bile duct confluence preserved. An empirical treatment for ESBL-producing Enterobacteriaceae may be appropriate in patients living in countries with a high rate of bacterial drug resistance.

  15. Surgical management of Stenson’s duct injury by using double J stent urethral catheter

    Directory of Open Access Journals (Sweden)

    Suha N. Aloosi

    2015-01-01

    Conclusions: Herein, we described an easy yet efficient technique in management of parotid duct injury using a JJ stent which is often used for urethra. We think that use of JJ stent is a valuable technique to be used in the diagnosis and surgical repair of the parotid duct during traumatic facial and/or parotid injuries.

  16. Isolated Right Segmental Hepatic Duct Injury Following Laparoscopic Cholecystectomy

    International Nuclear Information System (INIS)

    Perini, Rafael F.; Uflacker, Renan; Cunningham, John T.; Selby, J. Bayne; Adams, David

    2005-01-01

    Purpose. Laparoscopic cholecystectomy (LC) is the treatment of choice for gallstones. There is an increased incidence of bile duct injuries in LC compared with the open technique. Isolated right segmental hepatic duct injury (IRSHDI) represents a challenge not only for management but also for diagnosis. We present our experience in the management of IRSHDI, with long-term follow-up after treatment by a multidisciplinary approach. Methods. Twelve consecutive patients (9 women, mean age 48 years) were identified as having IRSHDI. Patients' demographics, clinical presentation, management and outcome were collected for analysis. The mean follow-up was 44 months (range 2-90 months). Results. Three patients had the LC immediately converted to open surgery without repair of the biliary injury before referral. Treatments before referral included endoscopic retrograde cholangiopancreatography (ERCP), percutaneous drainage and surgery, isolated or in combination. The median interval from LC to referral was 32 days. Eleven patients presented with biliary leak and biloma, one with obstruction of an isolated right hepatic segment. Post-referral management of the biliary lesion used a combination of ERCP stenting, percutaneous drainage and stent placement and surgery. In 6 of 12 patients ERCP was the first procedure, and in only one case was IRSHDI identified. In 6 patients, percutaneous transhepatic cholangiography (PTC) was performed first and an isolated right hepatic segment was demonstrated in all. The final treatment modality was endoscopic management and/or percutaneous drainage and stenting in 6 patients, and surgery in 6. The mean follow-up was 44 months. No mortality or significant morbidity was observed. Conclusion. Successful management of IRSHDI after LC requires adequate identification of the lesion, and multidisciplinary treatment is necessary. Half of the patients can be treated successfully by nonsurgical procedures

  17. Extrahepatic duct injury in blunt trauma: two case reports and a literature review.

    Science.gov (United States)

    Zago, Thiago Messias; Pereira, Bruno Monteiro Tavares; Calderan, Thiago Rodrigues Araujo; Hirano, Elcio Shiyoiti; Fraga, Gustavo Pereira

    2014-08-01

    Traumatic injuries of the extrahepatic biliary tract are rare. Associated injuries are usually responsible for immediate indication for surgical treatment, the time when an injury to the extrahepatic biliary ducts may be diagnosed. However, missed injuries are often common. The primary aim of this paper is to describe the clinical features, diagnosis, treatment, and outcome of two patients with left hepatic duct injury after blunt abdominal trauma. As a secondary objective, a literature review is presented. The two cases presented in this study are as follows: (1) A young male, involved in a motor vehicle crash, was admitted with blunt hepatic trauma in a general hospital. Endoscopic retrograde cholangiography was conducted 3 weeks later and revealed a large leakage at the left hepatic duct. Exploratory laparotomy was performed 26 days after the initial traumatic event and identified a complete section of the left hepatic duct, treated with anastomosis. (2) A male fell from a height. On exploratory laparotomy, a 30 % partial injury of the left hepatic duct was found in addition to hemoperitoneum, liver injury, gallbladder detachment together with cystic duct rupture, retroperitoneal hematoma to the right, and cecum hematoma. A high level of suspicion is necessary to identify injuries to the hepatic ducts. Early diagnosis that occurs during laparotomy due to associated injuries is important to reduce complications.

  18. Percutaneous rendezvous technique for the management of a bile duct injury.

    Science.gov (United States)

    Meek, James; Fletcher, Savannah; Crumley, Kristen; Culp, W C; Meek, Mary

    2018-02-01

    The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  19. Percutaneous rendezvous technique for the management of a bile duct injury

    Directory of Open Access Journals (Sweden)

    James Meek, DO

    2018-02-01

    Full Text Available The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  20. Risk Factors for Bile Duct Injury After Percutaneous Thermal Ablation of Malignant Liver Tumors: A Retrospective Case-Control Study.

    Science.gov (United States)

    Lin, Man-Xia; Ye, Jie-Yi; Tian, Wen-Shuo; Xu, Ming; Zhuang, Bo-Wen; Lu, Ming-De; Xie, Xiao-Yan; Kuang, Ming

    2017-04-01

    Bile duct injury after ablation of malignant liver tumors (MLTs) was not unusual and should be avoided. However, few studies have focused on evaluating the risk factors for intrahepatic bile duct injury. To evaluate the risk factors for intrahepatic bile duct injury after ablation of MLTs and to evaluate the minimum safe distance for ablating tumors abutting bile ducts. Sixty-five patients with intrahepatic bile duct injury after ablation of MLTs, and 65 controls were recruited. Risk factors for intrahepatic bile duct injury were analyzed. Tumor location was recorded as ≤5 mm (group A), 5-10 mm (group B), and >10 mm (group C) from the right/left main duct or segmental bile duct. Ascites history (P bile duct dilatation before ablation (P bile duct injury. Significant differences in the risk of intrahepatic bile duct injury were found between groups B and C (P = 0.000), but not between groups A and B (P = 0.751). Ascites history (P = 0.002) and tumor location (P Bile duct injury after ablation of MLTs was the result of local treatment-related factors combined with the patients' general condition. The minimum safe distance for ablation of tumor abutting a bile duct was 10 mm.

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

    African Journals Online (AJOL)

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

  2. Morbidity and mortality after minor bile duct injury following laparoscopic cholecystectomy

    NARCIS (Netherlands)

    Booij, Klaske A. C.; de Reuver, Philip R.; Yap, Kenneth; van Dieren, Susan; van Delden, Otto M.; Rauws, Erik A.; Gouma, Dirk J.

    2015-01-01

    Cystic duct and Luschka duct leakage after laparoscopic cholecystectomy are often classified as minor injuries because the outcome of endoscopic stenting and percutaneous drainage is generally reported to be good. However, the potential associated early mortality and risk factors for mortality are

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

    International Nuclear Information System (INIS)

    Wang Zhongqiu; Lu Guangming; Li Jieshou; Li Weiqin

    2005-01-01

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

  4. Liver segment IV hypoplasia as a risk factor for bile duct injury.

    Science.gov (United States)

    Mercado, Miguel Angel; Franssen, Bernardo; Arriola, Juan Carlos; Garcia-Badiola, Artemio; Arámburo, Rigoberto; Elnecavé, Alejandro; Cortés-González, Rubén

    2011-09-01

    Bile duct injury remains constant in the era of laparoscopic cholecystectomy and misidentification of structures remains one of the most common causes of such injuries. Abnormalities in liver segment IV, which is fully visible during laparoscopic cholecystectomy, may contribute to misidentification as proposed herein. We describe the case of a 36-year-old female who had a bile duct injury during a laparoscopic cholecystectomy where the surgeon noticed an unusually small distance between the gallbladder and the round ligament. We define hypoplasia of liver segment IV as well as describe the variation of the biliary anatomy in the case. We also intend to fit it in a broader spectrum of developmental anomalies that have both hyopoplasia of some portion of the liver and variations in gallbladder and bile duct anatomy that may contribute to bile duct injury. To our knowledge, hypoplasia of liver segment IV has not been suggested in the literature as a risk factor for bile duct injury except in the extreme case of a left-sided gallbladder. Surgeons should be vigilant during laparoscopic cholecystectomy when they become aware of an unusually small distance between the gallbladder bed and the round ligament prior to beginning their dissection, variations in the common bile duct and cystic duct should be expected.

  5. Laparoscopic bile duct injury: understanding the psychology and heuristics of the error.

    Science.gov (United States)

    Dekker, Sidney W A; Hugh, Thomas B

    2008-12-01

    Bile duct injury is an important unsolved problem of laparoscopic cholecystectomy, occurring with unacceptable frequency even in the hands of experienced surgeons. This suggests that a systemic predisposition to the injury is intrinsic to cholecystectomy and indicates that an analysis of the psychology and heuristics of surgical decision-making in relation to duct identification may be a guide to prevention. Review of published reports on laparoscopic bile duct injury from 1997 to 2007 was carried out. An analysis was also carried out of the circumstances of the injuries in 49 patients who had transection of an extrahepatic bile duct and who were referred for reconstruction or were assessed in a medicolegal context. Special emphasis was placed on identifying the possible psychological aspects of duct misidentification. Review of published work showed an emphasis on the technical aspects of correct identification of the cystic duct, with few papers addressing the heuristics and psychology of surgical decision-making during cholecystectomy. Duct misidentification was the cause of injury in 42 out of the 49 reviewed patients (86%). The injury was not recognized at operation in 70% and delay in recognition persisted into the postoperative period in 57%. Underestimation of risk, cue ambiguity and visual misperception ('seeing what you believe') were important factors in misidentification. Delay in recognition of the injury is a feature consistent with cognitive fixation and plan continuation, which help construct and sustain the duct misidentification during the operation and beyond. Changing the 'culture' of cholecystectomy is probably the most effective strategy for preventing laparoscopic bile duct injury, especially if combined with new technical approaches and an understanding of the heuristics and psychology of the duct misidentification error. Training of surgeons for laparoscopic cholecystectomy should emphasize the need to be alert for cues that the incorrect

  6. Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

    OpenAIRE

    Derakhshan, Adeeb; Lubelski, Daniel; Steinmetz, Michael P.; Corriveau, Mark; Lee, Sungho; Pace, Jonathan R.; Smith, Gabriel A.; Gokaslan, Ziya; Bydon, Mohamad; Arnold, Paul M.; Fehlings, Michael G.; Riew, K. Daniel; Mroz, Thomas E.

    2017-01-01

    Study Design: Multicenter retrospective case series. Objective: To determine the rate of thoracic duct injury during cervical spine operations. Methods: A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Ne...

  7. Emergency percutaneous treatment in surgical bile duct injury.

    Science.gov (United States)

    Carrafiello, Gianpaolo; Laganà, Domenico; Dizonno, Massimiliano; Ianniello, Andrea; Cotta, Elisa; Dionigi, Gianlorenzo; Dionigi, Renzo; Fugazzola, Carlo

    2008-09-01

    The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.

  8. Related issues in repair of bile duct injury and traumatic biliary stricture

    Directory of Open Access Journals (Sweden)

    WANG Shuguang

    2017-02-01

    Full Text Available Inappropriate treatment of bile duct injury and traumatic biliary stricture may cause serious consequences such as recurrent cholangitis, formation of hepatolithiasis, and biliary cirrhosis. This article elaborates on the influencing factors for the effect of the repair of bile duct injury and traumatic biliary stricture, repair principles, timing of repair or reconstruction, and related methods and techniques. It is pointed out that if there is no significant local infection and the bile duct wall defect is <2 cm, end-to-end anastomosis should be used for repair; if the bile duct wall defect is >2 cm, Roux-en-Y hepaticojejunostomy should be used for reconstruction. If the upper wall of the bile duct had a large defect and the lower wall has an integral structure, pedicled umbilical vein graft, pedicled jejunal wall seromuscular flap, or gastric wall seromuscular flap should be used for repair. The patients with severe congestion and edema at the site of injury should be treated with sufficient external drainage of the injured bile duct and then selective repair or reconstruction. Patients with hepatic duct stenosis in the liver lobe or hepatic segments and liver tissue atrophy can be treated with hepalobectomy or segmental hepatectomy. The key to successful repair is exposure and removal of high hilar bile duct stricture, while segmental hepatectomy of the Ⅳb segment can fully expose the left and right hepatic pedicles and help with the incision of the left and right hepatic ducts and secondary hepatic ducts, and therefore, it is a good method for exposing high bile duct stricture.

  9. Reconstruction of Bile Duct Injury and Defect with the Round Ligament.

    Science.gov (United States)

    Dokmak, Safi; Aussilhou, Béatrice; Ragot, Emilia; Tantardini, Camille; Cauchy, François; Ponsot, Philippe; Belghiti, Jacques; Sauvanet, Alain; Soubrane, Olivier

    2017-09-01

    Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the liver function test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal liver function test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

  10. Surgical management of bile duct injuries following open or laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Hadi, A.; Aman, Z.; Khan, S.A.

    2013-01-01

    Objective: To evaluate the management of bile duct injuries following open and laparoscopic cholecystectomy in a tertiary care hospital. Methods: The descriptive case series was conducted from July 2002 to June 2008 at Hayatabad Medical Complex Peshawar, Pakistan. A total of 32 patients who sustained extra hepatic bile duct injuries during open and laparoscopic cholecystectomy were included. Patients having hepatobiliary malignancy or those managed through endoscopic retrograde cholangiopancreatography and stenting were excluded. Patients were thoroughly investigated including to reach a final diagnosis, and were followed up for 02 years. Results: The mean age of patients was 45.4+9-2.7 years with a female preponderance (M:F=1:9.7). The time of presentation was up to 03 months after initial surgery. Seven (21.87%) patients sustained bile duct injury during laparoscopic cholecystectomy, while 25 (78.13%) sustained injury during open procedure. Abdominal ultrasound scan was performed in 29 (90.63%) cases, endoscopic retrograde cholangiopancreatography in 14 (43.75%) and magnetic resonance cholangiopancreatography in 26 (81.25%) cases. Eleven (34.37%) patients had common bile duct leak, 9 (28.13%) had common hepatic duct injury, 9 (28.13%) had CBD strictures and 3 (09.37%) had injury to the biliary tree at porta hepatis level. Operative procedures performed included Roux-en-Y hepaticojejunostomy in 19 (59.38%) cases, choledochoduodenostomy in 7 (21.88%) cases, Roux-en-Y portoentrostomy and primary repair in 3 (09.37%) cases each. Postoperative morbidity included recurrent cholangitis 9 (28.12%), wound infection 4 (12.50%) and bile leakage 2 (06.25%). Hospital stay ranged 08-16 days. Hospital mortality rate was 03.13%, (n=1). Conclusion: The most frequent site of bile duct injury during open and laparoscopic cholecystectomy was the common bile duct, and Roux-en-Y hepaticojejunostomy was the procedure of choice by experienced surgeons for the management of such injuries

  11. A cost analysis of operative repair of major laparoscopic bile duct injuries.

    Science.gov (United States)

    Hofmeyr, S; Krige, J E J; Bornman, P C; Beningfield, S J

    2015-06-01

    Major bile duct injuries occur infrequently after laparoscopic cholecystectomy, but may result in life-threatening complications. Few data exist on the financial implications of duct repair. This study calculated the costs of operative repair in a cohort of patients who underwent reconstruction of the bile duct after major ductal injury. To calculate the total in-hospital cost of surgical repair of patients referred with major bile duct injuries. A prospective database was reviewed to identify all patients referred to the University of Cape Town Private Academic Hospital, South Africa, between 2002 and 2013 for assessment and repair of major laparoscopic bile duct injuries. The detailed clinical records and billing information were evaluated to determine all costs from admission to discharge. Total costs for each patient were adjusted for inflation between the year of repair and 2013. Results. Forty-four patients (33 women, 11 men; median age 48 years, range 30 - 78) underwent reconstruction of a major bile duct injury. First-time repairs were performed at a median of 24.5 days (range 1 - 3,662) after initial surgery. Median hospital stay was 15 days (range 6 - 86). Mean cost of repair was ZAR215,711 (range ZAR68,764 - 980,830). Major contributors to cost were theatre expenses (22%), admission to intensive care (21%), radiology (17%) and specialist fees (12%). Admission to a general ward (10%), consumables (7%), pharmacy (5%), endoscopy (3%) and laboratory costs (3%) made up the balance. The cost of repair of a major laparoscopic bile duct injury is substantial owing to prolonged hospitalisation, complex surgicalintervention and intensive imaging requirements.

  12. BILE DUCT INJURIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY- A RETROSPECTIVE STUDY AT GOVERNMENT GENERAL HOSPITAL, KAKINADA

    Directory of Open Access Journals (Sweden)

    Ravichandra Matcha

    2017-11-01

    Full Text Available BACKGROUND This study aimed at assessing the outcome of laparoscopic cholecystectomy (LC by determining the frequency of complications, especially of bile duct injuries. MATERIALS AND METHODS The case files of all patients undergoing laparoscopic cholecystectomy between January 2008 and December 2016 at Government General Hospital, Kakinada were retrospectively analysed. We evaluated the data according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open. RESULTS During the eight years (January 2008 and December 2016, 336 patients underwent LC for chronic cholecystitis (CC, of whom 22 (6.5% developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%; 43 other patients (12.8% had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC. CONCLUSION Bile duct injury is a major complication of LC. Anatomical anomalies, local pathology, and poor surgical techniques are the main factors responsible. The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.

  13. Normothermic machine perfusion reduces bile duct injury and improves biliary epithelial function in rat donor livers.

    Science.gov (United States)

    Op den Dries, Sanna; Karimian, Negin; Westerkamp, Andrie C; Sutton, Michael E; Kuipers, Michiel; Wiersema-Buist, Janneke; Ottens, Petra J; Kuipers, Jeroen; Giepmans, Ben N; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J

    2016-07-01

    Bile duct injury may occur during liver procurement and transplantation, especially in livers from donation after circulatory death (DCD) donors. Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury compared to static cold storage (SCS). However, it is unknown whether NMP provides better preservation of bile ducts. The aim of this study was to determine the impact of NMP on bile duct preservation in both DCD and non-DCD livers. DCD and non-DCD livers obtained from Lewis rats were preserved for 3 hours using either SCS or NMP, followed by 2 hours ex vivo reperfusion. Biomarkers of bile duct injury (gamma-glutamyltransferase and lactate dehydrogenase in bile) were lower in NMP-preserved livers compared to SCS-preserved livers. Biliary bicarbonate concentration, reflecting biliary epithelial function, was 2-fold higher in NMP-preserved livers (P bile was significantly higher in NMP-preserved livers (7.63 ± 0.02 and 7.74 ± 0.05 for non-DCD and DCD livers, respectively) compared with SCS-preserved livers (7.46 ± 0.02 and 7.49 ± 0.04 for non-DCD and DCD livers, respectively). Scanning and transmission electron microscopy of donor extrahepatic bile ducts demonstrated significantly decreased injury of the biliary epithelium of NMP-preserved donor livers (including the loss of lateral interdigitations and mitochondrial injury). Differences between NMP and SCS were most prominent in DCD livers. Compared to conventional SCS, NMP provides superior preservation of bile duct epithelial cell function and morphology, especially in DCD donor livers. By reducing biliary injury, NMP could have an important impact on the utilization of DCD livers and outcome after transplantation. Liver Transplantation 22 994-1005 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

  14. Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review.

    Science.gov (United States)

    Derakhshan, Adeeb; Lubelski, Daniel; Steinmetz, Michael P; Corriveau, Mark; Lee, Sungho; Pace, Jonathan R; Smith, Gabriel A; Gokaslan, Ziya; Bydon, Mohamad; Arnold, Paul M; Fehlings, Michael G; Riew, K Daniel; Mroz, Thomas E

    2017-04-01

    Multicenter retrospective case series. To determine the rate of thoracic duct injury during cervical spine operations. A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Network Methodological Core for data processing, cleaning, and analysis. Of a total of 9591 patients reviewed that underwent cervical spine surgery, 2 (0.02%) incurred iatrogenic injury to the thoracic duct. Both patients underwent a left-sided anterior cervical discectomy and fusion. The interruption of the thoracic duct was addressed intraoperatively in one patient with no residual postoperative effects. The second individual developed a chylous fluid collection approximately 2 months after the operation that required drainage via needle aspiration. Damage to the thoracic duct during cervical spine surgery is a relatively rare occurrence. Rapid identification of the disruption of this lymphatic vessel is critical to minimize deleterious effects of this complication.

  15. [Surgical treatment of intraoperative injuries and cicatricial strictures of extrahepatic bile ducts].

    Science.gov (United States)

    Tret'iakov, A A; Slepykh, N I; Kornilov, A K; Karimov, Z Kh

    1998-01-01

    The analysis of 70 cases of surgical treatment for intraoperative injuries and cicatricial strictures of extrahepatic bile ducts was carried out. In 25 patients surgical procedure was restorative and in 45--reconstructiver. Most common causes of corrective operations were: iatrogenic injuries of extrahepatic bile ducts (14) and cicatricial strictures of hepaticocholedochal duct due to intraoperative trauma (31). The problems of operative technique in performing biliobilio-, hepato-hepatico and hepatico-jejuno-anastomoses are considered. There were three deaths in the early postoperative period: 2 patients died of hepatic failure, pyogenic cholangiogenic intoxication caused by cholangioectasies and intrahepatic abscesses, and 1-due to generalyzed peritonitis caused by acute gastric ulcer perforation. Special attention is paid to the choice of the method of prolonged drainage used in reconstructive as well as in restorative operations.

  16. Forced convection heat transfer correlation for finned plates in a duct

    International Nuclear Information System (INIS)

    Chae, Myeong-Seon; Moon, Je-Young; Chung, Bum-Jin

    2014-01-01

    Forced convection heat transfer experiments were conducted for plate-fin in a duct using various fin spacing, fin height, duct width, Reynolds number for Prandtl numbers 2,014. Based upon analogy concept, mass transfer rate were measured instead of heat transfer rates. The heat transfer rates were enhanced with the increase of fin height and decrease of fin spacing as they increase the heat transfer area. Meanwhile, heat transfer rates were impaired with the increase of the duct width as the bypass flows increased to tip clearance region. Forced convection heat transfer correlations were developed for laminar and turbulent flow conditions and for narrow and wide ducts. The work draws attention to the tip clearance on the heat transfer of the finned plate in a duct. (author)

  17. Changes in cholangiocyte bile salt transporter expression and bile duct injury after orthotopic liver transplantation

    NARCIS (Netherlands)

    Hoekstra, H.; Op Den Dries, S.; Buis, C.I.; Khan, A.A.; Gouw, A.S.H.; Groothuis, G.M.M.; Lisman, T.; Porte, R.J.

    2010-01-01

    Background: Bile salts have been shown to contribute to bile duct injury after orthotopic liver transplantation (OLT). Cholangiocytes modify bile composition by reabsorption of bile salts (cholehepatic shunt) and contribute to bile flow by active secretion of sodium and water via cystic fibrosis

  18. Rapid increase of bile salt secretion is associated with bile duct injury after human liver transplantation

    NARCIS (Netherlands)

    Geuken, Erwin; Visser, Dorien; Kuipers, Folkert; Blokzijl, Hans; Leuvenink, Henri G. D.; de Jong, Koert P.; Peeters, Paul M. J. G.; Jansen, Peter L. M.; Slooff, Maarten J. H.; Gouw, Annette S. H.; Porte, Robert J.

    2004-01-01

    BACKGROUND/AIMS: Biliary strictures are a serious cause of morbidity after liver transplantation. We have studied the role of altered bile composition as a mechanism of bile duct injury after human liver transplantation. METHODS: In 28 liver transplant recipients, bile samples were collected daily

  19. Rapid increase of bile salt secretion is associated with bile duct injury after human liver transplantation

    NARCIS (Netherlands)

    Geuken, E; Visser, D; Kuipers, F; Blokzijl, H; Leuvenink, HGD; de Jong, KP; Peeters, PMJG; Jansen, PLM; Slooff, MJH; Gouw, ASH; Porte, RJ

    2004-01-01

    Background/Aims: Biliary strictures are a serious cause of morbidity after liver transplantation. We have studied the role of altered bile composition as a mechanism of bile duct injury after human liver transplantation. Methods: In 28 liver transplant recipients, bile samples were collected daily

  20. Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation An Expert Panel Survey

    NARCIS (Netherlands)

    de Reuver, Philip R.; Dijkgraaf, Marcel G. W.; Gevers, Sjef K. M.; Gouma, Dirk J.

    2008-01-01

    Objective: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. Background Data: Malpractice litigation is an increasing concern in modem surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  1. Poor agreement among expert witnesses in bile duct injury malpractice litigation: an expert panel survey.

    NARCIS (Netherlands)

    Reuver, P.R. de; Dijkgraaf, M.G.; Gevers, S.K.; Gouma, D.J.; Bleichrodt, R.P.; Cuesta, M.A.; Erp, W.F. van; Gerritsen, J.; Hesselink, E.J.; Laarhoven, C.J.H.M. van; Lange, J. de; Obertop, H.; Stassen, L.P.; Terpstra, O.T.; Tilanus, H.W.; Vroonhoven, T.J.; Wit, L. de

    2008-01-01

    OBJECTIVE: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. BACKGROUND DATA: Malpractice litigation is an increasing concern in modern surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

  2. A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

    OpenAIRE

    Vedran Premuzic; Ranko Smiljanic; Drazen Perkov

    2018-01-01

    Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED) with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous c...

  3. S-Adenosylmethionine attenuates bile duct early warm ischemia reperfusion injury after rat liver transplantation.

    Science.gov (United States)

    Tang, Yong; Chu, Hongpeng; Cao, Guojun; Du, Xiaolong; Min, Xiaobo; Wan, Chidan

    2018-03-01

    Warm ischemia reperfusion injury (IRI) plays a key role in biliary complication, which is a substantial vulnerability of liver transplantation. The early pathophysiological changes of IRI are characterized by an excessive inflammatory response. S-Adenosylmethionine (SAM) is an important metabolic intermediate that modulates inflammatory reactions; however, its role in bile duct warm IRI is not known. In this study, male rats were treated with or without SAM (170 μmol/kg body weight) after orthotopic autologous liver transplantation. The histopathological observations showed that bile duct injury in the IRI group was more serious than in the SAM group. The alanine aminotransferase (ALT), alkaline phosphatase (ALP) and direct bilirubin (DBIL) levels in the serum of the IRI group were significantly increased compared to the SAM group (P liver and bile duct tissues, down-regulated TNF-α levels and up-regulated IL-10 expression in bile duct tissues compared to the IRI group (P livers were much higher compared to those in SAM-treated rats at 24 h after liver transplantation (P bile ducts against warm IRI by suppressing oxidative stress, inflammatory reactions and apoptosis of biliary epithelial cells after liver transplantation.α. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Hepatocellular carcinoma with bile duct tumor thrombi: Correlation of magnetic resonance imaging features to histopathologic manifestations

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    Liu Qingyu, E-mail: liu.qingyu@163.co [Department of Radiology, Second Affiliated Hospital of Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, Guangdong Province (China); Chen Jianyu, E-mail: chenjianyu5562@sina.co [Department of Radiology, The Second Affiliated Hospital of Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, Guangdong Province (China); Li Haigang, E-mail: lhg00433@yahoo.com.c [Department of Pathology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province (China); Liang Biling, E-mail: liangbl@163.ne [Department of Radiology, Second Affiliated Hospital of Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, Guangdong Province (China); Zhang Lei, E-mail: zhanglei646@126.co [Department of Hepatobiliary Surgery, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province (China); Hu Tao, E-mail: htwuaini@hotmail.co [Department of Radiology, Second Affiliated Hospital of Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, Guangdong Province (China)

    2010-10-15

    Purpose: This study was to analyze the magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with bile duct tumor thrombi, and explore their correlations to histopathology to improve the accuracy of diagnosis. Materials and methods: 21 patients with pathologically confirmed HCC with bile duct tumor thrombi was performed with a superconducting 1.5-T MR imager within two weeks before operation. Magnetic resonance cholangiopancreatography (MRCP) was performed on 18 patients. Images were retrospectively assessed for the size, location and MRI manifestations of HCC lesions and associated bile duct tumor thrombi. The differentiation of HCC lesions and the pathologic changes of bile duct tumor thrombi were retrospectively analyzed under microscope. Results: The average diameter of HCC lesions was 5.8 {+-} 2.8 cm, and {<=}5.0 cm in nine cases. Capsule formation was observed on MRI or pathology in 4 cases of HCC (19%). Of the 21 cases with bile duct tumor thrombi, 20 were clearly presented on MRI as cord-like or columnar masses in the bile duct with proximal cholangiectasis. The tumor thrombi showed slightly hypointense on T1WI and slightly hyperintense on T2WI. On enhanced scan, three cases of tumor thrombi, which were mainly consisted of necrotic tissue, did not show enhancement; 17 cases, which were mainly consisted of cancer cells, showed mild or moderate enhancement. On magnetic resonance cholangiopancreatogram (MRCP), 14 cases of tumor thrombi presented as filling defect in the bile duct, abrupt obstruction of the bile duct, and cholangiectasis above the obstruction; four presented as dilated intra-hepatic bile ducts with missing common bile duct. Of the 21 patients, 16 had biliary hemorrhage; three also had tumor thrombi in the portal vein. Seventeen of the 21 HCC with biliary thrombi were poorly differentiated, unencapsulated and with an invasive growth. Nineteen of 21 bile duct tumor thrombi did not invade the bile duct wall and could be

  5. Hepatocellular carcinoma with bile duct tumor thrombi: Correlation of magnetic resonance imaging features to histopathologic manifestations

    International Nuclear Information System (INIS)

    Liu Qingyu; Chen Jianyu; Li Haigang; Liang Biling; Zhang Lei; Hu Tao

    2010-01-01

    Purpose: This study was to analyze the magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with bile duct tumor thrombi, and explore their correlations to histopathology to improve the accuracy of diagnosis. Materials and methods: 21 patients with pathologically confirmed HCC with bile duct tumor thrombi was performed with a superconducting 1.5-T MR imager within two weeks before operation. Magnetic resonance cholangiopancreatography (MRCP) was performed on 18 patients. Images were retrospectively assessed for the size, location and MRI manifestations of HCC lesions and associated bile duct tumor thrombi. The differentiation of HCC lesions and the pathologic changes of bile duct tumor thrombi were retrospectively analyzed under microscope. Results: The average diameter of HCC lesions was 5.8 ± 2.8 cm, and ≤5.0 cm in nine cases. Capsule formation was observed on MRI or pathology in 4 cases of HCC (19%). Of the 21 cases with bile duct tumor thrombi, 20 were clearly presented on MRI as cord-like or columnar masses in the bile duct with proximal cholangiectasis. The tumor thrombi showed slightly hypointense on T1WI and slightly hyperintense on T2WI. On enhanced scan, three cases of tumor thrombi, which were mainly consisted of necrotic tissue, did not show enhancement; 17 cases, which were mainly consisted of cancer cells, showed mild or moderate enhancement. On magnetic resonance cholangiopancreatogram (MRCP), 14 cases of tumor thrombi presented as filling defect in the bile duct, abrupt obstruction of the bile duct, and cholangiectasis above the obstruction; four presented as dilated intra-hepatic bile ducts with missing common bile duct. Of the 21 patients, 16 had biliary hemorrhage; three also had tumor thrombi in the portal vein. Seventeen of the 21 HCC with biliary thrombi were poorly differentiated, unencapsulated and with an invasive growth. Nineteen of 21 bile duct tumor thrombi did not invade the bile duct wall and could be easily

  6. Repair of bile duct injuries with Gore-Tex vascular grafts: experimental study in dogs.

    Science.gov (United States)

    Gómez, Néstor A; Alvarez, Ludwig R; Mite, Alfredo; Andrade, Jean P; Alvarez, José R; Vargas, Paola E; Tomalá, Nancy E; Vivas, Alex F; Zapatier, Jorge A

    2002-01-01

    Bile duct injury is the most feared complication related to biliary tract operations. The goal of this investigation was to offer an alternative treatment that might prevent this complication. Twelve mongrel dogs, thin-walled FEP-ringed Gore-Tex vascular grafts, and Gore-Tex sutures were used in this study. The dogs were randomized into three groups of four according to the length of time of graft implantation: group 1 = 1 month; group 2 = 2 months; and group 3 = 3 months. During the first part of the study, a biliary injury was induced by ligating the middle choledocus after performing a conventional cholecystectomy. During the second part of the study, biliodigestive and biliobiliary anastomosis were performed using Gore-Tex vascular grafts prior to resection of the stenotic area. Initially, an increase in serum bilirubin and alkaline phosphatase levels was noted. Two weeks later, after implantation of the grafts, these values returned to normal. Thin-walled FEP-ringed Gore-Tex vascular grafts were found to be useful in the repair of bile duct injuries, especially in complete transections of the common bile duct. The ductility and flexibility of the material allows any type of anastomosis to be performed, especially when bile duct-gut anastomosis is technically difficult.

  7. Fluorescent Imaging With Indocyanine Green During Laparoscopic Cholecystectomy in Patients at Increased Risk of Bile Duct Injury

    NARCIS (Netherlands)

    Ankersmit, M.; Dam, D.A. van; Rijswijk, A.S. van; Tuynman, J.B.; Meijerink, W.J.H.J.

    2017-01-01

    BACKGROUND: Although rare, injury to the common bile duct (CBD) during laparoscopic cholecystectomy (LC) can be reduced by better intraoperative visualization of the cystic duct (CD) and CBD. The aim of this study was to establish the efficacy of early visualization of the CD and the added value of

  8. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes

    NARCIS (Netherlands)

    Schreuder, Anne Marthe; Booij, Klaske A. C.; de Reuver, Philip R.; van Delden, Otto M.; van Lienden, Krijn P.; Besselink, Marc G.; Busch, Olivier R.; Gouma, Dirk J.; Rauws, Erik A. J.; van Gulik, Thomas M.

    2018-01-01

    Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous

  9. Bile salt toxicity aggravates cold ischemic injury of bile ducts after liver transplantation in Mdr2+/- mice

    NARCIS (Netherlands)

    Hoekstra, H; Porte, RJ; Tian, Y; Jochum, W; Stieger, B; Moritz, W; Slooff, MJH; Graf, R; Clavien, PA

    Intrahepatic bile duct strictures are a serious complication after orthotopic liver transplantation (OLT). We examined the role of endogenous bile salt toxicity in the pathogenesis of bile duct injury after OLT. Livers from wild-type mice and mice heterozygous for disruption of the multidrug

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

    Science.gov (United States)

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

    2012-05-01

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

  11. MR elastography in primary sclerosing cholangitis: correlating liver stiffness with bile duct strictures and parenchymal changes.

    Science.gov (United States)

    Bookwalter, Candice A; Venkatesh, Sudhakar K; Eaton, John E; Smyrk, Thomas D; Ehman, Richard L

    2018-04-07

    To determine correlation of liver stiffness measured by MR Elastography (MRE) with biliary abnormalities on MR Cholangiopancreatography (MRCP) and MRI parenchymal features in patients with primary sclerosing cholangitis (PSC). Fifty-five patients with PSC who underwent MRI of the liver with MRCP and MRE were retrospectively evaluated. Two board-certified abdominal radiologists in agreement reviewed the MRI, MRCP, and MRE images. The biliary tree was evaluated for stricture, dilatation, wall enhancement, and thickening at segmental duct, right main duct, left main duct, and common bile duct levels. Liver parenchyma features including signal intensity on T2W and DWI, and hyperenhancement in arterial, portal venous, and delayed phase were evaluated in nine Couinaud liver segments. Atrophy or hypertrophy of segments, cirrhotic morphology, varices, and splenomegaly were scored as present or absent. Regions of interest were placed in each of the nine segments on stiffness maps wherever available and liver stiffness (LS) was recorded. Mean segmental LS, right lobar (V-VIII), left lobar (I-III, and IVA, IVB), and global LS (average of all segments) were calculated. Spearman rank correlation analysis was performed for significant correlation. Features with significant correlation were then analyzed for significant differences in mean LS. Multiple regression analysis of MRI and MRCP features was performed for significant correlation with elevated LS. A total of 439/495 segments were evaluated and 56 segments not included in MRE slices were excluded for correlation analysis. Mean segmental LS correlated with the presence of strictures (r = 0.18, p duct strictures. Segments with increased LS show T2 hyperintensity, DWI hyperintensity, and post-contrast hyperenhancement. Global liver stiffness shows a moderate correlation with number of segmental strictures and significantly correlates with spleen stiffness, splenomegaly, and varices.

  12. Hypothermic oxygenated machine perfusion reduces bile duct reperfusion injury after transplantation of donation after circulatory death livers

    Science.gov (United States)

    van Rijn, Rianne; van Leeuwen, Otto B.; Matton, Alix P. M.; Burlage, Laura C.; Wiersema‐Buist, Janneke; van den Heuvel, Marius C.; de Kleine, Ruben H. J.; de Boer, Marieke T.; Gouw, Annette S. H.

    2018-01-01

    Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia/reperfusion injury (IRI). This study aimed to determine whether DHOPE reduces IRI of the bile ducts in donation after circulatory death (DCD) liver transplantation. In a recently performed phase 1 trial, 10 DCD livers were preserved with DHOPE after static cold storage (SCS; http://www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient. Histological severity of biliary injury was graded according to an established semiquantitative grading system. Twenty liver transplantations using DCD livers not preserved with DHOPE served as controls. Baseline characteristics and the degree of bile duct injury at baseline (end of SCS) were similar between both groups. In controls, the degree of stroma necrosis (P = 0.002) and injury of the deep peribiliary glands (PBG; P = 0.02) increased after reperfusion compared with baseline. In contrast, in DHOPE‐preserved livers, the degree of bile duct injury did not increase after reperfusion. Moreover, there was less injury of deep PBG (P = 0.04) after reperfusion in the DHOPE group compared with controls. In conclusion, this study suggests that DHOPE reduces IRI of bile ducts after DCD liver transplantation. Liver Transplantation 24 655–664 2018 AASLD. PMID:29369470

  13. Pushing the boundaries in liver graft utilisation in transplantation: Case report of a donor with previous bile duct injury repair.

    Science.gov (United States)

    Sultana, Asma; Powell, James J; Oniscu, Gabriel C

    2017-01-01

    Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation. The liver was successfully recovered and transplanted into a 56-year-old male recipient with end stage liver disease consequent to alpha 1 antitrypsin deficiency. The graft continues to function well 36 months post-transplant, with normal liver function tests and imaging revealing a patent hepaticojejunostomy. The potential associated vascular injuries should be identified during bench preparation whilst the management of biliary reconstruction at the time of transplant should follow the principles of biliary reconstruction in cases with biliary injuries, extending the hilar opening into the left duct. This case highlights the successful utilisation of a post bile duct injury repair liver, employing an experienced procurement team and careful bench assessment and reconstruction. Copyright © 2017. Published by Elsevier Ltd.

  14. Inhibition of intestinal bile acid absorption improves cholestatic liver and bile duct injury in a mouse model of sclerosing cholangitis.

    Science.gov (United States)

    Baghdasaryan, Anna; Fuchs, Claudia D; Österreicher, Christoph H; Lemberger, Ursula J; Halilbasic, Emina; Påhlman, Ingrid; Graffner, Hans; Krones, Elisabeth; Fickert, Peter; Wahlström, Annika; Ståhlman, Marcus; Paumgartner, Gustav; Marschall, Hanns-Ulrich; Trauner, Michael

    2016-03-01

    Approximately 95% of bile acids (BAs) excreted into bile are reabsorbed in the gut and circulate back to the liver for further biliary secretion. Therefore, pharmacological inhibition of the ileal apical sodium-dependent BA transporter (ASBT/SLC10A2) may protect against BA-mediated cholestatic liver and bile duct injury. Eight week old Mdr2(-/-) (Abcb4(-/-)) mice (model of cholestatic liver injury and sclerosing cholangitis) received either a diet supplemented with A4250 (0.01% w/w) - a highly potent and selective ASBT inhibitor - or a chow diet. Liver injury was assessed biochemically and histologically after 4weeks of A4250 treatment. Expression profiles of genes involved in BA homeostasis, inflammation and fibrosis were assessed via RT-PCR from liver and ileum homogenates. Intestinal inflammation was assessed by RNA expression profiling and immunohistochemistry. Bile flow and composition, as well as biliary and fecal BA profiles were analyzed after 1week of ASBT inhibitor feeding. A4250 improved sclerosing cholangitis in Mdr2(-/-) mice and significantly reduced serum alanine aminotransferase, alkaline phosphatase and BAs levels, hepatic expression of pro-inflammatory (Tnf-α, Vcam1, Mcp-1) and pro-fibrogenic (Col1a1, Col1a2) genes and bile duct proliferation (mRNA and immunohistochemistry for cytokeratin 19 (CK19)). Furthermore, A4250 significantly reduced bile flow and biliary BA output, which correlated with reduced Bsep transcription, while Ntcp and Cyp7a1 were induced. Importantly A4250 significantly reduced biliary BA secretion but preserved HCO3(-) and biliary phospholipid secretion resulting in an increased HCO3(-)/BA and PL/BA ratio. In addition, A4250 profoundly increased fecal BA excretion without causing diarrhea and altered BA pool composition, resulting in diminished concentrations of primary BAs tauro-β-muricholic acid and taurocholic acid. Pharmacological ASBT inhibition attenuates cholestatic liver and bile duct injury by reducing biliary BA

  15. Long-term outcome after early repair of iatrogenic bile duct injury

    DEFF Research Database (Denmark)

    Stilling, Nicolaj M; Fristrup, Claus; Wettergren, André

    2015-01-01

    BACKGROUND: The aim of this retrospective study was to evaluate the peri-operative and long-term outcome after early repair with a hepaticojejunostomy (HJ). METHODS: Between 1995 and 2010, a nationwide, retrospective multi-centre study was conducted. All iatrogenic bile duct injury (BDI) sustained...... during a cholecystectomy and repaired with HJ in the five Hepato-Pancreatico-Biliary centres in Denmark were included. RESULTS: In total, 139 patients had an HJ repair. The median time from the BDI to reconstruction was 5 days. A concomitant vascular injury was identified in 26 cases (19%). Post...... with BDI repaired by early HJ we found a considerable risk of long-term complications (e.g. 30% stricture rate) and mortality in both the short- and the long-term perspective....

  16. A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

    Directory of Open Access Journals (Sweden)

    Vedran Premuzic

    2018-01-01

    Full Text Available Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous catheter for hemodialysis in left subclavian vein, he developed lymph leakage on puncture site beside the catheter, at drainage rate of 75 ml/h. In the absence of more serious clinical symptoms, conservative treatment with close patient monitoring and diet changes was chosen, rather than more invasive treatment options.

  17. Impact of recombinant globular adiponectin on early warm ischemia-reperfusion injury in rat bile duct after liver transplantation.

    Science.gov (United States)

    Xia, Yang; Gong, Jian-Ping

    2014-09-19

    Adiponectin (APN) is an adipocyte protein with anti-diabetic properties, which has been recently revealed to have anti-inflammatory activity in organ ischemia- reperfusion injury (IRI). However, little is known about its function in bile duct IRI after liver transplantation. Therefore, we investigated whether APN affects early warm IRI in rat bile duct using a liver autologous transplantation model. In our study, rats were randomly divided into three experimental groups: a sham group, a IRI group, and a APN group. The serum enzyme levels and BDISS scores of bile duct histology associated with bile duct injury, decreased after administration of APN. Subsequently, the expression of proinflammatory cytokines, such as tumor necrosis factor(TNF-α),.interleukin-6(IL-6) and myeloperoxidase (MPO) decreased. Furthermore, pretreatment with APN suppressed the activation of nuclear factor-kappa B (NF-κB) (p65), a transcription factor involved in inflammatory reactions, compared to other two groups. Administration of APN also downregulated the expression of Fas protein and attenuated caspase-3 activity to decrease bile duct apoptosis. Our results illustrate that APN protects the rat bile duct against early warm IRI by suppressing the inflammatory response and hepatocyte apoptosis, and NF-κB (p65) plays an important role in this process.

  18. Glechoma hederacea extracts attenuate cholestatic liver injury in a bile duct-ligated rat model.

    Science.gov (United States)

    Wang, Ya-Yu; Lin, Shih-Yi; Chen, Wen-Ying; Liao, Su-Lan; Wu, Chih-Cheng; Pan, Pin-Ho; Chou, Su-Tze; Chen, Chun-Jung

    2017-05-23

    In traditional Chinese medicine, Glechoma hederacea is frequently prescribed to patients with cholelithiasis, dropsy, abscess, diabetes, inflammation, and jaundice. Polyphenolic compounds are main bioactive components of Glechoma hederacea. This study was aimed to investigate the hepatoprotective potential of hot water extract of Glechoma hederacea against cholestatic liver injury in rats. Cholestatic liver injury was produced by ligating common bile ducts in Sprague-Dawley rats. Saline and hot water extract of Glechoma hederacea were orally administrated using gastric gavages. Liver tissues and bloods were collected and subjected to evaluation using histological, molecular, and biochemical approaches. Using a rat model of cholestasis caused by bile duct ligation (BDL), daily oral administration of Glechoma hederacea hot water extracts showed protective effects against cholestatic liver injury, as evidenced by the improvement of serum biochemicals, ductular reaction, oxidative stress, inflammation, and fibrosis. Glechoma hederacea extracts alleviated BDL-induced transforming growth factor beta-1 (TGF-β1), connective tissue growth factor, and collagen expression, and the anti-fibrotic effects were accompanied by reductions in α-smooth muscle actin-positive matrix-producing cells and Smad2/3 activity. Glechoma hederacea extracts attenuated BDL-induced inflammatory cell infiltration/accumulation, NF-κB and AP-1 activation, and inflammatory cytokine production. Further studies demonstrated an inhibitory effect of Glechoma hederacea extracts on the axis of high mobility group box-1 (HMGB1)/toll-like receptor-4 (TLR4) intracellular signaling pathways. The hepatoprotective, anti-oxidative, anti-inflammatory, and anti-fibrotic effects of Glechoma hederacea extracts seem to be multifactorial. The beneficial effects of daily Glechoma hederacea extracts supplementation were associated with anti-oxidative, anti-inflammatory, and anti-fibrotic potential, as well as down

  19. Long-term Impact of Bile Duct Injury on Morbidity, Mortality, Quality of Life, and Work Related Limitations

    NARCIS (Netherlands)

    Booij, Klaske A. C.; de Reuver, Philip R.; van Dieren, Susan; van Delden, Otto M.; Rauws, Erik A.; Busch, Olivier R.; van Gulik, Thomas M.; Gouma, Dirk J.

    2017-01-01

    Assessment of long-term comprehensive outcome of multimodality treatment of bile duct injury (BDI) in terms of morbidity, mortality, quality of life (QoL), survival, and work related limitations. The impact of BDI on work ability is scarcely investigated. BDI patients referred to a tertiary center

  20. The antifibrinolytic drug tranexamic acid reduces liver injury and fibrosis in a mouse model of chronic bile duct injury.

    Science.gov (United States)

    Joshi, Nikita; Kopec, Anna K; Towery, Keara; Williams, Kurt J; Luyendyk, James P

    2014-06-01

    Hepatic fibrin deposition has been shown to inhibit hepatocellular injury in mice exposed to the bile duct toxicant α-naphthylisothiocyanate (ANIT). Degradation of fibrin clots by fibrinolysis controls the duration and extent of tissue fibrin deposition. Thus, we sought to determine the effect of treatment with the antifibrinolytic drug tranexamic acid (TA) and plasminogen activator inhibitor-1 (PAI-1) deficiency on ANIT-induced liver injury and fibrosis in mice. Plasmin-dependent lysis of fibrin clots was impaired in plasma from mice treated with TA (1200 mg/kg i.p., administered twice daily). Prophylactic TA administration reduced hepatic inflammation and hepatocellular necrosis in mice fed a diet containing 0.025% ANIT for 2 weeks. Hepatic type 1 collagen mRNA expression and deposition increased markedly in livers of mice fed ANIT diet for 4 weeks. To determine whether TA treatment could inhibit this progression of liver fibrosis, mice were fed ANIT diet for 4 weeks and treated with TA for the last 2 weeks. Interestingly, TA treatment largely prevented increased deposition of type 1 collagen in livers of mice fed ANIT diet for 4 weeks. In contrast, biliary hyperplasia/inflammation and liver fibrosis were significantly increased in PAI-1(-/-) mice fed ANIT diet for 4 weeks. Overall, the results indicate that fibrinolytic activity contributes to ANIT diet-induced liver injury and fibrosis in mice. In addition, these proof-of-principle studies suggest the possibility that therapeutic intervention with an antifibrinolytic drug could form a novel strategy to prevent or reduce liver injury and fibrosis in patients with liver disease.

  1. The role of bile salt toxicity in the pathogenesis of bile duct injury after non-heart-beating porcine liver transplantation

    NARCIS (Netherlands)

    Yska, Marit J.; Buis, Carlijn I.; Monbaliu, Diethard; Schuurs, Theo A.; Gouw, Annette S. H.; Kahmann, Olivier N. H.; Visser, Dorien S.; Pirenne, Jacques; Porte, Robert J.

    2008-01-01

    Background. Intrahepatic bile duct strictures are a serious complication after non-heart-beating (NHB) liver transplantation. Bile salt toxicity has been identified as an important factor in the pathogenesis of bile duct injury and cholangiopathies. The role of bile salt toxicity in the development

  2. Correlations for heat transfer coefficient and friction factor for turbulent flow of air through square and hexagonal ducts with twisted tape insert

    Science.gov (United States)

    Yadav, Rupesh J.; Kore, Sandeep S.; Joshi, Prathamesh S.

    2018-05-01

    The experimental and numerical Nusselt number and friction factor investigation for turbulent flow through a non-circular duct with twisted-tape inserts have been presented. The non-circular ducts include square, hexagonal duct. The results of non-circular ducts are compared with circular duct. All the ducts have same equivalent diameter. The twist ratios used for the experiment are Y = 3.5, 4.5, 5.5 and 6.5. Experiments were carried out on square duct, hexagonal duct and circular duct. The Reynolds number lied between 10,000 and 1, 05,000. The present study is restricted to the flow of air at Pr = 0.7 only and within a narrow temperature range of 40 to 75 ΟC, within which the compressible nature of air can be neglected. The results reveal that, both Nusselt number and friction factor increases as the side of non-circular duct increases. Maximum Nusselt number and friction factor is obtained in case of circular duct with twisted tape. Further the correlations of Nu and f are given for different non circular duct with twisted tape insert for engineering applications for the turbulent regime. Since the thermal performance factor (η) is observed to be within the range of 0.8 to 1.13 for both circular and noncircular ducts, the overall benefit of using twisted tape in the flow field shall nevertheless be marginal.

  3. Quality of life after iatrogenic bile duct injury: a case control study.

    LENUS (Irish Health Repository)

    Hogan, Aisling M

    2012-02-01

    OBJECTIVE: To compare quality of life (QOL) of patients following iatrogenic bile duct injuries (BDI) to matched controls. SUMMARY BACKGROUND DATA: BDI complicate approximately 0.3% of all cholecystectomy procedures. The literature regarding impact on quality of life is conflicted as assessment using clinical determinants alone is insufficient. METHODS: The medical outcomes study short form 36 (SF-36), a sensitive tool for quantification of life quality outcome, was used. The study group of iatrogenic BDI was compared with an age- and sex-matched group who underwent uncomplicated cholecystectomy. Telephone questionnaire using the SF-36 quality of life tool was administered to both groups at a median postoperative time of 12 years 8 months (range, 2 months -20 years). RESULTS: Seventy-eight patients were referred with BDI but due to mortality (n = 10) and unavailability (n = 6) 62 participated. The age- and sex-matched control cohort had undergone uncomplicated cholecystectomy (n = 62). Comparison between groups revealed that 7 of 8 variables examined were statistically similar to those of the control group (physical functioning, role physical, bodily pain, general health perceptions, vitality and social functioning, and mental health index). Mean role emotional scores were slightly worse in the BDI group (46 vs. 50) but the significance was borderline (P = 0.045). Subgroup analysis by method of intervention for BDI did not demonstrate significant differences. CONCLUSION: Quality of life of surviving patients following BDI compares favorably to that after uncomplicated laparoscopic cholecystectomy.

  4. Cilostazol attenuates cholestatic liver injury and its complications in common bile duct ligated rats.

    Science.gov (United States)

    Abdel Kawy, Hala S

    2015-04-05

    Cilostazol is a phosphodiesterase III inhibitor increases adenosine 3', 5'-cyclic monophosphate (cyclic AMP) level which inhibits hepatic stellate cell activation. Its pharmacological effects include vasodilation, inhibition of vascular smooth muscle cell growth, inhibition of platelet activation and aggregation. The aim of the current study was to determine the effects of early administration of low dose cilostazol on cholestatic liver injury induced by common bile duct ligation (CBDL) in rat. Male Wistar rats (180-200g) were divided into three groups: Group A; simple laparotomy group (sham). Group B; CBDL, Group C; CBDL rats treated with cilostazol (9mg/kg daily for 21 days). Six rats from each group were killed by the end of weeks one and three after surgery, livers and serum were collected for biochemical and histopathological studies. Aspartate aminotransferase, alanine aminotransferase, gama glutamyl transferase, alkaline phosphatase and total bilirubin serum levels decreased in the cilostazol treated rats, when compared with CBDL rats. The hepatic levels of tumor necrosis factor-alpha, transforming growth factor-beta, and platelet derived growth factor-B were significantly lower in cilostazol treated rats than that in CBDL rats. Cilostazol decreased vascular endothelial growth factor level and hemoglobin content in the livers. Cilostazol significantly lowered portal pressure, inhibited ductular proliferation, portal inflammation, hepatic fibrosis and decreased hepatic hydroxyproline contents. Administration of cilostazol in CBDL rats improved hepatic functions, decreased ductular proliferation, ameliorated portal inflammation, lowered portal hypertension and reduced fibrosis. These effects of cilostazol may be useful in the attenuation of liver injury in cholestasis. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes.

    Science.gov (United States)

    Schreuder, Anne Marthe; Booij, Klaske A C; de Reuver, Philip R; van Delden, Otto M; van Lienden, Krijn P; Besselink, Marc G; Busch, Olivier R; Gouma, Dirk J; Rauws, Erik A J; van Gulik, Thomas M

    2018-01-19

     Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous procedure.  All consecutive patients with BDI referred to our tertiary referral center between 1995 and 2016 were analyzed. A rendezvous procedure was performed when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists. Classification of BDI, technical success of the rendezvous procedure, procedure-related adverse events, and outcomes were assessed.  Among a total of 812 patients, rendezvous was performed in 47 (6 %), 31 (66 %) of whom were diagnosed with complete transection of the bile duct (Amsterdam type D/Strasberg type E injury). The primary success rate of rendezvous was 94 % (44 /47 patients). Overall morbidity was 18 % (10 /55 procedures). No life-threatening adverse events or 90-day mortality occurred. After a median follow-up of 40 months (interquartile range 23 - 54 months), rendezvous was the final successful treatment in 26 /47 patients (55 %). In 14 /47 patients (30 %), rendezvous acted as a bridge to surgery, with hepaticojejunostomy being chosen either primarily or secondarily to treat refractory or relapsing stenosis. In experienced hands, rendezvous was a safe procedure, with a long-term success rate of 55 %. When endoscopic or transhepatic interventions fail to restore bile duct continuity in patients with BDI, rendezvous should be considered, either as definitive treatment or as a bridge to elective surgery. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Loss of cellular FLICE-inhibitory protein promotes acute cholestatic liver injury and inflammation from bile duct ligation.

    Science.gov (United States)

    Gehrke, Nadine; Nagel, Michael; Straub, Beate K; Wörns, Marcus A; Schuchmann, Marcus; Galle, Peter R; Schattenberg, Jörn M

    2018-03-01

    Cholestatic liver injury results from impaired bile flow or metabolism and promotes hepatic inflammation and fibrogenesis. Toxic bile acids that accumulate in cholestasis induce apoptosis and contribute to early cholestatic liver injury, which is amplified by accompanying inflammation. The aim of the current study was to evaluate the role of the antiapoptotic caspase 8-homolog cellular FLICE-inhibitory (cFLIP) protein during acute cholestatic liver injury. Transgenic mice exhibiting hepatocyte-specific deletion of cFLIP (cFLIP -/- ) were used for in vivo and in vitro analysis of cholestatic liver injury using bile duct ligation (BDL) and the addition of bile acids ex vivo. Loss of cFLIP in hepatocytes promoted acute cholestatic liver injury early after BDL, which was characterized by a rapid release of proinflammatory and chemotactic cytokines (TNF, IL-6, IL-1β, CCL2, CXCL1, and CXCL2), an increased presence of CD68 + macrophages and an influx of neutrophils in the liver, and resulting apoptotic and necrotic hepatocyte cell death. Mechanistically, liver injury in cFLIP -/- mice was aggravated by reactive oxygen species, and sustained activation of the JNK signaling pathway. In parallel, cytoprotective NF-κB p65, A20, and the MAPK p38 were inhibited. Increased injury in cFLIP -/- mice was accompanied by activation of hepatic stellate cells and profibrogenic regulators. The antagonistic caspase 8-homolog cFLIP is a critical regulator of acute, cholestatic liver injury. NEW & NOTEWORTHY The current paper explores the role of a classical modulator of hepatocellular apoptosis in early, cholestatic liver injury. These include activation of NF-κB and MAPK signaling, production of inflammatory cytokines, and recruitment of neutrophils in response to cholestasis. Because these signaling pathways are currently exploited in clinical trials for the treatment of nonalcoholic steatohepatitis and cirrhosis, the current data will help in the development of novel pharmacological

  7. Quercetin protects liver injury induced by bile duct ligation via attenuation of Rac1 and NADPH oxidase1 expression in rats.

    Science.gov (United States)

    Kabirifar, Razieh; Ghoreshi, Zohreh-Al-Sadat; Safari, Fatemeh; Karimollah, Alireza; Moradi, Ali; Eskandari-Nasab, Ebrahim

    2017-02-01

    Bile duct ligation (BDL) and subsequent cholestasis are correlated with oxidative stress, hepatocellular injury and fibrosis. Quercetin is a flavonoid with antifibrotic, and hepatoprotective properties. However, the molecular mechanism underlying quercetin-mediated hepatoprotection is not fully understood. The current study was to evaluate mechanisms of hepatoprotective effect of quercetin in BDL rat model. We divided male Wistar rats into 4 groups (n=8 for each): sham, sham+quercetin (30 mg/kg per day), BDL, and BDL+quercetin (30 mg/kg per day). Four weeks later, the rats were sacrificed, the blood was collected for liver enzyme measurements and liver for the measurement of Rac1, Rac1-GTP and NOX1 mRNA and protein levels by quantitative PCR and Western blotting, respectively. Quercetin significantly alleviated liver injury in BDL rats as evidenced by histology and reduced liver enzymes. Furthermore, the mRNA and protein expression of Rac1, Rac1-GTP and NOX1 were significantly increased in BDL rats compared with those in the sham group (Pliver injury through increasing antioxidant capacity of the liver tissue, while preventing the production of Rac1, Rac1-GTP and NOX1 proteins.

  8. Percutaneous transhepatic balloon dilation of biliary-enteric anastomotic strictures after surgical repair of iatrogenic bile duct injuries.

    Directory of Open Access Journals (Sweden)

    Andrew Y Lee

    Full Text Available PURPOSE: To evaluate the efficacy of percutaneous balloon dilation of biliary-enteric anastomotic strictures resulting from surgical repair of laparoscopic cholecystectomy-related bile duct injuries. MATERIAL AND METHODS: A total of 61 patients were referred to our institution from 1995 to 2010 for treatment of obstruction at the biliary-enteric anastomosis following surgical repair of laparoscopic cholecystectomy-related bile duct injuries. Of these 61 patients, 27 underwent surgical revision upon stricture diagnosis, and 34 patients were managed using balloon dilation. Of these 34 patients, 2 were lost to follow up, leaving 32 patients for analysis. The primary study objective was to determine the clinical success rate of balloon dilation of biliary-enteric anastomotic strictures. Secondary study objectives included determining anastomosis patency, rates of stricture recurrence following treatment, and morbidity. RESULTS: Balloon dilation of biliary-enteric anastomotic strictures was clinically successful in 21 of 32 patients (66%. Anastomotic stricture recurred in one of 21 patients (5% after an average of 13.1 years of follow-up. Patients who were unsuccessfully managed with balloon dilation required significantly more invasive procedures (6.8 v. 3.4; p = 0.02 and were left with an indwelling biliary catheter for a significantly longer period of time (8.8 v. 2.0 months; p = 0.02 than patients whose strictures could be resolved by balloon dilation. No significant differences in the number of balloon dilations performed (p = 0.17 or in the maximum balloon diameter used (p = 0.99 were demonstrated for patients with successful or unsuccessful balloon dilation outcomes. CONCLUSION: Percutaneous balloon dilation of anastomotic biliary strictures following surgical repair of laparoscopic cholecystectomy-related injuries may result in lasting patency of the biliary-enteric anastomosis.

  9. Worsening cholestasis and possible cefuroxime-induced liver injury following "successful" therapeutic endoscopic retrograde cholangiopancreatography for a distal common bile duct stone: a case report.

    Science.gov (United States)

    Niriella, Madunil Anuk; Kumarasena, Ravindu Sujeewa; Dassanayake, Anuradha Supun; Pathirana, Aloka; de Silva Hewavisenthi, Janaki; de Silva, Hithanadura Janaka

    2016-12-21

    Cefuroxime very rarely causes drug-induced liver injury. We present a case of a patient with paradoxical worsening of jaundice caused by cefuroxime-induced cholestasis following therapeutic endoscopic retrograde cholangiopancreatography for a distal common bile duct stone. A 51-year-old, previously healthy Sri Lankan man presented to our hospital with obstructive jaundice caused by a distal common bile duct stone. Endoscopic retrograde cholangiopancreatography with stone extraction, common bile duct clearance, and stenting failed to improve the cholestasis, with paradoxical worsening of his jaundice. A liver biopsy revealed features of drug-induced intrahepatic cholestasis. Although his case was complicated by an episode of cholangitis, the patient made a complete recovery in 4 months with supportive treatment and withdrawal of the offending drug. This case highlights a very rare drug-induced liver injury caused by cefuroxime as well as our approach to treating a patient with paradoxical worsening of jaundice after therapeutic endoscopic retrograde cholangiopancreatography.

  10. Delphi consensus on bile duct injuries during laparoscopic cholecystectomy: an evolutionary cul-de-sac or the birth pangs of a new technical framework?

    NARCIS (Netherlands)

    Iwashita, Yukio; Hibi, Taizo; Ohyama, Tetsuji; Umezawa, Akiko; Takada, Tadahiro; Strasberg, Steven M.; Asbun, Horacio J.; Pitt, Henry A.; Han, Ho-Seong; Hwang, Tsann-Long; Suzuki, Kenji; Yoon, Yoo-Seok; Choi, In-Seok; Yoon, Dong-Sup; Huang, Wayne Shih-Wei; Yoshida, Masahiro; Wakabayashi, Go; Miura, Fumihiko; Okamoto, Kohji; Endo, Itaru; de Santibañes, Eduardo; Giménez, Mariano Eduardo; Windsor, John A.; Garden, O. James; Gouma, Dirk J.; Cherqui, Daniel; Belli, Giulio; Dervenis, Christos; Deziel, Daniel J.; Jonas, Eduard; Jagannath, Palepu; Supe, Avinash Nivritti; Singh, Harjit; Liau, Kui-Hin; Chen, Xiao-Ping; Chan, Angus C. W.; Lau, Wan Yee; Fan, Sheung Tat; Chen, Miin-Fu; Kim, Myung-Hwan; Honda, Goro; Sugioka, Atsushi; Asai, Koji; Wada, Keita; Mori, Yasuhisa; Higuchi, Ryota; Misawa, Takeyuki; Watanabe, Manabu; Matsumura, Naoki; Rikiyama, Toshiki; Sata, Naohiro; Kano, Nobuyasu; Tokumura, Hiromi; Kimura, Taizo; Kitano, Seigo; Inomata, Masafumi; Hirata, Koichi; Sumiyama, Yoshinobu; Inui, Kazuo; Yamamoto, Masakazu

    2017-01-01

    Bile duct injury (BDI) during laparoscopic cholecystectomy remains a serious iatrogenic surgical complication. BDI most often occurs as a result of misidentification of the anatomy; however, clinical evidence on its precise mechanism and surgeons' perceptions is scarce. Surgeons from Japan, Korea,

  11. Effect of heme oxygenase-1 on the protection of ischemia reperfusion injury of bile duct in rats after liver transplantation.

    Science.gov (United States)

    Zhan, Xi; Zhang, Zhiqing; Huang, Hanfei; Zhang, Yujun; Zeng, Zhong

    2018-06-01

    To investigate the effect of heme oxygenase-1 (HO-1) on the ischemic reperfusion injury (IRI) of bile duct in rat models after liver transplantation. 320 SD rats were equally and randomly divided into 5 groups, which were group A receiving injection of 3×10 8 /pfu/ml adenovirus (adv), group B with donor receiving Adv-HO-1 and recipient receiving Adv-HO-1-siRNA, group C with donor and recipient both receiving Adv-HO-1, group D with donor receiving Adv-HO-1-siRNA and recipient receiving Adv-HO-1, and group E with donor and recipient both receiving Adv-HO-1-siRNA at 24h before liver transplantation. Donor liver was stored in UW liquid at 4°C followed by measuring HO-1 level by western blot before transplantation. On d1, d3, d7 and d14, serum and liver was isolated for analysis of liver function, inflammatory cell infiltration by H&E staining, ultrastructure of liver by transmission electron microscopy as well as the expression of HO-1, Bsep, Mrp2 and Ntcp by western blot. Compared with group D and E, group B and C displayed improved liver function as demonstrated by lower level of ALT, AST, LDH, TBIL, ALP and GGT, increased secretion of TBA and PL as well as expression of transporter proteins (Bsep, Mrp2 and Ntcp), reduced inflammatory cells infiltration and liver injury. Our study demonstrated that overexpression of HO-1 in donor liver can ameliorate the damage to bile duct and liver, and improved liver function, suggesting HO-1 might be a new therapeutic target in the treatment of IRI after liver transplantation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Subnormothermic ex vivo liver perfusion reduces endothelial cell and bile duct injury after donation after cardiac death pig liver transplantation.

    Science.gov (United States)

    Knaak, Jan M; Spetzler, Vinzent N; Goldaracena, Nicolas; Boehnert, Markus U; Bazerbachi, Fateh; Louis, Kristine S; Adeyi, Oyedele A; Minkovich, Leonid; Yip, Paul M; Keshavjee, Shaf; Levy, Gary A; Grant, David R; Selzner, Nazia; Selzner, Markus

    2014-11-01

    An ischemic-type biliary stricture (ITBS) is a common feature after liver transplantation using donation after cardiac death (DCD) grafts. We compared sequential subnormothermic ex vivo liver perfusion (SNEVLP; 33°C) with cold storage (CS) for the prevention of ITBS in DCD liver grafts in pig liver transplantation (n = 5 for each group). Liver grafts were stored for 10 hours at 4°C (CS) or preserved with combined 7-hour CS and 3-hour SNEVLP. Parameters of hepatocyte [aspartate aminotransferase (AST), international normalized ratio (INR), factor V, and caspase 3 immunohistochemistry], endothelial cell (EC; CD31 immunohistochemistry and hyaluronic acid), and biliary injury and function [alkaline phosphatase (ALP), total bilirubin, and bile lactate dehydrogenase (LDH)] were determined. Long-term survival (7 days) after transplantation was similar between the SNEVLP and CS groups (60% versus 40%, P = 0.13). No difference was observed between SNEVLP- and CS-treated animals with respect to the peak of serum INR, factor V, or AST levels within 24 hours. CD31 staining 8 hours after transplantation demonstrated intact EC lining in SNEVLP-treated livers (7.3 × 10(-4) ± 2.6 × 10(-4) cells/μm(2)) but not in CS-treated livers (3.7 × 10(-4) ± 1.3 × 10(-4) cells/μm(2) , P = 0.03). Posttransplant SNEVLP animals had decreased serum ALP and serum bilirubin levels in comparison with CS animals. In addition, LDH in bile fluid was lower in SNEVLP pigs versus CS pigs (14 ± 10 versus 60 ± 18 μmol/L, P = 0.02). Bile duct histology revealed severe bile duct necrosis in 3 of 5 animals in the CS group but none in the SNEVLP group (P = 0.03). Sequential SNEVLP preservation of DCD grafts reduces bile duct and EC injury after liver transplantation. © 2014 American Association for the Study of Liver Diseases.

  13. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    Directory of Open Access Journals (Sweden)

    Mert Çalış

    2017-12-01

    Full Text Available Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospital after maxillofacial trauma are reviewed in this study. Exploration of the facial nerve and Stensen’s duct was planned for all patients within the first 72 hours after their injuries. After intraoral catheterization of the Stensen’s duct through the papilla using an epidural catheter, microsurgical end-to-end anastomosis was performed. Concurrently, 100 units of botulinum toxin A was injected at standardized eight points to the parotid gland. Results: Postoperative magnetic resonance (MR sialography revealed patency in all patients at the end of postoperative first year. The mean postoperative parotid volume of the injured and non-injured sides were 19.82±10.55 cm3 and 17.79±10.98 cm3, respectively, and the results were found to be comparable. Fibrillation potentials in the postoperative electromyography recordings and clinical examination demonstrated nerve regeneration. Conclusion: Botulinum toxin A appears to be effective in treating duct injuries accompanied by glandular involvement in an acute setting, as well as in preventing long-term complications.

  14. Correlation between hypermobility score and injury rate in artistic gymnastics.

    Science.gov (United States)

    Bukva, Bojan; Vrgoč, Goran; Madić, Dejan; Sporiš, Goran; Trajković, Nebojša

    2018-01-10

    Generalized Joint Hypermobility (GJH) is suggested as a contributing factor for injuries in young athletes and adults. It is presumed that GJH causes decreased joint stability, thereby increasing the risk of joint and soft tissue injuries during sports activities. The aim of this study was to determine the correlation between the hypermobility rate (using the Beighton`s modification of the Carter-Wilkinson criteria of hypermobility) in gymnasts and injury rate, during the period of one year. This study observed 24 artistic gymnasts (11-26 years old), members of Qatar National Team in artistic gymnastics. We examined the Beighton joint hypermobility screen and a seasonal injury survey. The gymnasts characteristics (age, gender) and gymnastics characteristics (training per day and number of years in training artistic gymnastics) and its' relations to injury rate were also included. The most common injury was the lower back pain injury, followed by knee, shoulder, hip and ankle injuries. We found strong correlation of number of years gymnastics training and injury rate (p0.05). According to this study there is no correlation between GJH rate and injury rate in artistic gymnasts in Qatar. Total training period in gymnastics have greater contribution in injury rate.

  15. Placement of a covered self-expandable nitinol stent for bile duct stricture that caused by ischemic injury after transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kweon; Seo, Tae Seok; Cha, In Ho; Huh, Sik; Byun, Kwan Soo [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2008-10-15

    The authors report here on a case of focal stricture in the common hepatic duct that was caused by ischemic bile duct injury after repeat TACE procedures for hepatocellular carcinoma, and the patient was successfully treated with a covered self-expandable nitinol stent.

  16. Metabolomic Assessment of Acute Cholestatic Injuries Induced by Thioacetamide and by Bile Duct Ligation, and the Protective Effects of Huang-Lian-Jie-Du-Decoction

    Directory of Open Access Journals (Sweden)

    Dan-Dan Wei

    2018-05-01

    Full Text Available Huang-Lian-Jie-Du-Decoction, a traditional Chinese formula, has been reported to protect liver from various injuries. Two cholestasis models of rats induced by thioacetamide and by bile duct ligation were established and treated with Huang-Lian-Jie-Du-Decoction. Nuclear Magnetic Resonance-based urinary metabolic profiles were analyzed by orthogonal partial least squares discriminant analysis and univariate analysis to excavate differential metabolites associated with the injuries of the two models and the treatment effects of Huang-Lian-Jie-Du-Decoction. The two cholestatic models shared common metabolic features of excessive fatty acid oxidation, insufficient glutathione regeneration and disturbed gut flora, with specific characteristics of inhibited urea cycle and DNA damage in thioacetamide-intoxicated model, and perturbed Kreb's cycle and inhibited branched chain amino acid oxidation in bile duct ligation model. With good treatment effects, Huang-Lian-Jie-Du-Decoction could regain the balance of the disturbed metabolic status common in the two cholestasis injuries, e.g., unbalanced redox system and disturbed gut flora; and perturbed urea cycle in thioacetamide-intoxicated model and energy crisis (disturbed Kreb's cycle and oxidation of branched chain amino acid in bile duct ligation model, respectively.

  17. Heat transfer and friction correlations for artificially roughened solar air heater duct with discrete W-shaped ribs

    International Nuclear Information System (INIS)

    Kumar, Arvind; Bhagoria, J.L.; Sarviya, R.M.

    2009-01-01

    An experimental investigation has been carried out to study the heat transfer and friction characteristics in solar air heater by using discrete W-shaped roughness on one broad wall of solar air heater with an aspect ratio of 8:1, the roughened wall being heated while the remaining three walls are insulated. The experiment encompassed Reynolds number (Re) range from 3000 to 15,000, relative roughness height (e/D h ) in the range of 0.0168-0.0338, relative roughness pitch (p/e) 10 and the angle of attack (α) in the range of 30-75 deg. The effect of parameters on the heat transfer and friction are compared with the result of smooth duct under similar flow conditions. Correlations for heat transfer and friction have been developed as a function of roughness and flow parameters.

  18. A rare case of hepatic duct injury from blunt abdominal trauma.

    Science.gov (United States)

    Hasaniya, Nahidh W; Premaratne, Shyamal; Premaratne, Ishani D; McNamara, J Judson

    2013-01-01

    A 25 year-old male was brought to the emergency room following an apparent suicide attempt by jumping from the fourth floor. Patient had a large abdominal laceration in the right upper quadrant (RUQ). CT scan showed a sub-scapular hematoma of the liver. Due to the repeated episodes of hypotension, a laporotomy was performed and the left hepatic artery was ligated while the ductal injury was managed with a Roux-en-Y left hepatic jejunostomy and stent. Bile leakage was resolved post-operatively by day 5 and the patient was discharged home on day 13 after clearance from psychiatry. While non-iatrogenic extrahepatic biliary trauma is rare, a high degree of suspicion is essential, especially in cases like the one discussed in this report. Diagnosis can be difficult in patients undergoing observation.

  19. MRI of acute cervical injury: correlation with neurologic deficit

    International Nuclear Information System (INIS)

    Hyun, Chang Dong; Kwon, Soon Tae; Lim, Seung Chul; Shin, Myung Jin; Han, Boo Kyung; Kim, Sang Joon; Park, Man Soo; Yoon, Hyun Ki; Suh, Dae Chul

    1995-01-01

    To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1Wl (TR/TE: 500/20), gradient-echo (TR/TE: 300/14), sagittal T1Wl (TR/TE: 500/20), proton (TR/TE: 2000. 20 msec), T2Wl (TR/TE: 2000/80) were performed. In 11 patients, post-enhancement T1Wl was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. 15 patients had flexion injury, seven had extension injury and three had injury of unknown mechanism. Twelve patients showed iso-signal intensity on T2Wl and high signal intensity on T2Wl. Three patients showed low signal intensity on T1Wl and high signal intensity on T2Wl. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16 (64%), 17 (68%), 15 (60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6 (eight patients) and C5 (five patients). MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent

  20. Swertianlarin, an Herbal Agent Derived from Swertia mussotii Franch, Attenuates Liver Injury, Inflammation, and Cholestasis in Common Bile Duct-Ligated Rats

    Directory of Open Access Journals (Sweden)

    Liangjun Zhang

    2015-01-01

    Full Text Available Swertianlarin is an herbal agent abundantly distributed in Swertia mussotii Franch, a Chinese traditional herb used for treatment of jaundice. To study the therapeutic effect of swertianlarin on cholestasis, liver injury, serum proinflammatory cytokines, and bile salt concentrations were measured by comparing rats treated with swertianlarin 100 mg/kg/d or saline for 3, 7, or 14 days after bile duct ligation (BDL. Serum alanine aminotransferase (ATL and aspartate aminotransferase (AST levels were significantly decreased in BDL rats treated with swertianlarin for 14 days (P<0.05. The reduced liver injury in BDL rats by swertianlarin treatment for 14 days was further confirmed by liver histopathology. Levels of serum tumor necrosis factor alpha (TNFα were decreased by swertianlarin in BDL rats for 3 and 7 days (P<0.05. Moreover, reductions in serum interleukins IL-1β and IL-6 levels were also observed in BDL rats treated with swertianlarin (P<0.05. In addition, most of serum toxic bile salt concentrations (e.g., chenodeoxycholic acid (CDCA and deoxycholic acid (DCA in cholestatic rats were decreased by swertianlarin (P<0.05. In conclusion, the data suggest that swertianlarin derived from Swertia mussotii Franch attenuates liver injury, inflammation, and cholestasis in bile duct-ligated rats.

  1. Correlations between coping styles and symptom expectation for whiplash injury.

    Science.gov (United States)

    Ferrari, Robert; Russell, Anthony S

    2010-11-01

    In pain conditions, active coping has been found to be associated with less severe depression, increased activity level, and less functional impairment. Studies indicate that Canadians have a high expectation for chronic pain following whiplash injury. Expectation of recovery has been shown to predict recovery in whiplash victims. The objective of this study was to compare both the expectations and the coping style for whiplash injury in injury-naive subjects. The Vanderbilt Pain Management Inventory was administered to university students. Subjects who had not yet experienced whiplash injury were given a vignette concerning a neck sprain (whiplash injury) in a motor vehicle collision and were asked to indicate how likely they were to have thoughts or behaviors indicated in the coping style questionnaire. Subjects also completed expectation questionnaires regarding whiplash injury. Subjects (57%) held an expectation of chronic pain after whiplash injury. The mean active coping style score was 28.5±6.6 (40 is the maximum score for active coping). The mean passive coping style score was 28.5±6.6 (50 is the maximum score for passive coping). Those with high passive coping styles had a higher mean expectation score. The correlation between passive coping style score and expectation score was 0.62, while the correlation between active coping style score and expectation was -0.48. Both expectations and coping styles may interact or be co-modifiers in the outcomes of whiplash injury in whiplash victims. Further studies of coping style as an etiologic factor in the chronic whiplash syndrome are needed.

  2. Effect of L-cysteine on remote organ injury in rats with severe acute pancreatitis induced by bile-pancreatic duct obstruction.

    Science.gov (United States)

    Yang, Li-Juan; Wan, Rong; Shen, Jia-Qing; Shen, Jie; Wang, Xing-Peng

    2013-08-01

    Remote organ failure occurs in cases of acute pancreatitis (AP); however, the reports on AP induced by pancreatic duct obstruction are rare. In this study we determined the effect of L-cysteine on pancreaticobiliary inflammation and remote organ damage in rats after pancreaticobiliary duct ligation (PBDL). AP was induced by PBDL in rats with 5/0 silk. Sixty rats were randomly divided into 4 groups. Groups A and B were sham-operated groups that received injections of saline or L-cysteine (10 mg/kg) intraperitoneally (15 rats in each group). Groups C and D were PBDL groups that received injections of saline or L-cysteine (10 mg/kg) intraperitoneally (15 rats in each group). The tissue samples of the pancreas and remote organs such as the lung, liver, intestine and kidney were subsequently examined for pathological changes under a light microscope. The samples were also stored for the determination of malondialdehyde and glutathione levels. Blood urea nitrogen (BUN), plasma amylase, ALT and AST levels were determined spectrophotometrically using an automated analyzer. Also, we evaluated the effect of L-cysteine on remote organ injury in rats with AP induced by retrograde infusion of 3.5% sodium taurocholate (NaTc) into the bile-pancreatic duct. Varying degrees of injury in the pancreas, lung, liver, intestine and kidney were observed in the rats 24 hours after PBDL. The severity of injury to the lung, liver and intestine was attenuated, while injury status was not changed significantly in the pancreas and kidney after L-cysteine treatment. Oxidative stress was also affected by L-cysteine in PBDL-treated rats. The concentration of tissue malondialdehyde decreased in the pancreas and remote organs of PBDL and L-cysteine administrated rats, and the concentration of glutathione increased more significantly than that of the model control group. However, L-cysteine administration reduced the severity of injury in remote organs but not in the pancreas in rats with Na

  3. Colesevelam attenuates cholestatic liver and bile duct injury in Mdr2-/- mice by modulating composition, signalling and excretion of faecal bile acids.

    Science.gov (United States)

    Fuchs, Claudia Daniela; Paumgartner, Gustav; Mlitz, Veronika; Kunczer, Victoria; Halilbasic, Emina; Leditznig, Nadja; Wahlström, Annika; Ståhlman, Marcus; Thüringer, Andrea; Kashofer, Karl; Stojakovic, Tatjana; Marschall, Hanns-Ulrich; Trauner, Michael

    2018-04-10

    Interruption of the enterohepatic circulation of bile acids (BAs) may protect against BA-mediated cholestatic liver and bile duct injury. BA sequestrants are established to treat cholestatic pruritus, but their impact on the underlying cholestasis is still unclear. We aimed to explore the therapeutic effects and mechanisms of the BA sequestrant colesevelam in a mouse model of sclerosing cholangitis. Mdr2 -/- mice received colesevelam for 8 weeks. Gene expression profiles of BA homeostasis, inflammation and fibrosis were explored in liver, intestine and colon. Hepatic and faecal BA profiles and gut microbiome were analysed. Glucagon-like peptide 1 (GLP-1) levels in portal blood were measured by ELISA. Furthermore, Mdr2 -/- mice as well as wild-type 3,5-diethoxy-carbonyl-1,4-dihydrocollidine-fed mice were treated with GLP-1-receptor agonist exendin-4 for 2 weeks prior to analysis. Colesevelam reduced serum liver enzymes, BAs and expression of proinflammatory and profibrogenic markers. Faecal BA profiling revealed increased levels of secondary BAs after resin treatment, while hepatic and biliary BA composition showed a shift towards more hydrophilic BAs. Colonic GLP-1 secretion, portal venous GLP-1 levels and intestinal messenger RNA expression of gut hormone Proglucagon were increased, while ileal Fgf15 expression was abolished by colesevelam. Exendin-4 treatment increased bile duct mass without promoting a reactive cholangiocyte phenotype in mouse models of sclerosing cholangitis. Microbiota analysis showed an increase of the phylum δ-Proteobacteria after colesevelam treatment and a shift within the phyla Firmicutes from Clostridiales to Lactobacillus . Colesevelam increases faecal BA excretion and enhances BA conversion towards secondary BAs, thereby stimulating secretion of GLP-1 from enteroendocrine L-cells and attenuates liver and bile duct injury in Mdr2 -/- mice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

  4. Assessment of Chronological Effects of Irreversible Electroporation on Hilar Bile Ducts in a Porcine Model

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Woong, E-mail: cooljay@korea.ac.kr; Lu, David S. K., E-mail: dlu@mednet.ucla.edu; Osuagwu, Ferdnand, E-mail: fosuagwu@mednet.ucla.edu; Raman, Steven, E-mail: sraman@mednet.ucla.edu [David Geffen School of Medicine at UCLA, Department of Radiology (United States); Lassman, Charles, E-mail: classman@mednet.ucla.edu [David Geffen School of Medicine at UCLA, Department of Pathology (United States)

    2013-11-07

    PurposeTo evaluate the chronological effects of irreversible electroporation (IRE) on large hilar bile ducts in an in vivo porcine model correlated with computed tomography (CT) cholangiography and histopathology.Materials and MethodsTwelve IRE zones were made along hilar bile ducts intraoperatively under ultrasound (US)-guidance in 11 pigs. Paired electrodes were placed either on opposing sides of the bile duct (straddle [STR]) or both on one side of the bile duct (one-sided [OSD]). The shortest electrode-to-duct distance was classified as periductal (≤2 mm) or nonperiductal (>2 mm). CT cholangiography and laboratory tests were performed before IRE and again at 2 days, 4 weeks, and 8 weeks after IRE. Degree of bile duct injury were graded as follows: grade 0 = no narrowing; grade 1 = ≤50 % duct narrowing; grade 2 = >50 % narrowing without proximal duct dilatation; grade 3 = grade 2 with proximal duct dilatation; and grade 4 = grade 3 with enzyme elevation. Pigs were selected for killing and histopathology at 2 days, 4, and 8 weeks.ResultsNonperiductal electrode placement produced no long-term strictures in 5 of 5 ducts. Periductal electrode placement produced mild narrowing in 6 of 7 ducts: 5 grade 1 and 1 grade 2. None showed increased enzymes. There was no significant difference between STR versus OSD electrode placement. Histopathology showed minor but relatively greater ductal mural changes in narrowed ducts.ConclusionIn the larger hilar ducts, long-term patency and mural integrity appear resistant to IRE damage with the energy deposition used, especially if the electrode is not immediately periductal in position.

  5. Assessment of Chronological Effects of Irreversible Electroporation on Hilar Bile Ducts in a Porcine Model

    International Nuclear Information System (INIS)

    Choi, Jae Woong; Lu, David S. K.; Osuagwu, Ferdnand; Raman, Steven; Lassman, Charles

    2014-01-01

    PurposeTo evaluate the chronological effects of irreversible electroporation (IRE) on large hilar bile ducts in an in vivo porcine model correlated with computed tomography (CT) cholangiography and histopathology.Materials and MethodsTwelve IRE zones were made along hilar bile ducts intraoperatively under ultrasound (US)-guidance in 11 pigs. Paired electrodes were placed either on opposing sides of the bile duct (straddle [STR]) or both on one side of the bile duct (one-sided [OSD]). The shortest electrode-to-duct distance was classified as periductal (≤2 mm) or nonperiductal (>2 mm). CT cholangiography and laboratory tests were performed before IRE and again at 2 days, 4 weeks, and 8 weeks after IRE. Degree of bile duct injury were graded as follows: grade 0 = no narrowing; grade 1 = ≤50 % duct narrowing; grade 2 = >50 % narrowing without proximal duct dilatation; grade 3 = grade 2 with proximal duct dilatation; and grade 4 = grade 3 with enzyme elevation. Pigs were selected for killing and histopathology at 2 days, 4, and 8 weeks.ResultsNonperiductal electrode placement produced no long-term strictures in 5 of 5 ducts. Periductal electrode placement produced mild narrowing in 6 of 7 ducts: 5 grade 1 and 1 grade 2. None showed increased enzymes. There was no significant difference between STR versus OSD electrode placement. Histopathology showed minor but relatively greater ductal mural changes in narrowed ducts.ConclusionIn the larger hilar ducts, long-term patency and mural integrity appear resistant to IRE damage with the energy deposition used, especially if the electrode is not immediately periductal in position

  6. Sortilin 1 Loss-of-Function Protects Against Cholestatic Liver Injury by Attenuating Hepatic Bile Acid Accumulation in Bile Duct Ligated Mice.

    Science.gov (United States)

    Li, Jibiao; Woolbright, Benjamin L; Zhao, Wen; Wang, Yifeng; Matye, David; Hagenbuch, Bruno; Jaeschke, Hartmut; Li, Tiangang

    2018-01-01

    Sortilin 1 (Sort1) is an intracellular trafficking receptor that mediates protein sorting in the endocytic or secretory pathways. Recent studies revealed a role of Sort1 in the regulation of cholesterol and bile acid (BA) metabolism. This study further investigated the role of Sort1 in modulating BA detoxification and cholestatic liver injury in bile duct ligated mice. We found that Sort1 knockout (KO) mice had attenuated liver injury 24 h after bile duct ligation (BDL), which was mainly attributed to less bile infarct formation. Sham-operated Sort1 KO mice had about 20% larger BA pool size than sham-operated wildtype (WT) mice, but 24 h after BDL Sort1 KO mice had significantly attenuated hepatic BA accumulation and smaller BA pool size. After 14 days BDL, Sort1 KO mice showed significantly lower hepatic BA concentration and reduced expression of inflammatory and fibrotic marker genes, but similar degree of liver fibrosis compared with WT mice. Unbiased quantitative proteomics revealed that Sort1 KO mice had increased hepatic BA sulfotransferase 2A1, but unaltered phase-I BA metabolizing cytochrome P450s or phase-III BA efflux transporters. Consistently, Sort1 KO mice showed elevated plasma sulfated taurocholate after BDL. Finally, we found that liver Sort1 was repressed after BDL, which may be due to BA activation of farnesoid x receptor. In conclusion, we report a role of Sort1 in the regulation of hepatic BA detoxification and cholestatic liver injury in mice. The mechanisms underlying increased hepatic BA elimination in Sort1 KO mice after BDL require further investigation. © The Author 2017. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Blunt trauma pancreatic duct injury managed by non-operative technique, a case study and literature review

    Directory of Open Access Journals (Sweden)

    A. Zala

    2015-02-01

    Full Text Available We describe the case of a 15 year old boy who presented with generalised abdominal pain following a seemingly minor collision at weekend soccer. Investigation revealed a grade IV pancreatic injury that was subsequently managed with pancreatic stent insertion by endoscopic retrograde cholangiopancreatography (ERCP and total parenteral nutrition (TPN prior to recommencing low fat diet 10 days post-injury. Keywords: Trauma, Blunt injury, Pancreas, Non-operative

  8. Bile Duct Exploration

    Science.gov (United States)

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

  9. Fatigue in the first year after traumatic brain injury: course, relationship with injury severity, and correlates.

    Science.gov (United States)

    Beaulieu-Bonneau, Simon; Ouellet, Marie-Christine

    2017-10-01

    The objectives of this study were to document the evolution of fatigue in the first year after traumatic brain injury (TBI), and to explore correlates of fatigue. Participants were 210 adults who were hospitalised following a TBI. They completed questionnaires 4, 8, and 12 months post-injury, including the Multidimensional Fatigue Inventory (MFI). Participants with severe TBI presented greater mental and physical fatigue, and reduced activity compared to participants with moderate TBI. For all MFI subscales except reduced motivation, the general pattern was a reduction of fatigue levels over time after mild TBI, an increase of fatigue after severe TBI, and stable fatigue after moderate TBI. Fatigue was significantly associated with depression, insomnia, cognitive difficulties, and pain at 4 months; the same variables and work status at 8 months; and depression, insomnia, cognitive difficulties, and work status at 12 months. These findings suggest that injury severity could have an impact on the course of fatigue in the first year post-TBI. Depression, insomnia, and cognitive difficulties remain strong correlates of fatigue, while for pain and work status the association with fatigue evolves over time. This could influence the development of intervention strategies for fatigue, implemented at specific times for each severity subgroup.

  10. Endoscopic Management of Perforation of Right Hepatic Duct Following Non-Surgical Abdominal Trauma

    OpenAIRE

    Sharma, B. C.; Maini, A.; Saraswat, V. A.

    1997-01-01

    Isolated bile duct injuries after blunt abdominal trauma are rare. Surgery is the usual mode of treatment. We report a patient with a right hepatic duct injury following blunt abdominal trauma who was managed successfully by endoscopic papillotomy.

  11. Partial Portal Vein Arterialization Attenuates Acute Bile Duct Injury Induced by Hepatic Dearterialization in a Rat Model.

    Science.gov (United States)

    Jiang, Jun; Wei, Jishu; Wu, Junli; Gao, Wentao; Li, Qiang; Jiang, Kuirong; Miao, Yi

    2016-01-01

    Hepatic infarcts or abscesses occur after hepatic artery interruption. We explored the mechanisms of hepatic deprivation-induced acute liver injury and determine whether partial portal vein arterialization attenuated this injury in rats. Male Sprague-Dawley rats underwent either complete hepatic arterial deprivation or partial portal vein arterialization, or both. Hepatic ischemia was evaluated using biochemical analysis, light microscopy, and transmission electron microscopy. Hepatic ATP levels, the expression of hypoxia- and inflammation-associated genes and proteins, and the expression of bile transporter genes were assessed. Complete dearterialization of the liver induced acute liver injury, as evidenced by the histological changes, significantly increased serum biochemical markers, decreased ATP content, increased expression of hypoxia- and inflammation-associated genes and proteins, and decreased expression of bile transporter genes. These detrimental changes were extenuated but not fully reversed by partial portal vein arterialization, which also attenuated ductular reaction and fibrosis in completely dearterialized rat livers. Collectively, complete hepatic deprivation causes severe liver injury, including bile infarcts and biloma formation. Partial portal vein arterialization seems to protect against acute ischemia-hypoxia-induced liver injury.

  12. Partial Portal Vein Arterialization Attenuates Acute Bile Duct Injury Induced by Hepatic Dearterialization in a Rat Model

    Directory of Open Access Journals (Sweden)

    Jun Jiang

    2016-01-01

    Full Text Available Hepatic infarcts or abscesses occur after hepatic artery interruption. We explored the mechanisms of hepatic deprivation-induced acute liver injury and determine whether partial portal vein arterialization attenuated this injury in rats. Male Sprague-Dawley rats underwent either complete hepatic arterial deprivation or partial portal vein arterialization, or both. Hepatic ischemia was evaluated using biochemical analysis, light microscopy, and transmission electron microscopy. Hepatic ATP levels, the expression of hypoxia- and inflammation-associated genes and proteins, and the expression of bile transporter genes were assessed. Complete dearterialization of the liver induced acute liver injury, as evidenced by the histological changes, significantly increased serum biochemical markers, decreased ATP content, increased expression of hypoxia- and inflammation-associated genes and proteins, and decreased expression of bile transporter genes. These detrimental changes were extenuated but not fully reversed by partial portal vein arterialization, which also attenuated ductular reaction and fibrosis in completely dearterialized rat livers. Collectively, complete hepatic deprivation causes severe liver injury, including bile infarcts and biloma formation. Partial portal vein arterialization seems to protect against acute ischemia-hypoxia-induced liver injury.

  13. Usefulness of real-time elastography strain ratio in the assessment of bile duct ligation-induced liver injury and the hepatoprotective effect of chitosan: an experimental animal study.

    Science.gov (United States)

    Dudea, Marina; Clichici, Simona; Olteanu, Diana Elena; Nagy, Andras; Cucoş, Maria; Dudea, Sorin

    2015-01-01

    The purpose of the study described here was to evaluate the usefulness of the elastographic strain ratio in the assessment of liver changes in an experimental animal setting and the hepatoprotective effects of chitosan. Ultrasonography and Strain Ratio calculation were performed before and after bile duct ligation (BDL) in three groups of Wistar albino rats (n = 10 animals per group): (i) rats subjected to bile duct ligation only; (ii) rats subjected to bile duct ligation and administered chitosan for 14 d; (iii) rats subjected to bile duct ligation and administered chitosan for 7 d. The results were compared with the laboratory data and pathologic findings. Strain ratios revealed an increase in liver stiffness after bile duct ligation (p liver response to injury. To the best of our knowledge, this is the first study reporting on the usefulness of the sonoelastographic liver-to-kidney strain ratio in assessing the effects of experimentally induced liver lesions. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  14. Liver fibrosis in bile duct-ligated rats correlates with increased hepatic IL-17 and TGF-β2 expression.

    Science.gov (United States)

    Zepeda-Morales, Adelaida Sara M; Del Toro-Arreola, Susana; García-Benavides, Leonel; Bastidas-Ramírez, Blanca E; Fafutis-Morris, Mary; Pereira-Suárez, Ana L; Bueno-Topete, Miriam R

    2016-01-01

    BACKGROUND AND RATIONALE FOR THE STUDY: IL-17, TGF-β1/2 are cytokines involved in the development of kidney, pulmonary and liver fibrosis. However, their expression kinetics in the pathogenesis of cholestatic liver fibrosis have not yet been fully explored. The aim of the study was to analyze the expression of IL-17, RORγt, NKp46, TGF-β1, and TGF-β2 in the liver of rats with bile duct ligation (BDL). Hepatic IL-17A gene expression analyzed by qRT-PCR showed a dramatic increase of 350 and 10 fold, at 8 and 30 days post BDL, respectively. TGFβ1 and TGFβ2 gene expression significantly increased throughout the whole fibrotic process. At the protein level in liver homogenates, IL-17, TGF-β1, and RORγt significantly increased at 8 and 30 days after BDL. Interestingly, a significant increase in the protein levels of TGF-β2 and decrease of NKp46 was observed only 30 days after BDL. Unexpectedly, TGF-β2 exhibited stronger signals than TGF-β1 at the gene expression and protein levels. Histological analysis showed bile duct proliferation and collagen deposition. Our results suggest that pro-fibrogenic cytokines IL-17, TGF-β1 and, strikingly, TGF-β2 might be important players of liver damage in the pathogenesis of early and advanced experimental cholestatic fibrosis. Th17 cells might represent an important source of IL-17, while NK cell depletion may account for the perpetuation of liver damage in the BDL model.

  15. Hemodynamic and metabolic correlates of perinatal white matter injury severity.

    Directory of Open Access Journals (Sweden)

    Art Riddle

    Full Text Available Although the spectrum of perinatal white matter injury (WMI in preterm infants is shifting from cystic encephalomalacia to milder forms of WMI, the factors that contribute to this changing spectrum are unclear. We hypothesized that the variability in WMI quantified by immunohistochemical markers of inflammation could be correlated with the severity of impaired blood oxygen, glucose and lactate.We employed a preterm fetal sheep model of in utero moderate hypoxemia and global severe but not complete cerebral ischemia that reproduces the spectrum of human WMI. Since there is small but measurable residual brain blood flow during occlusion, we sought to determine if the metabolic state of the residual arterial blood was associated with severity of WMI. Near the conclusion of hypoxia-ischemia, we recorded cephalic arterial blood pressure, blood oxygen, glucose and lactate levels. To define the spectrum of WMI, an ordinal WMI rating scale was compared against an unbiased quantitative image analysis protocol that provided continuous histo-pathological outcome measures for astrogliosis and microgliosis derived from the entire white matter.A spectrum of WMI was observed that ranged from diffuse non-necrotic lesions to more severe injury that comprised discrete foci of microscopic or macroscopic necrosis. Residual arterial pressure, oxygen content and blood glucose displayed a significant inverse association with WMI and lactate concentrations were directly related. Elevated glucose levels were the most significantly associated with less severe WMI.Our results suggest that under conditions of hypoxemia and severe cephalic hypotension, WMI severity measured using unbiased immunohistochemical measurements correlated with several physiologic parameters, including glucose, which may be a useful marker of fetal response to hypoxia or provide protection against energy failure and more severe WMI.

  16. Evaluation analysis of correlations for predicting the void fraction and slug velocity of slug flow in an inclined narrow rectangular duct

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Chaoxing, E-mail: yanchaoxing0808@163.com [Fundamental Science on Nuclear Safety and Simulation Technology Laboratory, Harbin Engineering University, Harbin 150001 (China); Yan, Changqi, E-mail: Changqi_yan@163.com [Fundamental Science on Nuclear Safety and Simulation Technology Laboratory, Harbin Engineering University, Harbin 150001 (China); Shen, Yunhai [Science and Technology on Reactor System Design Technology Laboratory, Nuclear Power Institute of China, Chengdu 610041 (China); Sun, Licheng; Wang, Yang [Fundamental Science on Nuclear Safety and Simulation Technology Laboratory, Harbin Engineering University, Harbin 150001 (China)

    2014-07-01

    Highlights: • 46 void fraction correlations are evaluated on void fraction. • Evaluation of void fraction correlations on slug velocity is studied. • Effect of void fraction correlations on separated frictional pressure drop is studied. • Drift-flux type correlation shows best agreement with experimental data. • Evaluation is investigated in different flow regions. - Abstract: A visualized investigation was conducted on inclined upward air–water slug flow in a narrow rectangular duct with the cross section of 43 mm × 3.25 mm. The slug velocity and void fraction were obtained through image processing. 46 correlations for predicting void fraction, covering the types of slip ratio, Kβ, Lockhart and Martinelli, drift-flux and general were evaluated against the experimental data. In the experiment, four inclined conditions including 0°, 10°, 20° and 30° were investigated and the ranges of gas and liquid superficial velocity were 0.16–2.63 m/s and 0.12–3.59 m/s, respectively. The results indicate that the inclination has no significant influence on prediction error for a given correlation and the drift-flux type correlations are more competitive than the others in the prediction of slug velocity and void fraction. In addition, most of drift-flux type correlations are quite accurate in turbulent flow region, while they provide relative poor predictions in laminar flow region. As for the frictional pressure drop separated from the measured total pressure drop, the deviation arising from the calculation of the void fraction by different correlations is significant in laminar flow region, whereas is negligible in turbulent flow region.

  17. An incidence study on thyroglossal duct cysts in adults

    International Nuclear Information System (INIS)

    Kurt, A.; Ortug, C.; Aydar, Y.; Ortug, G.

    2007-01-01

    To investigate the incidence of the asymptomatic thyroglossal duct anomalies and to review the literature and make comments on the significance of this condition. A total of 80 cadavers were dissected in the present study. This study was carried out during 2005, where the cadavers were randomly included from the criminal laboratories of the Ministry of Justice, Republic of Turkey in Istanbul. None of the cadavers had laryngeal and cervical injuries resulting from a trauma or the cause of their death. The examined cadavers included 59 men and 21 females, and their ages were ranged from 35-80 years old. The larynges were removed and fixed in 10% formalin and then dissected. The sections were examined using surgical SMZ 10 Nikon stereomicroscope. We evaluated the presence, localization and diameter of the cysts with regard to age and sex of the cadavers. We observed a total of 12 different localization of thyroglossal ducts and cysts among the 80 dissected cadavers. Ten of these ducts cysts were found in males with an age range of 35-68 years and 2 female cadavers aged 45-65 years. In 6 cases, the thyroglossal ducts and cysts were located in the left of the midline of the neck, while 3 cases were from the right of the midline, and the remaining was located on the midline of the neck. In all cases, thryoglossal ducts and cysts were complete and restricted to the infrahyoid region: all of them had connection with the hyoid bone, but not with the perichondrium of the cartilage. In addition, the thyroglossal ducts have connection with the left lobe of the thyroid glands in 3 cases, one case in the right lobe, and 2 cases with the isthmus of the thyroid gland. Finally in 5 cases thyroglossal ducts were complete and had well developed cysts. Thyroglossal duct remnants are one of the most often seen congenital asymptomatic masses of the neck region (7%). The presence of these duct remnants may lead to abnormal phonation and epithelial carcinomas. Therefore, correlation of

  18. Parotid Duct Repair with Intubation Tube: Technical Note

    Science.gov (United States)

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

    2017-01-01

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

  19. 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

  20. 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.

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

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

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

  2. Bile Duct Cancer (Cholangiocarcinoma)

    Science.gov (United States)

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

  3. Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

    Directory of Open Access Journals (Sweden)

    Geneviève Chaput

    2016-01-01

    Full Text Available Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1 and 8 weeks (Time 2 after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2. Results. The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31 to .44, number of postconcussion symptoms reported (r=.35 to .45, psychological distress (r=.57 to .67, and level of functionality (r=-.43 to -.29. Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2. Conclusions. Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

  4. Serum oxidative stress is increased in patients with post cholecystectomy bile duct injury Aumento del estrés oxidativo en el suero de pacientes con lesiones de vías biliares postcolecistectomía

    Directory of Open Access Journals (Sweden)

    A. G. Miranda-Díaz

    2010-06-01

    Full Text Available Background: post-cholecystectomy bile duct injuries are identified by the onset of jaundice as well as elevated bilirubin and alkaline phosphatase levels during the peri-operative period. It is unknown how serum oxidative stress markers are modified in patients with post-cholecystectomy bile duct injuries. Objective: to determine serum oxidative stress marker levels (lipid peroxidation by-products, nitrites/nitrates and total antioxidant capacity in patients with post-cholecystectomy bile duct injuries. Patients and methods: a prospective, transversal and analytical study was designed with two groups. Group 1: 5 healthy volunteer subjects. Group 2: 52 patients with post-cholecystectomy bile duct injuries (43 female and 9 male. An elective bilio-digestive reconstruction was performed at week 8. The serum oxidative stress marker levels were quantified by colorimetric method. Results: patients with bile duct injuries had a significant increased serum lipid peroxides (malondialdehyde and 4-hydroxy-alkenals and nitric oxide metabolites (nitrites/nitrates levels compared to the control group. In contrast, total antioxidant capacity in patients with bile duct injuries remained similar compared to healthy controls. Conclusions: the results show that oxidative stress is usually associated to bile duct injury.Introducción: las lesiones de las vías biliares postcolecistectomía se establecen por la aparición de ictericia, elevación de las bilirrubinas y de la fosfatasa alcalina durante el periodo perioperatorio. Se desconoce cómo se modifican los marcadores de estrés oxidativo en el suero de los pacientes con lesiones de las vías biliares postcolecistectomía. Objetivo: determinar los marcadores de estrés oxidativo (productos de peroxidación de lípidos, catabolitos del óxido nítrico y capacidad antioxidante total en el suero de pacientes con lesiones de las vías biliares. Pacientes y métodos: se realizó un estudio prospectivo transversal

  5. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    OpenAIRE

    Mert Çalış; Zeynep Öz; Hakan Uzun; Burçe Özgen; Alp Çetin3; Ali Emre Aksu

    2017-01-01

    Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospita...

  6. Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study.

    Science.gov (United States)

    Majeedkutty, Nizar A; Khairulanuar, Nor A B

    2017-01-01

    Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and above were included in the study. Out of 169 participants, 93 were females and 76 were males. The correlation of injuries to gender, age, level of experience, exercise habits, use of safety measures, and type of equestrian sport were determined. Chi-square test was performed to test for statistical significance. The prevalence was high with 85.8% of the participants reporting symptoms and characteristics of injuries in the past 12 months. The most frequently perceived symptoms reported were in the upper extremities (43.4%) followed by lower extremities (40.7%), head injury (8.3%) and injuries of upper and lower back (3.4%). There was a higher prevalence of injury among female participants (55.03%) than males (42.60%). A significant correlation was found between gender and prevalence of injuries. About 70% of the riders sustained soft tissue injuries. Fifty-five percent of the injured were involved in recreational riding. The most common mechanism of injury was a fall from a horse. Sixty percent of the injured riders did not seek medical attention after being injured, and physiotherapy consultation was even lower with 10.3%. The high prevalence of injuries and low rate of medical consultation emphasize the need for education programs on safety in Malaysia. Sessions should be held to improve coaching for riders and instructors, and their knowledge of the nature of the horse, mechanisms of injuries, horse handling, and riding skills to help them host safe equestrian activities.

  7. Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nizar A Majeedkutty

    2017-01-01

    Full Text Available Background: Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. Objective: The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. Subjects And Methods: A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and above were included in the study. Out of 169 participants, 93 were females and 76 were males. The correlation of injuries to gender, age, level of experience, exercise habits, use of safety measures, and type of equestrian sport were determined. Chi-square test was performed to test for statistical significance. Results: The prevalence was high with 85.8% of the participants reporting symptoms and characteristics of injuries in the past 12 months. The most frequently perceived symptoms reported were in the upper extremities (43.4% followed by lower extremities (40.7%, head injury (8.3% and injuries of upper and lower back (3.4%. There was a higher prevalence of injury among female participants (55.03% than males (42.60%. A significant correlation was found between gender and prevalence of injuries. About 70% of the riders sustained soft tissue injuries. Fifty-five percent of the injured were involved in recreational riding. The most common mechanism of injury was a fall from a horse. Sixty percent of the injured riders did not seek medical attention after being injured, and physiotherapy consultation was even lower with 10.3%. Conclusions: The high prevalence of injuries and low rate of medical consultation emphasize the need for education programs on safety in Malaysia. Sessions should be held to improve coaching for riders and instructors, and their knowledge of the nature of the horse, mechanisms of injuries, horse handling, and riding skills to help them host safe

  8. Therapeutic Hypothermia Following Traumatic Spinal Injury: Morphological and Functional Correlates

    National Research Council Canada - National Science Library

    Yezierski, Robert P

    1998-01-01

    The general purpose of experiments carried out during the first year focused on the neuroprotective effects of systemic hypothermia and pharmacological treatments following moderate and severe spinal cord injury...

  9. Computed tomographic findings of splenic injury and correlation with treatment

    International Nuclear Information System (INIS)

    Kim, Dong Jin; Koh, Joo Yaul; Kim, Myung Soon; Hong, In Soo; Cho, Whi Youl; Sung, Ki Joon

    1990-01-01

    According to recently reported classification, 46 patients with blunt splenic trauma were evaluate preoperatively with computed tomography(CT). Injures were graded I through IV and describe as capsular or subcapsular disruptions without parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); injuries involving hilum(3 patients); and fragmentation(17 patients). Nineteen patients were managed conservatively and 27 patients were managed surgically. Twelve patients(47%) out of those with Type I or Type II were managed surgically including five hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries and unknown surgical criteria. On the other hand hemodynamically stable patients(25%) out of those with Type III or Type IV were managed surgically. The amount of hemoperitoneum was graded into small, moderate and large; small in three patients, moderate in 39 patients, and large in two patients. The amount of hemoperitoneum in patients with conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneum in patients with operative treatment was small in three patients, moderate in 23 patients and large in one patient. We concluded that CT was accurate method of determining the extent of splenic injury and evaluation of hemoperitoneum, but treatment choice should be based on the hemodynamic status of patients rather than the type of injury or the amount of hemoperitoneum by CT

  10. Computed tomographic findings of splenic injury and correlation with treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Jin; Koh, Joo Yaul; Kim, Myung Soon; Hong, In Soo; Cho, Whi Youl; Sung, Ki Joon [Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    1990-12-15

    According to recently reported classification, 46 patients with blunt splenic trauma were evaluate preoperatively with computed tomography(CT). Injures were graded I through IV and describe as capsular or subcapsular disruptions without parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); injuries involving hilum(3 patients); and fragmentation(17 patients). Nineteen patients were managed conservatively and 27 patients were managed surgically. Twelve patients(47%) out of those with Type I or Type II were managed surgically including five hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries and unknown surgical criteria. On the other hand hemodynamically stable patients(25%) out of those with Type III or Type IV were managed surgically. The amount of hemoperitoneum was graded into small, moderate and large; small in three patients, moderate in 39 patients, and large in two patients. The amount of hemoperitoneum in patients with conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneum in patients with operative treatment was small in three patients, moderate in 23 patients and large in one patient. We concluded that CT was accurate method of determining the extent of splenic injury and evaluation of hemoperitoneum, but treatment choice should be based on the hemodynamic status of patients rather than the type of injury or the amount of hemoperitoneum by CT.

  11. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, J.J. [Radboud University Nijmegen Medical Center, Department of Radiology, P.O. Box 9101, Nijmegen (Netherlands); Wentink, N. [Atrium Medisch Centrum, Department of Surgery, PO Box 4446, Heerlen (Netherlands); Beumer, A.; Moonen, A.F.C.M. [Amphia Ziekenhuis Hospital, Department of Orthopaedics, PO Box 90158, Breda (Netherlands); Hop, W.C.J. [Erasmus University Medical Center Rotterdam, Department of Biostatistics, PO Box 2040, Rotterdam (Netherlands); Heijboer, M.P. [Erasmus University Medical Center Rotterdam, Department of Orthopaedics, PO Box 2040, Rotterdam (Netherlands); Ginai, A.Z. [Erasmus University Medical Center Rotterdam, Department of Radiology, PO Box 2040, Rotterdam (Netherlands)

    2012-07-15

    Owing to the shortcomings of clinical examination and radiographs, injury to the syndesmotic ligaments is often misdiagnosed. When there is no indication requiring that the fractured ankle be operated on, the syndesmosis is not tested intra-operatively, and rupture of this ligamentous complex may be missed. Subsequently the patient is not treated properly leading to chronic complaints such as instability, pain, and swelling. We evaluated three fracture classification methods and radiographic measurements with respect to syndesmotic injury. Prospectively the radiographs of 51 consecutive ankle fractures were classified according to Weber, AO-Mueller, and Lauge-Hansen. Both the fracture type and additional measurements of the tibiofibular clear space (TFCS), tibiofibular overlap (TFO), medial clear space (MCS), and superior clear space (SCS) were used to assess syndesmotic injury. MRI, as standard of reference, was performed to evaluate the integrity of the distal tibiofibular syndesmosis. The sensitivity and specificity for detection of syndesmotic injury with radiography were compared to MRI. The Weber and AO-Mueller fracture classification system, in combination with additional measurements, detected syndesmotic injury with a sensitivity of 47% and a specificity of 100%, and Lauge-Hansen with both a sensitivity and a specificity of 92%. TFCS and TFO did not correlate with syndesmotic injury, and a widened MCS did not correlate with deltoid ligament injury. Syndesmotic injury as predicted by the Lauge-Hansen fracture classification correlated well with MRI findings. With MRI the extent of syndesmotic injury and therefore fracture stage can be assessed more accurately compared to radiographs. (orig.)

  12. Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury

    Science.gov (United States)

    Max, Jeffrey E.; Wilde, Elisabeth A.; Bigler, Erin D.; Thompson, Wesley K.; MacLeod, Marianne; Vasquez, Ana C.; Merkley, Tricia L.; Hunter, Jill V.; Chu, Zili D.; Yallampalli, Ragini; Hotz, Gillian; Chapman, Sandra B.; Yang, Tony T.; Levin, Harvey S.

    2012-01-01

    Objective: To study magnetic resonance imaging (MRI) correlates of novel (new-onset) psychiatric disorders (NPD) after traumatic brain injury (TBI) and orthopedic injury (OI). Method: Participants were 7 to 17 years of age at the time of hospitalization for either TBI or OI. The study used a prospective, longitudinal, controlled design with…

  13. Iliopsoas injury: an MRI study of patterns and prevalence correlated with clinical findings

    International Nuclear Information System (INIS)

    Bui, Kimmie L.; Ilaslan, Hakan; Recht, Michael; Sundaram, Murali

    2008-01-01

    The objective was to retrospectively determine the prevalence and patterns of iliopsoas injuries based on consecutive MRI examinations, correlated with clinical findings. From 4,862 consecutive MRI examinations of the hips and pelvis, 32 patients with 33 iliopsoas injuries were identified and graded as muscle strain, partial tendon tear, and complete tendon tears. These patients' medical records were reviewed to determine age, gender, and cause of symptoms. The prevalence of iliopsoas tendon and myotendinous injuries was 0.66% (95% CI: 0.44-0.89). There were 18 females and 14 males whose ages ranged from 7 to 95 years (mean, 54 years). The most frequent presenting symptom was hip pain and the most frequent clinical diagnosis, an occult fracture. The most common injuries in patients under 65 years (16 patients) were muscle strains and partial tendon tears, most often due to an athletic injury. The most common injury in patients 65 years and older (16 patients) was a complete tear (8 patients, all females), 2 of which were spontaneous in origin. Each grade of iliopsoas injury occurred with similar frequency. The more advanced the age of the patient, the more severe the injury. Non-athletic injuries predominated in patients 65 years and older; athletic injuries were the most common cause of iliopsoas injury in patients under 65 years. (orig.)

  14. Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students.

    Science.gov (United States)

    Ruemper, Alia; Watkins, Katherine

    2012-12-01

    The first objective of this study was to ascertain the prevalence of general joint hypermobility (GJH) and joint hypermobility syndrome (JHS) in BA Dance Theatre 1st and 3rd year students at a contemporary dance conservatory. The second objective was to determine the statistical correlation between GJH, JHS, and injury in this population. A total of 85 (female, N = 78; male, N = 7) contemporary dance students participated in the study. The Beighton score (with a forward flexion test modification) was used to determine GJH, and the Brighton criteria were used to verify JHS. Participants completed a self-reported injury questionnaire that included type of injury (physical complaint, medical diagnosis, or time-loss) and injury frequency. Statistical analysis (Pearson correlation) was used to correlate GJH, JHS, and frequency-of-injury scores. Overall, 69% of the students were found to have GJH, and 33% had JHS. A statistical correlation of r = + 0.331 (p dance students and suggests that screening programs should include the Brighton criteria to identify JHS in these dancers. Subsequent injury tracking and injury prevention programs would then provide data for further research in this area.

  15. Neuroanatomic correlates of stroke-related myocardial injury.

    Science.gov (United States)

    Ay, H; Koroshetz, W J; Benner, T; Vangel, M G; Melinosky, C; Arsava, E M; Ayata, C; Zhu, M; Schwamm, L H; Sorensen, A G

    2006-05-09

    Myocardial injury can occur after ischemic stroke in the absence of primary cardiac causes. The neuroanatomic basis of stroke-related myocardial injury is not well understood. To identify regions of brain infarction associated with myocardial injury using a method free of the bias of an a priori hypothesis as to any specific location. Of 738 consecutive patients with acute ischemic stroke, the authors identified 50 patients in whom serum cardiac troponin T (cTnT) elevation occurred in the absence of any apparent cause within 3 days of symptom onset. Fifty randomly selected, age- and sex-matched patients with ischemic stroke without cTnT elevation served as controls. Diffusion-weighted images with outlines of infarction were co-registered to a template, averaged, and then subtracted to find voxels that differed between the two groups. Voxel-wise p values were determined using a nonparametric permutation test to identify specific regions of infarction that were associated with cTnT elevation. The study groups were well balanced with respect to stroke risk factors, history of coronary artery disease, infarction volume, and frequency of right and left middle cerebral artery territory involvement. Brain regions that were a priori associated with cTnT elevation included the right posterior, superior, and medial insula and the right inferior parietal lobule. Among patients with right middle cerebral artery infarction, the insular cluster was involved in 88% of patients with and 33% without cTnT elevation (odds ratio: 15.00; 95% CI: 2.65 to 84.79). Infarctions in specific brain regions including the right insula are associated with elevated serum cardiac troponin T level indicative of myocardial injury.

  16. Nonfatal Injuries and Psychosocial Correlates among Middle School Students in Cambodia and Vietnam

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2017-03-01

    Full Text Available The aim of the study was to estimate the prevalence and psychosocial correlates of nonfatal injury among middle school students in Cambodia and Vietnam. Cross-sectional data from 7137 school children (mean age 15.5 years, SD = 1.4 who were randomly sampled for participation in nationally representative Global School-based Health Surveys (GSHS in Cambodia and Vietnam were analyzed. The proportion of school children reporting one or more serious injuries in the past year was 22.6% among boys and 17.5% among girls in Cambodia and 34.3% among boys and 25.1% among girls in Vietnam. The most prevalent cause of the most serious injury in Cambodia was traffic injuries (4.7% among boys and 4.3% among girls and in Vietnam it was falls (10.0% among boys and 7.0% among girls. In multinomial logistic regression analyses, experiencing hunger (as an indicator for low socioeconomic status and drug use were associated with having sustained one injury and two or more injuries in the past 12 months in Cambodia. In addition, poor mental health was associated with two or more injuries. In Vietnam, being male, experiencing hunger, current alcohol use, poor mental health and ever having had sex were associated with having sustained one injury and two or more injuries in the past 12 months. Several psychosocial variables were identified which could help in designing injury prevention strategies among middle school children in Cambodia and Vietnam.

  17. The correlation of insulin resistance with the cerebral injury and stress reaction in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Zhan Lan

    2017-04-01

    Full Text Available Objective: To study the correlation of insulin resistance with the cerebral injury and stress reaction in patients with traumatic brain injury (TBI. Methods: 78 patients who were diagnosed with acute traumatic brain injury in our hospital between May 2014 and August 2016 were selected as the TBI group, and 90 healthy volunteers who received physical examination during the same period were selected as the control group. The peripheral blood was collected to detect glucose, insulin and nerve injury marker molecules, stress hormones as well as oxidative stress reaction products, and the insulin resistance index (HOMA-IR was calculated. Results: The HOMA-IR index of TBI group was significantly higher than that of control group (P<0.05; serum neuron-specific enolase (NSE, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1, S100β, myelin basic protein (MBP, glucagon, growth hormone, cortisol, malondialdehyde (MDA and 8-hydroxy-deoxyguanosine (8-OHdGlevels of TBI group were significantly higher than those of control group (P<0.05; serum NSE, UCH-L1, S100β, MBP, glucagon, growth hormone, cortisol, MDA and 8-OHdG levels of patients with high HOMA-IR were significantly higher than those of patients with low HOMA-IR (P<0.05. Conclusion: The insulin resistance increases significantly in patients with traumatic brain injury, and is closely related to the degree of cerebral injury and stress reaction.

  18. Bile duct stricture

    Science.gov (United States)

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

  19. Injury Source and Correlation Analysis of Riders in Car-Electric Bicycle Accidents

    Directory of Open Access Journals (Sweden)

    Tiefang Zou

    2018-01-01

    Full Text Available The knowledge about the injury source and correlation of riders in car-electric bicycle accident will be helpful in the cross validation of traces and vehicle safety design. In order to know more information about such kind of knowledge, 57 true car-electric bicycle accidents were reconstructed by PC-Crash and then data on injury information of riders were collected directly from the reconstructed cases. These collected data were validated by some existing research results firstly, and then 4 abnormal cases were deleted according to the statistical method. Finally, conclusions can be obtained according to the data obtained from the remaining 53 cases. Direct injuries of the head and right leg are from the road pavement upon low speed; the source laws of indirect head injuries are not obvious. Upon intermediate and high speed, the injuries of the above parts are from automobiles. Injuries of the left leg, femur, and right knee are from automobiles; left knee injuries are from automobiles, the road pavement and automobiles, respectively, upon low, intermediate, and high speed. The source laws of indirect torso injuries are not obvious upon intermediate and low speed, which are from automobiles upon high speed, while direct torso injuries are from the road pavement. And there is no high correlation between all parts of the injury of riders. The largest correlation coefficient was the head-left femur and left femur-right femur, which was 0.647, followed by the head-right femur (0.638 and head-torso which was 0.617.

  20. Injury Source and Correlation Analysis of Riders in Car-Electric Bicycle Accidents.

    Science.gov (United States)

    Zou, Tiefang; Yi, Liang; Cai, Ming; Hu, Lin; Li, Yuelin

    2018-01-01

    The knowledge about the injury source and correlation of riders in car-electric bicycle accident will be helpful in the cross validation of traces and vehicle safety design. In order to know more information about such kind of knowledge, 57 true car-electric bicycle accidents were reconstructed by PC-Crash and then data on injury information of riders were collected directly from the reconstructed cases. These collected data were validated by some existing research results firstly, and then 4 abnormal cases were deleted according to the statistical method. Finally, conclusions can be obtained according to the data obtained from the remaining 53 cases. Direct injuries of the head and right leg are from the road pavement upon low speed; the source laws of indirect head injuries are not obvious. Upon intermediate and high speed, the injuries of the above parts are from automobiles. Injuries of the left leg, femur, and right knee are from automobiles; left knee injuries are from automobiles, the road pavement and automobiles, respectively, upon low, intermediate, and high speed. The source laws of indirect torso injuries are not obvious upon intermediate and low speed, which are from automobiles upon high speed, while direct torso injuries are from the road pavement. And there is no high correlation between all parts of the injury of riders. The largest correlation coefficient was the head-left femur and left femur-right femur, which was 0.647, followed by the head-right femur (0.638) and head-torso which was 0.617.

  1. Evaluation of pancreatic exocrine insufficiency by cine-dynamic MRCP using spatially selective inversion-recovery (IR) pulse: Correlation with severity of chronic pancreatitis based on morphological changes of pancreatic duct.

    Science.gov (United States)

    Yasokawa, Kazuya; Ito, Katsuyoshi; Kanki, Akihiko; Yamamoto, Akira; Torigoe, Teruyuki; Sato, Tomohiro; Tamada, Tsutomu

    2018-05-01

    To evaluate the correlation between the pancreatic exocrine insufficiency estimated by cine-dynamic MRCP using spatially selective IR pulse and the severity stages (modified Cambridge classification) based on morphological changes of the pancreatic duct in patients with suspected chronic pancreatitis. Thirty-nine patients with suspected chronic pancreatitis underwent cine-dynamic MRCP with a spatially selective IR pulse. The secretion grading score (5-point scale) based on the moving distance of pancreatic juice inflow on cine-dynamic MRCP was assessed, and compared with the stage of the severity of chronic pancreatitis based on morphological changes of pancreatic duct. The stage of the severity of chronic pancreatitis based on morphological changes had significant negative correlations with the secretion grade (r=-0.698, P0.70 in 2 (33%) of 6 patients showing normal pancreatic exocrine function. It should be noted that the degree of morphological changes of pancreatic duct does not necessarily reflect the severity of pancreatic exocrine insufficiency at cine-dynamic MRCP in stage 2-3 chronic pancreatitis. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Histopathologic correlation of magnetic resonance imaging signal patterns in a spinal cord injury model.

    Science.gov (United States)

    Weirich, S D; Cotler, H B; Narayana, P A; Hazle, J D; Jackson, E F; Coupe, K J; McDonald, C L; Langford, L A; Harris, J H

    1990-07-01

    Magnetic resonance imaging (MRI) provides a noninvasive method of monitoring the pathologic response to spinal cord injury. Specific MR signal intensity patterns appear to correlate with degrees of improvement in the neurologic status in spinal cord injury patients. Histologic correlation of two types of MR signal intensity patterns are confirmed in the current study using a rat animal model. Adult male Sprague-Dawley rats underwent spinal cord trauma at the midthoracic level using a weight-dropping technique. After laminectomy, 5- and 10-gm brass weights were dropped from designated heights onto a 0.1-gm impounder placed on the exposed dura. Animals allowed to regain consciousness demonstrated variable recovery of hind limb paraplegia. Magnetic resonance images were obtained from 2 hours to 1 week after injury using a 2-tesla MRI/spectrometer. Sacrifice under anesthesia was performed by perfusive fixation; spinal columns were excised en bloc, embedded, sectioned, and observed with the compound light microscope. Magnetic resonance axial images obtained during the time sequence after injury demonstrate a distinct correlation between MR signal intensity patterns and the histologic appearance of the spinal cord. Magnetic resonance imaging delineates the pathologic processes resulting from acute spinal cord injury and can be used to differentiate the type of injury and prognosis.

  3. Connective tissue injury in calf muscle tears and return to play: MRI correlation.

    Science.gov (United States)

    Prakash, Ashutosh; Entwisle, Tom; Schneider, Michal; Brukner, Peter; Connell, David

    2017-10-26

    The aim of our study was to assess a group of patients with calf muscle tears and evaluate the integrity of the connective tissue boundaries and interfaces. Further, we propose a novel MRI grading system based on integrity of the connective tissue and assess any correlation between the grading score and time to return to play. We have also reviewed the anatomy of the calf muscles. We retrospectively evaluated 100 consecutive patients with clinical suspicion and MRI confirmation of calf muscle injury. We evaluated each calf muscle tear with MRI for the particular muscle injured, location of injury within the muscle and integrity of the connective tissue structure at the interface. The muscle tears were graded 0-3 depending on the degree of muscle and connective tissue injury. The time to return to play for each patient and each injury was found from the injury records and respective sports doctors. In 100 patients, 114 injuries were detected. Connective tissue involvement was observed in 63 out of 100 patients and failure (grade 3 injury) in 18. Mean time to return to play with grade 0 injuries was 8 days, grade 1 tears was 17 days, grade 2 tears was 25 days and grade 3 tears was 48 days (pmuscle tears. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Directory of Open Access Journals (Sweden)

    Humberto Ferreira Arquez

    2017-11-01

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

  5. Seizure Severity Is Correlated With Severity of Hypoxic-Ischemic Injury in Abusive Head Trauma.

    Science.gov (United States)

    Dingman, Andra L; Stence, Nicholas V; O'Neill, Brent R; Sillau, Stefan H; Chapman, Kevin E

    2017-12-12

    The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma. We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored. Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (r s =0.61, P interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03). Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury. Published by Elsevier Inc.

  6. Localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images: findings of malignancy prediction

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Wan; Kim, Gab Chul; Jeong, Han Young; Lee, Hui Joong; Lee, Jae Hyuck; Ryeom, Hun Kyu [Kyungpook National University Hospital, Daegu (Korea, Republic of); Kim, Jong Yeol [Kumi Cha Medical Center, Collge of Medicine, Pochon CHA University, Kumi (Korea, Republic of)

    2008-09-15

    This study was preformed to evaluate factors that can predict the presence of a malignancy for localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images. A total of 29 patients (male: 16, female: 13) who had localized intrahepatic bile duct dilatation without a visible mass, stone or injury as depicted on CT images were included in the study. A history of extrahepatic malignancy and biliary stone disease, tumor marker levels, CT findings of the intrahepatic bile duct and associated findings were reviewed. The findings were analyzed between two groups (patients with a malignancy and patients with benign disease) on follow-up. In 29 patient, 11 patients had malignant lesions (four metastases and seven cholangiocarcinomas). The history of an extrahepatic malignancy and the shape of an intrahepatic duct obstruction or stenosis as seen on CT were significantly correlated with the results between the benign and malignant group of patients. The follow-up results of the malignant group of patients indicated that for six patients who had developed a new mass, one patient each showed aggravation of ductal dilatation and thickening of the ductal wall. When a patient with localized intrahepatic bile duct dilatation without a definite cause has a history of an extrahepatic malignancy or shows abrupt tapering or irregular narrowing on CT images, short-term follow-up should be performed. The patient should be investigated carefully for mass formation or a change of the dilated bile duct due to a possibility of malignant ductal dilatation.

  7. Localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images: findings of malignancy prediction

    International Nuclear Information System (INIS)

    Choi, Ju Wan; Kim, Gab Chul; Jeong, Han Young; Lee, Hui Joong; Lee, Jae Hyuck; Ryeom, Hun Kyu; Kim, Jong Yeol

    2008-01-01

    This study was preformed to evaluate factors that can predict the presence of a malignancy for localized intrahepatic bile duct dilatation without a visible mass or stone as depicted on CT images. A total of 29 patients (male: 16, female: 13) who had localized intrahepatic bile duct dilatation without a visible mass, stone or injury as depicted on CT images were included in the study. A history of extrahepatic malignancy and biliary stone disease, tumor marker levels, CT findings of the intrahepatic bile duct and associated findings were reviewed. The findings were analyzed between two groups (patients with a malignancy and patients with benign disease) on follow-up. In 29 patient, 11 patients had malignant lesions (four metastases and seven cholangiocarcinomas). The history of an extrahepatic malignancy and the shape of an intrahepatic duct obstruction or stenosis as seen on CT were significantly correlated with the results between the benign and malignant group of patients. The follow-up results of the malignant group of patients indicated that for six patients who had developed a new mass, one patient each showed aggravation of ductal dilatation and thickening of the ductal wall. When a patient with localized intrahepatic bile duct dilatation without a definite cause has a history of an extrahepatic malignancy or shows abrupt tapering or irregular narrowing on CT images, short-term follow-up should be performed. The patient should be investigated carefully for mass formation or a change of the dilated bile duct due to a possibility of malignant ductal dilatation

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  9. [Correlation between morphogical factor of lateral plateau fracture and meniscus injury].

    Science.gov (United States)

    Bai, L; Zhou, W; Zhang, W T; Huang, W; You, T; Chen, P; Zhang, H L

    2016-04-18

    To analyze morphological character of lateral tibial plateau fracture fragment, and its correlation to the presence of a meniscus injury in tibial plateau fractures. A total of 79 consecutive patients of the simple lateral tibial plateau fractures from July 2011 to July 2015 were included in this study, with 65 males and 14 females with an average age of (34.3±7.2) years and 22-61 years. According to Schatzker classification, 21 cases were of Type I, 41 cases Type II, and 17 cases Type III. The characteristics of lateral tibial plateau fractures were evaluated by plain X-ray and magnetic resonance imaging (MRI). The type and severity of meniscus injury were diagnosed by MRI scan. Three-dimensional measurements of the lateral fragment width (LFW), the lateral plateau depression (LPD), the coronal angulation of lateral fragment (CALF), and tibial plateau widening (TPW) were measured with Picture Archiving and Communication Systems(PACS) software. The patients with and without meniscus injuries were divided into different groups and analyzed respectively. Comparison of the above measurements between the two groups was analyzed by independent t test. In all the 79 lateral tibial plateau fracture patients, 26 cases (32.9%) of meniscus injuries were detected by MRI. Among all the meniscus injury cases, 3 were of Schatzker I, 16 Schatzker II, and 7 Schatzker III. In meniscus intact group, the average LFW was (22.0±2.8) mm while in meniscus injury group it was (21.3± 3.3) mm (t=-1.008, P=0.317).The average LPD of non meniscus injury group was (5.4±2.8) mm, while in meniscus injury group was (8.7±2.8) mm (t=4.98, P=0.001). The average CALF of the two groups were 9.1°±6.1°and 10.6°± 7.1°, and there was no significant difference between the two groups (t=0.38, P=0.831). The average TPW was (3.0± 1.1) mm, and (4.8±1.7) mm of the two groups. There were significant differences between the two groups (t=5.216, P=0.001). There was no obvious correlation between the

  10. Walking and child pedestrian injury: a systematic review of built environment correlates of safe walking.

    Science.gov (United States)

    Rothman, Linda; Buliung, Ron; Macarthur, Colin; To, Teresa; Howard, Andrew

    2014-02-01

    The child active transportation literature has focused on walking, with little attention to risk associated with increased traffic exposure. This paper reviews the literature related to built environment correlates of walking and pedestrian injury in children together, to broaden the current conceptualization of walkability to include injury prevention. Two independent searches were conducted focused on walking in children and child pedestrian injury within nine electronic databases until March, 2012. Studies were included which: 1) were quantitative 2) set in motorized countries 3) were either urban or suburban 4) investigated specific built environment risk factors 5) had outcomes of either walking in children and/or child pedestrian roadway collisions (ages 0-12). Built environment features were categorized according to those related to density, land use diversity or roadway design. Results were cross-tabulated to identify how built environment features associate with walking and injury. Fifty walking and 35 child pedestrian injury studies were identified. Only traffic calming and presence of playgrounds/recreation areas were consistently associated with more walking and less pedestrian injury. Several built environment features were associated with more walking, but with increased injury. Many features had inconsistent results or had not been investigated for either outcome. The findings emphasise the importance of incorporating safety into the conversation about creating more walkable cities.

  11. MR imaging and histopathologic correlations of thermal injuries induced by interstitial laser applications

    International Nuclear Information System (INIS)

    Anzai, Y.; Lufkin, R.B.; Castro, D.J.; Farahani, K.; Chen, H.W.; Hirchowiz, S.

    1991-01-01

    Interstitial laser phototherapy for deep-seated tumors may become an attractive therapeutic modality when a noninvasive, accurate monitoring system is developed. In this paper, to devaluate the ability of MR imaging to differentiate reversible and irreversible thermal injuries induced by laser therapy, the precise correlation of MR and histopathologic findings are investigated in the in vivo model. Nd:YAG lasers were applied to normal musculature of rabbits, and MR examinations were performed immediately after laser exposure and followed up for up to 10 weeks. The sequential MR images were correlated with histopathologic findings. T2-weighted MR imaging clearly showed laser-induced thermal injuries on any postoperative day. MR imaging of acute thermal injuries showed a central cavity, low-signal zone of coagulative necrosis and a peripheral high-signal layer of interstitial edema. The infiltration of neutrophils followed by fibrovascular response was identified on the marginal edema layer after 6 postoperative days

  12. Correlation between subacute sensorimotor deficits and brain water content after surgical brain injury in rats

    OpenAIRE

    McBride, Devin W.; Wang, Yuechun; Sherchan, Prativa; Tang, Jiping; Zhang, John H.

    2015-01-01

    Brain edema is a major contributor to poor outcome and reduced quality of life after surgical brain injury (SBI). Although SBI pathophysiology is well-known, the correlation between cerebral edema and neurological deficits has not been thoroughly examined in the rat model of SBI. Thus, the purpose of this study was to determine the correlation between brain edema and deficits in standard sensorimotor neurobehavior tests for rats subjected to SBI. Sixty male Sprague-Dawley rats were subjected ...

  13. Statistical and perceptual updating: correlated impairments in right brain injury.

    Science.gov (United States)

    Stöttinger, Elisabeth; Filipowicz, Alex; Marandi, Elahe; Quehl, Nadine; Danckert, James; Anderson, Britt

    2014-06-01

    It has been hypothesized that many of the cognitive impairments commonly seen after right brain damage (RBD) can be characterized as a failure to build or update mental models. We (Danckert et al. in Neglect as a disorder of representational updating. NOVA Open Access, New York, 2012a; Cereb Cortex 22:2745-2760, 2012b) were the first to directly assess the association between RBD and updating and found that RBD patients were unable to exploit a strongly biased play strategy in their opponent in the children's game rock, paper, scissors. Given that this game required many other cognitive capacities (i.e., working memory, sustained attention, reward processing), RBD patients could have failed this task for various reasons other than a failure to update. To assess the generality of updating deficits after RBD, we had RBD, left brain-damaged (LBD) patients and healthy controls (HCs) describe line drawings that evolved gradually from one figure (e.g., rabbit) to another (e.g., duck) in addition to the RPS updating task. RBD patients took significantly longer to alter their perceptual report from the initial object to the final object than did LBD patients and HCs. Although both patient groups performed poorly on the RPS task, only the RBD patients showed a significant correlation between the two, very different, updating tasks. We suggest these data indicate a general deficiency in the ability to update mental representations following RBD.

  14. Correlating learning and memory improvements to long-term potentiation in patients with brain injury

    Institute of Scientific and Technical Information of China (English)

    Xingfu Peng; Qian Yu

    2008-01-01

    BACKGROUND:Brain injury patients often exhibit learning and memory functional deficits.Long-term potentiation(LTP)is a representative index for studying learning and memory cellular models; the LTP index correlates to neural plasticity. OBJECTIVE:This study was designed to investigate correlations of learning and memory functions to LTP in brain injury patients,and to summarize the research advancements in mechanisms underlying brain functional improvements after rehabilitation intervention. RETRIEVAL STRATEGY:Using the terms "brain injuries,rehabilitation,learning and memory,long-term potentiation",manuscripts that were published from 2000-2007 were retrieved from the PubMed database.At the same time,manuscripts published from 2000-2007 were also retrieved from the Database of Chinese Scientific and Technical Periodicals with the same terms in the Chinese language.A total of 64 manuscripts were obtained and primarily screened.Inclusion criteria:studies on learning and memory,as well as LTP in brain injury patients,and studies focused on the effects of rehabilitation intervention on the two indices; studies that were recently published or in high-impact journals.Exclusion criteria:repetitive studies.LITERATURE EVALUATION:The included manuscripts primarily focused on correlations between learning and memory and LTP,the effects of brain injury on learning and memory,as well as LTP,and the effects of rehabilitation intervention on learning and memory after brain injury.The included 39 manuscripts were clinical,basic experimental,or review studies. DATA SYNTHESIS:Learning and memory closely correlates to LTP.The neurobiological basis of learning and memory is central nervous system plasticity,which involves neural networks,neural circuits,and synaptic connections,in particular,synaptic plasticity.LTP is considered to be an ideal model for studying synaptic plasticity,and it is also a classic model for studying neural plasticity of learning and memory.Brain injury

  15. Examining the Correlation between Objective Injury Parameters, Personality Traits and Adjustment Measures among Burn Victims

    Directory of Open Access Journals (Sweden)

    Josef Mordechai Haik

    2015-03-01

    Full Text Available Background: Burn victims experience immense physical and mental hardship during their process of rehabilitation and regaining functionality. We examined different objective burn related factors as well as psychological ones, in the form of personality traits, that may affect the rehabilitation process and its outcome. Objective: To assess the influence and correlation of specific personality traits and objective injury related parameters on the adjustment of burn victims post-injury. Methods: 62 male patients admitted to our burn unit due to burn injuries were compared with 36 healthy male individuals by use of questionnaires to assess each group's psychological adjustment parameters. Multivariate and hierarchical regression analysis was conducted to identify differences between the groups. Results: A significant negative correlation was found between the objective burn injury severity (e.g. TBSA and burn depth and the adjustment of burn victims (p<0.05, p<0.001, table 3. Moreover, patients more severely injured tend to be more neurotic (p<0.001, and less extroverted and agreeable (p<0.01, table 4. Conclusions: Extroverted burn victims tend to adjust better to their post-injury life while the neurotic patients tend to have difficulties adjusting. This finding may suggest new tools for early identification of maladjustment-prone patients and therefore provide them with better psychological support in a more dedicated manner.

  16. Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2015-11-01

    Full Text Available The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS included 21,699 students (predominantly ≤13 to ≥17 years that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were “fall” (9.9% and motor vehicle accident or being hit by a motor vehicle (5.4%, and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2% and a broken bone or dislocated joint (4.2%. In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status, substance use (tobacco and cannabis use, frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied, psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.

  17. Unintentional Injuries and Psychosocial Correlates among in-School Adolescents in Malaysia.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2015-11-20

    The study aimed to provide estimates of the prevalence and psychosocial correlates of unintentional injury among school-going adolescents in Malaysia. Cross-sectional data from the Global School-Based Health Survey (GSHS) included 21,699 students (predominantly ≤13 to ≥17 years) that were selected by a two-stage cluster sample design to represent all secondary school students in Forms 1 to 5. The percentage of school children reporting one or more serious injuries in the past year was 34.9%, 42.1% of boys and 27.8% of girls. The two major causes of the most serious injury were "fall" (9.9%) and motor vehicle accident or being hit by a motor vehicle (5.4%), and the most frequent type of injury sustained was cut, puncture, or stab wound (6.2%) and a broken bone or dislocated joint (4.2%). In multivariable logistic regression analysis, sociodemographic factors (being male and low socioeconomic status), substance use (tobacco and cannabis use), frequent soft drink consumption, attending physical education classes three or more times a week, other risky behavior (truancy, ever having had sex, being bullied), psychological distress, and lack of parental or guardian bonding were associated with annual injury prevalence. Several factors were identified, which could be included in injury prevention promotion programs among secondary school children.

  18. Significance of radiographic abnormalities in patients with tibial stress injuries: correlation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kijowski, Richard; Choi, James; Smet, Arthur de; Mukharjee, Rajat

    2007-01-01

    The objective was to correlate radiographic findings with magnetic resonance imaging (MRI) findings in patients with suspected tibial stress injuries in order to determine the significance of radiographic signs of stress injury in these individuals. The study group consisted of 80 patients with suspected tibial stress injuries who underwent a radiographic and MR examination of the tibia. Nineteen patients had bilateral involvement. Thus, a total of 99 tibias were evaluated. All radiographs and MR examinations were retrospectively reviewed, 1 month apart, in consensus by two musculoskeletal radiologists. The radiographs were reviewed without knowledge of the site of the clinical symptoms. Fisher's exact tests were used to determine the association between a positive radiograph and the presence of various MRI signs of a high-grade stress injury. There was a strong association between the presence of periosteal reaction on radiographs at the site of the clinical symptoms and a Fredericson grade 4 stress injury on MRI. The presence of periosteal reaction on radiographs at the site of clinical symptoms is predictive of a high-grade stress injury by MRI criteria. (orig.)

  19. Correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists in single-vehicle crashes.

    Science.gov (United States)

    Wang, Chen; Lu, Linjun; Lu, Jian; Wang, Tao

    2016-01-01

    In order to improve motorcycle safety, this article examines the correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists, under multiple precrash conditions. Ten-year crash data for single-vehicle motorcycle crashes from the General Estimates Systems (GES) were analyzed, using partial proportional odds models (i.e., generalized ordered logit models). The modeling results show that "braking (no lock-up)" is associated with a higher probability of increased severity, whereas "braking (lock-up)" is associated with a higher probability of decreased severity, under all precrash conditions. "Steering" is associated with a higher probability of reduced injury severity when other vehicles are encroaching, whereas it is correlated with high injury severity under other conditions. "Braking and steering" is significantly associated with a higher probability of low severity under "animal encounter and object presence," whereas it is surprisingly correlated with high injury severity when motorcycles are traveling off the edge of the road. The results also show that a large number of motorcyclists did not perform any crash avoidance maneuvers or conducted crash avoidance maneuvers that are significantly associated with high injury severity. In general, this study suggests that precrash maneuvers are an important factor associated with motorcyclists' injury severity. To improve motorcycle safety, training/educational programs should be considered to improve safety awareness and adjust driving habits of motorcyclists. Antilock brakes and such systems are also promising, because they could effectively prevent brake lock-up and assist motorcyclists in maneuvering during critical conditions. This study also provides valuable information for the design of motorcycle training curriculum.

  20. Attachment Style, Social Support, and Coping as Psychosocial Correlates of Happiness in Persons with Spinal Cord Injuries

    Science.gov (United States)

    Wilson, Lisa; Catalano, Denise; Sung, Connie; Phillips, Brian; Chou, Chih-Chin; Chan, Jacob Yui Chung; Chan, Fong

    2013-01-01

    Objective: To examine the roles of attachment, social support, and coping as psychosocial correlates in predicting happiness in people with spinal cord injuries. Design: Quantitative descriptive research design using multiple regression and correlation techniques. Participants: 274 individuals with spinal cord injuries. Outcome Measures: Happiness…

  1. Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

    Science.gov (United States)

    Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

    2014-09-01

    The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

  2. Blocked Tear Duct

    Science.gov (United States)

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

  3. Spinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion.

    Science.gov (United States)

    Martínez-Pérez, R; Paredes, I; Cepeda, S; Ramos, A; Castaño-León, A M; García-Fuentes, C; Lobato, R D; Gómez, P A; Lagares, A

    2014-05-01

    In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. We retrospectively reviewed 108 patients diagnosed with traumatic spinal cord injury after cervical trauma between 1990-2011. Plain films, CT, and MR imaging were performed on patients and then reviewed for this study. MR imaging was performed within 96 hours after cervical trauma for all patients. Data regarding ligamentous injury, disk injury, and the extent of the spinal cord injury were collected from an adequate number of MR images. We evaluated anterior longitudinal ligaments, posterior longitudinal ligaments, and the ligamentum flavum. Length of lesion, disk disruption, and ligamentous injury association, as well as the extent of the spinal cord injury were statistically assessed by means of univariate analysis, with the use of nonparametric tests and multivariate analysis along with linear regression. There were significant differences in lesion length on T2-weighted images for anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum in the univariate analysis; however, when this was adjusted by age, level of injury, sex, and disruption of the soft tissue evaluated (disk, anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum) in a multivariable analysis, only ligamentum flavum showed a statistically significant association with lesion length. Furthermore, the number of ligaments affected had a positive correlation with the extension of the lesion. In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies

  4. Considering built environment and spatial correlation in modelling pedestrian injury severity

    DEFF Research Database (Denmark)

    Prato, Carlo G.; Kaplan, Sigal; Patrier, Alexandre

    traffic calming measures, illumination solutions, road maintenance programs and speed limit reductions. Moreover, this study emphasises the role of the built environment, as shopping areas, residential areas, and walking traffic density are positively related to a reduction in pedestrian injury severity......This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by posing attention on the built environment and considering spatial correlation...... of pedestrians to sustain a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users, and crashes with heavy vehicles and in roads with higher speed limits...

  5. Considering built environment and spatial correlation in modelling pedestrian injury severity

    DEFF Research Database (Denmark)

    Prato, Carlo G.; Kaplan, Sigal; Patrier, Alexandre

    2018-01-01

    traffic calming measures, illumination solutions, road maintenance programs and speed limit reductions. Moreover, this study emphasises the role of the built environment, as shopping areas, residential areas, and walking traffic density are positively related to a reduction in pedestrian injury severity......This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by posing attention on the built environment and considering spatial correlation...... of pedestrians to sustain a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users, and crashes with heavy vehicles and in roads with higher speed limits...

  6. Blunt hepatic and splenic trauma in children: correlation of a CT injury severity scale with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Ruess, L. [Dept. of Diagnostic Imaging and Radiology, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences, Washington, DC (United States); Sivit, C.J. [Dept. of Diagnostic Imaging and Radiology, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences, Washington, DC (United States)]|[Dept. of Pediatrics, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences, Washington, DC (United States); Eichelberger, M.R. [Dept. of Pediatrics, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences, Washington, DC (United States)]|[Dept. of Surgery, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences Washington, DC (United States); Taylor, G.A. [Dept. of Diagnostic Imaging and Radiology, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences, Washington, DC (United States); Bond, S.J. [Dept. of Surgery, Children`s National Medical Center, and George Washington Univ. School of Medicine and Health Sciences Washington, DC (United States)

    1995-07-01

    The purpose of this report is to compare a computed tomography (CT) injury severity scale for hepatic and splenic injury with the following outcome measures: requirement for surgical hemostasis, requirement for blood transfusion and late complications. Sixty-nine children with isolated hepatic injury and 53 with isolated splenic injury were prospectively classified at CT according to extent of parenchymal involvement. Clinical records were reviewed to determine clinical outcome. Ninety-seven children (80%) were managed non-operatively without transfusion. One child with hepatic injury required surgical hemostasis, and 17 (25%) required transfusion of blood. Increasing severity of hepatic injury at CT was associated with progressively greater frequency of transfusion (P = 0.002 by {chi}{sup 2}-test). One child with splenic injury underwent surgery and eight (15%) required transfusion of blood. Splenic injury grade at CT did not correlate with frequency (P = 0.41 by {chi}{sup 2}-test) or amount (P = 0.35 by factorial analysis of variance) of transfusion. There was one late complication in the nonsurgical group. A majority of children with hepatic and splenic injury were managed non-operatively without requiring blood transfusion. The severity of injury by CT scan did not correlate with need for surgery. Increasing grade of hepatic injury at CT was associated with increasing frequency of blood transfusion. CT staging was not discriminatory in predicting transfusion requirement in splenic injury. (orig.)

  7. Blunt hepatic and splenic trauma in children: correlation of a CT injury severity scale with clinical outcome

    International Nuclear Information System (INIS)

    Ruess, L.; Sivit, C.J.; Eichelberger, M.R.; Taylor, G.A.; Bond, S.J.

    1995-01-01

    The purpose of this report is to compare a computed tomography (CT) injury severity scale for hepatic and splenic injury with the following outcome measures: requirement for surgical hemostasis, requirement for blood transfusion and late complications. Sixty-nine children with isolated hepatic injury and 53 with isolated splenic injury were prospectively classified at CT according to extent of parenchymal involvement. Clinical records were reviewed to determine clinical outcome. Ninety-seven children (80%) were managed non-operatively without transfusion. One child with hepatic injury required surgical hemostasis, and 17 (25%) required transfusion of blood. Increasing severity of hepatic injury at CT was associated with progressively greater frequency of transfusion (P = 0.002 by χ 2 -test). One child with splenic injury underwent surgery and eight (15%) required transfusion of blood. Splenic injury grade at CT did not correlate with frequency (P = 0.41 by χ 2 -test) or amount (P = 0.35 by factorial analysis of variance) of transfusion. There was one late complication in the nonsurgical group. A majority of children with hepatic and splenic injury were managed non-operatively without requiring blood transfusion. The severity of injury by CT scan did not correlate with need for surgery. Increasing grade of hepatic injury at CT was associated with increasing frequency of blood transfusion. CT staging was not discriminatory in predicting transfusion requirement in splenic injury. (orig.)

  8. Plasma creatine kinase B correlates with injury severity and symptoms in professional boxers.

    Science.gov (United States)

    Kilianski, Joseph; Peeters, Sophie; Debad, Jeff; Mohmed, Joseph; Wolf, Steven E; Minei, Joseph P; Diaz-Arrastia, Ramon; Gatson, Joshua W

    2017-11-01

    Each year in the United States, approximately 1.7 million people sustain a traumatic brain injury (TBI). Of these TBI events, about 75 percent are characterized as being mild brain injuries. Immediately following TBI, a secondary brain damage persists for hours, days, and even months. Previously, detection of neuronal and glial biomarkers have proven to be useful to predict neurological outcomes. Here, we hypothesized that creatine kinase, brain (CKBB) is a sensitive biomarker for acute secondary brain injury in professional boxers. Blood (8cc) was collected from the boxing athletes (n=18) prior to and after competition (∼30min). The plasma levels of CKBB were measured using the Meso Scale Diagnostic (MSD) electrochemiluminescence (ECL) array-based multiplex format. Additional data such as number of blows to the head and symptom score (Rivermead Post Concussion Symptoms Questionnaire) were collected. At approximately 30min after the competition, the plasma levels of CKBB were significantly elevated in concussed professional boxers and correlated with the number of blows to the head and symptom scores. Additionally, receiver operating curve (ROC) analysis yielded a 77.8% sensitivity and a specificity of 82.4% with an area under the curve (AUC) of 90% for CKBB as an identifier of secondary brain injury within this population. This study describes the detection of CKBB as a brain biomarker to detect secondary brain injury in professional athletes that have experienced multiple high impact blows to the head. This acute biomarker may prove useful in monitoring secondary brain injury after injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.

    Science.gov (United States)

    Salzler, Matthew J; Kirwan, Hollie J; Scarborough, Donna M; Walker, James T; Guarino, Anthony J; Berkson, Eric M

    2016-11-01

    Minimalist running is increasing in popularity based upon a concept that it can reduce impact forces and decrease injury rates. The purpose of this investigation is to identify the rate and severity of injuries in runners transitioning from traditional to minimalist footwear. The secondary aims were to identify factors correlated with injuries. Fourteen habitually shod (traditional running shoes) participants were enrolled for this prospective study investigating injury prevalence during transition from traditional running shoes to 5-toed minimalist shoes. Participants were uninjured, aged between 22-41 years, and ran at least twenty kilometers per week in traditional running shoes. Participants were given industry recommended guidelines for transition to minimalist footwear and fit with a 5-toed minimalist running shoe. They completed weekly logs for identification of injury, pain using Visual Analogue Scale (VAS), injury location, and severity. Foot strike pattern and impact forces were collected using 3D motion analysis at baseline, 4 weeks, and 12 weeks. Injuries were scored according to a modified Running Injury Severity Score (RISS). Fourteen runners completed weekly training and injury logs over an average of 30 weeks. Twelve of 14 (86%) runners sustained injuries. Average injury onset was 6 weeks (range 1-27 weeks). Average weekly mileage of 23.9 miles/week prior to transition declined to 18.3 miles/week after the transition. The magnitude of the baseline impact transient peak in traditional shoes and in minimalist shoes negatively correlated with RISS scores (r = -0.45, p = 0.055 and r = -0.53, p = 0.026, respectively). High injury rates occurred during the transition from traditional to minimalist footwear. Non-compliance to transition guidelines and high injury rates suggest the need for improved education. High impact transient forces unexpectedly predicted lower modified RISS scores in this population.

  10. Correlation between bone contusion and ligament, menisci injury of knee joint

    International Nuclear Information System (INIS)

    Zhang Lijuan; Li Pei; Tu Changzhuo; Wu Guangren; Qi Yuliang; Yan Xiaoqun

    2004-01-01

    Objective: To evaluate the correlation between bone contusion and ligament, meniscus injury of knee joint with MR imaging. Methods: Thirty-five patients with acute trauma of knee joint were studied retrospectively. All eases showed negative on X-ray and bone cont, -sion on MR imaging. Results: in all patients, ligament and meniscus injury were seen in 25 cases (71%), incorporate anterior cruciate ligament injury in 12 cases, posterior cruciate ligament in 6, tibial collateral ligament in 8 cases, fibular collateral ligament in 6 cases, medial meniscus tear in 4 cases, lateral meniscus tear in 5 cases, and hydrops in 29 cases. There were only 3 patients with ligament or meniscus injury but no bone contusion during the same period. Conclusion: It is necessary to check by MR for the patients with acute trauma of knee joint, who have clinical symptom such as ache, swelling, move un-freely showing bone contusion on MR Imaging but without any abnormality on X-ray in order to avoid failure in diagnosing injury of ligament and meniscus. (authors)

  11. Correlation between muscle electrical impedance data and standard neurophysiologic parameters after experimental neurogenic injury

    International Nuclear Information System (INIS)

    Ahad, M; Rutkove, S B

    2010-01-01

    Previous work has shown that electrical impedance measurements of muscle can assist in quantifying the degree of muscle atrophy resulting from neuronal injury, with impedance values correlating strongly with standard clinical parameters. However, the relationship between such data and neurophysiologic measurements is unexplored. In this study, 24 Wistar rats underwent sciatic crush, with measurement of the 2–1000 kHz impedance spectrum, standard electrophysiological measures, including nerve conduction studies, needle electromyography, and motor unit number estimation (MUNE) before and after sciatic crush, with animals assessed weekly for 4 weeks post-injury. All electrical impedance values, including a group of 'collapsed' variables, in which the spectral characteristics were reduced to single values, showed reductions as high as 47.2% after sciatic crush, paralleling and correlating with changes in compound motor action potential amplitude, conduction velocity and most closely to MUNE, but not to the presence of fibrillation potentials observed on needle electromyography. These results support the concept that localized impedance measurements can serve as surrogate makers of nerve injury; these measurements may be especially useful in assessing nerve injury impacting proximal or axial muscles where standard quantitative neurophysiologic methods such as nerve conduction or MUNE cannot be readily performed

  12. Correlations of radiological assessment of skeletal maturity and orthopaedic injuries in the standardbred

    International Nuclear Information System (INIS)

    Pasolini, M.P.; Meomartino, L.; Fatone, G.; Brunetti, A.; Laratta, I.

    2003-01-01

    The aim of this study was to define a correlation between the incidence of orthopaedic injuries and the skeletal maturity, radiologically assessed, in a group of 23 standardbred horses. Starting at 18 months of age, radiograms of calcaneus and distal radial physis were taken at two months intervals, until X-ray evidence of closure. All the physis were blindly graded as: C: open physis; B-: initial evidence of central closure; B: partially closed physis; B+: full closure of the central portion of the physis; A: closed physis. Based on this classification, the horses were grouped as I (immature subject - C, B- and B), or M (mature subject - B+ and A). Orthopaedic injuries were classified as major lesion, if causing prolonged or definitive interruption of training, or minor, if causing brief or no interruption of training. Estimation of injury incidence in the different groups was calculated using the chi-square test (significance level P0.01). The average ages of physis closure (mean +- SD) were 24.1 +- 2.6 months (range 19-28), for the calcaneal physis, and 28.2 +- 2 months (range 26-33), for the distal radial physis, without significant differences between colts and fillies. In our study, according to a previous report, no correlation between X-ray skeletal maturity and incidence of orthopaedic injuries was demonstrated [it

  13. No correlation between initial arterial carboxyhemoglobin level and degree of lung injury following ovine burn and smoke inhalation.

    Science.gov (United States)

    Lange, Matthias; Cox, Robert A; Traber, Daniel L; Hamahata, Atsumori; Nakano, Yoshimitsu; Traber, Lillian D; Enkhbaatar, Perenlei

    2014-04-01

    Fire victims often suffer from burn injury and concomitant inhalation trauma, the latter significantly contributing to the morbidity and mortality in these patients. Measurement of blood carboxyhemoglobin levels has been proposed as a diagnostic marker to verify and, perhaps, quantify the degree of lung injury following inhalation trauma. However, this correlation has not yet been sufficiently validated. A total of 77 chronically instrumented sheep received sham injury, smoke inhalation injury, or combined burn and inhalation trauma following an established protocol. Arterial carboxyhemoglobin concentrations were determined directly after injury and correlated to several clinical and histopathological determinants of lung injury that were detected 48 hours post-injury. The injury induced severe impairment of pulmonary gas exchange and increases in transvascular fluid flux, lung water content, and airway obstruction scores. No significant correlations were detected between initial carboxyhemoglobin levels and all measured clinical and histopathological determinants of lung injury. In conclusion, the amount of arterial carboxyhemoglobin concentration cannot predict the degree of lung injury at 48 hours after ovine burn and smoke inhalation trauma.

  14. Patellofemoral Instability in Children: Correlation Between Risk Factors, Injury Patterns, and Severity of Cartilage Damage.

    Science.gov (United States)

    Kim, Hee Kyung; Shiraj, Sahar; Kang, Chang Ho; Anton, Christopher; Kim, Dong Hoon; Horn, Paul S

    2016-06-01

    The purpose of this study was to compare MRI findings between groups with and without patellofemoral instability and to correlate the MRI findings with the severity of patellar cartilage damage. Fifty-three children with patellofemoral instability and 53 age- and sex-matched children without patellofemoral instability (15.9 ± 2.4 years) were included. Knee MRI with T2-weighted mapping was performed. On MR images, femoral trochlear dysplasia, patellofemoral malalignment, medial retinaculum injury, and bone marrow edema were documented. The degree of patellar cartilage damage was evaluated on MR images by use of a morphologic grading scale (0-4) and on T2 maps with mean T2 values at the medial, central, and lateral facets. MRI findings were compared between the two groups. In cases of patellofemoral instability, MRI findings were correlated with the severity of cartilage damage at each region. Trochlear structure and alignment were significantly different between the two groups (Wilcoxon p patellofemoral instability, a high-riding patella was associated with central patellar cartilage damage with a higher morphologic grade and T2 value (Spearman p patellofemoral instability have significantly different trochlear structure and alignment than those who do not, and these differences are known risk factors for patellofemoral instability. However, the only risk factors or injury patterns that directly correlated with the severity of patellar cartilage damage were patella alta, medial stabilizer injury, and bone marrow edema.

  15. Hepatopulmonary syndrome induced by common bile duct ligation in a rabbit model: correlation between pulmonary vascular dilatation on thin-section CT and angiography and serum nitrite concentration or endothelial nitric oxide synthase (eNOS)1 expression

    International Nuclear Information System (INIS)

    Lee, Ki Nam; Yoon, Seong Kuk; Lee, Jin Wha; Kim, Ki Nam; Park, Byung Ho; Kwak, Jong Young; Jeong, Jin Sook; Kim, Young Hoon

    2004-01-01

    To investigate the correlation between radiologic vascular dilatation and serum nitrite concentration and eNOS expression in the endothelial cell and pneumocyte in a rabbit model of hepatopulmonary syndrome induced by common bile duct ligation (CBDL). Thin-section CT scans of the lung and pulmonary angiography were obtained 3 weeks after CBDL (n=6), or a sham operation (n=4), and intrapulmonary vasodilatation was assessed. The diameter and tortuosity of peripheral vessels in the right lower lobe by thin-section CT and angiography at the same level of the right lower lobe in all subjects were correlated to serum nitrite concentration and eNOS (endothelial nitric oxide synthase) expression as determined by immunostaining. The diameters of pulmonary vessels on thin-section CT were well correlated with nitrite concentrations in serum (r=0.92, ρ < 0.001). Dilated pulmonary vessels were significantly correlated with an increased eNOS expression (r=0.94, ρ < 0.0001), and the severity of pulmonary vessel tortuosity was found to be well correlated with serum nitrite concentration (r=0.90, ρ < 0.001). The peripheral pulmonary vasculature in hepatopulmonary syndrome induced by CBLD was dilated on thin-section CT and on angiographs. Our findings suggest that peripheral pulmonary vascular dilatations are correlated with serum nitrite concentrations and pulmonary eNOS expression

  16. Congenital double bile duct presenting as recurrent cholangitis in a child

    Directory of Open Access Journals (Sweden)

    K.D. Chakravarty

    2015-12-01

    Full Text Available Double common bile duct (DCBD is a rare congenital anomaly. Most of these bile duct anomalies are associated with bile duct stones, anomalous pancreaticobiliary junction (APBJ, pancreatitis and bile duct or gastric cancers. Early detection and treatment is important to avoid long term complications. Surgical resection of the anomalous bile duct and reconstruction of the biliary enteric anastomosis is the treatment of choice. We report a rare case of DCBD anomaly in a girl, who presented with recurrent cholangitis. She had type Va DCBD anomaly. She underwent successful resection of the bile duct and reconstruction of the biliary enteric anastomosis. Preoperative imaging and diagnosis of the congenital biliary anomaly is very important to avoid intraoperative bile duct injury. Review of the literature shows very few cases of type Va DCBD, presenting with either bile duct stones or APBJ.

  17. Modified nasolacrimal duct stenting

    International Nuclear Information System (INIS)

    Tian Min; Jin Mei; Chen Huanjun; Li Yi

    2008-01-01

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

  18. Bile duct obstruction

    Science.gov (United States)

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

  19. Ducted fuel injection

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Charles J.

    2018-03-06

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

  20. Identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    PENG Lei

    2015-10-01

    Full Text Available ObjectiveTo investigate the identification and treatment of variation of extrahepatic bile duct in laparoscopic cholecystectomy (LC, and to reduce the occurrence of bile duct injury. MethodsThis study included 60 patients who received LC in the People′s Hospital of Caidian District in Wuhan and had structural variation of extrahepatic bile duct found during the operation from January 2012 to January 2014. The clinical data were retrospectively analyzed, and the intraoperative and postoperative conditions were summarized. ResultsDuring operation, cystic duct variation was found in 32 cases, abnormal position of the point where the cystic duct joins the extrahepatic bile duct in 20 cases, the cystic duct and the common hepatic duct having the common wall before joining the common bile duct in 2 cases, aberrant bile duct in the gallbladder bed in 2 cases, and accessory hepatic duct in 4 cases. Fifty-one patients (85% successfully underwent LC; 9 patients (15% were converted to open surgery. All patients finished surgery successfully. There were 2 cases of postoperative complications; one patient developed residual stones in the bile duct, and bile leakage occurred in the other patient at one week after LC, who recovered after reoperation. All patients were cured and discharged, without severe complications such as intraperitoneal hemorrhage, infection, and intestinal injury. ConclusionIdentifying the structural variation of extrahepatic bile duct, dissecting the Calot′s triangle meticulously, and determining the type of variation of extrahepatic bile duct play important roles in LC and significantly reduce the incidence of bile duct injury.

  1. Chest and spine radiography abnormality in blunt chest trauma correlated with major vessel injury in an unselected patient population

    International Nuclear Information System (INIS)

    Fernandez, G.; Kadir, S.; Encarnacion, C.

    1989-01-01

    To assess the true incidence of major vessel injury, the authors retrospectively reviewed all arch aortograms obtained for blunt chest trauma (BCT) during a 24-month period beginning December 1986. Aortograms were correlated with preangiographic chest radiographic and operative findings. The goals of this review were to examine the usefulness of commonly employed screening criteria for aortography and determine whether thoracic spine fractures imply a decreased likelihood of aortic injury. One hundred twenty aortograms were obtained during this period. The incidence of aortic laceration was 6.7%, and 7.5% had brachiocerebral vascular injury. Only 51% of chest radiographs were suggestive of vascular injury. Two patients with subtle radiographic findings had aortic laceration. One patient with a burst fracture of T-4 had aortic laceration. The results of this review indicate the incidence of great vessel injury is as high as that of injury to the aorta itself and that the presence of spine fractures does not exclude vascular injury

  2. The correlation between the imaging characteristics of hamstring injury and time required before returning to sports: a literature review.

    Science.gov (United States)

    Svensson, Kjell; Alricsson, Marie; Eckerman, Mattias; Magounakis, Theofilos; Werner, Suzanne

    2016-06-01

    Injuries to the hamstring muscles are common in athletes. Track and field, Australian football, American football and soccer are examples of sports where hamstring injuries are the most common. The purpose of this study was to investigate whether there is a correlation between a hamstring injury prognosis and its characteristics of imaging parameters. The literature search was performed in the databases PubMed and CINAHL, and eleven articles were included. Seven out of the 11 articles showed a correlation between the size of the hamstring injury and length of time required before returning to sports. Different authors have reported contrasting results about length of time required before returning to sports due to location of injury within specific muscle. Majority of the articles found hamstring strain correlated to an extended amount of time required before returning to sports.

  3. A correlative study between prevalence of chondromalacia patellae and sports injury in 4068 students.

    Science.gov (United States)

    Zhang, Hui; Kong, Xiang-qing; Cheng, Cong; Liang, Mao-hua

    2003-12-01

    To study the prevalence of chondromalacia patella among college students and the correlation with sports injury. 354 students from gymnastic department and 429 from nongymnastic department with knee joint pain were selected. 184 students from gymnastic department and 342 from nongymnastic department were checked randomly by a surgeon. 77 patients (37 males, 40 females) from gymnastic department and 119 patients (62 males, 57 females) from nongymnastic department were diagnosed as chondromalacia patellae. The amount of exercise and the occurrence of sports injury were investigated in each student. All data were analyzed with SPSS 10.0 statistical software. The prevalence of chondromalacia patella was 20.1% in female students and 11.6% in male students from gymnastic department, and 5.61% in female students and 4.92% in male students from nongymnastic department. The amount of exercise and the occurrence of sports injury to the knee joint in students from gymnastic department were greater than those from nongymnastic department. In both female and male students, the prevalence of chondromalacia patella is higher in gymnastic department than nongymnastic department. Sports injury is an important cause of chondromalacia patella.

  4. Correlation between subacute sensorimotor deficits and brain water content after surgical brain injury in rats.

    Science.gov (United States)

    McBride, Devin W; Wang, Yuechun; Sherchan, Prativa; Tang, Jiping; Zhang, John H

    2015-09-01

    Brain edema is a major contributor to poor outcome and reduced quality of life after surgical brain injury (SBI). Although SBI pathophysiology is well-known, the correlation between cerebral edema and neurological deficits has not been thoroughly examined in the rat model of SBI. Thus, the purpose of this study was to determine the correlation between brain edema and deficits in standard sensorimotor neurobehavior tests for rats subjected to SBI. Sixty male Sprague-Dawley rats were subjected to either sham surgery or surgical brain injury via partial frontal lobectomy. All animals were tested for neurological deficits 24 post-SBI and fourteen were also tested 72 h after surgery using seven common behavior tests: modified Garcia neuroscore (Neuroscore), beam walking, corner turn test, forelimb placement test, adhesive removal test, beam balance test, and foot fault test. After assessing the functional outcome, animals were euthanized for brain water content measurement. Surgical brain injury resulted in significantly elevated frontal lobe brain water content 24 and 72 h after surgery compared to that of sham animals. In all behavior tests, significance was observed between sham and SBI animals. However, a correlation between brain water content and functional outcome was observed for all tests except Neuroscore. The selection of behavior tests is critical to determine the effectiveness of therapeutics. Based on this study's results, we recommend using beam walking, the corner turn test, the beam balance test, and the foot fault test since correlations with brain water content were observed at both 24 and 72 h post-SBI. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Correlation between subacute sensorimotor deficits and brain water content after surgical brain injury in rats

    Science.gov (United States)

    McBride, Devin W.; Wang, Yuechun; Sherchan, Prativa; Tang, Jiping; Zhang, John H.

    2015-01-01

    Brain edema is a major contributor to poor outcome and reduced quality of life after surgical brain injury (SBI). Although SBI pathophysiology is well-known, the correlation between cerebral edema and neurological deficits has not been thoroughly examined in the rat model of SBI. Thus, the purpose of this study was to determine the correlation between brain edema and deficits in standard sensorimotor neurobehavior tests for rats subjected to SBI. Sixty male Sprague-Dawley rats were subjected to either sham surgery or surgical brain injury via partial frontal lobectomy. All animals were tested for neurological deficits 24 post-SBI and fourteen were also tested 72 hours after surgery using seven common behavior tests: modified Garcia neuroscore (Neuroscore), beam walking, corner turn test, forelimb placement test, adhesive removal test, beam balance test, and foot fault test. After assessing the functional outcome, animals were euthanized for brain water content measurement. Surgical brain injury resulted in a significantly elevated frontal lobe brain water content 24 and 72 hours after surgery compared to that of sham animals. In all behavior tests, significance was observed between sham and SBI animals. However, a correlation between brain water content and functional outcome was observed for all tests except Neuroscore. The selection of behavior tests is critical to determine the effectiveness of therapeutics. Based on this study’s results, we recommend using beam walking, the corner turn test, the beam balance test, and the foot fault test since correlations with brain water content were observed at both 24 and 72 hours post-SBI. PMID:25975171

  6. Larger ATV engine size correlates with an increased rate of traumatic brain injury.

    Science.gov (United States)

    Butts, C Caleb; Rostas, Jack W; Lee, Y L; Gonzalez, Richard P; Brevard, Sidney B; Frotan, M Amin; Ahmed, Naveed; Simmons, Jon D

    2015-04-01

    Since the introduction of all-terrain vehicles (ATV) to the United States in 1971, injuries and mortalities related to their use have increased significantly. Furthermore, these vehicles have become larger and more powerful. As there are no helmet requirements or limitations on engine-size in the State of Alabama, we hypothesised that larger engine size would correlate with an increased incidence of traumatic brain injury (TBI) in patients following an ATV crash. Patient and ATV data were prospectively collected on all ATV crashes presenting to a level one trauma centre from September 2010 to May 2013. Collected data included: demographics, age of driver, ATV engine size, presence of helmet, injuries, and outcomes. The data were grouped according to the ATV engine size in cubic centimetres (cc). For the purposes of this study, TBI was defined as any type of intracranial haemorrhage on the initial computed tomography scan. There were 61 patients identified during the study period. Two patients (3%) were wearing a helmet at the time of injury. Patients on an ATV with an engine size of 350 cc or greater had higher Injury Severity Scores (13.9 vs. 7.5, p ≤ 0.05) and an increased incidence of TBI (26% vs. 0%, p ≤ 0.05) when compared to patients on ATV's with an engine size less than 350 cc. Patients on an ATV with an engine size of 350 cc or greater were more likely to have a TBI. The use of a helmet was rarely present in this cohort. Legislative efforts to implement rider protection laws for ATVs are warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Curved-Duct

    Directory of Open Access Journals (Sweden)

    Je Hyun Baekt

    2000-01-01

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

  8. Bile ductal injury and ductular reaction are frequent phenomena with different significance in autoimmune hepatitis.

    Science.gov (United States)

    Verdonk, Robert C; Lozano, Mallaki F; van den Berg, Aad P; Gouw, Annette S H

    2016-09-01

    The significance of bile duct injury and ductular reaction in biopsies from autoimmune hepatitis patients is not clear. We aim to establish the prevalence and clinical relevance of both phenomena in autoimmune hepatitis. Cases of newly diagnosed, untreated autoimmune hepatitis without overlap syndrome were selected. Pretreatment and follow up biopsies were scored for inflammation, fibrosis, bile ductal injury and ductular reaction. Thirty-five cases were studied of whom 14 cases had follow up biopsies. Bile duct injury was present in 29 cases (83%), mostly in a PBC-like pattern and was not correlated with demographical or laboratory findings. Ductular reaction, observed in 25 of 35 cases (71%) using conventional histology and in 30 of 32 cases (94%) using immunohistochemistry, was correlated with portal and lobular inflammation, interface hepatitis and centrilobular necrosis as well as bile duct injury and fibrosis. In 11 of 14 cases (79%) ductular reaction remained present on post-treatment biopsy whereas bile duct injury persisted in six of 14 (43%) of cases. Bile duct injury and ductular reaction are very common in newly diagnosed autoimmune hepatitis and cannot be predicted biochemically. Bile duct injury may subside in the majority of treated AIH cases while DR tends to persist during follow up. These findings show that the two phenomena are part of the spectrum of AIH with dissimilar responses to treatment and do not necessarily point towards an overlap syndrome. Persistence of ductular reaction after treatment supports the notion that it represents a regenerative response. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  10. Patent arterial duct

    Directory of Open Access Journals (Sweden)

    Martin Robin P

    2009-07-01

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

  11. Prevalence and regional correlates of road traffic injury among Chinese urban residents: A 21-city population-based study.

    Science.gov (United States)

    Rockett, Ian R H; Jiang, Shuhan; Yang, Qian; Yang, Tingzhong; Yang, Xiaozhao Y; Peng, Sihui; Yu, Lingwei

    2017-08-18

    This study estimated the prevalence of road traffic injury among Chinese urban residents and examined individual and regional-level correlates. A cross-sectional multistage process was used to sample residents from 21 selected cities in China. Survey respondents reported their history of road traffic injury in the past 12 months through a community survey. Multilevel, multivariable logistic regression analysis was used to identify injury correlates. Based on a retrospective 12-month reporting window, road traffic injury prevalence among urban residents was 13.2%. Prevalence of road traffic injury, by type, was 8.7, 8.7, 8.5, and 7.7% in the automobile, bicycle, motorcycle, and pedestrian categories, respectively. Multilevel analysis showed that prevalence of road traffic injury was positively associated with minority status, income, and mental health disorder score at the individual level. Regionally, road traffic injury was associated with geographic location of residence and prevalence of mental health disorders. Both individual and regional-level variables were associated with road traffic injury among Chinese urban residents, a finding whose implications transcend wholesale imported generic solutions. This descriptive research demonstrates an urgent need for longitudinal studies across China on risk and protective factors, in order to inform injury etiology, surveillance, prevention, treatment, and evaluation.

  12. Vitamin E levels in preeclampsia placenta tissue and its correlation with oxidative stress injury and apoptosis

    Directory of Open Access Journals (Sweden)

    Jun Li

    2017-04-01

    Full Text Available Objective: To study the vitamin E levels in preeclampsia placenta tissue and its correlation with oxidative stress injury and apoptosis. Methods: A total of 60 pregnant women with preeclampsia who received treatment and gave birth in our hospital between July 2012 and January 2016 were collected and divided into mild preeclampsia group (n=41 and severe preeclampsia group (n=19 according to the disease severity; 38 normal pregnant women who received pregnancy test and gave birth in our hospital during the same period were selected as healthy control group. The placental tissue samples of three groups of research subjects were retained, high performance liquid chromatograph-mass spectrometry was used to detect VitE levels in tissue grinding fluid, automatic biochemical analyzer was used to detect the levels of oxidative stress injury indexes, and fluorescence quantitative PCR method was used to detect the mRNA expression of apoptosis molecules. Results: VitE, SOD and CAT levels in grinding fluid of severe preeclampsia group were lower than those of mild preeclampsia group and healthy control group while ROS and AOPP levels were higher than those of mild preeclampsia group and healthy control group; Fas, caspase and Apaf-1 mRNA expression were higher than those of mild preeclampsia group and healthy control group while anti-apoptotic molecules Bcl-2, Bcl-xl, Mcl-2 and p57kip2 mRNA expression were lower than those of mild preeclampsia group and healthy control group. Spearman correlation analysis showed that VitE level in the preeclampsia placenta tissue was directly correlated with oxidative stress injury and cell apoptosis. Conclusion: VitE deficiency is the direct factor that results in oxidative stress and cell apoptosis in patients with preeclampsia, and the VitE supplementation in time is expected to become the auxiliary treatment means for patients with preeclampsia.

  13. Clinical and magnetic resonance imaging correlation in acute spinal cord injury

    International Nuclear Information System (INIS)

    Ramon, S.; Dominguez, R.; Ramirez, L.; Garcia Fernandez, L.

    1998-01-01

    The aim of this study was to correlate traumatic spinal cord injury (SCI) patients'outcome with magnetic resonance imaging (MRI) performed within the first 15 days following trauma. We retrospectively analyzed 55 SCI patients. Early functional prognosis may be established on the basis of clinical presentation of SCI and associated MRI. Cord hemorrhage and transection are irreversible, while edema has a potential for neurological recovery. Cord contusion tends to be associated with an incomplete SCI, unlike the compression pattern, in which the prognosis depends on the degree of the initial neurological damage. (author)

  14. Clinical and magnetic resonance imaging correlation in acute spinal cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Ramon, S.; Dominguez, R.; Ramirez, L.; Garcia Fernandez, L. [University Hospital Vall d`Hebron, Barcelona (Spain)

    1998-04-01

    The aim of this study was to correlate traumatic spinal cord injury (SCI) patients`outcome with magnetic resonance imaging (MRI) performed within the first 15 days following trauma. We retrospectively analyzed 55 SCI patients. Early functional prognosis may be established on the basis of clinical presentation of SCI and associated MRI. Cord hemorrhage and transection are irreversible, while edema has a potential for neurological recovery. Cord contusion tends to be associated with an incomplete SCI, unlike the compression pattern, in which the prognosis depends on the degree of the initial neurological damage. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

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

    International Nuclear Information System (INIS)

    Courtney, Malachi; Ayyagari, Raj R.

    2015-01-01

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

  17. Correlation of serum homocysteine levels with nerve injury and atherosclerosis in patients with stroke

    Directory of Open Access Journals (Sweden)

    Gai-Zhuang Liu

    2017-07-01

    Full Text Available Objective: To study the correlation of serum homocysteine levels with nerve injury and atherosclerosis in patients with stroke. Methods: Patients who were diagnosed with ischemic stroke in our hospital between January 2014 and December 2016 were selected and then divided into moderate-severe stenosis group (C group, mild stenosis group (B group and no stenosis group (A group according to carotid artery ultrasonography; healthy volunteers who received physical examination during the same period were chosen as control group. The serum levels of homocysteine, nerve injury indexes and atherosclerosis indexes were detected. Results: Serum Hcy, S100B, NSE, UCH-L1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels of C group, B group and A group were significantly higher than those of control group, and the severer the carotid stenosis, the higher the serum S100B, NSE, UCHL1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels; serum S100B, NSE, UCHL1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels in stoke patients with high Hcy were significantly higher than those of patients with normal Hcy. Conclusions: Serum homocysteine levels increase in patients with stroke and are closely related to the nerve injury and atherosclerosis.

  18. Brain lesion correlates of fatigue in individuals with traumatic brain injury.

    Science.gov (United States)

    Schönberger, Michael; Reutens, David; Beare, Richard; O'Sullivan, Richard; Rajaratnam, Shantha M W; Ponsford, Jennie

    2017-10-01

    The purpose of this study was to investigate the neurological correlates of both subjective fatigue as well as objective fatigability in individuals with traumatic brain injury (TBI). The study has a cross-sectional design. Participants (N = 53) with TBI (77% male, mean age at injury 38 years, mean time since injury 1.8 years) underwent a structural magnetic resonance imaging (MRI) scan and completed the Fatigue Severity Scale (FSS), while a subsample (N = 36) was also tested with a vigilance task. While subjective fatigue (FSS) was not related to measures of brain lesions, multilevel analyses showed that a change in the participants' decision time was significantly predicted by grey matter (GM) lesions in the right frontal lobe. The time-dependent development of the participants' error rate was predicted by total brain white matter (WM) lesion volumes, as well as right temporal GM and WM lesion volumes. These findings could be explained by decreased functional connectivity of attentional networks, which results in accelerated exhaustion during cognitive task performance. The disparate nature of objectively measurable fatigability on the one hand and the subjective experience of fatigue on the other needs further investigation.

  19. Particle deposition in ventilation ducts

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-09-01

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

  20. Surgical, pathological and clinical correlation of Tc-99m DISIDA hepatobiliary imaging in 138 adult males, in the diagnosis of functional cystic duct obstruction VS acute or chronic cholecystitis

    International Nuclear Information System (INIS)

    Yoo, J.H.K.; Beal, W.H.; Ware, R.W.; Straw, J.D.; Chaudhuri, T.K.

    1985-01-01

    Despite the wide acceptance of the hepatobiliary scintigraphy as a popular diagnostic imaging modality for gallbladder and hepatobiliary disease, correlation between radionuclide diagnoses and the final clinical and/or pathologic findings have not been thoroughly evaluated. The lack of correlative studies frequently generates difficulties in making appropriate diagnostic interpretation of the objective findings. A retrospective clinical pathological and surgical correlative study was undertaken by the authors in 138 male veteran patients, who underwent computer assisted minute by minute Tc-99m DISIDA cholescintigraphy. A very high percentage (75%) revealed abnormalities; non-visualization of gallbladder (GB) with normal choledochus system (46%), choledochal obstruction with no GB visualization (13%), choledochal obstruction with normal GB visualization (6%), severe hepatocellular disease with non-diagnostic GB (4%), and delayed GB visualization (longer than 60 minutes) (3%). Non-visualization of GB but normal choledochus demonstrated diverse pathologic etiologies, acute and chronic cholecystitis (64%), S/P cholecystectomy (8%), functional obstruction secondary to sepsis or pancreatitis (6%), and various other pathologies including porcelain GB and cholangitis (22%). The most important cause of choledochal obstruction was mass lesions or local infiltration with metastases (33%) rather than acute cholecystitis (27%). Although the sensitivity (98%) and specificity (92%) for cystic duct obstruction were very high, the specificity decreases significantly for cholecystitis

  1. Experimental evaluation of neural probe’s insertion induced injury based on digital image correlation method

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Wenguang, E-mail: zhwg@sjtu.edu.cn; Ma, Yakun; Li, Zhengwei [State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240 (China)

    2016-01-15

    Purpose: The application of neural probes in clinic has been challenged by probes’ short lifetime when implanted into brain tissue. The primary goal is to develop an evaluation system for testing brain tissue injury induced by neural probe’s insertion using microscope based digital image correlation method. Methods: A brain tissue phantom made of silicone rubber with speckle pattern on its surface was fabricated. To obtain the optimal speckle pattern, mean intensity gradient parameter was used for quality assessment. The designed testing system consists of three modules: (a) load module for simulating neural electrode implantation process; (b) data acquisition module to capture micrographs of speckle pattern and to obtain reactive forces during the insertion of the probe; (c) postprocessing module for extracting tissue deformation information from the captured speckle patterns. On the basis of the evaluation system, the effects of probe wedge angle, insertion speed, and probe streamline on insertion induced tissue injury were investigated. Results: The optimal quality speckle pattern can be attained by the following fabrication parameters: spin coating rate—1000 r/min, silicone rubber component A: silicone rubber component B: softener: graphite = 5 ml: 5 ml: 2 ml: 0.6 g. The probe wedge angle has a significant effect on tissue injury. Compared to wedge angle 40° and 20°, maximum principal strain of 60° wedge angle was increased by 40.3% and 87.5%, respectively; compared with a relatively higher speed (500 μm/s), the maximum principle strain within the tissue induced by slow insertion speed (100 μm/s) was increased by 14.3%; insertion force required by probe with convex streamline was smaller than the force of traditional probe. Based on the experimental results, a novel neural probe that has a rounded tip covered by a biodegradable silk protein coating with convex streamline was proposed, which has both lower insertion and micromotion induced tissue

  2. Squamous metaplasia of lactiferous ducts (SMOLD)

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  3. Effects of partial portal vein arterialization on the hilar bile duct in a rat model.

    Science.gov (United States)

    Guo, Shao-Hua; Li, Chong-Hui; Chen, Yong-Liang; Song, Jian-Ning; Zhang, Ai-Qun; Zhou, Cheng

    2011-10-01

    Liver revascularization is frequently required during the enlarged radical operation for hilar cholangiocarcinoma involving the hepatic artery. Researchers have carried out a number of experiments applying partial portal vein arterialization (PVA) in clinical practice. In this study we aimed to establish a theoretical basis for clinical application of partial PVA and to investigate the effects of partial PVA on rat hilar bile duct and hepatic functions. Thirty rats were randomly and equally assigned into 3 groups: control (group A), hepatic artery ligation+bile duct recanalization (group B), and partial PVA+bile duct recanalization (group C). Proliferation and apoptosis of rat hilar bile duct epithelial cells, arteriolar counts of the peribiliary plexus (PBP) of the bile duct wall, changes in serum biochemistry, and pathologic changes in the bile duct were assessed 1 month after operation. The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C (Philar bile duct epithelial cells were detected in any of the groups. The PBP arteriolar counts of the hilar bile duct wall were similar in groups A and C (P>0.05), but the count was lower in group B than in group A (Philar bile duct walls were observed only in group B. Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.

  4. Benign bile duct stenosis: diagnosis and treatment

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  5. [Bile duct lesions in laparoscopic cholecystectomy].

    Science.gov (United States)

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

    1994-09-01

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

  6. Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis.

    Science.gov (United States)

    Filardo, Giuseppe; Kon, Elizaveta; Tentoni, Francesco; Andriolo, Luca; Di Martino, Alessandro; Busacca, Maurizio; Di Matteo, Berardo; Marcacci, Maurilio

    2016-01-01

    Bone marrow oedema (BME) in the knee is a feature of several pathological conditions, and it has been described with high frequency in patients with acute anterior cruciate ligament (ACL) injury. The aim of this study is to evaluate the significance of BME, assessed in MRIs performed for ACL injury, with regards to clinical outcome and return to sport. A total of 134 patients (98 men, 36 women) with ACL tear and MRI knee scan within six months from trauma were analysed. The presence of BME was evaluated on MRI images considering: extension and hyperintensity, the WORMS score oedema classification, and measuring the BME area. The clinical results were documented by IKDC-subjective score and the sport activity level by Tegner score at a minimum of five years follow up. BME was present in 74 knees (55.2 %), with a mean area of 523 ± 370 mm². The presence of BME showed a gradual decrease over time (p = 0.008), being detectable in MRIs performed more than three months after trauma in just 25.0 % of cases. Although 54 % of the patients without BME after three months returned to their previous sport level, no patients with oedema reached a full sport recovery (p = 0.01). In the group that underwent ACL reconstruction, the BME area was significantly correlated with a return to the previous sport level at the mid/long-term follow-up (p = 0.038). BME is a common finding, which decreases over time after injury. However, when BME is still detectable it correlates with clinical prognosis, and even in sport-active patients undergoing ACL reconstruction, a higher BME area is a negative predictive factor for a successful outcome at the mid/long-term follow-up.

  7. Considering built environment and spatial correlation in modeling pedestrian injury severity.

    Science.gov (United States)

    Prato, Carlo G; Kaplan, Sigal; Patrier, Alexandre; Rasmussen, Thomas K

    2018-01-02

    This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by focusing attention on the built environment and considering spatial correlation across crashes. Reports for 6,539 pedestrian crashes occurred in Denmark between 2006 and 2015 were merged with geographic information system resources containing detailed information about the built environment and exposure at the crash locations. A linearized spatial logit model estimated the probability of pedestrians sustaining a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users and crashes with heavy vehicles and in roads with higher speed limits being related to the most severe outcomes. This study provides novel perspectives by showing positive spatial correlations of crashes with the same severity outcomes and emphasizing the role of the built environment in the proximity of the crash. This study emphasizes the need for thinking about traffic calming measures, illumination solutions, road maintenance programs, and speed limit reductions. Moreover, this study emphasizes the role of the built environment, because shopping areas, residential areas, and walking traffic density are positively related to a reduction in pedestrian injury severity. Often, these areas have in common a larger pedestrian mass that is more likely to make other road users more aware and attentive, whereas the same does not seem to apply to areas with lower pedestrian density.

  8. Correlation between brain injury and dysphagia in adult patients with stroke

    Directory of Open Access Journals (Sweden)

    Nunes, Maria Cristina de Alencar

    2012-01-01

    Full Text Available Introduction: In the literature, the incidence of oropharyngeal dysphagia in patients with cerebrovascular accident (AVE ranges 20-90%. Some studies correlate the location of a stroke with dysphagia, while others do not. Objective: To correlate brain injury with dysphagia in patients with stroke in relation to the type and location of stroke. Method: A prospective study conducted at the Hospital de Clinicas with 30 stroke patients: 18 women and 12 men. All patients underwent clinical evaluation and swallowing nasolaryngofibroscopy (FEES®, and were divided based on the location of the injury: cerebral cortex, cerebellar cortex, subcortical areas, and type: hemorrhagic or transient ischemic. Results: Of the 30 patients, 18 had ischemic stroke, 10 had hemorrhagic stroke, and 2 had transient stroke. Regarding the location, 10 lesions were in the cerebral cortex, 3 were in the cerebral and cerebellar cortices, 3 were in the cerebral cortex and subcortical areas, and 3 were in the cerebral and cerebellar cortices and subcortical areas. Cerebral cortex and subcortical area ischemic strokes predominated in the clinical evaluation of dysphagia. In FEES®, decreased laryngeal sensitivity persisted following cerebral cortex and ischemic strokes. Waste in the pharyngeal recesses associated with epiglottic valleculae predominated in the piriform cortex in all lesion areas and in ischemic stroke. A patient with damage to the cerebral and cerebellar cortices from an ischemic stroke exhibited laryngeal penetration and tracheal aspiration of liquid and honey. Conclusion: Dysphagia was prevalent when a lesion was located in the cerebral cortex and was of the ischemic type.

  9. Vitellointestinal Duct Anomalies in Infancy

    OpenAIRE

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

    2016-01-01

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

  10. Magnetohydrodynamics in rectangular ducts

    International Nuclear Information System (INIS)

    Lenhart, L.

    1994-04-01

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

  11. Correlation Between Subacute Sensorimotor Deficits and Brain Edema in Rats after Surgical Brain Injury.

    Science.gov (United States)

    McBride, Devin W; Wang, Yuechun; Adam, Loic; Oudin, Guillaume; Louis, Jean-Sébastien; Tang, Jiping; Zhang, John H

    2016-01-01

    No matter how carefully a neurosurgical procedure is performed, it is intrinsically linked to postoperative deficits resulting in delayed healing caused by direct trauma, hemorrhage, and brain edema, termed surgical brain injury (SBI). Cerebral edema occurs several hours after SBI and is a major contributor to patient morbidity, resulting in increased postoperative care. Currently, the correlation between functional recovery and brain edema after SBI remains unknown. Here we examine the correlation between neurological function and brain water content in rats 42 h after SBI. SBI was induced in male Sprague-Dawley rats via frontal lobectomy. Twenty-four hours post-ictus animals were subjected to four neurobehavior tests: composite Garcia neuroscore, beam walking test, corner turn test, and beam balance test. Animals were then sacrificed for right-frontal brain water content measurement via the wet-dry method. Right-frontal lobe brain water content was found to significantly correlate with neurobehavioral deficits in the corner turn and beam balance tests: the number of left turns (percentage of total turns) for the corner turn test and distance traveled for the beam balance test were both inversely proportional with brain water content. No correlation was observed for the composite Garcia neuroscore or the beam walking test.

  12. MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea Arthroscopic correlation and clinical significance

    International Nuclear Information System (INIS)

    Huegli, Rolf W.; Moelleken, Sonja M.C.; Stork, Alexander; Bonel, Harald M.; Bredella, Miriam A.; Meckel, Stephan; Genant, Harry K.; Tirman, Phillip F.J.

    2005-01-01

    Objective: To assess and describe post-traumatic articular cartilage injuries isolated to the trochlear groove and provide insight into potential mechanism of injury. Materials and methods: We retrospectively evaluated MR imaging findings of all knee MRIs performed at our institution over the last 2 years (2450). Thirty patients met the criteria of a cartilage injury confined to the trochlear groove. In 15 cases, which were included in our study, arthroscopic correlation was available. Each plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. Any additional pathological derangement was documented and information about the mechanism of injury was retrieved by chart review. Results: In all cases the cartilaginous injury was well demonstrated on MRI. In 13 patients additional pathological findings could be observed. The most frequently associated injury was a meniscal tear in nine patients. In eight cases, the arthroscopic grading of the trochlear injury matched exactly with the MRI findings. In the remaining seven cases, the discrepancy between MRI and arthroscopy was never higher than one grade. In 13 out of 15 of patients trauma mechanism could be evaluated. Twelve patients suffered an indirect twisting injury and one suffered a direct trauma to their knee. Conclusion: The findings of this study demonstrate that MR imaging allows reliable grading of isolated injury to the trochlear groove cartilage and assists in directing surgical diagnosis and treatment. These injuries may be the only hyaline cartilage injury in the knee and meniscal tears are a frequently associated finding. Therefore, it is important to search specifically for cartilage injuries of the trochlear groove in patients with anterior knee pain, even if other coexistent pathology could potentially explain the patient's symptoms

  13. MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea Arthroscopic correlation and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, Rolf W. E-mail: rhuegli@uhbs.ch; Moelleken, Sonja M.C.; Stork, Alexander; Bonel, Harald M.; Bredella, Miriam A.; Meckel, Stephan; Genant, Harry K.; Tirman, Phillip F.J

    2005-01-01

    Objective: To assess and describe post-traumatic articular cartilage injuries isolated to the trochlear groove and provide insight into potential mechanism of injury. Materials and methods: We retrospectively evaluated MR imaging findings of all knee MRIs performed at our institution over the last 2 years (2450). Thirty patients met the criteria of a cartilage injury confined to the trochlear groove. In 15 cases, which were included in our study, arthroscopic correlation was available. Each plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. Any additional pathological derangement was documented and information about the mechanism of injury was retrieved by chart review. Results: In all cases the cartilaginous injury was well demonstrated on MRI. In 13 patients additional pathological findings could be observed. The most frequently associated injury was a meniscal tear in nine patients. In eight cases, the arthroscopic grading of the trochlear injury matched exactly with the MRI findings. In the remaining seven cases, the discrepancy between MRI and arthroscopy was never higher than one grade. In 13 out of 15 of patients trauma mechanism could be evaluated. Twelve patients suffered an indirect twisting injury and one suffered a direct trauma to their knee. Conclusion: The findings of this study demonstrate that MR imaging allows reliable grading of isolated injury to the trochlear groove cartilage and assists in directing surgical diagnosis and treatment. These injuries may be the only hyaline cartilage injury in the knee and meniscal tears are a frequently associated finding. Therefore, it is important to search specifically for cartilage injuries of the trochlear groove in patients with anterior knee pain, even if other coexistent pathology could potentially explain the patient's symptoms.

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

    Science.gov (United States)

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

    2018-02-01

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

  15. Reciprocity principle in duct acoustics

    Science.gov (United States)

    Cho, Y.-C.

    1979-01-01

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

  16. Magnetic resonance imaging evaluation of acute crush injury of rabbit sciatic nerve: correlation with histology

    International Nuclear Information System (INIS)

    Li, X.; Shen, J.; Chen, J.; Wang, X.; Liu, Q.; Liang, B.

    2008-01-01

    To investigate the relation between the quantitative assessment of magnetic resonance imaging (MRI) features and the correlation with histology and functional recovery by using the rabbit sciatic nerve crush model. In New Zealand, 32 rabbits were randomly divided into 2 groups (group A and B); all rabbits underwent crushing injury of their left sciatic nerve. In group A (n = 16), the sciatic nerves were crushed by using microvessel clamps with a strength of 3.61 kg. In group B (n = 16), the sciatic nerves were crushed with a strength of 10.50 kg. Right sciatic nerves were served as controls. Serial MRI of both hind limbs in each rabbit was performed before and at the time point of 1, 2, 4, and 8 weeks after crushed injury. The MRI protocol included T1-weighted spin-echo (T1WI), 3 dimension turbo spin-echo T2-weighted (3DT2WI), T2-weighted turbo spin-echo images with spectral presaturation with inversion recovery (T2WI/SPIR), balanced fast-field echo (B-FFE) and short-time inversion recovery (STIR) sequences. The coronal image of the sciatic nerve was obtained. The nerve and muscle signal ratio (SIR) on each sequence was measured. The function recovery was observed and pathological examination was performed at each time point. A signal intensity increase of the distal segment of crushed sciatic nerves was found on 3DT2WI, T2WI/SP1R, B-FFE, and STIR, but not on T,WI images. Of 32 crushed nerves, 30 nerves showed high signal intensity. The correct diagnostic rate was 93.75% with false negative-positive of 6.25%. The SIR of the crushed sciatic nerve at distal portion was higher than those of the control nerves; there was a statistically significant difference (P 0.05). The SIR between group A and group B was not found statistically significantly different (P > 0.05). The SIR of crushed nerves at distal portion increased at one week after the crush injury, subsequently further increased, and reached a maximum at 2 weeks. The pathological examination revealed myelin

  17. Microstructural Consequences of Blast Lung Injury Characterized with Digital Volume Correlation

    Directory of Open Access Journals (Sweden)

    Hari Arora

    2017-12-01

    Full Text Available This study focuses on microstructural changes that occur within the mammalian lung when subject to blast and how these changes influence strain distributions within the tissue. Shock tube experiments were performed to generate the blast injured specimens (cadaveric Sprague-Dawley rats. Blast overpressures of 100 and 180 kPa were studied. Synchrotron tomography imaging was used to capture volumetric image data of lungs. Specimens were ventilated using a custom-built system to study multiple inflation pressures during each tomography scan. These data enabled the first digital volume correlation (DVC measurements in lung tissue to be performed. Quantitative analysis was performed to describe the damaged architecture of the lung. No clear changes in the microstructure of the tissue morphology were observed due to controlled low- to moderate-level blast exposure. However, significant focal sites of injury were observed using DVC, which allowed the detection of bias and concentration in the patterns of strain level. Morphological analysis corroborated the findings, illustrating that the focal damage caused by a blast can give rise to diffuse influence across the tissue. It is important to characterize the non-instantly fatal doses of blast, given the transient nature of blast lung in the clinical setting. This research has highlighted the need for better understanding of focal injury and its zone of influence (alveolar interdependency and neighboring tissue burden as a result of focal injury. DVC techniques show great promise as a tool to advance this endeavor, providing a new perspective on lung mechanics after blast.

  18. Correlation Between Euro NCAP Pedestrian Test Results and Injury Severity in Injury Crashes with Pedestrians and Bicyclists in Sweden.

    Science.gov (United States)

    Strandroth, Johan; Sternlund, Simon; Lie, Anders; Tingvall, Claes; Rizzi, Matteo; Kullgren, Anders; Ohlin, Maria; Fredriksson, Rikard

    2014-11-01

    Pedestrians and bicyclists account for a significant share of deaths and serious injuries in the road transport system. The protection of pedestrians in car-to-pedestrian crashes has therefore been addressed by friendlier car fronts and since 1997, the European New Car Assessment Program (Euro NCAP) has assessed the level of protection for most car models available in Europe. In the current study, Euro NCAP pedestrian scoring was compared with real-life injury outcomes in car-to-pedestrian and car-tobicyclist crashes occurring in Sweden. Approximately 1200 injured pedestrians and 2000 injured bicyclists were included in the study. Groups of cars with low, medium and high pedestrian scores were compared with respect to pedestrian injury severity on the Maximum Abbreviated Injury Scale (MAIS)-level and risk of permanent medical impairment (RPMI). Significant injury reductions to both pedestrians and bicyclists were found between low and high performing cars. For pedestrians, the reduction of MAIS2+, MAIS3+, RPMI1+ and RPMI10+ ranged from 20-56% and was significant on all levels except for MAIS3+ injuries. Pedestrian head injuries had the highest reduction, 80-90% depending on level of medical impairment. For bicyclist, an injury reduction was only observed between medium and high performing cars. Significant injury reductions were found for all body regions. It was also found that cars fitted with autonomous emergency braking including pedestrian detection might have a 60-70% lower crash involvement than expected. Based on these results, it was recommended that pedestrian protection are implemented on a global scale to provide protection for vulnerable road users worldwide.

  19. Assessment of motor recovery and MRI correlates in a porcine spinal cord injury model

    Directory of Open Access Journals (Sweden)

    Igor Šulla

    2014-01-01

    Full Text Available The study concentrated on behavioral and magnetic resonance imaging (MRI characteristics in a porcine spinal cord injury model. Six adult minipigs weighing 32–35 kg were narcotized by thiopental, intubated, and placed on a volume-cycled ventilator. Anaesthesia was maintained by 1.5% sevoflurane with oxygen. Following location of the 1st lumbar vertebra animals were fastened in an immobilization frame. The spinal cord, exposed through a laminectomy, was compressed by a 5 mm thick circular rod with a peak force of 0.8 kg at a velocity of 3 cm·s-1. The next day the minipigs were paraplegic but improved rapidly to paraparesis. On the 12th postoperative day they were euthanasied. Neural tissue changes were evaluated by post mortem MRI, which showed damage to the spinal cord white and/or gray matter in the epicentre of compression with longitudinal spreading over one segment cranially and caudally. Statistical analyses performed by Spearman’s rho test revealed positive correlations between damaged areas and the whole area of the spinal cord white/gray matter (P = 0.047; rs = 0.742 and (P = 0.002; rs = 0.943, respectively. The study confirmed the reliability and reproducibility of the utilised model of spinal cord trauma. The structural changes in the epicentre of injury did not impede the rapid but incomplete recovery of motor functions.

  20. Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms.

    Science.gov (United States)

    Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

    2015-08-01

    Unintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and children's behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in children's injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

  1. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.

    Directory of Open Access Journals (Sweden)

    Gabriela Ilie

    Full Text Available Our knowledge on the adverse correlates of traumatic brain injuries (TBI, including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario.Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS. Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9 of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52, attempting suicide (AOR = 3.39, seeking counselling through a crisis help-line (AOR = 2.10, and being prescribed medication for anxiety, depression, or both (AOR = 2.45. Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70, being cyber-bullied (AOR = 2.05, and being threatened with a weapon at school (AOR = 2.90, compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours.Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may

  2. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.

    Science.gov (United States)

    Ilie, Gabriela; Mann, Robert E; Boak, Angela; Adlaf, Edward M; Hamilton, Hayley; Asbridge, Mark; Rehm, Jürgen; Cusimano, Michael D

    2014-01-01

    Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce

  3. EKSTRAHEPATIC BILE DUCT CANCER

    OpenAIRE

    Aleš Tomažič; Dragan Stanisavljevič; Valentin Sojar; Blaž Trotovšek

    2003-01-01

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

  4. Noise suppression in duct

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  5. Bowing-reactivity trends in EBR-II assuming zero-swelling ducts

    International Nuclear Information System (INIS)

    Meneghetti, D.

    1994-01-01

    Predicted trends of duct-bowing reactivities for the Experimental Breeder Reactor II (EBR-II) are correlated with predicted row-wise duct deflections assuming use of idealized zero-void-swelling subassembly ducts. These assume no irradiation induced swellings of ducts but include estimates of the effects of irradiation-creep relaxation of thermally induced bowing stresses. The results illustrate the manners in which at-power creeps may affect subsequent duct deflections at zero power and thereby the trends of the bowing component of a subsequent power reactivity decrement

  6. EEG indices correlate with sustained attention performance in patients affected by diffuse axonal injury.

    Science.gov (United States)

    Coelli, Stefania; Barbieri, Riccardo; Reni, Gianluigi; Zucca, Claudio; Bianchi, Anna Maria

    2018-06-01

    The aim of this study is to assess the ability of EEG-based indices in providing relevant information about cognitive engagement level during the execution of a clinical sustained attention (SA) test in healthy volunteers and DAI (diffused axonal injury)-affected patients. We computed three continuous power-based engagement indices (P β /P α , 1/P α , and P β / (P α + P θ )) from EEG recordings in a control group (n = 7) and seven DAI-affected patients executing a 10-min Conners' "not-X" continuous performance test (CPT). A correlation analysis was performed in order to investigate the existence of relations between the EEG metrics and behavioral parameters in both the populations. P β /P α and 1/P α indices were found to be correlated with reaction times in both groups while P β / (P α + P θ ) and P β /P α also correlated with the errors rate for DAI patients. In line with previous studies, time course fluctuations revealed a first strong decrease of attention after 2 min from the beginning of the test and a final fading at the end. Our results provide evidence that EEG-derived indices extraction and evaluation during SA tasks are helpful in the assessment of attention level in healthy subjects and DAI patients, offering motivations for including EEG monitoring in cognitive rehabilitation practice. Graphical abstract Three EEG-derived indices were computed from four electrodes montages in a population of seven healthy volunteers and a group of seven DAI-affected patients. Results show a significant correlation between the time course of the indices and behavioral parameters, thus demonstrating their usefulness in monitoring mental engagement level during a sustained attention task.

  7. Biliary reconstruction options for bile duct stricture in patients with prior Roux-en-Y reconstruction.

    Science.gov (United States)

    Shah, Mihir M; Martin, Benjamin M; Stetler, Jamil L; Patel, Ankit D; Davis, S Scott; Lin, Edward; Sarmiento, Juan M

    2017-09-01

    Comprehensive description with illustrations of the 4 biliary reconstruction options for bile duct injury in patients with history of Roux-en-Y gastric bypass. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  8. BACTERIOLOGICAL INVESTIGATION ON Fasciola hepatica AND CATTLE BILIARY DUCTS

    Directory of Open Access Journals (Sweden)

    A. Panebianco

    2009-03-01

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

  9. Correlation between voluntary cough and laryngeal cough reflex flows in patients with traumatic brain injury.

    Science.gov (United States)

    Lee, Sang Chul; Kang, Seong-Woong; Kim, Min Tae; Kim, Yong Kyun; Chang, Won Hyuk; Im, Sang Hee

    2013-08-01

    To correlate voluntary cough and laryngeal cough reflex (LCR) flows in patients with traumatic brain injury (TBI). Cross-sectional study. University rehabilitation hospital. Patients with TBI (n=25) and healthy controls (n=48). Not applicable. Peak cough flows (PCFs) and LCR flows were measured using a peak flow meter at the oral-nasal interface. The largest value of 3 attempts was recorded for PCF and LCR, respectively. LCR was elicited by 20% solution of pharmaceutic-grade citric acid dissolved in sterile .15M NaCl solution that was inhaled from a nebulizer. PCF was 447.4 ± 99.0 L/min in the control group and 211.7 ± 58.2 L/min in the patient group. LCR was 209.2 ± 63.8L/min in the control group and 170.0 ± 59.7 L/min in the patient group. Both PCF (P=.000) and LCR (P=.013) were significantly reduced in patients with TBI compared to that of the control group. LCR was strongly related to the PCF in both control (R=.645; P=.000) and patient (R=.711; P=.000) groups. As LCR can be measured as a numerical value and significantly correlates with PCF, LCR can be used to estimate cough ability of patients with TBI who cannot cooperate with PCF measurement. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. [Retrospective analysis of correlative factors between digestive system injury and anticoagulant or antiplatelet-agents].

    Science.gov (United States)

    Cui, Ning; Luo, Hesheng

    2014-05-27

    To explore the correlative factors and clinical characteristics of digestive system injury during the treatment of anticoagulant and (or) antiplatelet-agents. A total of 1 443 hospitalized patients on anticoagulant and (or) antiplatelet-agents from January 2010 to December 2013 at Renmin Hospital of Wuhan University were analyzed retrospectively. Their length of hospital stay was from 5 to 27 days. Most of them were elderly males (n = 880, 61.0%) with an average age of (62 ± 6) years. 1 138 patients (78.9%) were farmers, workers or someone without a specific occupation. During the treatment of anticoagulant/antiplatelet-agents, statistical difference existed (P = 0.01) between positively and negatively previous digestive disease groups for actively newly occurring digestive system injury (16.0% (41/256) vs 15.9% (189/1 187)). After the dosing of anticoagulant and (or) antiplatelet-agents, 57 (66.3%, 57/86) patients were complicated by hemorrhage of digestive tract, taking 62.9% (61/97) of all positive result patients for Helicobacter pylori test. Comparing preventive PPI group with no PPI group, there was no marked statistical differences (P = 2.67) for digestive system complication (including hemorrhage of digestive tract) while receiving anticoagulant and (or) antiplatelet-agents (13.9% (74/533) vs 17.1% (156/910)). During anticoagulant and/or antiplatelet-agent therapy, 185 patients (12.8%) were complicated by peptic ulcer or peptic ulcer with bleeding, 40 patients (2.8%) had erosive gastritis and 5 (0.3%) developed acute gastric mucosal lesions. And 42 of 76 patients complicated by hemorrhage of digestive tract underwent endoscopic hemostasis while 2 patients were operated. Ninety-seven patients (6.7%) died, including 61 (62.9%, 61/97) from hemorrhage of digestive tract. The remainder became cured, improved and discharged. Moreover, no significant statistical differences existed (P = 2.29) among three combination group (aspirin, clopidogrel, warfarin), two

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

    Directory of Open Access Journals (Sweden)

    Seung Eun Lee

    2016-01-01

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

  12. Development of Metabolic Indicators of Burn Injury: Very Low Density Lipoprotein (VLDL and Acetoacetate Are Highly Correlated to Severity of Burn Injury in Rats

    Directory of Open Access Journals (Sweden)

    Maria-Louisa Izamis

    2012-07-01

    Full Text Available Hypermetabolism is a significant sequela to severe trauma such as burns, as well as critical illnesses such as cancer. It persists in parallel to, or beyond, the original pathology for many months as an often-fatal comorbidity. Currently, diagnosis is based solely on clinical observations of increased energy expenditure, severe muscle wasting and progressive organ dysfunction. In order to identify the minimum number of necessary variables, and to develop a rat model of burn injury-induced hypermetabolism, we utilized data mining approaches to identify the metabolic variables that strongly correlate to the severity of injury. A clustering-based algorithm was introduced into a regression model of the extent of burn injury. As a result, a neural network model which employs VLDL and acetoacetate levels was demonstrated to predict the extent of burn injury with 88% accuracy in the rat model. The physiological importance of the identified variables in the context of hypermetabolism, and necessary steps in extension of this preliminary model to a clinically utilizable index of severity of burn injury are outlined.

  13. The correlation of initial radiographic characteristics of distal radius fractures and injuries of the triangular fibrocartilage complex.

    Science.gov (United States)

    Kasapinova, K; Kamiloski, V

    2016-06-01

    Our purpose was to determine the correlation of initial radiographic parameters of a distal radius fracture with an injury of the triangular fibrocartilage complex. In a prospective study, 85 patients with surgically treated distal radius fractures were included. Wrist arthroscopy was used to identify and classify triangular fibrocartilage complex lesions. The initial radial length and angulation, dorsal angulation, ulnar variance and distal radioulnar distance were measured. Wrist arthroscopy identified a triangular fibrocartilage complex lesion in 45 patients. Statistical analysis did not identify a correlation with any single radiographic parameter of the distal radius fractures with the associated triangular fibrocartilage complex injuries. The initial radiograph of a distal radius fracture does not predict a triangular fibrocartilage complex injury. III. © The Author(s) 2016.

  14. Radiation resistant ducted superconductive coil

    International Nuclear Information System (INIS)

    Schleich, A.

    1976-01-01

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

  15. Duct having oscillatory side wall

    Science.gov (United States)

    Sprouse, Kenneth M.

    2018-04-03

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

  16. Decreasing Signs of Negative Affect and Correlated Self-Injury in an Individual with Mental Retardation and Mood Disturbances.

    Science.gov (United States)

    Lindauer, Steven E.; DeLeon, Iser G.; Fisher, Wayne W.

    1999-01-01

    This study evaluated effects of an enriched environment, based on a paired-choice preference assessment, on rates of self-injurious behavior (SIB) and frequency of negative affect displayed by a woman with mental retardation and a mood disorder. Results suggested that SIB and negative affect were highly correlated and that the enriched environment…

  17. Disrupted Gamma Synchrony after Mild Traumatic Brain Injury and Its Correlation with White Matter Abnormality

    Directory of Open Access Journals (Sweden)

    Chao Wang

    2017-10-01

    Full Text Available Mild traumatic brain injury (mTBI has been firmly associated with disrupted white matter integrity due to induced white matter damage and degeneration. However, comparatively less is known about the changes of the intrinsic functional connectivity mediated via neural synchronization in the brain after mTBI. Moreover, despite the presumed link between structural and functional connectivity, no existing studies in mTBI have demonstrated clear association between the structural abnormality of white matter axons and the disruption of neural synchronization. To investigate these questions, we recorded resting state EEG and diffusion tensor imaging (DTI from a cohort of military service members. A newly developed synchronization measure, the weighted phase lag index was applied on the EEG data for estimating neural synchronization. Fractional anisotropy was computed from the DTI data for estimating white matter integrity. Fifteen service members with a history of mTBI within the past 3 years were compared to 22 demographically similar controls who reported no history of head injury. We observed that synchronization at low-gamma frequency band (25–40 Hz across scalp regions was significantly decreased in mTBI cases compared with controls. The synchronization in theta (4–7 Hz, alpha (8–13 Hz, and beta (15–23 Hz frequency bands were not significantly different between the two groups. In addition, we found that across mTBI cases, the disrupted synchronization at low-gamma frequency was significantly correlated with the white matter integrity of the inferior cerebellar peduncle, which was also significantly reduced in the mTBI group. These findings demonstrate an initial correlation between the impairment of white matter integrity and alterations in EEG synchronization in the brain after mTBI. The results also suggest that disruption of intrinsic neural synchronization at low-gamma frequency may be a characteristic functional pathology

  18. Deficient conditioned pain modulation after spinal cord injury correlates with clinical spontaneous pain measures.

    Science.gov (United States)

    Albu, Sergiu; Gómez-Soriano, Julio; Avila-Martin, Gerardo; Taylor, Julian

    2015-02-01

    The contribution of endogenous pain modulation dysfunction to clinical and sensory measures of neuropathic pain (NP) has not been fully explored. Habituation, temporal summation, and heterotopic noxious conditioning stimulus-induced modulation of tonic heat pain intensity were examined in healthy noninjured subjects (n = 10), and above the level of spinal cord injury (SCI) in individuals without (SCI-noNP, n = 10) and with NP (SCI-NP, n = 10). Thermoalgesic thresholds, Cz/AFz contact heat evoked potentials (CHEPs), and phasic or tonic (30 seconds) heat pain intensity were assessed within the C6 dermatome. Although habituation to tonic heat pain intensity (0-10) was reported by the noninjured (10 s: 3.5 ± 0.3 vs 30 s: 2.2 ± 0.5 numerical rating scale; P = 0.003), loss of habituation was identified in both the SCI-noNP (3.8 ± 0.3 vs 3.6 ± 0.5) and SCI-NP group (4.2 ± 0.4 vs 4.9 ± 0.8). Significant temporal summation of tonic heat pain intensity was not observed in the 3 groups. Inhibition of tonic heat pain intensity induced by heterotopic noxious conditioning stimulus was identified in the noninjured (-29.7% ± 9.7%) and SCI-noNP groups (-19.6% ± 7.0%), but not in subjects with SCI-NP (+1.1% ± 8.0%; P pain modulation response correlated positively with Cz/AFz CHEP amplitude (ρ = 0.8; P = 0.015) and evoked heat pain intensity (ρ = 0.8; P = 0.007) in the SCI-NP group. Stepwise regression analysis revealed that the mean conditioned pain modulation (R = 0.72) correlated with pain severity and pressing spontaneous pain in the SCI-NP group. Comprehensive assessment of sensory dysfunction above the level of injury with tonic thermal test and conditioning stimuli revealed less-efficient endogenous pain modulation in subjects with SCI-NP.

  19. Transcystic duct treatment of common bile duct stones

    International Nuclear Information System (INIS)

    Amberg, J.R.; Chun, G.

    1981-01-01

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

  20. Computed Tomography Appearance of Early Radiation Injury to the Lung: Correlation With Clinical and Dosimetric Factors

    International Nuclear Information System (INIS)

    Jenkins, Peter; Welsh, Anne

    2011-01-01

    Purpose: To systematically assess the spectrum of radiologic changes in the lung after radiation therapy for non-small-cell lung cancer. Methods and Materials: We reviewed the cases of 146 patients treated with radical radiotherapy at our institution. All patients had computed tomography (CT) scans performed 3 months after completion of therapy. Radiographic appearances were categorized using a standard grading system. The association of these abnormalities with pretreatment factors and clinical radiation pneumonitis (RP) was investigated. Results: New intrapulmonary abnormalities were seen in 92 patients (63%). These were ground-glass opacity in 16 (11%), patchy consolidation in 19 (13%), and diffuse consolidation in 57 (39%). Twenty-five patients (17%) developed clinical symptoms of RP. Although 80% of the patients with RP had areas of consolidation seen on the posttreatment CT scan, the majority (74%) of patients with such radiographic changes were asymptomatic. For patients with lung infiltrates, the minimum isodose encompassing the volume of radiologic abnormality was usually ≥27 Gy. Traditional dose-volume metrics, pulmonary function tests, and the coadministration of angiotensin converting enzyme inhibitors (ACE-I) were all strongly correlated with the presence of radiologic injury on univariate analysis (p ≤ 0.002). There was also an inverse correlation between prior smoking history and CT scan changes (p = 0.02). On multivariate analysis, dosimetric parameters and the use of ACE-I retained significance (p = 0.005). Conclusions: Our findings suggest that there is substantial interindividual variation in lung radiosensitivity. ACE-I prevented the radiologic changes seen after high-dose radiation therapy, and their role as radioprotectants warrants further investigation.

  1. Differential metabolic rearrangements after cold storage are correlated with chilling injury resistance of peach fruits

    Directory of Open Access Journals (Sweden)

    Claudia A Bustamante

    2016-09-01

    Full Text Available Reconfiguration of the metabolome is a key component involved in the acclimation to cold in plants; however, few studies have been devoted to the analysis of the overall metabolite changes after cold storage of fruits prior to consumption. Here, metabolite profiling of six peach varieties with differential susceptibility to develop mealiness, a chilling-injury (CI symptom, was performed. According to metabolic content at harvest; after cold treatment; and after ripening, either following cold treatment or not; peach fruits clustered in distinct groups, depending on harvest-time, cold treatment, and ripening state. Both common and distinct metabolic responses among the six varieties were found; common changes including dramatic galactinol and raffinose rise; GABA, Asp and Phe increase; and 2-oxo-glutarate and succinate decrease. Raffinose content after long cold treatment quantitatively correlated to the degree of mealiness resistance of the different peach varieties; and thus, raffinose emerges as a candidate biomarker of this CI disorder. Xylose increase after cold treatment was found only in the susceptible genotypes, indicating a particular cell wall reconfiguration of these varieties while being cold-stored. Overall, results indicate that peach fruit differential metabolic rearrangements due to cold treatment, rather than differential metabolic priming before cold, are better related with CI resistance. The plasticity of peach fruit metabolism renders it possible to induce a diverse metabolite array after cold, which is successful, in some genotypes, to avoid CI

  2. Propagation of sound waves in ducts

    DEFF Research Database (Denmark)

    Jacobsen, Finn

    2000-01-01

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

  3. The early IL-6 and IL-10 response in trauma is correlated with injury severity and mortality

    DEFF Research Database (Denmark)

    Stensballe, J; Christiansen, M; Tønnesen, E

    2009-01-01

    BACKGROUND: Trauma has previously been shown to influence interleukin (IL)-6 and IL-10 levels, but the association of injury severity and mortality with IL-6 and IL-10 responses in the early phase of accidental trauma remains to be investigated. We wished to describe serum levels of IL-6 and IL-10...... in the first 24 h after trauma and to assess the relationship with severity of injury and mortality. METHODS: Prospective, descriptive cohort study in a Level 1 trauma centre, Copenhagen, Denmark. We included 265 consecutive adult trauma patients admitted directly from the accident scene during an 18-month...... period. Serum levels of IL-6 and IL-10 were measured upon arrival and at 6, 12, and 24 h after admittance using an enzyme-linked immunosorbent assay. Correlation analysis was used to assess the relationship between Injury Severity Score (ISS) and levels of IL-6 and IL-10. Analysis of variance was used...

  4. Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

    DEFF Research Database (Denmark)

    Sidaros, Annette; Skimminge, Arnold Jesper Møller; Liptrot, Matthew George

    2009-01-01

    with percent brain volume change (%BVC) ranging between − 0.6% and − 9.4% (mean − 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using......Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D...... scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy...

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  6. Baseball and softball sliding injuries: incidence and correlates during one high school league varsity season.

    Science.gov (United States)

    Stovak, Mark; Parikh, Amit; Harvey, Anne T

    2012-11-01

    To estimate injury rates associated with sliding in high school baseball and softball. Prospective cohort study. Community high school athletic events. Ten high school varsity baseball and softball teams over 1 season. All sliding attempts were recorded during each game and recorded as headfirst, feetfirst, or diveback. Base type, playing surface, and field conditions were also noted. Injury exposure rates by game exposures and sliding/diveback exposures. Data were collected from 153 baseball games and 166 softball games. A greater proportion of slides were associated with injury in softball than in baseball (42.0 and 4.9 per 1000 slides; P softball (55 vs 35 per 1000 slides; P = 0.74). More powerful studies are required to determine whether efforts to prevent baseball sliding injuries at the high school level should focus on better education in sliding technique or changes in equipment. Softball players are vulnerable to injury when wearing inadequate protective sliding apparel.

  7. Study of correlation between clinical, magnetic resonance imaging, and arthroscopic findings in meniscal and anterior cruciate ligament injuries

    Directory of Open Access Journals (Sweden)

    Subhash R Puri

    2013-01-01

    Full Text Available Background: Approx. 28% of patients presents to orthopedic OPD with complaints of knee pain. Common medical complications include an unstable knee, chronic knee pain, and post traumatic arthritis. Aim: To study the correlation between clinical, magnetic resonance imaging (MRI, and arthroscopic findings in knee injuries. Materials and Methods: About 30 cases with history of rotational injury having knee pain and recurrent swelling were subjected to study. Results: MRI had better sensitivity (0.95 vs. 0.85 and specificity (1.0 vs. 0.5 in comparison with clinical examination for medial meniscus. In lateral meniscus injury (sensitivity 0.65 vs. 0.61 and specificity 0.95 vs. 0.92 and in ACL injury (Sensitivity 0.77 vs. 0.8 and specificity 1.0 vs. 0.96 the sensitivity and specificity of MRI versus clinical examination showed minimal difference. Conclusion: Our conclusion is that carefully performed clinical examination can give equal or better diagnosis of meniscal and ACL injuries in comparison with MRI scan. MRI may be used as an additional tool for diagnosis.

  8. Hippocampal CA3 transcriptome signature correlates with initial precipitating injury in refractory mesial temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Silvia Y Bando

    Full Text Available BACKGROUND: Prolonged febrile seizures constitute an initial precipitating injury (IPI commonly associated with refractory mesial temporal lobe epilepsy (RMTLE. In order to investigate IPI influence on the transcriptional phenotype underlying RMTLE we comparatively analyzed the transcriptomic signatures of CA3 explants surgically obtained from RMTLE patients with (FS or without (NFS febrile seizure history. Texture analyses on MRI images of dentate gyrus were conducted in a subset of surgically removed sclerotic hippocampi for identifying IPI-associated histo-radiological alterations. METHODOLOGY/PRINCIPAL FINDINGS: DNA microarray analysis revealed that CA3 global gene expression differed significantly between FS and NFS subgroups. An integrative functional genomics methodology was used for characterizing the relations between GO biological processes themes and constructing transcriptional interaction networks defining the FS and NFS transcriptomic signatures and its major gene-gene links (hubs. Co-expression network analysis showed that: i CA3 transcriptomic profiles differ according to the IPI; ii FS distinctive hubs are mostly linked to glutamatergic signalization while NFS hubs predominantly involve GABAergic pathways and neurotransmission modulation. Both networks have relevant hubs related to nervous system development, what is consistent with cell genesis activity in the hippocampus of RMTLE patients. Moreover, two candidate genes for therapeutic targeting came out from this analysis: SSTR1, a relevant common hub in febrile and afebrile transcriptomes, and CHRM3, due to its putative role in epilepsy susceptibility development. MRI texture analysis allowed an overall accuracy of 90% for pixels correctly classified as belonging to FS or NFS groups. Histological examination revealed that granule cell loss was significantly higher in FS hippocampi. CONCLUSIONS/SIGNIFICANCE: CA3 transcriptional signatures and dentate gyrus morphology fairly

  9. Abnormalities of intrahepatic bile ducts in extrahepatic biliary atresia.

    Science.gov (United States)

    Raweily, E A; Gibson, A A; Burt, A D

    1990-12-01

    The infantile cholangiopathies are a group of conditions associated with neonatal jaundice, which include extrahepatic biliary atresia, paucity of intra-hepatic bile ducts and disorders associated with persistence of fetal biliary structures, the so-called ductal plate malformations. Although previously regarded as distinct entities, it has recently been suggested that they may represent parts of a disease spectrum in which the principal process is one of bile duct destruction, the morphological manifestations in individual cases being influenced by the stage of intra-uterine development at which such injury occurs and by the site within the biliary system at which there is maximum damage. To further examine this concept, we have studied liver biopsy specimens from 37 neonates with extrahepatic biliary atresia, with particular reference to abnormalities of the intrahepatic bile ducts. Paucity of intrahepatic ducts, defined as a bile duct: portal tract ratio of less than 0.9, was identified in six cases (16.2%). In eight cases (21.6%) we found concentric tubular ductal structures similar to those observed in ductal plate malformations. In one case, both abnormalities could be demonstrated. Our findings support the concept that there is overlap between the various types of infantile cholangiopathy.

  10. The correlation between pedestrian injury severity in real-life crashes and Euro NCAP pedestrian test results.

    Science.gov (United States)

    Strandroth, Johan; Rizzi, Matteo; Sternlund, Simon; Lie, Anders; Tingvall, Claes

    2011-12-01

    The aim of the present study was to estimate the correlation between Euro NCAP pedestrian rating scores and injury outcome in real-life car-to-pedestrian crashes, with special focus on long-term disability. Another aim was to determine whether brake assist (BA) systems affect the injury outcome in real-life car-to-pedestrian crashes and to estimate the combined effects in injury reduction of a high Euro NCAP ranking score and BA. In the current study, the Euro NCAP pedestrian scoring was compared with the real-life outcome in pedestrian crashes that occurred in Sweden during 2003 to 2010. The real-life crash data were obtained from the data acquisition system Swedish Traffic Accident Data Acquisition (STRADA), which combines police records and hospital admission data. The medical data consisted of International Classification of Diseases (ICD) diagnoses and Abbreviated Injury Scale (AIS) scoring. In all, approximately 500 pedestrians submitted to hospital were included in the study. Each car model was coded according to Euro NCAP pedestrian scores. In addition, the presence or absence of BA was coded for each car involved. Cars were grouped according to their scoring. Injury outcomes were analyzed with AIS and, at the victim level, with permanent medical impairment. This was done by translating the injury scores for each individual to the risk of serious consequences (RSC) at 1, 5, and 10 percent risk of disability level. This indicates the total risk of a medical disability for each victim, given the severity and location of injuries. The mean RSC (mRSC) was then calculated for each car group and t-tests were conducted to falsify the null hypothesis at p ≤ .05 that the mRSC within the groups was equal. The results showed a significant reduction of injury severity for cars with better pedestrian scoring, although cars with a high score could not be studied due to lack of cases. The reduction in RSC for medium-performing cars in comparison with low-performing cars

  11. Thermal performance test of the hot gas ducts of HENDEL

    International Nuclear Information System (INIS)

    Hishida, M.; Kunitomi, K.; Ioka, I.; Umenishi, K.; Tanaka, T.; Shimomura, H.; Sanokawa, K.

    1984-01-01

    A hot gas duct provided with internal thermal insulation is to be used for high-temperature gas-cooled reactors (HTGR). This type of hot gas duct has not been used so far in industrial facilities, and only a couple of tests on such a large-scale model of a hot gas duct have been conducted. The present report deals with the results of the thermal performance of the single tube type hot gas ducts which are installed as parts of a helium engineering demonstration loop (HENDEL). Uniform temperature and heat flux distribution at the surface of the duct were observed, the experimental correlations being obtained for the effective thermal conductivity of the internal thermal insulation layer. The measured temperature distribution of the pressure tube was in good agreement with the calculation by a TRUMP heat transfer computer code. The temperature distribution of the inner tube of the co-axial hot gas duct was evaluated and no hot spot was detected. These results would be very valuable for the design and development of HTGR. (orig.)

  12. Correlates of undefined cause of injury coded mortality data in Australia.

    Science.gov (United States)

    McKenzie, Kirsten; Chen, Linping; Walker, Susan M

    The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12,591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data. It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2,314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office. To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths.

  13. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers.

    Science.gov (United States)

    Wilk, Kevin E; Macrina, Leonard C; Fleisig, Glenn S; Porterfield, Ronald; Simpson, Charles D; Harker, Paul; Paparesta, Nick; Andrews, James R

    2011-02-01

    Glenohumeral internal rotation deficit (GIRD) indicates a 20° or greater loss of internal rotation of the throwing shoulder compared with the nondominant shoulder. To determine whether GIRD and a deficit in total rotational motion (external rotation + internal rotation) compared with the nonthrowing shoulder correlate with shoulder injuries in professional baseball pitchers. Case series; Level of evidence, 4. Over 3 competitive seasons (2005 to 2007), passive range of motion measurements were evaluated on the dominant and nondominant shoulders for 170 pitcher-seasons. This included 122 professional pitchers during the 3 seasons of data collection, in which some pitchers were measured during multiple seasons. Ranges of motion were measured with a bubble goniometer during the preseason, by the same examiner each year. External and internal rotation of the glenohumeral joint was assessed with the participant supine and the arm abducted 90° in the plane of the scapula, with the scapula stabilized anteriorly at the coracoid process. The reproducibility of the test methods had an intraclass correlation coefficient of .81. Days in which the player was unable to participate because of injury or surgery were recorded during the season by the medical staff of the team and defined as an injury. Pitchers with GIRD (n = 40) were nearly twice as likely to be injured as those without but without statistical significance (P = .17). Pitchers with total rotational motion deficit greater than 5° had a higher rate of injury. Minor league pitchers were more likely than major league pitchers to be injured. However, when players were injured, major league pitchers missed a significantly greater number of games than minor league pitchers. Compared with pitchers without GIRD, pitchers with GIRD appear to be at a higher risk for injury and shoulder surgery.

  14. The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.

    Directory of Open Access Journals (Sweden)

    Gabriela Ilie

    Full Text Available Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates.Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th-12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8. Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying, bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study.TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for more tailored injury prevention efforts.

  15. The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.

    Science.gov (United States)

    Ilie, Gabriela; Adlaf, Edward M; Mann, Robert E; Boak, Angela; Hamilton, Hayley; Asbridge, Mark; Colantonio, Angela; Turner, Nigel E; Rehm, Jürgen; Cusimano, Michael D

    2014-01-01

    Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI) among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates. Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th-12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8). Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying), bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study. TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for more tailored injury prevention efforts.

  16. Vitellointestinal Duct Anomalies in Infancy.

    Science.gov (United States)

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

    2016-01-01

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

  17. Acute and repeated inhalation lung injury by 3-methoxybutyl chloroformate in rats: CT-pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yeon Soo [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Chung, Myung Hee [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)]. E-mail: mhchung@catholic.ac.kr; Park, Seog Hee [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Kim, Hyeon-Yeong [Industrial Chemicals Research Center, Industrial Safety and Health Research Institute KISCO, 104-8, Moonji-dong, Yusong-gu, Taejon-si 305-380 (Korea, Republic of); Choi, Byung Gil [Department of Radiology, Kangnam St. Mary Hospital, Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040 (Korea, Republic of); Lim, Hyun Wook [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of); Kim, Jin Ah [Department of Pathology, Holy Family Hospital, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon-si, Kyung gi-do 420-717 (Korea, Republic of); Yoo, Won Jong [Department of Radiology, Holy Family Hospital, College of Medicine, Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Pucheon, Kyung gi-do 420-717 (Korea, Republic of)

    2007-05-15

    Objectives: To investigate the acute and repeated pulmonary damage in Sprague-Dawley rats caused by the inhalation of 3-methoxybutyl chloroformate (3-MBCF) using computed tomography (CT), and to correlate these results with those obtained from a pathological study. Methods: Sixty, 7-week-old rats were exposed to 3-MBCF vapor via inhalation (6 h/day) for 1 day (N = 20), 3 days (N = 20), and 28 days (5 days/week) (N = 20) using whole body exposure chambers at a concentration of 0 (control), 3, 6 and 12 ppm. CT examinations including densitometry and histopathologic studies were carried out. For the follow-up study, the rats exposed for 3 days were scanned using CT and their pathology was examined at 7, 14, and 28 days. Results: There was a significant decrease in the parenchymal density in the groups exposed to the 3-MBCF vapors for 1 day at 3 ppm (p = 0.022) or 6 ppm (p = 0.010), compared with the control. The parenchymal density of the rats exposed to12 ppm was significantly higher. The pathological findings in this period, the grades of vascular congestion, tracheobronchial exfoliation, and alveolar rupture were significant. In the groups exposed for 3 days, there was a large decrease in the parenchymal density with increasing dose (control: -675.48 {+-} 32.82 HU, 3 ppm: -720.65 {+-} 34.21 HU, 6 ppm: -756.41 {+-} 41.68 HU, 12 ppm: -812.56 {+-} 53.48 HU) (p = 0.000). There were significant density differences between each dose in the groups exposed for 28 days (p = 0.000). The CT findings include an irregular lung surface, areas of multifocal, wedge-shaped increased density, a heterogeneous lung density, bronchial dilatation, and axial peribronchovascular bundle thickening. The histopathology examination revealed the development of alveolar interstitial thickening and vasculitis, and an aggravation of the mainstem bronchial exudates and bronchial inflammation. The alveolar wall ruptures and bronchial dilatation became severe during this period. On the follow

  18. Prevalence and correlates of needle-stick injuries among active duty police officers in Tijuana, Mexico.

    Science.gov (United States)

    Mittal, María Luisa; Beletsky, Leo; Patiño, Efraín; Abramovitz, Daniela; Rocha, Teresita; Arredondo, Jaime; Bañuelos, Arnulfo; Rangel, Gudelia; Strathdee, Steffanie A

    2016-01-01

    Police officers are at an elevated risk for needle-stick injuries (NSI), which pose a serious and costly occupational health risk for HIV and viral hepatitis. However, research on NSIs among police officers is limited, especially in low- and middle-income countries. Despite the legality of syringe possession in Mexico, half of people who inject drugs (PWID) in Tijuana report extrajudicial syringe-related arrests and confiscation by police, which has been associated with needle-sharing and HIV infection. We assessed the prevalence and correlates of NSIs among Tijuana police officers to inform efforts to improve occupational safety and simultaneously reduce HIV risks among police and PWID. Tijuana's Department of Municipal Public Safety (SSPM) is among Mexico's largest. Our binational, multi-sectoral team analyzed de-identified data from SSPM's 2014 anonymous self-administered occupational health survey. The prevalence of NSI and syringe disposal practices was determined. Logistic regression with robust variance estimation via generalized estimating equations identified factors associated with ever having an occupational NSI. Approximately one-quarter of the Tijuana police force was given the occupational health survey (N=503). Respondents were predominantly male (86.5%) and ≤35 years old (42.6%). Nearly one in six officers reported ever having a NSI while working at SSPM (15.3%), of whom 14.3% reported a NSI within the past year. Most participants reported encountering needles/syringes while on duty (n=473, 94%); factors independently associated with elevated odds of NSIs included frequently finding syringes that contain drugs (adjusted odds ratio (AOR): 2.98; 95% confidence interval (CI): 1.56-5.67) and breaking used needles (AOR: 2.25; 95% CI: 1.29-3.91), while protective factors included being willing to contact emergency services in case of NSIs (AOR: 0.39; 95% CI: 0.22-0.69), and wearing needle-stick resistant gloves (AOR: 0.43; 95% CI: 0.19-0.91). Tijuana

  19. Acute and repeated inhalation lung injury by 3-methoxybutyl chloroformate in rats: CT-pathologic correlation

    International Nuclear Information System (INIS)

    Lim, Yeon Soo; Chung, Myung Hee; Park, Seog Hee; Kim, Hyeon-Yeong; Choi, Byung Gil; Lim, Hyun Wook; Kim, Jin Ah; Yoo, Won Jong

    2007-01-01

    Objectives: To investigate the acute and repeated pulmonary damage in Sprague-Dawley rats caused by the inhalation of 3-methoxybutyl chloroformate (3-MBCF) using computed tomography (CT), and to correlate these results with those obtained from a pathological study. Methods: Sixty, 7-week-old rats were exposed to 3-MBCF vapor via inhalation (6 h/day) for 1 day (N = 20), 3 days (N = 20), and 28 days (5 days/week) (N = 20) using whole body exposure chambers at a concentration of 0 (control), 3, 6 and 12 ppm. CT examinations including densitometry and histopathologic studies were carried out. For the follow-up study, the rats exposed for 3 days were scanned using CT and their pathology was examined at 7, 14, and 28 days. Results: There was a significant decrease in the parenchymal density in the groups exposed to the 3-MBCF vapors for 1 day at 3 ppm (p = 0.022) or 6 ppm (p = 0.010), compared with the control. The parenchymal density of the rats exposed to12 ppm was significantly higher. The pathological findings in this period, the grades of vascular congestion, tracheobronchial exfoliation, and alveolar rupture were significant. In the groups exposed for 3 days, there was a large decrease in the parenchymal density with increasing dose (control: -675.48 ± 32.82 HU, 3 ppm: -720.65 ± 34.21 HU, 6 ppm: -756.41 ± 41.68 HU, 12 ppm: -812.56 ± 53.48 HU) (p = 0.000). There were significant density differences between each dose in the groups exposed for 28 days (p = 0.000). The CT findings include an irregular lung surface, areas of multifocal, wedge-shaped increased density, a heterogeneous lung density, bronchial dilatation, and axial peribronchovascular bundle thickening. The histopathology examination revealed the development of alveolar interstitial thickening and vasculitis, and an aggravation of the mainstem bronchial exudates and bronchial inflammation. The alveolar wall ruptures and bronchial dilatation became severe during this period. On the follow-up study, the

  20. Is damage to the common bile duct during laparoscopic cholecystectomy an inherent risk of the operation?

    Science.gov (United States)

    Fischer, Josef E

    2009-06-01

    Laparoscopic cholocystectomy has been practiced for close to 20 years. The rate of common duct injury remains somewhere between 0.4 to 0.7 percent and is approximately the same around the world. Recent papers have stressed ways in which laparoscopic common duct injury can be avoided, but none of the methods mentioned is foolproof. In addition, this complication can occur to even the most experienced laparoscopic surgeon. The author believes that injury to the common duct during laparoscopic cholocystectomy is not a result of the practice below the standard, but an inherent risk of the operation. This injury needs to be emphasized by the surgical community as an inherent risk of the operation, and patients should be fully informed of this potential complication.

  1. Hodgkin's lymphoma-related vanishing bile duct syndrome: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Kiong-Ming Wong

    2013-11-01

    Full Text Available We report the case of a 38-year-old man who developed vanishing bile duct syndrome in association with Hodgkin's lymphoma. He was noted to have cervical lymphadenopathy and marked elevation of total serum bilirubin at diagnosis. He achieved complete remission with normalization of serum bilirubin after eight courses of Adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy followed with autologous hematopoietic cell transplantation. Consecutive liver biopsies performed at diagnosis and at the stage of complete remission revealed the disappearance and regeneration of interlobular bile ducts, respectively. Our case provides pathological evidence that Hodgkin's lymphoma-related vanishing bile duct syndrome is a reversible bile duct injury disease. Bilirubin is a reliable serum marker to monitor the treatment response of these cases. The mechanism to develop hyperbilirubinemia with vanishing bile duct in such a case of Hodgkin's lymphoma remains to be studied. A literature review was carried out.

  2. The Use of a Hemostasis Introducer for Percutaneous Extraction of Bile Duct Stones.

    Science.gov (United States)

    Feisthammel, Juergen; Moche, Micheal; Mossner, Joachim; Hoffmeister, Albrecht

    2012-02-01

    Choledocholithiasis is defined as presence of at least one gallstone in the bile duct. Those bile duct stones (BDS) usually are extracted by ERCP. In case the bile duct is not accessible endoscopically (e.g. after major abdominal surgery), PTCD has to be performed. Extraction of the stones via PTCD has several risks as are hemorrhage, pancreatitis and injuries of the liver tissue. We here report about our experience with a significant modification of this technique by use of a 13-french hemostasis introducer as a sheath to track the transhepatic access to the bile ducts in order to reduce time and risk. Three patients were treated by use of the reported modification. In all cases, the stones were successfully removable without complications. We demonstrate that the use of a hemostasis introducer for percutaneous extraction of common bile duct stones seems to be promising in terms of shortening hospital stay and increasing patient safety.

  3. Deliberate self-injury functions and their clinical correlates among adolescent psychiatric inpatients.

    Science.gov (United States)

    Radziwiłłowicz, Wioletta; Lewandowska, Magdalena

    2017-04-30

    The aim of the study was to analyze the relationships between clinical variables (the severity of depression symptoms, feelings towards the body, dissociation, number and type of traumatic events) and deliberate self-injury functions. Moreover, we investigated whether the of group self-mutilating adolescents is internally diverse in terms of how important individual functions of self-mutilation are, and whether the subgroups singled out by these functions differ between each other in terms of clinical variables. The Inventory of Statements about Self-Injury was used. Characterizations of examined individuals and other research tools are included in our previous article (year, issue, pages). Associated with negative feelings towards the body are the functions of self-injuries (anti-dissociation, self-punishment) that can be described as interpersonal. High levels of depression symptoms (self-depreciation included) are mainly associated with the self-injury functions: self-punishment, anti-dissociation, establishing interpersonal boundaries. Affect regulation becomes more important as a function of self-inflicted injuries in cases of biological dysregulation and intense dissociative symptoms. The adolescents psychiatric inpatients are internally diverse in terms of dominant functions of self-injuries, which can be categorized into intra- and interpersonal. Intrapersonal functions dominate when an individual experiences severe depression, dissociative symptoms, and negative feelings towards the body. In cases of moderate intensity of depression, dissociative symptoms and negative feelings towards the body, both intrapersonal and interpersonal functions of self-mutilation are similarly important. Further research is required to explain the lowest severity of depression symptoms, dissociative symptoms and negative feelings towards the body co-occurs with no awareness of self-injuries functions.

  4. Diffusion Tensor Imaging (DTI Correlates of Self-Reported Sleep Quality and Depression Following Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Adam C. Raikes

    2018-06-01

    Full Text Available Background: Mild traumatic brain injuries (mTBIs are a significant social, sport, and military health issue. In spite of advances in the clinical management of these injuries, the underlying pathophysiology is not well-understood. There is a critical need to advance objective biomarkers, allowing the identification and tracking of the long-term evolution of changes resulting from mTBI. Diffusion-weighted imaging (DWI allows for the assessment of white-matter properties in the brain and shows promise as a suitable biomarker of mTBI pathophysiology.Methods: 34 individuals within a year of an mTBI (age: 24.4 ± 7.4 and 18 individuals with no history of mTBI (age: 23.2 ± 3.4 participated in this study. Participants completed self-report measures related to functional outcomes, psychological health, post-injury symptoms, and sleep, and underwent a neuroimaging session that included DWI. Whole-brain white matter was skeletonized using tract-based spatial statistics (TBSS and compared between groups as well as correlated within-group with the self-report measures.Results: There were no statistically significant anatomical differences between the two groups. After controlling for time since injury, fractional anisotropy (FA demonstrated a negative correlation with sleep quality scores (higher FA was associated with better sleep quality and increasing depressive symptoms in the mTBI participants. Conversely, mean (MD and radial diffusivity (RD demonstrated positive correlations with sleep quality scores (higher RD was associated with worse sleep quality and increasing depressive symptoms. These correlations were observed bilaterally in the internal capsule (anterior and posterior limbs, corona radiata (anterior and superior, fornix, and superior fronto-occipital fasciculi.Conclusion: The results of this study indicate that the clinical presentation of mTBI, particularly with respect to depression and sleep, is associated with reduced white

  5. Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations.

    Science.gov (United States)

    Palisch, Andrew; Zoga, Adam C; Meyers, William C

    2013-07-01

    Athletes frequently injure their hips and core muscles. Accurate diagnosis and proper treatment of groin pain in the athlete can be tricky, frequently posing vexing problem for trainers and physicians. Clinical presentations of the various hip problems overlap with respect to history and physical examination. This article reviews clinical presentations and magnetic resonance imaging findings specific to the various causes of groin pain in the athlete. The focus is on the core muscle injuries (athletic pubalgia or "sports hernia"). The goal is to raise awareness about the variety of injuries that occur and therapeutic options. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Family functioning in severe brain injuries: correlations with caregivers' burden, perceived social support and quality of life.

    Science.gov (United States)

    Tramonti, Francesco; Bonfiglio, Luca; Di Bernardo, Carolina; Ulivi, Chiara; Virgillito, Alessandra; Rossi, Bruno; Carboncini, Maria Chiara

    2015-01-01

    Severe brain injuries have long-term consequences on functional status and psychosocial functioning. Family life can be greatly influenced as well, and features of high caregiver burden can emerge. Although the data on caregivers' distress are constantly increasing, less information is available about the role of family functioning. Thirty caregivers of hospitalised patients with severe brain injuries received questionnaires for the evaluation of caregiver burden, family functioning and perceived social support. A semi-structured interview was performed for the evaluation of quality of life. Family cohesion and adaptability positively correlated with caregivers' quality of life and perceived social support. Partner caregivers' scores were significantly higher on the time-dependent burden than those of sons and daughters, whereas the latter scored higher on the emotional burden.

  7. A quadriplegic patient's cholescintigraphic findings: delayed gallbladder visualization and common bile duct dilation.

    Science.gov (United States)

    Shih, W. J.; Magoun, S.; Lu, G.

    1996-01-01

    A Tc-99m DISIDA cholescintigraphic study of a 37-year-old patient with a 20-year history of quadriplegia demonstrated dilation of the common bile duct and delayed gallbladder visualization. A concurrent sonographic study showed an enlarged gallbladder with stones and dilation of the common bile duct. These findings were proved by autopsy. Quadriplegia secondary to a high level of spinal cord injury may result in gallbladder dysfunction. Images Figure PMID:8776068

  8. How bicycle level of traffic stress correlate with reported cyclist accidents injury severities: A geospatial and mixed logit analysis.

    Science.gov (United States)

    Chen, Chen; Anderson, Jason C; Wang, Haizhong; Wang, Yinhai; Vogt, Rachel; Hernandez, Salvador

    2017-11-01

    Transportation agencies need efficient methods to determine how to reduce bicycle accidents while promoting cycling activities and prioritizing safety improvement investments. Many studies have used standalone methods, such as level of traffic stress (LTS) and bicycle level of service (BLOS), to better understand bicycle mode share and network connectivity for a region. However, in most cases, other studies rely on crash severity models to explain what variables contribute to the severity of bicycle related crashes. This research uniquely correlates bicycle LTS with reported bicycle crash locations for four cities in New Hampshire through geospatial mapping. LTS measurements and crash locations are compared visually using a GIS framework. Next, a bicycle injury severity model, that incorporates LTS measurements, is created through a mixed logit modeling framework. Results of the visual analysis show some geospatial correlation between higher LTS roads and "Injury" type bicycle crashes. It was determined, statistically, that LTS has an effect on the severity level of bicycle crashes and high LTS can have varying effects on severity outcome. However, it is recommended that further analyses be conducted to better understand the statistical significance and effect of LTS on injury severity. As such, this research will validate the use of LTS as a proxy for safety risk regardless of the recorded bicycle crash history. This research will help identify the clustering patterns of bicycle crashes on high-risk corridors and, therefore, assist with bicycle route planning and policy making. This paper also suggests low-cost countermeasures or treatments that can be implemented to address high-risk areas. Specifically, with the goal of providing safer routes for cyclists, such countermeasures or treatments have the potential to substantially reduce the number of fatalities and severe injuries. Published by Elsevier Ltd.

  9. CORRELATION BETWEEN OZONE EXPOSURE AND VISIBLE FOLIAR INJURY IN PONDEROSA AND JEFFREY PINES. (R825433)

    Science.gov (United States)

    Ozone exposure was related to ozone-induced visible foliar injury in ponderosa and Jeffrey pines growing on the western slopes of the Sierra Nevada Mountains of California. Measurements of ozone exposure, chlorotic mottle and fascicle retention were collected during the years ...

  10. Decreased apparent diffusion coefficient in the pituitary and correlation with hypopituitarism in patients with traumatic brain injury.

    Science.gov (United States)

    Zheng, Ping; He, Bin; Guo, Yijun; Zeng, Jingsong; Tong, Wusong

    2015-07-01

    The relationship between microstructural abnormality in patients with traumatic brain injury (TBI) and hormone-secreting status remains unknown. In this study, the authors aimed to identify the role of the apparent diffusion coefficient (ADC) using a diffusion-weighted imaging (DWI) technique and to evaluate the association of such changes with hypopituitarism in patients with TBI. Diffusion-weighted images were obtained in 164 consecutive patients with TBI within 2 weeks after injury to generate the pituitary ADC as a measure of microstructural change. Patients with TBI were further grouped into those with and those without hypopituitarism based on the secretion status of pituitary hormones at 6 months postinjury. Thirty healthy individuals were enrolled in the study and underwent MRI examinations for comparison. Mean ADC values were compared between this control group, the patients with TBI and hypopituitarism, and the patients with TBI without hypopituitarism; correlational studies were also performed. Neurological outcome was assessed with the Glasgow Outcome Scale (GOS) for all TBI patients 6 months postinjury. In the TBI group, 84 patients had hypopituitarism and 80 had normal pituitary function. The pituitary ADC in TBI patients was significantly less than that in controls (1.83 ± 0.16 vs 4.13 ± 0.33, p correlated with neurological outcome at 6 months following TBI (r = 0.602, p correlated with hormone-secreting status in TBI patients. The authors suggest that pituitary ADC may be a useful biomarker to predict pituitary function in patients with TBI.

  11. Evaluation of the ultimate pressure capacity of rectangular HVAC ducts for nuclear pwoer plants

    International Nuclear Information System (INIS)

    Wedellsborg, B.W.

    1984-01-01

    Typical Category I HVAC ducts in a nuclear plant must be designed for loads and load combinations including positive and negative pressure loads which are generated due to the normal operation and postulated accident conditions. These pressure loads most often govern the design of the HVAC ducts. Structural design criteria are presently based on the AISI Code which limits the duct panel width-to-thickness ratio to a maximum of 500 and the maximum height-to-thickness ratio to 200, unless it can be shown by structural tests that larger ratios can be used. Test Programs performed on rectangular HVAC ducts subjected to vacumm loads have substantiated the use of ducts having panel width to thickness ratios of up to 1600. The results of the test programs were subsequently incorporated into the design through a more rational analytical design method which was developed from and correlates well with the test results. The purpose of this paper is to present the analytical design method and its correlation with the test results. Simple formulae for the design of rectangular HVAC ducts are presented. Lower bound values of duct sheet, and stiffener ultimate loads are derived, and correlated with recent test results. Analytically predicted ultimate pressures are also compared with other available duct test data

  12. Inflammatory-induced hibernation in the fetus: priming of fetal sheep metabolism correlates with developmental brain injury.

    Directory of Open Access Journals (Sweden)

    Matthias Keller

    Full Text Available Prenatal inflammation is considered an important factor contributing to preterm birth and neonatal mortality and morbidity. The impact of prenatal inflammation on fetal bioenergetic status and the correlation of specific metabolites to inflammatory-induced developmental brain injury are unknown. We used a global metabolomics approach to examine plasma metabolites differentially regulated by intrauterine inflammation. Preterm-equivalent sheep fetuses were randomized to i.v. bolus infusion of either saline-vehicle or LPS. Blood samples were collected at baseline 2 h, 6 h and daily up to 10 days for metabolite quantification. Animals were killed at 10 days after LPS injection, and brain injury was assessed by histopathology. We detected both acute and delayed effects of LPS on fetal metabolism, with a long-term down-regulation of fetal energy metabolism. Within the first 3 days after LPS, 121 metabolites were up-regulated or down-regulated. A transient phase (4-6 days, in which metabolite levels recovered to baseline, was followed by a second phase marked by an opposing down-regulation of energy metabolites, increased pO(2 and increased markers of inflammation and ADMA. The characteristics of the metabolite response to LPS in these two phases, defined as 2 h to 2 days and at 6-9 days, respectively, were strongly correlated with white and grey matter volumes at 10 days recovery. Based on these results we propose a novel concept of inflammatory-induced hibernation of the fetus. Inflammatory priming of fetal metabolism correlated with measures of brain injury, suggesting potential for future biomarker research and the identification of therapeutic targets.

  13. The management of complex pancreatic injuries

    African Journals Online (AJOL)

    Nicky

    pancreatic injuries. Leakage of pancreatic exocrine secre- ... gland damage and the likelihood of duct injury is usually sufficient to ..... creatic function. The decision to resort to pancreaticoduo- denectomy is based upon the extent of the pancreatic injury, the size and vascular status of any duodenal injury, the integrity of the ...

  14. Ultrasound appearance of radiation-induced hepatic injury. Correlation with computed tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Garra, B.S.; Shawker, T.H.; Chang, R.; Kaplan, K.; White, R.D.

    1988-01-01

    The ultrasound findings in three cases of radiation-induced hepatic injury are described and compared with computed tomography and magnetic resonance imaging findings. Fatty infiltration of the liver was present in two of the cases in which concurrent chemotherapy was being administered. On ultrasound B-scans, the regions of radiation injury were hypoechoic relative to the remainder of the liver. This finding was more obvious in the patients with fatty livers. CT scans on the patients with fatty infiltrated livers showed higher attenuation in the irradiated region than in unexposed liver. In the patient where no fatty infiltration was present, the radiated section of liver had lower attenuation consistent with previous reports. Magnetic resonance imaging showed decreased signal in the exposed areas on T1 weighted images

  15. Psychosocial correlates of non-suicidal self-injury and firesetting among school-based adolescents

    OpenAIRE

    Tanner, Alicia

    2017-01-01

    Adolescence marks a period of increased vulnerability for the development of high-risk or problem behaviors, with these behaviors often observed to co-occur among youth. Nonsuicidal self-injury (NSSI) and firesetting are two distinct variants of problem behavior representing significant public health concerns. While existing research examining cooccurring NSSI and firesetting indicates that these behaviors may be functionally related, most of these studies have been conducted within adult cor...

  16. An experimental study on acute brain radiation injury: Dynamic changes in proton magnetic resonance spectroscopy and the correlation with histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hui, E-mail: lihui@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Li, Jian-peng, E-mail: lijp@sysucc.org.cn [Department of Radiology, Dongguan People' s Hospital, Dongguan City (China); Lin, Cheng-guang, E-mail: linchg@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou (China); Liu, Xue-wen, E-mail: liuxw@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Geng, Zhi-jun, E-mail: gengzhj@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Mo, Yun-xian, E-mail: moyx@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Zhang, Rong, E-mail: zhangr@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China); Xie, Chuan-miao, E-mail: xchuanm@sysucc.org.cn [State Key Laboratory of Oncology in Southern China, Guangzhou (China); Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou (China)

    2012-11-15

    Purpose: To investigate the correlation between the alterations of single-voxel {sup 1}H MRS and the histopathological characteristics of radiation brain injury following radiation. Materials and methods: Twenty-seven rabbits were randomized into nine groups to receive radiation with a single dose of 25 Gy. The observation time points included a pre-radiation and 1, 2, 3, 4, 5, 6, 7, and 8 wk following radiation. Each treatment group underwent conventional MRI and single-voxel {sup 1}H MRS, N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were observed over the region of interest, and the presence or absence of lactate (Lac) and lipid (Lip) was detected. Histological specimens of each group were obtained after image acquisition. Results: The values of Cho were significantly increased in the first 3 wk, and decreased over the following 5 wk after radiation. Levels of NAA showed a trend toward a decrease 5 wk after radiation. The levels of Cr were not changed between before and after radiation. The Cho/NAA metabolic ratio was significantly increased in weeks 6, 7, and 8 following irradiation, compared to pre-radiation values. Vascular and glial injury appeared on 2 wk after RT in the histology samples, until 4 wk after RT, necrosis of the oligodendrocytes, neuronal degeneration and demyelination could be observed. Conclusions: MRS is sensitive to detect metabolic changes following radiation, and can be used in the early diagnosis of radiation brain injury.

  17. Correlation of QRS complex after percutaneous coronary intervention with myocardial ischemia reperfusion injury and apoptosis molecule contents

    Directory of Open Access Journals (Sweden)

    Ming-Min Jiang

    2017-11-01

    Full Text Available Objective: To study the correlation of QRS complex after percutaneous coronary intervention (PCI with myocardial ischemia reperfusion injury and apoptosis molecule contents. Methods: Patients with non-ST-segment elevation myocardial infarction who were treated in Nanchong Central Hospital between June 2014 and August 2016 were selected and divided into the PCI group who received emergency PCI surgery and the control group who accepted selective PCI or refused emergency PCI after the medical data were retrospectively analyzed. The fQRS as well as the contents of ischemia reperfusion injury indexes and apoptosis molecules was determined after 1 week of treatment. Results: The incidence of fQRS in PCI group was significantly lower than that in control group; serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group were greatly lower than those of control group; serum MDA, cTnI, H-FABP, sTWEAK, sFas, sTRAIL and Caspase-3 contents as well as peripheral blood Nrf-2 and HO-1 expression of PCI group of patients with fQRS complex (+ were greatly higher than those of patients with fQRS complex (-. Conclusion: The occurrence of fQRS after PCI is closely related to myocardial ischemia reperfusion injury and apoptosis.

  18. Should you get your heating ducts cleaned?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

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

  19. Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery

    International Nuclear Information System (INIS)

    Hughes, David G.; Jackson, Alan; Mason, Damon L.; Berry, Elizabeth; Hollis, Sally; Yates, David W.

    2004-01-01

    Mild traumatic brain injury (MTBI) is a common reason for hospital attendance and is associated with significant delayed morbidity. We studied a series of 80 persons with MTBI. Magnetic resonance imaging (MRI) and neuropsychological testing were used in the acute phase and a questionnaire for post-concussion syndrome (PCS) and return to work status at 6 months. In 26 subjects abnormalities were seen on MRI, of which 5 were definitely traumatic. There was weak correlation with abnormal neuropsychological tests for attention in the acute period. There was no significant correlation with a questionnaire for PCS and return to work status. Although non-specific abnormalities are frequently seen, standard MRI techniques are not helpful in identifying patients with MTBI who are likely to have delayed recovery. (orig.)

  20. Noninvasive study of anatomic variations of the bile and pancreatic duct using magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    Fernandez, E.; Falco, J.; Campo, R.; Martin, J.; Brullet, E.; Espinos, J.

    1999-01-01

    To identify anatomic variations of the bile duct and pancreatic duct and papillary anomalies by means of magnetic resonance cholangiopancreatography (MRCP) and determine their correlation with endoscopic retrograde cholangiopancreatography (ERCP) findings. Eighty-five patients were selected by means of a prospective study comparing MRCP and ERCP. Coronal and axial HASTE images and coronal and oblique coronal RARE images were acquired in all the patients. Four of the studies (6%) were excluded because of poor technical quality. Anatomic variations were observed in 26 cases (30.5%), including trifurcation (n=7; 27%), right hepatic duct draining into left hepatic duct (n=2, 7.7%), right hepatic duct draining into common bile duct (n=4; 15.4%), extrahepatic confluence (n=2; 7.7%), medial cystic duct (n=2; 7.7%), parallel cystic duct (n=3; 11.5%), juxtapapillary duodenal diverticulum (n=3; 11.5%) and pancreas divisum (n=3; 11.5%). A good correlation was observed between the MRCP and ERCP findings. The introduction of MRCP into the noninvasive study of biliary disease may be useful in the detection of anatomic variations relevant to laparoscopic surgery and other endoscopic and interventional techniques. (Author) 11 refs

  1. Treatment Options for Extrahepatic Bile Duct Cancer

    Science.gov (United States)

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

  2. Treatment Option Overview (Extrahepatic Bile Duct Cancer)

    Science.gov (United States)

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

  3. General Information about Extrahepatic Bile Duct Cancer

    Science.gov (United States)

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

  4. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Science.gov (United States)

    2010-01-01

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

  5. The autopsy-correlation of computed tomography in acute severe head injuries

    International Nuclear Information System (INIS)

    Tomita, Shin; Kim, Hong; Mikabe, Toshio; Karasawa, Hideharu; Watanabe, Saburo

    1981-01-01

    We discuss the importance of Contrast-Enhanced CT (C.E.CT) in establishing the variety of the intracranial pathological process in acute severe head injuries. During a two-and-a-half-year period (June, 1977 - December, 1979) thirty-three patients with acute severe head injuries were autopsied, all of whom had been scanned on admission. Among them, 14 patients had undergone both plain CT and C.E.CT on admission. Brain slices were examined macroscopically in three categories; brain contusion, subarachnoid hemorrhage, and intracerebral hemorrhage. Each category was then compared retrospectively with the plain CT and C.E.CT findings. C.E.CT was found to correspond much better to the autopsy finding than plain CT in the following three points: (1) C.E.CT clearly enhances the contusion areas and reveals occult contusion areas. (2) C.E.CT enhances the areas corresponding to the subarachnoid space due to the breakdown of brain-surface blood vessels. (3) C.E.CT reveals the enlargement and formation of the intracerebral hematoma by the extravasation of the intravenous contrast material from injured arterial vessels. (author)

  6. Correlates of Non-suicidal Self-injury and Suicide Attempts in Bulimic Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Alexandra Gómez-Expósito

    2016-08-01

    Full Text Available Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD and suicide attempts (SA, BSD patients with non-suicidal self-injury (NSSI, and BSD patients without these behaviors. Method: 122 female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD, BSD with lifetime NSSI (BSD+NSSI or BSD with lifetime SA (BSD+SA. Results: The BSD+NSSI and BSD+SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD+SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD+NSSI groups. No differences in impulsivity between the BSD and BSD+NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD+SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e. BSD+NSSI, may have a regulatory role rather than being due to impulsivity.

  7. Trauma center designation correlates with functional independence after severe but not moderate traumatic brain injury.

    Science.gov (United States)

    Brown, Joshua B; Stassen, Nicole A; Cheng, Julius D; Sangosanya, Ayodele T; Bankey, Paul E; Gestring, Mark L

    2010-08-01

    The mortality of traumatic brain injury (TBI) continues to decline, emphasizing functional outcomes. Trauma center designation has been linked to survival after TBI, but the impact on functional outcomes is unclear. The objective was to determine whether trauma center designation influenced functional outcomes after moderate and severe TBI. Trauma subjects presenting to an American College of Surgeons (ACS) Level I or II trauma center with a Glasgow Coma Score (GCS) independence (FI) defined as a modified functional independence measure (FIM) of 12, and independent expression (IE) defined as a FIM component of 4. These were compared between Level I and Level II centers in subjects with both moderate (GCS 9-12) and severe (GCS injuries, and comorbidities. Analysis identified 25,170 subjects (72% severe TBI). After adjusting for covariates, ACS Level I designation was associated with FI (odds ratio: 1.16; confidence interval: 1.07-1.24, p < 0.01) and IE (1.10; 1.03-1.17, p < 0.01) after severe TBI. Trauma center designation was not associated with FI or IE after moderate TBI. ACS trauma center designation is significantly associated with FI and IE after severe, but not moderate TBI. Prospective study is warranted to verify and explore factors contributing to this discrepancy.

  8. Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders

    Science.gov (United States)

    Gómez-Expósito, Alexandra; Wolz, Ines; Fagundo, Ana B.; Granero, Roser; Steward, Trevor; Jiménez-Murcia, Susana; Agüera, Zaida; Fernández-Aranda, Fernando

    2016-01-01

    Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors. Method: One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA). Results: The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity. PMID:27597836

  9. Partial Avulsion of Common Bile Duct and Duodenal Perforation in a Blunt Abdominal Trauma

    OpenAIRE

    Mirza, Bilal; Ijaz, Lubna; Iqbal, Shahid; Sheikh, Afzal

    2010-01-01

    Complete or partial avulsion of common bile duct is a very rare injury following blunt abdominal trauma in children. A 7-year old boy presented to ER following blunt abdominal trauma by a moving motorcycle. X ray abdomen revealed free air under diaphragm and CT scan showed pancreatic contusion injury. At operation anterior wall of common bile duct (CBD) along with a 2mm rim of duodenal tissue on either side of anterior wall of CBD were found avulsed from the duodenum. The avulsed portion of C...

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

    African Journals Online (AJOL)

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

  11. Wind Turbine With Concentric Ducts

    Science.gov (United States)

    Muhonen, A. J.

    1983-01-01

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

  12. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli

    OpenAIRE

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-01

    Abstract Background Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats...

  13. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  14. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    International Nuclear Information System (INIS)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel; Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke

    2011-01-01

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  15. Importance of resin ducts in reducing ponderosa pine mortality from bark beetle attack.

    Science.gov (United States)

    Kane, Jeffrey M; Kolb, Thomas E

    2010-11-01

    The relative importance of growth and defense to tree mortality during drought and bark beetle attacks is poorly understood. We addressed this issue by comparing growth and defense characteristics between 25 pairs of ponderosa pine (Pinus ponderosa) trees that survived and trees that died from drought-associated bark beetle attacks in forests of northern Arizona, USA. The three major findings of our research were: (1) xylem resin ducts in live trees were >10% larger (diameter), >25% denser (no. of resin ducts mm(-2)), and composed >50% more area per unit ring growth than dead trees; (2) measures of defense, such as resin duct production (no. of resin ducts year(-1)) and the proportion of xylem ring area to resin ducts, not growth, were the best model parameters of ponderosa pine mortality; and (3) most correlations between annual variation in growth and resin duct characteristics were positive suggesting that conditions conducive to growth also increase resin duct production. Our results suggest that trees that survive drought and subsequent bark beetle attacks invest more carbon in resin defense than trees that die, and that carbon allocation to resin ducts is a more important determinant of tree mortality than allocation to radial growth.

  16. HAARP-Induced Ionospheric Ducts

    International Nuclear Information System (INIS)

    Milikh, Gennady; Vartanyan, Aram

    2011-01-01

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

  17. Risk of pancreatitis after pancreatic duct guidewire placement during endoscopic retrograde cholangiopancreatography.

    Directory of Open Access Journals (Sweden)

    Yuki Ishikawa-Kakiya

    Full Text Available Advanced techniques have been developed to overcome difficult cannulation cases in endoscopic retrograde cholangiopancreatography (ERCP. Pancreatic duct guidewire placement method (PGW is performed in difficult cannulation cases; it is possible that it places patients at risk of post-ERCP pancreatitis (PEP. The mechanism of PEP is still unclear, but pancreatic duct pressure and injury of pancreatic duct are known causes of PEP. Therefore, we hypothesized a relationship between pancreatic duct diameter and PEP and predicted that PGW would increase the risk of PEP in patients with non-dilated pancreatic ducts. This study aimed to investigate whether PGW increased the risk of PEP in patients with pancreatic duct diameter ≤ 3 mm.We analyzed 332 patients with pancreatic duct ≤ 3 mm who performed first time ERCP session. The primary endpoint was the rate of adverse event of PEP. We evaluated the risk of PEP in patients who had undergone PGW compared to those who had not, using the inverse probability of treatment weighting (IPTW analysis.PGW was found to be an independent risk factor for PEP by univariate analysis (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.12-5.38; p = 0.03 after IPTW in patients with pancreatic duct diameter ≤ 3 mm. Adjusted for all covariates, PGW remained an independent risk factor for PEP (OR, 3.12; 95% CI, 1.33-7.33; p = 0.01.Our results indicate that PGW in patients with pancreatic duct diameter ≤ 3 mm increases the risk of PEP.

  18. [Correlation between serum uric acid level and acute renal injury after coronary artery bypass grafting].

    Science.gov (United States)

    Xu, D Q; Du, J; Zheng, Z; Tang, Y; Zou, L; Zhang, Y H; Zhang, H T

    2017-07-11

    Objective: To evaluate whether early postoperative serum uric acid level can predict postoperative acute renal injury (AKI) among patients undergoing coronary artery bypass grafting (CABG). Methods: The study retrospectively enrolled 1 306 patients undergoing CABG in Fuwai Hospital between September 2012 and December 2013. The patients were divided into 5 groups by the concentrations of serum uric acid measured on the morning of the first postoperative day, and uric acid categories were as follow: less than 195 μmol/L (Q1 group, 262 cases), 195-236 μmol/L (Q2 group, 263 cases), 237-280 μmol/L (Q3 group, 260 cases), 281-336 μmol/L (Q4 group, 261 cases), more than 336 μmol/L (Q5 group, 260 cases). The primary end points were AKI (RIFLE criteria), severe AKI (AKI≥stage Ⅰ), postoperative continuous renal replacement therapy (CRRT) requirement, in-hospital death, length of stay in hospital and intensive care unit(ICU). The area under the receiver-operating characteristic (ROC) curve (AUC) was used to determine the ability of the early postoperative serum uric acid level as a risk factor for postoperative AKI prediction. Results: Among the 1 306 patients enrolled in the study, AKI was found in 335 patients (25.65%). After adjusting for variables that were different between the 5 groups, the Q5 group had significantly higher risk of AKI, AKI≥ stage Ⅰ and the requirement of CRRT ( P uric acid levels alone were used (both P uric acid was a better predictor than serum creatinine( P uric acid concentration within 12 hours after operation is an independent predictor of postoperative AKI in patients undergoing CABG, which could be used to identify patients at high risk for AKI.

  19. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study from India

    Directory of Open Access Journals (Sweden)

    Deepak Sharma

    2016-01-01

    Full Text Available Objective The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. Material and Methods This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3 were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3 or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. Results Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively. There was a significant increase in serum lactate dehydrogenase (LDH and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with

  20. Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping.

    Science.gov (United States)

    Tebala, Giovanni D

    2006-05-01

    The technique of laparoscopic cholecystectomy (LC) still has areas of refinements. To decrease the number of ports, a cannula may be replaced by a percutaneous suture suspension of the gallbladder. The risk of tissue injury caused by repeat blind extraction and insertion of various instruments in and out of the abdomen may be decreased by the use of the multipurpose harmonic dissector. One hundred consecutive patients with symptomatic cholelithiasis underwent 3-port LC entirely performed by harmonic dissector without cystic duct and artery clipping. In 8 cases, a fourth trocar was necessary. In 2 cases, the cystic duct was clipped after an unsafe ultrasound sealing. In 1 case, continuous bleeding from the liver required the use of diathermy. No common bile duct injury was registered. The 3-port harmonic LC is a feasible, effective, and safe technique.

  1. Enhanced visualization of the bile duct via parallel white light and indocyanine green fluorescence laparoscopic imaging

    Science.gov (United States)

    Demos, Stavros G.; Urayama, Shiro

    2014-03-01

    Despite best efforts, bile duct injury during laparoscopic cholecystectomy is a major potential complication. Precise detection method of extrahepatic bile duct during laparoscopic procedures would minimize the risk of injury. Towards this goal, we have developed a compact imaging instrumentation designed to enable simultaneous acquisition of conventional white color and NIR fluorescence endoscopic/laparoscopic imaging using ICG as contrast agent. The capabilities of this system, which offers optimized sensitivity and functionality, are demonstrated for the detection of the bile duct in an animal model. This design could also provide a low-cost real-time surgical navigation capability to enhance the efficacy of a variety of other image-guided minimally invasive procedures.

  2. Expression of JMJD2A in infiltrating duct carcinoma was markedly higher than fibroadenoma, and associated with expression of ARHI, p53 and ER in infiltrating duct carcinoma.

    Science.gov (United States)

    Li, Bei-Xu; Li, Jia; Luo, Cheng-Liang; Zhang, Ming-Chang; Li, Hui; Li, Li-Liang; Xu, Hong-Fei; Shen, Yi-Wen; Xue, Ai-Min; Zhao, Zi-Qin

    2013-03-01

    Jumonji Domain Containing 2A (JMJD2A) may be a cancer-associated gene involved in human breast cancer. With a view to investigating expression of JMJD2A in human breast cancer and benign lesion tissues as well as relationship between JMJD2A and tumor related proteins, histological and immunohistochemical analysis, Western blot and quantitative real-time PCR in infiltrating duct carcinoma and fibroadenoma for JMJD2A and immunohistochemical analysis and quantitative real-time PCR in infiltrating duct carcinoma for tumor related proteins (ARHI, p53, ER, PR and CerbB-2) were performed. Histological examination validated the clinical diagnosis. The JMJD2A positive rate of infiltrating duct carcinoma was significantly higher than fibroadenoma by immunohistochemical analysis. The mean optical density of JMJD2A in infiltrating duct carcinoma was higher than fibroadenoma by western blot. JMJD2A mRNA level in infiltrating duct carcinoma was higher than fibroadenoma by quantitative real-time PCR. Spearman correlation analysis revealed that the expression of JMJD2A was associated with ARHI, p53 and ER from immunohistochemical results respectively. Pearson correlation analysis revealed that the expression of JMJD2A was associated with ARHI, p53 and ER from quantitative real-time PCR results respectively. Expression of JMJD2A in infiltrating duct carcinoma was higher, and associated with ARHI, p53 and ER. The results may take JMJD2A as a potential diagnostic and therapeutic target in human breast cancer.

  3. Correlation of lipid metabolism characteristics with bile acid metabolism and placental hypoxia injury in patients with intrahepatic cholestasis of pregnancy

    Directory of Open Access Journals (Sweden)

    Liang Tang

    2017-05-01

    Full Text Available Objective: To study the correlation of lipid metabolism characteristics with bile acid metabolism and placental hypoxia injury in patients with intrahepatic cholestasis of pregnancy (ICP. Methods: ICP pregnant women and healthy pregnant women who received antenatal care and delivered in Obstetrics Department of Panzhihua Maternal and Child Health Care Hospital between May 2013 and October 2016 were collected and included in ICP group and control group respectively. Serum lipid metabolism and bile acid metabolism indexes were measured at 20 weeks, 24 weeks, 28 weeks, 32 weeks and 36 weeks of gestation; mitochondria damage molecule expression levels in placenta were determined after childbirth. Results: Serum TC, LDL-C and HDL-C levels were not different between two groups of pregnant women at 20 weeks of gestation, and serum TC and LDL-C levels of ICP group at 24 weeks, 28 weeks, 32 weeks and 36 weeks of gestation were significantly higher than those of control group while HDL-C levels were significantly lower than those of control group; serum TBA, ALT and AST levels were not different between two groups of pregnant women at 20 weeks, 24 weeks and 28 weeks of gestation, and serum TBA, ALT and AST levels of ICP group at 32 weeks and 36 weeks of gestation were significantly higher than those of control group; CCO, ATPase, SDH and Bcl-2 protein expression in placenta tissue of ICP group were significantly lower than those of control group while Bax and Caspase-3 protein expression were significantly higher than those of control group. Serum LDL-C levels at 24 weeks, 28 weeks, 32 weeks and 36 weeks of gestation were positively correlated with TBA, ALT and AST levels in serum as well as Bax and Caspase-3 protein expression in placental tissue, and negatively correlated with CCO, ATPase, SDH and Bcl-2 protein expression in placental tissue. Conclusion: Midtrimester lipid metabolism characteristics can early predict the risk of ICP and evaluate the

  4. Adenosine receptors in rat and human pancreatic ducts stimulate chloride transport

    DEFF Research Database (Denmark)

    Novak, Ivana; Hede, Susanne; Hansen, Mette

    2007-01-01

    , it was found that 58% of PANC-1 cells responded to adenosine, whereas only 9% of CFPAC-1 cells responded. Adenosine elicited Ca(2+) signals only in a few rat and human duct cells, which did not seem to correlate with Cl(-) signals. A(2A) receptors were localized in the luminal membranes of rat pancreatic ducts......, plasma membrane of many PANC-1 cells, but only a few CFPAC-1 cells. Taken together, our data indicate that A(2A) receptors open Cl(-) channels in pancreatic ducts cells with functional CFTR. We propose that adenosine can stimulate pancreatic secretion and, thereby, is an active player in the acini...

  5. How does Euro NCAP results correlate to real life injury risks - a paired comparison study of car-to-car crashes in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Lie, A. [Swedish National Road Administration, Borlaenge (Sweden)]|[ Karolinska Institutet (Sweden); Tingvall, C. [Monash University, Accident Research Centre (Australia)

    2001-07-01

    Euro NCAP is a resource for consumers regarding vehicle crash safety. The program also promotes safety developments, and credits car manufacturers focussing on safety. This study, based on real life car to car crashes, shows that the overall indication of the safety level, provided by the crash testing, is a valid prediction, at least when looking at the star rating and severe to fatal injuries. For minor injuries no significant injury risk differences are seen. The cars with three or four stars are approximately 30% safer, compared to two star cars or cars without an Euro NCAP score, in car to car collisions. The good general correlation between injury risk, and Euro NCAP scores is not necessarily similarly good for individual car models. Pedestrian safety and child occupant protection was not studied. (orig.)

  6. Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture

    OpenAIRE

    Park, Seongsik

    2012-01-01

    Background Although it is rare for the fracture itself to become a life threatening injury in patients suffering from rib fracture, the lives of these patients are occasionally threatened by other associated injuries. Especially, early discovery of patients with rib fracture and intra-abdominal organ injury is extremely important to the prognosis. This study analyzed the link between rib fracture and intra-abdominal injury to achieve improved treatment. Materials and Methods Among trauma pati...

  7. Is there a correlation between coaches’ leadership styles and injuries in elite football teams? A study of 36 elite teams in 17 countries

    Science.gov (United States)

    Ekstrand, Jan; Lundqvist, Daniel; Lagerbäck, Lars; Vouillamoz, Marc; Papadimitiou, Niki; Karlsson, Jon

    2018-01-01

    Background Do coaches’ leadership styles affect injury rates and the availability of players in professional football? Certain types of leadership behaviour may cause stress and have a negative impact on players’ health and well-being. Aim To investigate the transformational leadership styles of head coaches in elite men’s football and to evaluate the correlation between leadership styles, injury rates and players’ availability. Methods Medical staff from 36 elite football clubs in 17 European countries produced 77 reports at four postseason meetings with a view to assessing their perception of the type of leadership exhibited by the head coaches of their respective teams using the Global Transformational Leadership scale. At the same time, they also recorded details of individual players’ exposure to football and time-loss injuries. Results There was a negative correlation between the overall level of transformational leadership and the incidence of severe injuries (rho=−0.248; n=77; p=0.030); high levels of transformational leadership were associated with smaller numbers of severe injuries. Global Transformational Leadership only explained 6% of variation in the incidence of severe injuries (r2=0.062). The incidence of severe injuries was lower at clubs where coaches communicated a clear and positive vision, supported staff members and gave players encouragement and recognition. Players’ attendance rates at training were higher in teams where coaches gave encouragement and recognition to staff members, encouraged innovative thinking, fostered trust and cooperation and acted as role models. Conclusions There is an association between injury rates and players’ availability and the leadership style of the head coach. PMID:29056596

  8. Is there a correlation between coaches' leadership styles and injuries in elite football teams? A study of 36 elite teams in 17 countries.

    Science.gov (United States)

    Ekstrand, Jan; Lundqvist, Daniel; Lagerbäck, Lars; Vouillamoz, Marc; Papadimitiou, Niki; Karlsson, Jon

    2018-04-01

    Do coaches' leadership styles affect injury rates and the availability of players in professional football? Certain types of leadership behaviour may cause stress and have a negative impact on players' health and well-being. To investigate the transformational leadership styles of head coaches in elite men's football and to evaluate the correlation between leadership styles, injury rates and players' availability. Medical staff from 36 elite football clubs in 17 European countries produced 77 reports at four postseason meetings with a view to assessing their perception of the type of leadership exhibited by the head coaches of their respective teams using the Global Transformational Leadership scale. At the same time, they also recorded details of individual players' exposure to football and time-loss injuries. There was a negative correlation between the overall level of transformational leadership and the incidence of severe injuries (rho=-0.248; n=77; p=0.030); high levels of transformational leadership were associated with smaller numbers of severe injuries. Global Transformational Leadership only explained 6% of variation in the incidence of severe injuries (r 2 =0.062). The incidence of severe injuries was lower at clubs where coaches communicated a clear and positive vision, supported staff members and gave players encouragement and recognition. Players' attendance rates at training were higher in teams where coaches gave encouragement and recognition to staff members, encouraged innovative thinking, fostered trust and cooperation and acted as role models. There is an association between injury rates and players' availability and the leadership style of the head coach. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. A Pilot Study of Common Bile Duct Reconstruction with CorMatrix Extracellular Matrix in Swine (Sus scrofa)

    Science.gov (United States)

    2015-02-06

    additional pages if necessary.) PROTOCOL#: FDG20140008A DATE: 6 February 2015 PROTOCOL TITLE: A Pilot Study of Common Bile Duct Reconstruction with...obstruction or bile peritonitis. This was reported to the IACUC chair. 9. REDUCTION, REFINEMENT, OR REPLACEMENT OF ANIMAL USE; REPLACEMENT...benefit the DoD/USAF? We developed a porcine model of common bile duct injury and interposition grafting, gained experience managing these patients

  10. Objective measures of motor dysfunction after compression spinal cord injury in adult rats: correlations with locomotor rating scores.

    Science.gov (United States)

    Semler, Joerg; Wellmann, Katharina; Wirth, Felicitas; Stein, Gregor; Angelova, Srebrina; Ashrafi, Mahak; Schempf, Greta; Ankerne, Janina; Ozsoy, Ozlem; Ozsoy, Umut; Schönau, Eckhard; Angelov, Doychin N; Irintchev, Andrey

    2011-07-01

    Precise assessment of motor deficits after traumatic spinal cord injury (SCI) in rodents is crucial for understanding the mechanisms of functional recovery and testing therapeutic approaches. Here we analyzed the applicability to a rat SCI model of an objective approach, the single-frame motion analysis, created and used for functional analysis in mice. Adult female Wistar rats were subjected to graded compression of the spinal cord. Recovery of locomotion was analyzed using video recordings of beam walking and inclined ladder climbing. Three out of four parameters used in mice appeared suitable: the foot-stepping angle (FSA) and the rump-height index (RHI), measured during beam walking, and for estimating paw placement and body weight support, respectively, and the number of correct ladder steps (CLS), assessing skilled limb movements. These parameters, similar to the Basso, Beattie, and Bresnahan (BBB) locomotor rating scores, correlated with lesion volume and showed significant differences between moderately and severely injured rats at 1-9 weeks after SCI. The beam parameters, but not CLS, correlated well with the BBB scores within ranges of poor and good locomotor abilities. FSA co-varied with RHI only in the severely impaired rats, while RHI and CLS were barely correlated. Our findings suggest that the numerical parameters estimate, as intended by design, predominantly different aspects of locomotion. The use of these objective measures combined with BBB rating provides a time- and cost-efficient opportunity for versatile and reliable functional evaluations in both severely and moderately impaired rats, combining clinical assessment with precise numerical measures.

  11. Correlation between regional cerebral blood flow and degree of brain tissue injury of interictal epileptic activity in patients with epilepsy

    International Nuclear Information System (INIS)

    Ma Huan; Chen Xuehong; Wang Zhengjiang; Ma Dongmei; Feng Jianzhong; Liu Jiangyan

    2011-01-01

    Objective: To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods: Forty-eight patients with epilepsy and 30 healthy persons were included in the study from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visual and semi-quantitative analyses were used to analyze the epileptic foci. SPSS 11.0 was applied for variance and linear correlation analyses. Results: Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572±0.163) μg/L vs (0.218±0.134) μg/L, t =9.96, P<0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases achieved partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0.809±0.056) μg/L) and the percentage change of rCBF ((0.337±0.060) %) were significantly higher than those of CC ((0.443±0.083) μg/L, (0.035±0.038) %) and those of PC ((0.585±0.108) μg/L, (0.187±0.075)%), F=56. 740, 92. 316, P<0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0.887, P<0.01). Conclusion: Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity. (authors)

  12. Quadcopter thrust optimization with ducted-propeller

    Directory of Open Access Journals (Sweden)

    Kuantama Endrowednes

    2017-01-01

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

  13. Neural correlates of apathy in patients with neurodegenerative disorders, acquired brain injury, and psychiatric disorders.

    Science.gov (United States)

    Kos, Claire; van Tol, Marie-José; Marsman, Jan-Bernard C; Knegtering, Henderikus; Aleman, André

    2016-10-01

    Apathy can be described as a loss of goal-directed purposeful behavior and is common in a variety of neurological and psychiatric disorders. Although previous studies investigated associations between abnormal brain functioning and apathy, it is unclear whether the neural basis of apathy is similar across different pathological conditions. The purpose of this systematic review was to provide an extensive overview of the neuroimaging literature on apathy including studies of various patient populations, and evaluate whether the current state of affairs suggest disorder specific or shared neural correlates of apathy. Results suggest that abnormalities within fronto-striatal circuits are most consistently associated with apathy across the different pathological conditions. Of note, abnormalities within the inferior parietal cortex were also linked to apathy, a region previously not included in neuroanatomical models of apathy. The variance in brain regions implicated in apathy may suggest that different routes towards apathy are possible. Future research should investigate possible alterations in different processes underlying goal-directed behavior, ranging from intention and goal-selection to action planning and execution. Copyright © 2016. Published by Elsevier Ltd.

  14. Tenascin-C levels in synovial fluid are elevated after injury to the human and canine joint and correlate with markers of inflammation and matrix degradation

    DEFF Research Database (Denmark)

    Chockalingam, P S; Glasson, S S; Lohmander, Stefan

    2013-01-01

    meniscus lesions, isolated knee meniscus injury, acute inflammatory arthritis (AIA) and knee osteoarthritis (OA). TN-C was measured in synovial fluid samples using an enzyme-linked immunosorbent assay (ELISA) and results correlated to other cartilage markers. TN-C release was also monitored in joints...

  15. Correlation of shoulder range of motion limitations at discharge with limitations in activities and participation one year later in persons with spinal cord injury

    NARCIS (Netherlands)

    Eriks-Hoogland, Inge E.; de Groot, Sonja; Post, Marcel W. M.; van der Woude, Lucas H. V.

    Objective: To study the correlation between limited shoulder range of motion in persons with spinal cord injury at discharge and the performance of activities, wheeling performance, transfers and participation one year later. Design: Multicentre prospective cohort study. Subjects: A total of 146

  16. Thermal neutrons streaming in straight duct

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  17. Molecular Mechanisms of Bile Duct Development

    OpenAIRE

    Zong, Yiwei; Stanger, Ben Z.

    2010-01-01

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

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

    African Journals Online (AJOL)

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

  19. Parotid salivary duct stenosis following caudal maxillectomy.

    Science.gov (United States)

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

    2014-01-01

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

  20. Nasopalatine duct cyst: A case report

    Directory of Open Access Journals (Sweden)

    Saikrishna Pasupuleti

    2015-01-01

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

  1. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    International Nuclear Information System (INIS)

    Zhang, Guang-ying; Ding, Hong-yu; Zheng, Lei; Ji, Bing-jun; Shi, Hao; Feng, Yan

    2017-01-01

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  2. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Guang-ying; Ding, Hong-yu [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Ultrasonography, Jinan (China); Zheng, Lei; Ji, Bing-jun [Shandong Provincial Corps Hospital of Chinese People' s Armed Police Force, Department of Radiology, Jinan (China); Shi, Hao [Shandong Provincial Qianfoshan Hospital of Shandong University, Department of Radiology, Jinan (China); Feng, Yan [Affiliated Hospital of Binzhou Medical College, Department of Radiology, Binzhou (China)

    2017-03-15

    To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. (orig.)

  3. The Impact of Bile Duct Cultures on Surgical Site Infections in Pancreatic Surgery.

    Science.gov (United States)

    Herzog, Torsten; Belyaev, Orlin; Akkuzu, Rehsan; Hölling, Janine; Uhl, Waldemar; Chromik, Ansgar M

    2015-08-01

    In pancreatic surgery pre-operative biliary drainage (PBD) is associated with bacteribilia, which increases the risk for surgical site infections (SSIs). This study is a retrospective observational cohort design that compared micro-organisms of intra-operative bile duct cultures with micro-organisms of SSIs after pancreaticoduodenectomy. From January 2004 until December 2010, 887 patients underwent pancreaticoduodenectomy or hepaticojejunostomy for benign and malignant peri-ampullary lesions. Surgical site infections occurred in 10% (87/887). Cultures of SSIs with corresponding intra-operative bile duct cultures were available for 59 patients. Sixty-four percent (38/59) had undergone PBD. Pre-operative biliary drainage was associated with positive intra-operative bile duct cultures in 95% (36/38), versus 48% (10/21; p≤0.001). The correlation of SSIs with intra-operative bile duct cultures was 59% (35/59). There was a significant association between the micro-organisms cultured from SSIs and the corresponding bile duct cultures for Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), Enterobacteriaceae with extended spectrum ß-lactamase (ESBL), and Candida spp. After pancreaticoduodenectomy, SSIs are often caused by the same micro-organisms that are present on intra-operative bile duct cultures, especially after PBD. Therefore, intra-operative bile duct cultures should be performed routinely to adjust the antibiotic prophylaxis according to the local hospital surveillance data.

  4. A correlation study of the expression of resistin and glycometabolism in muscle tissue after traumatic brain injury in rats

    Institute of Scientific and Technical Information of China (English)

    Jin Peng; Zhu Lielie; Zhang Jiasheng; Xie Songling; Pan Da; Wen Hao; Meng Weiyang

    2014-01-01

    Objective:To investigate the expression pattern of resistin (RSTN) in skeletal muscle tissue and its influence on glycometabolism in rats with traumatic brain injury (TBI).Methods:Seventy-eight SD rats were randomly divided into traumatic group (n=36),RSTN group (n=36) and sham operation group (n=6).Fluid percussion TBI model was developed in traumatic and RSTN groups and the latter received additional 1 mg RSTN antibody treatment for each rat.At respectively 12 h,24 h,72 h,1 w,2 w,and 4 w after operation,venous blood was collected and the right hind leg skeletal muscle tissue was sampled.We used real-time PCR to determine mRNA expression of RSTN in skeletal muscles,western blot to determine RSTN protein expression and ELISA to assess serum insulin as well as fasting blood glucose (FBG) levels.Calculation of the quantitative insulin sensitivity check index (Q value) was also conducted.The above mentioned indicators and their correction were statistically analyzed.Results:Compared with sham operation group,the RSTN expression in the skeletal muscle as well as serum insulin and FBG levels revealed significant elevation (P<0.05),and reduced Q value (P<0.05) in traumatic group.Single factor linear correlation analysis showed a significant negative correlation between RSTN expression and Q values (P<0.001) in traumatic group.Conclusion:The expression of RSTN has been greatly increased in the muscular tissue of TBI rats and it was closely related to the index of glycometabolism.RSTN may play an important role in the process of insulin resistance after TBI.

  5. Analysis of behavioral and EEG correlatives of attention in the dynamics of recovery of consciousness following severe brain injury

    Directory of Open Access Journals (Sweden)

    E. V. Sharova

    2016-01-01

    Full Text Available Objective: to determine the behavioral manifestations and electroencephalographic correlates of modality-nonspecific attention using a clinical model of severe brain injury (SBI.Patients and methods. 35 patients with SBI in the dynamics of post-coma recovery of mental activity (a study group and 23 healthy subjects (a control group were examined. The behavioral manifestations of NSA from coma to clear consciousness were analyzed in the patients. Changes in the pattern of EEG and in the indices of its coherence in the presence and activation of different forms of attention (an orienting response to the sound and eye opening; involuntary and voluntary visual forms, by applying specially developed computerized techniques, were investigated. The features of associated with attention changes in interhemispheric EEG coherence (IHC with the data of 3T diffusion tensor tractography of the corpus callosum (CC were compared.Results. Attention disorders were shown to be essential and an «axial disorder» in patients with SBI. There were statistically confirmed qualitative and quantitative differences attention-associated changes in the EEG pattern and IHC in reversible and chronic unconsciousness. The important favorable prognostic sign proved to be reactive changes in interhemispheric EEG relations, including frontal ones characterized by the absence of clear external manifestations of consciousness in the very earliest stages. There was a significant correlation between the preservation of CC tracts (primarily, the rostrum, anterior portion, and splenium and attention-related reactivity of IHC, which reflects the specific, though nonrigid, structural determinacy of the latter.

  6. [Electrophysiological correlates of efficacy of nootropic drugs in the treatment of consequences of traumatic brain injury in adolescents].

    Science.gov (United States)

    Iznak, E V; Iznak, A F; Pankratova, E A; Zavadenko, N N; Guzilova, L S; Guzilova, Iu I

    2010-01-01

    To assess objectively a dynamics of brain functional state, EEG spectral power and peak latency of the P300 component of cognitive auditory evoked potentials have been analyzed in adolescents during the course of nootropic therapy of residual asthenic consequences of traumatic brain injury (ICD-10 F07.2). The study included 76 adolescents, aged 12-18 years, who have undergone severe closed head trauma with brain commotion 1/2--5 years ago. Patients have been divided into 3 groups treated during one month with cerebrolysin, piracetam or magne-B6, respectively. After the end of the nootropic therapy, 77% of patients treated with cerebrolysin as well as 50% of patients treated with piracetam and magne-B6 have demonstrated the positive dynamics of their brain functional state that manifested itself in the appearance of occipital EEG alpha rhythm or in the increase of its spectral power; in the normalization of alpha rhythm frequency; in the decrease in the spectral power of slow wave (theta and delta) EEG activity, in the amount (up to the disappearance) of paroxysmal EEG activity, in the EEG response to hyperventilation and in the shortening of the P300 peak latency. Such positive changes of neurophysiological parameters have been associated with the improvement of clinical conditions of patients and correlated significantly with the dynamics of psychometric scores of attention and memory.

  7. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    Science.gov (United States)

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

  8. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students.

    Science.gov (United States)

    DeCamp, Whitney; Bakken, Nicholas W

    2016-01-01

    Research has suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI) among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behavior may help identify troubled students and initiate preventative measures. Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects--including those from sexual activity, substance use, and unhealthy dieting behaviors--significantly differed based on gender and orientation. Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts. © 2016 KUMS, All rights reserved.

  9. Self-injury, suicide ideation, and sexual orientation: differences in causes and correlates among high school students

    Directory of Open Access Journals (Sweden)

    Whitney DeCamp

    2016-01-01

    Full Text Available BACKGROUND: Researchhas suggested that sexual minority youth are more likely to experience a number of behavioral and health-related risk factors due to their exposure to negative attitudes and beliefs about sexual minorities. Few studies, however, have examined the prevalence of non-suicidal self-injury (NSSI among sexual minority youth. With self-cutting and suicidal ideation common in middle and high schools, understanding the antecedents and correlates of such behaviormay help identify troubled students and initiate preventative measures. METHODS: Bivariate probit regression analyses are performed using data from 7,326 high school students collected via the Delaware Youth Risk Behavior Survey. RESULTS: Results indicate that bullying victimization, fighting, substance use, sexual behavior, depression, and unhealthy dieting behaviors were generally associated with NSSI and suicidal ideation. Some effects - including those from sexual activity, substance use, and unhealthy dieting behaviors – significantly differed based on gender and orientation. CONCLUSIONS: Risk factors for suicide and NSSI vary by gender and orientation. Both prevention/intervention specialists and researchers should consider the intersection of these risk factors with sexual orientation in their efforts.

  10. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  11. Prevalence and socio-demographic correlates for serious injury among adolescents participating in the Djibouti 2007 Global School-based Health Survey.

    Science.gov (United States)

    Muula, Adamson S; Siziya, Seter; Rudatsikira, Emmanuel

    2011-09-27

    Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months. The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females) reported having sustained serious injury (SSI). Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last 12 months (AOR = 1.27; 95% CI [1.06, 1.52] for 3-5 days of bullying victimization per month, and AOR = 3.19; 95% CI [2.28, 4.47] for 6-9 days per month. Adolescents who were engaged in physical fighting were 47% (AOR = 1.47, 95% CI [1.40, 1.55] more likely to have sustained serious injury compared to those who were not engaged in the fighting. Meanwhile, adolescents who used substances (cigarettes, other forms of tobacco or drugs) were 30% (AOR = 1.30, 95% CI [1.19, 1.42]) more likely to have sustained serious injury compared to those who did not use substances. Serious injury is common among adolescents in Djibouti, and we suggest that health workers attending to injured adolescents explore the patients' psycho-social environment. Further, we suggest longitudinal studies where reduction of substance use and bullying may be assessed if they have an impact in reducing serious injury among adolescents.

  12. Prevalence and socio-demographic correlates for serious injury among adolescents participating in the Djibouti 2007 Global School-based Health Survey

    Directory of Open Access Journals (Sweden)

    Rudatsikira Emmanuel

    2011-09-01

    Full Text Available Abstract Background Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months. Findings The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females reported having sustained serious injury (SSI. Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last 12 months (AOR = 1.27; 95% CI [1.06, 1.52] for 3-5 days of bullying victimization per month, and AOR = 3.19; 95% CI [2.28, 4.47] for 6-9 days per month. Adolescents who were engaged in physical fighting were 47% (AOR = 1.47, 95% CI [1.40, 1.55] more likely to have sustained serious injury compared to those who were not engaged in the fighting. Meanwhile, adolescents who used substances (cigarettes, other forms of tobacco or drugs were 30% (AOR = 1.30, 95% CI [1.19, 1.42] more likely to have sustained serious injury compared to those who did not use substances. Conclusions Serious injury is common among adolescents in Djibouti, and we suggest that health workers attending to injured adolescents explore the patients' psycho-social environment. Further, we suggest longitudinal studies where reduction of substance use and bullying may be assessed if they have an impact in reducing serious injury among adolescents.

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

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R.; Puttagunta, S.

    2011-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-01

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

  15. Correlation of serum GFAP, S100B and NSE contents with posttraumatic oxidative stress response and insulin resistance in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Bing-Feng Tian

    2018-07-01

    Full Text Available Objective: To study the correlation of serum GFAP, S100B and NSE contents with posttraumatic oxidative stress response and insulin resistance in patients with traumatic brain injury. Methods: A total of 110 patients with traumatic brain injury who were treated in our hospital between January 2015 and December 2016 were collected as the observation group, and 60 healthy subjects who received physical examination in our hospital during the same period were collected as normal control group. Serum GFAP, S100B and NSE levels as well as oxidative stress index and insulin resistance index levels of two groups of subjects were detected, and Pearson test was used to further evaluate the correlation of serum GFAP, S100B and NSE contents with oxidative stress response and insulin resistance in patients with traumatic brain injury. Results: Serum GFAP, S100B and NSE contents of observation group were significantly higher than those of normal control group; serum oxidative stress indexes MDA, MPO and LPO contents were higher than those of normal control group while SOD and TAC contents were lower than those of normal control group; serum insulin resistance indexes GLU, INS and HOMA-IR levels were higher than those of control group. Pearson test showed that serum GFAP, S100B and NSE contents in patients with traumatic brain injury were directly correlated with post-traumatic oxidative stress and insulin resistance. Conclusion: The serum GFAP, S100B and NSE contents increase in patients with traumatic brain injury, and the increase is directly correlated with the oxidative stress and insulin resistance.

  16. Ducted wind turbine optimization : A numerical approach

    NARCIS (Netherlands)

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

    2017-01-01

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

  17. Visualization of the thoracic duct by lymphoscintigraphy

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  18. Vacuum exhaust duct used for thermonuclear device

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  19. Isolated Avulsion of the Common Hepatic Duct from Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2012-01-01

    Full Text Available Isolated extrahepatic biliary tract injury following blunt abdominal trauma is rare. The underlying pathogenic mechanisms remain obscure, but include shear and/or compression forces on the biliary system. Associated morbidity rates are high and largely the result of delays in diagnosis. Imaging modalities commonly employed for diagnosis include ultrasonography, computed tomography, nuclear medicine, and magnetic resonance imaging. Percutaneous and endoscopic techniques have been used both for diagnosis and treatment. Treatment options are dictated by the stability of the patient and the extent of bile duct and concomitant injuries. In this paper, we discuss a case of isolated avulsion of the hepatic duct confluence following blunt trauma that was successfully managed with Roux-en-Y hepaticojejunostomy. To our knowledge, this specific injury pattern has not been previously reported.

  20. Cholangiographic evaluation of bile duct carcinoma

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  1. Tackler’s head position relative to the ball carrier is highly correlated with head and neck injuries in rugby

    Science.gov (United States)

    Hasegawa, Yoshinori; Shiota, Yuki; Ota, Chihiro; Yoneda, Takeshi; Tahara, Shigeyuki; Maki, Nobukazu; Matsuura, Takahiro; Sekiguchi, Masahiro; Itoigawa, Yoshiaki; Tateishi, Tomohiko; Kaneko, Kazuo

    2018-01-01

    Objectives To characterise the tackler’s head position during one-on-one tackling in rugby and to determine the incidence of head, neck and shoulder injuries through analysis of game videos, injury records and a questionnaire completed by the tacklers themselves. Methods We randomly selected 28 game videos featuring two university teams in competitions held in 2015 and 2016. Tackles were categorised according to tackler’s head position. The ‘pre-contact phase’ was defined; its duration and the number of steps taken by the ball carrier prior to a tackle were evaluated. Results In total, 3970 tackles, including 317 (8.0%) with the tackler’s head incorrectly positioned (ie, in front of the ball carrier) were examined. Thirty-two head, neck or shoulder injuries occurred for an injury incidence of 0.8% (32/3970). The incidence of injury in tackles with incorrect head positioning was 69.4/1000 tackles; the injury incidence with correct head positioning (ie, behind or to one side of the ball carrier) was 2.7/1000 tackles. Concussions, neck injuries, ‘stingers’ and nasal fractures occurred significantly more often during tackles with incorrect head positioning than during tackles with correct head positioning. Significantly fewer steps were taken before tackles with incorrect head positioning that resulted in injury than before tackles that did not result in injury. Conclusion Tackling with incorrect head position relative to the ball carrier resulted in a significantly higher incidence of concussions, neck injuries, stingers and nasal fractures than tackling with correct head position. Tackles with shorter duration and distance before contact resulted in more injuries. PMID:29162618

  2. Prognostic factors for open globe injuries and correlation of Ocular Trauma Score at a tertiary referral eye care centre in Singapore

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    2013-01-01

    Full Text Available Objective: To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to correlate the Ocular trauma score. Materials and Methods: Retrospective case analysis of patients with open globe injuries at a tertiary referral eye care centre in Singapore was performed. Pre-operative factors affecting final vision outcome in patients with open globe injury and correlation of ocular trauma score in our study with international ocular trauma scoring system was performed. Results: Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 years. Mean follow up was 12.26 m. Males were pre-dominantly affected. Initial visual acuity was ≥20/40, 20/50 < 20/200, 20/200- CF, HM- PL and NLP in 24 (14%, 39 (22.7%, 16 (9.3%, 66 (38.4% and 27 (15.7% eyes respectively. Final visual acuity was ≤20/40, 20/50 < 20/200, 20/200- 1/200, HM- PL and NLP in 76 (44.2%, 28 (16.3%, 11 (6.4%, 30 (17.4% and 27 (15.7% eyes respectively. Ocular trauma score in our study correlates with international ocular trauma scoring system. Conclusion: The present study showed pre-operative variables such as mode of injury, pre-operative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous lossand vitreous hemorrhage to be adversely affecting the final vision outcome. Our study showed a good synchrony with international ocular trauma score (OTS and based on this study we were able to validate application of OTS in Singapore population. Recognizing these factors can help the surgeon in evidence based counseling.

  3. Correlation of shoulder range of motion limitations at discharge with limitations in activities and participation one year later in persons with spinal cord injury.

    Science.gov (United States)

    Eriks-Hoogland, Inge E; de Groot, Sonja; Post, Marcel W M; van der Woude, Lucas H V

    2011-02-01

    To study the correlation between limited shoulder range of motion in persons with spinal cord injury at discharge and the performance of activities, wheeling performance, transfers and participation one year later. Multicentre prospective cohort study. A total of 146 newly injured subjects with spinal cord injury. Shoulder range of motion was measured at discharge. One year later, Functional Independence Measure (FIM), transfer ability, wheelchair circuit and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were assessed. Corrections were made for possible confounding factors (age, gender, level and completeness of injury, time since injury and shoulder pain). All subjects with limited shoulder range of motion at discharge had a lower FIM motor score and were less likely (total group 5 times, and subjects with tetraplegia 10 times less likely) to be able to perform an independent transfer one year later. Subjects with limited shoulder range of motion in the total group needed more time to complete the wheelchair circuit. No significant associations with the PASIPD were found in either group. Persons with spinal cord injury and limited shoulder range of motion at discharge are more limited in their activities one year later than those without limited shoulder range of motion.

  4. The diameter of main pancreatic duct on endoscopic retrograde pancreatography and the appearance of main pancreatic duct on computed tomography

    International Nuclear Information System (INIS)

    Tanno, Naoaki; Yamazaki, Hideo; Toyota, Takayoshi; Nakanome, Chiyuki; Sasaki, Masayoshi; Sato, Waichi; Komatsu, Kanji.

    1990-01-01

    We have carried out a comparative study of the diameter of main pancreatic duct (MPD) on endoscopic retrograde pancreatography (ERP) with the fequency of detection of MPD by computed tomography (CT) in order to clarify the importance of MPD appearance on CT in the pancreatic and biliary diseases. The normal MPD on ERP was demonstrated by CT in a low frequency. MPD was most frequently observed in the pancreatic body on CT. The dilatation of MPD on ERP was found in both moderate and advanced pancreatitis group. However, the significant demonstration of MPD by CT was found in advanced group alone. We observed that CT finding of dilated duct correlated with that on ERP in advanced group alone. (author)

  5. Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Christopher J. Kirwan

    2013-01-01

    Full Text Available Introduction. RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI, but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI. Aim. This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl in critically ill patients with AKI. Methods. Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl. Results. eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD. Conclusions. eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

  6. Bile Duct Adenoma with Oncocytic Features

    Directory of Open Access Journals (Sweden)

    E. J. Johannesen

    2014-01-01

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

  7. Attention Functions in Traumatic Brain Injury and Stroke: An Exploration of the Predictors of Daily Living Difficulties and the Correlates of the CogniPlus Vigilance Training Programme

    OpenAIRE

    Shehab, Al Amira Safa

    2012-01-01

    Attention deficits are common in traumatic brain injury and stroke. These difficulties can impact the individual’s everyday life, affecting activities of daily living such as running errands, increasing cognitive errors such as failing to notice signs, and minimising community integration. They also call for specific training to improve these functions. We investigated the relationship between attention functions and these daily living aspects, as well as the correlates of the CogniPlus VIG t...

  8. Endoscopic management of biliary injuries and leaks

    Directory of Open Access Journals (Sweden)

    T S Chandrasekar

    2012-01-01

    Full Text Available Bile duct injuries and subsequent leaks can occur following laparoscopic and open cholecystectomies and also during other hepatobiliary surgeries. Various patient related and technical factors are implicated in the causation of biliary injuries. Over a period of twenty five years managing such patients of biliary injuries our team has found a practical approach to assess the cause of biliary injuries based on the symptoms, clinical examination and imaging. Bismuth classification is helpful in most of the cases. Immediate referral to a centre experienced in the management of bile duct injury and timely intervention is associated with improved outcomes. Resuscitation, correcting dyselectrolytemia, aspiration of undrained biloma and antibiotics take the priority in the management. The goal is to restore the bile conduit, and to prevent short and longterm complications such as biliary fistula, intra-abdominal abscess, biliary stricture, recurrent cholangitis and secondary biliary cirrhosis. Endoscopic therapy by reducing the transpapillary pressure gradient helps in reducing the leak. Endoscopic therapy with biliary sphincterotomy alone or with additional placement of a biliary stent/ nasobiliary drainage is advocated. In our tertiary care referral unit, we found endoscopic interventions are useful in situations where there is leak with associated CBD calculus or a foreign body, peripheral bile duct injury, cystic duct stump leak and partial bile duct injury with leak/ narrowing of the lumen. Endotherapy is not useful in case of complete transection (total cut off and complete stricture involving common hepatic or common bile ducts. In conclusion, endoscopic treatment can be considered a highly effective therapy and should be the first-line therapy in such patients. Though less successful, an endoscopic attempt is warranted in patients suffering from central bile duct leakages failing which surgical management is recommended.

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

    Science.gov (United States)

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

    2001-01-20

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

  10. Experimental and theoretical investigations on the dynamic response of EBR-II ducts under pressure pulse loading

    International Nuclear Information System (INIS)

    Chopra, P.S.; Srinivas, S.

    1975-01-01

    In order to assess the potential damage to hexagonal subassembly ducts (cans) that may result from rapid gas release from a failed element the EBR-II project has conducted experiments and analyses. Additional experimental and analytical investigations are now being conducted to assure fail-safety of the ducts. Fail-safety is defined as the ability of a duct to withstand pressure pulses from failed elements during all reactor conditions without damage to adjacent ducts or any other problems in fuel handling. The results of 93 EBR-II duct tests conducted primarily by Koenig have been reported previously. The results of empirical correlations of some of these tests to determine the influence of several variables on the pressure pulse experienced by a duct and on the duct deformation are presented. The variables include the type of gas contained in the simulated element (tube), the element and duct materials, the presence or absence of flow restrictors in the element, and the way gas was released. 8 references. (auth)

  11. Corrosion mapping in ducts using the automated ultrasonic technique C-Scan - correlation with results given by pig inspection; Mapeamento de corrosao em dutos atraves da tecnica ultrassonica C-Scan

    Energy Technology Data Exchange (ETDEWEB)

    Feres Filho, Pedro; Moura, Nestor Carlos de [Physical Acoustics South America (PASA), Sao Paulo, SP (Brazil)

    2005-07-01

    In-service inspection has received diverse contributions from technologies and documents with the objective of maximizing equipment availability and minimizing inadequate repairs. Amongst the available technologies, there are the automated ultrasound tests, in the B and C-scan versions. This paper describes an evaluation methodology based on the correlation between the test techniques of instrumented electromagnetic PIG and automated ultrasound, both applied with the purpose of detecting and mapping areas with corrosion in pipes for oil transport. The main objective of the application of the C-scan methodology, in this case, was the measuring and detailing of the corroded area, thus providing an adequate maintenance plan through the substitution or installation of a double gutter. The result demonstrates the correlation between the measurements taken by the PIG and the sizing of the regions done using the C-scan method, consisting of the length, width and thickness values in the points affected by the corrosion. (author)

  12. Long-term assessments after pancreaticoduodenectomy with pancreatic duct invagination anastomosis

    International Nuclear Information System (INIS)

    Fujino, Yasuhiro; Matsumoto, Ippei; Sakai, Tetsuya; Ajiki, Tetsuo; Ueda, Takashi; Kuroda, Yoshikazu; Suzuki, Yasuyuki

    2007-01-01

    The purpose of this cohort was to evaluate the long-term patency of the anastomosis and the remnant pancreatic functions. Fifty-six consecutive patients undergoing a pancreaticoduodenectomy with pancreatic duct invagination anastomosis were enrolled in this study. During the follow-up, changes in the remnant pancreatic duct size, pancreatic exocrine and endocrine functions, and nutritional status were monitored. No seriously activated pancreatic fistula, no hemorrhagic complications, no reoperations, and no in-hospital deaths were observed after surgery. A dilatation of remnant pancreatic duct was detected a total of 37 times (51%) during annual computed tomography (CT) evaluations. Pancreatic dysfunctions were observed in a considerable number of patients (exocrine 4/12, 9/14, and 8/16, endocrine 9/35, 8/27, and 4/16 at 1, 2, and 3 postoperative years, respectively). Functional declines in the remnant pancreas, duct dilatation, and a decrease in the body mass index were observed from the first year. However, these data did not progressively deteriorate thereafter, at least during the first 3 postoperative years. This study demonstrated a significant correlation between the duct dilatation and endocrine dysfunction. Our pancreatic duct invagination anastomosis resulted in somewhat limited long-term outcomes, although it did prevent serious complications in the short-term. (author)

  13. Thermal performance test of hot gas ducts of helium engineering demonstration loop (HENDEL)

    International Nuclear Information System (INIS)

    Hishida, Makoto; Kunitomi, Kazuhiko; Ioka, Ikuo; Umenishi, Koji; Kondo, Yasuo; Tanaka, Toshiyuki; Shimomura, Hiroaki

    1984-01-01

    A hot gas duct provided with internal thermal insulation is supposed to be used for an experimental very high-temperature gas-cooled reactor (VHTR) which has been developed by the Japan Atomic Energy Research Institute (JAERI). This type of hot gas duct has not been used so far in industrial facilities, and only a couple of tests on such a large-scale model of hot gas duct have been conducted. The present test was to investigate the thermal performance of the hot gas ducts which are installed as parts of a helium engineering demonstration loop (HENDEL) of JAERI. Uniform temperature and heat flux distributions at the surface of the duct were observed, the experimental correlation being obtained for the effective thermal conductivity of the internal thermal insulation layer. The measured temperature distribution of the pressure tube was in good agreement with the calculation by a TRUMP heat transfer computer code. The temperature distribution of the inner tube of VHTR hot gas duct was evaluated, and no hot spot was detected. These results would be very valuable for the design and development of VHTR. (author)

  14. Fatigue and Cognitive Fatigability in Mild Traumatic Brain Injury are Correlated with Altered Neural Activity during Vigilance Test Performance

    Directory of Open Access Journals (Sweden)

    Marika C. Möller

    2017-09-01

    Full Text Available IntroductionFatigue is the most frequently reported persistent symptom following a mild traumatic brain injury (mTBI, but the explanations for the persisting fatigue symptoms in mTBI remain controversial. In this study, we investigated the change of cerebral blood flow during the performance of a psychomotor vigilance task (PVT by using pseudo-continuous arterial spin labeling (PCASL MRI technique to better understand the relationship between fatigability and brain activity in mTBI.Material and methodsTen patients (mean age: 37.5 ± 11.2 years with persistent complaints of fatigue after mTBI and 10 healthy controls (mean age 36.9 ± 11.0 years were studied. Both groups completed a 20-min long PVT inside a clinical MRI scanner during simultaneous measurements of reaction time and regional cerebral blood flow (rCBF with PCASL technique. Cognitive fatigability and neural activity during PVT were analyzed by dividing the performance and rCBF data into quintiles in addition to the assessment of self-rated fatigue before and after the PVT.ResultsThe patients showed significant fatigability during the PVT while the controls had a stable performance. The variability in performance was also significantly higher among the patients, indicating monitoring difficulty. A three-way ANOVA, modeling of the rCBF data demonstrated that there was a significant interaction effect between the subject group and performance time during PVT in a mainly frontal/thalamic network, indicating that the pattern of rCBF change for the mTBI patients differed significantly from that of healthy controls. In the mTBI patients, fatigability at the end of the PVT was related to increased rCBF in the right middle frontal gyrus, while self-rated fatigue was related to increased rCBF in left medial frontal and anterior cingulate gyri and decreases of rCBF in a frontal/thalamic network during this period.DiscussionThis study demonstrates that PCASL is a useful technique to

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  17. Transmission of wave energy in curved ducts

    Science.gov (United States)

    Rostafinski, W.

    1973-01-01

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

  18. Submandibular duct sialolithiasis an unusual presentation

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  19. Hollow-duct radiation delivery system investigation

    Directory of Open Access Journals (Sweden)

    Kramer D.

    2013-05-01

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

  20. Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update).

    Science.gov (United States)

    Abajas Bustillo, Rebeca; Leal Costa, César; Ortego Mate, María Del Carmen; Zonfrillo, Mark R; Seguí Gómez, María; Durá Ros, María Jesús

    2018-02-01

    To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.

  1. A Comparison of Simulation Capabilities for Ducts

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-01

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

  2. Numerical model describing the heat transfer between combustion products and ventilation-system duct walls

    International Nuclear Information System (INIS)

    Bolstad, J.W.; Foster, R.D.; Gregory, W.S.

    1983-01-01

    A package of physical models simulating the heat transfer processes occurring between combustion gases and ducts in ventilation systems is described. The purpose of the numerical model is to predict how the combustion gas in a system heats up or cools down as it flows through the ducts in a ventilation system under fire conditions. The model treats a duct with (forced convection) combustion gases flowing on the inside and stagnant ambient air on the outside. The model is composed of five submodels of heat transfer processes along with a numerical solution procedure to evaluate them. Each of these quantities is evaluated independently using standard correlations based on experimental data. The details of the physical assumptions, simplifications, and ranges of applicability of the correlations are described. A typical application of this model to a full-scale fire test is discussed, and model predictions are compared with selected experimental data

  3. A study of burden of care and its correlates among family members supporting relatives and loved ones with traumatic spinal cord injuries.

    Science.gov (United States)

    Castellano-Tejedor, Carmina; Lusilla-Palacios, Pilar

    2017-07-01

    To understand and describe in a sample of caregivers of persons with spinal cord injury, their burden of care, resilience and life satisfaction and to explore the relationship between these variables. Cross-sectional design. One Spinal Cord Injury Acute Inpatient Unit from a general hospital. Seventy-five relatives of persons with spinal cord injuries (84% women) with a mean age of 48.55 ( SD = 12.55) years. None. Demographics (neurological loss and severity according to the American Spinal Injury Association criteria), the Zarit Burden Interview, the Resilience Scale and the Life Satisfaction Checklist. All caregivers experienced feelings of different intensities of burden (52% mild-to-moderate, 43% moderate-to-severe and 5% severe), and none of them expressed little or no burden at the assessment moment. Caregivers' main worries were "dependence" and "the future of the injured." Resilience was medium-to-high (mean = 141.93, SD = 23.44) for the whole sample with just a minority of them revealing low (15%) or very low resilience (7%). The highest scores were obtained in relation to "caregivers' independence" and "meaning of their lives." Life satisfaction scores were medium-to-high (mean = 36.6, SD = 6). These scores were not related to demographics or the severity of the injury. Zarit Burden Interview scores were negatively correlated to Resilience Scale ( r = -.370, P = .001) and Life Satisfaction Checklist scores ( r = -.412, P resilient and satisfied caregivers experienced lower burden. Burden is moderate-to-high and mainly related to uncertainty about the future, caregivers' insecurity with caregiving and dependence of the injured.

  4. Prevalence, causes, and correlates of traumatic dental injuries among seven-to-twelve-year-old school children in Dera Bassi

    Directory of Open Access Journals (Sweden)

    Rohini Dua

    2012-01-01

    Full Text Available Aim : The paper aims to present a study conducted in Dera Bassi, Mohali, India. The purpose of the study was to ascertain the prevalence of traumatic dental injuries (TDI in children of age group 7-12 years in private schools in Gulabgarh village. Material & Method : Age & sex distribution, etiological factors, risk factors and cause of injury were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS statistical software program. Results : The overall prevalence of dental trauma was 14.5%, amongst the 880 subjects examined, out of which, 63.2% males and 36.4% females were found to be affected. The maxillary central incisor was found to be most commonly affected tooth (43.8%. The most common cause of injury reported was fall during playing (37.5%. Conclusion : Enamel fracture was most prevalent (50%. No risk factor was significantly higher than others; however children with Angle′s class II div 1 malocclusion exhibited greater risk factor for traumatic injuries.

  5. Pharmacological correlation between the formalin test and the neuropathic pain behavior in different species with chronic constriction injury.

    NARCIS (Netherlands)

    Vissers, K.C.P.; Geenen, F.; Biermans, R.; Meert, T.F.

    2006-01-01

    Research on mechanisms of drug action, and preclinical screening of molecules with a potential activity on neuropathic pain requires extensive animal work. The chronic constriction injury model is one of the best-characterized models of neuropathic pain behavior in rats, but requires extensive time

  6. Partner aggression among men and women in substance use disorder treatment: correlates of psychological and physical aggression and injury.

    Science.gov (United States)

    Chermack, Stephen T; Murray, Regan L; Walton, Maureen A; Booth, Brenda A; Wryobeck, John; Blow, Frederic C

    2008-11-01

    This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the inter-relationships among substance, aggression and depressive symptoms.

  7. Ultrasound appearance of chronic mammary duct ectasia

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-15

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

  8. Ultrasound appearance of chronic mammary duct ectasia

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  9. A radiographic study of nasopalatine duct cysts

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-02-15

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

  10. A radiographic study of nasopalatine duct cysts

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  11. ITER L 6 equatorial maintenance duct remote handling study

    International Nuclear Information System (INIS)

    Millard, J.

    1996-09-01

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

  12. Molecular characterization of apocrine salivary duct carcinoma.

    Science.gov (United States)

    Chiosea, Simion I; Williams, Lindsay; Griffith, Christopher C; Thompson, Lester D R; Weinreb, Ilan; Bauman, Julie E; Luvison, Alyssa; Roy, Somak; Seethala, Raja R; Nikiforova, Marina N

    2015-06-01

    Contemporary classification and treatment of salivary duct carcinoma (SDC) require its thorough molecular characterization. Thirty apocrine SDCs were analyzed by the Ion Ampliseq Cancer HotSpot panel v2 for mutations in 50 cancer-related genes. Mutational findings were corroborated by immunohistochemistry (eg, TP53, BRAF, β-catenin, estrogen, and androgen receptors) or Sanger sequencing/SNaPshot polymerase chain reaction. ERBB2 (HER2), PTEN, FGFR1, CDKN2A/P16, CMET, EGFR, MDM2, and PIK3CA copy number changes were studied by fluorescence in situ hybridization. TP53 mutations (15/27, 56%), PTEN loss (11/29, 38%, including 2 cases with PTEN mutation), PIK3CA hotspot mutations (10/30, 33%), HRAS hotspot mutations (10/29; 34%), and ERBB2 amplification (9/29, 31%, including 1 case with mutation) represented the 5 most common abnormalities. There was no correlation between genetic changes and clinicopathologic parameters. There was substantial overlap between genetic changes: 8 of 9 cases with ERBB2 amplification also harbored a PIK3CA, HRAS, and TP53 mutation and/or PTEN loss. Six of 10 cases with PIK3CA mutation also had an HRAS mutation. These findings provide a molecular rationale for dual targeting of mitogen-activated protein kinase and phosphoinositide 3-kinase pathways in SDC. FGFR1 amplification (3/29, 10%) represents a new potential target. On the basis of studies of breast carcinomas, the efficacy of anti-ERBB2 therapy will likely be decreased in SDC with ERBB2 amplification co-occurring with PIK3CA mutation or PTEN loss. Therefore, isolated ERBB2 testing is insufficient for theranostic stratification of apocrine SDC. On the basis of the prevalence and type of genetic changes, apocrine SDC appears to resemble one subtype of breast carcinoma-"luminal androgen receptor positive/molecular apocrine."

  13. Characterization of flow in a scroll duct

    Science.gov (United States)

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

    1985-01-01

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

  14. Levels of procoagulant microvesicles are elevated after traumatic injury and platelet microvesicles are negatively correlated with mortality

    Directory of Open Access Journals (Sweden)

    Nicola Curry

    2014-10-01

    Full Text Available Background: Microvesicles (MV have been implicated in the development of thrombotic disease, such as acute respiratory distress syndrome (ARDS and multiple organ failure (MOF. Trauma patients are at increased risk of late thrombotic events, particularly those who receive a major transfusion. The aims of this study were: (a to determine whether there were increased numbers of pro-coagulant MV following injury; (b to determine their cellular origin; and (c to explore the effects of MV with clinical outcomes; in particular red cell transfusion requirements and death. Methods: Trauma patients were recruited at a Level 1 trauma centre. The presence of MV procoagulant phospholipid (PPL was assessed using 2 activity assays (PPL and thrombin generation. Enumeration and MV cellular origin was assessed using 2 colour flow cytometry. Results: Fifty consecutive patients were recruited; median age 38 (IQR: 24–55, median ISS 18 (IQR: 9–27. Circulating procoagulant MV, rich in phospholipid, were significantly elevated following traumatic injury relative to controls and remained elevated at 72 h post-injury. Red cell/AnnV+ and platelet/AnnV+ MV numbers were 6-fold and 2-fold higher than controls, respectively. Patients who died (n=9, 18% had significantly fewer CD41/AnnV+ MV and lower endogenous thrombin potential relative to patients who survived. Conclusions: MV are elevated following traumatic injury and may be implicated in the increased risk of trauma patients to pro-thrombotic states such as MOF and ARDS. Lower levels of procoagulant MV are associated with mortality and further investigation of this association is warranted.

  15. Salivary duct carcinoma: a Danish national study

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  16. Evaluation of PEGIT duct connection system

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-08-01

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

  17. Fluid flow in a spiral microfluidic duct

    Science.gov (United States)

    Harding, Brendan; Stokes, Yvonne

    2018-04-01

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

  18. The Canadian residential duct and chimney survey

    Energy Technology Data Exchange (ETDEWEB)

    Fugler, D.

    2003-12-01

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

  19. Assessment of the form and patency of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP)

    International Nuclear Information System (INIS)

    Kitamura, Masaya; Takahashi, Tuyoshi; Yoshida, Muneki; Shimada, Ken; Kakita, Akira; Isobe, Yoshinori

    1999-01-01

    There have been no reliable methods for the assessment of the patency of an end-to-side style pancreaticojejunal anastomosis in Whipple procedure. We evaluated the ability of MR-Cholangiopancreatography (MRCP) to assess the form and patency of the pancreatic duct in 181 patients. The pancreatic duct was displayed on MRCP in 70.9% of the patients. The domostrative rate of the pancreatic duct on MRCP and the PFD test were well correlated (p=0.031). Further, we assessed the patency of pancreaticojejunal anastomosis in Whipple procedure by MRCP following a secretin load. It was considered that the pancreatic duct to be patent when pancreatic excretion into the jejunum had increased and/or the ability to display the pancreatic duct had improved on MRCP following an i.v. load of secretin. A secretin-loading MRCP was suggested to be of much help in the assessment of the patency of pancreaticojejunostomy in patients undergoing Whipple procedure for a long-term follow up. (author)

  20. Assessment of the form and patency of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP)

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Masaya; Takahashi, Tuyoshi; Yoshida, Muneki; Shimada, Ken; Kakita, Akira; Isobe, Yoshinori [Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine

    1999-02-01

    There have been no reliable methods for the assessment of the patency of an end-to-side style pancreaticojejunal anastomosis in Whipple procedure. We evaluated the ability of MR-Cholangiopancreatography (MRCP) to assess the form and patency of the pancreatic duct in 181 patients. The pancreatic duct was displayed on MRCP in 70.9% of the patients. The domostrative rate of the pancreatic duct on MRCP and the PFD test were well correlated (p=0.031). Further, we assessed the patency of pancreaticojejunal anastomosis in Whipple procedure by MRCP following a secretin load. It was considered that the pancreatic duct to be patent when pancreatic excretion into the jejunum had increased and/or the ability to display the pancreatic duct had improved on MRCP following an i.v. load of secretin. A secretin-loading MRCP was suggested to be of much help in the assessment of the patency of pancreaticojejunostomy in patients undergoing Whipple procedure for a long-term follow up. (author)

  1. A numerical investigation of laminar forced convection in a solar collector with non-circular duct

    Directory of Open Access Journals (Sweden)

    Teleszewski Tomasz Janusz

    2017-01-01

    Full Text Available This paper presents a two-dimensional numerical study to investigate laminar flow in a flat plate solar collector with non-circular duct (regular polygonal, elliptical, and Cassini oval shape featuring forced convection with constant axial wall heat flux and constant peripheral wall temperature (H1 condition. Applying the velocity profile obtained for the duct laminar flow, the energy equation was solved exactly for the constant wall heat flux using the Boundary Element Method (BEM. Poiseuille and Nusselt numbers were obtained for flows having a different number of geometrical factors. The results are presented and discussed in the form of tables and graphs. The area goodness factor and volume goodness factor are calculated. The predicted correlations for Poiseuille and Nusselt numbers may be a very useful resource for the design and optimization of solar collectors with non-circular ducts.

  2. Study on the natural convection heat transfer characteristics in the air duct

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y. K.; Lee, Y. B.; Choi, S. K.; Hwang, J. S.; Nam, H. Y. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    Temperature distribution measurements in the mockup apparatus of reactor vessel were performed to determine the effective thermal conductivity of porous media with different geometry and to obtain the experimental data for the heat transfer processes by natural convection occurring in the air duct. The temperature distributions at four separated sections with different arrangements of porous media have different slopes according to the geometrical configuration. From the measured temperature distribution, effective thermal conductivity have been derived using the least square fitting method. The test at air duct was performed to the high heat removal at 3.4kW/m{sup 2} by the natural convection from the outer wall to the air. And also the temperature distributions in the sir duct agree well with the 1/7th power-law turbulent temperature distribution. The obtained heat transfer data have been compared with the Shin`s and Sieger`s correlations. 10 refs., 6 figs. (Author)

  3. The ''liver scan'' appearance in cholescintigraphy. A sign of complete common bile duct obstruction

    International Nuclear Information System (INIS)

    Noel, A.W.; Velchik, M.G.; Alavi, A.

    1985-01-01

    One hundred consecutive Tc-99m IDA hepatobiliary scans were reviewed revealing 14 scans (14%), that showed nonvisualization of the common bile duct (CBD), gallbladder (GB), and small bowel (SB), but good hepatic uptake of Tc-99m IDA derivative, a pattern designated by us as ''the liver scan appearance.'' In 11 of 14 cases (79%), the diagnosis of complete CBD obstruction was confirmed by surgery, percutaneous transhepatic cholangiogram (PTC), endoscopic retrograde cholangiopancreatography (ERCP), and/or percutaneous needle biopsy (PBx). Common bile duct obstruction was suspected but not proven in the other three cases. The cholescintigraphic, ultrasound, PTC, ERCP, intraoperative cholangiogram, clinical, laboratory, and surgical findings are presented and correlated. The ''liver scan-appearance'' by cholescintigraphy should suggest a diagnosis of complete common bile duct obstruction; however, it does not specifically differentiate between stone or tumor as the cause of obstruction

  4. Study on the natural convection heat transfer characteristics in the air duct

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y K; Lee, Y B; Choi, S K; Hwang, J S; Nam, H Y [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1998-12-31

    Temperature distribution measurements in the mockup apparatus of reactor vessel were performed to determine the effective thermal conductivity of porous media with different geometry and to obtain the experimental data for the heat transfer processes by natural convection occurring in the air duct. The temperature distributions at four separated sections with different arrangements of porous media have different slopes according to the geometrical configuration. From the measured temperature distribution, effective thermal conductivity have been derived using the least square fitting method. The test at air duct was performed to the high heat removal at 3.4kW/m{sup 2} by the natural convection from the outer wall to the air. And also the temperature distributions in the sir duct agree well with the 1/7th power-law turbulent temperature distribution. The obtained heat transfer data have been compared with the Shin`s and Sieger`s correlations. 10 refs., 6 figs. (Author)

  5. A numerical investigation of laminar forced convection in a solar collector with non-circular duct

    Science.gov (United States)

    Janusz Teleszewski, Tomasz

    2017-11-01

    This paper presents a two-dimensional numerical study to investigate laminar flow in a flat plate solar collector with non-circular duct (regular polygonal, elliptical, and Cassini oval shape) featuring forced convection with constant axial wall heat flux and constant peripheral wall temperature (H1 condition). Applying the velocity profile obtained for the duct laminar flow, the energy equation was solved exactly for the constant wall heat flux using the Boundary Element Method (BEM). Poiseuille and Nusselt numbers were obtained for flows having a different number of geometrical factors. The results are presented and discussed in the form of tables and graphs. The area goodness factor and volume goodness factor are calculated. The predicted correlations for Poiseuille and Nusselt numbers may be a very useful resource for the design and optimization of solar collectors with non-circular ducts.

  6. Bundle duct interaction studies for fuel assemblies

    International Nuclear Information System (INIS)

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

    1981-06-01

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

  7. Acoustic power balance in lined ducts

    Science.gov (United States)

    Eversman, W.

    1979-01-01

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

  8. Boron neutron capture therapy using mixed epithermal and thermal neutron beams in patients with malignant glioma-correlation between radiation dose and radiation injury and clinical outcome

    International Nuclear Information System (INIS)

    Kageji, Teruyoshi; Nagahiro, Shinji; Matsuzaki, Kazuhito; Mizobuchi, Yoshifumi; Toi, Hiroyuki; Nakagawa, Yoshinobu; Kumada, Hiroaki

    2006-01-01

    Purpose: To clarify the correlation between the radiation dose and clinical outcome of sodium borocaptate-based intraoperative boron neutron capture therapy in patients with malignant glioma. Methods and Materials: The first protocol (P1998, n = 8) prescribed a maximal gross tumor volume (GTV) dose of 15 Gy. In 2001, a dose-escalated protocol was introduced (P2001, n 11), which prescribed a maximal vascular volume dose of 15 Gy or, alternatively, a clinical target volume (CTV) dose of 18 Gy. Results: The GTV and CTV doses in P2001 were 1.1-1.3 times greater than those in P1998. The maximal vascular volume dose of those with acute radiation injury was 15.8 Gy. The mean GTV and CTV dose in long-term survivors with glioblastoma was 26.4 and 16.5 Gy, respectively. A statistically significant correlation between the GTV dose and median survival time was found. In the 11 glioblastoma patients in P2001, the median survival time was 19.5 months and 1- and 2-year survival rate was 60.6% and 37.9%, respectively. Conclusion: Dose escalation contributed to the improvement in clinical outcome. To avoid radiation injury, the maximal vascular volume dose should be <12 Gy. For long-term survival in patients with glioblastoma after boron neutron capture therapy, the optimal mean dose of the GTV and CTV was 26 and 16 Gy, respectively

  9. The Correlation of Gene Expression of Inflammasome Indicators and Impaired Fertility in Rat Model of Spinal Cord Injury: A Time Course Study.

    Science.gov (United States)

    Nikmehr, Banafsheh; Bazrafkan, Mahshid; Hassanzadeh, Gholamreza; Shahverdi, Abdolhossein; Sadighi Gilani, Mohammad Ali; Kiani, Sahar; Mokhtari, Tahmineh; Abolhassani, Farid

    2017-11-04

    Expression assessment of the inflammasome genes in the acute and the chronic phases of Spinal cord injury (SCI) on adult rat testis and examination of associations between inflammasome complex expression and sperm parameters. In this study, 25 adult male rats were randomly divided into 5 groups. SCI surgery was performed at T10-T11 level of rats' spinal cord in four groups (SCI1, SCI3, SCI7, and SCI56). They were sacrificed after 1day, 3days, 7days and 56 days post SCI, respectively. One group remained intact as control (Co).CASA analysis of sperm parameters and qRT-PCR (ASC and Caspase-1) were made in all cases. Our data showed a severe reduction in sperm count and motility, especially on day 3 and 7. ASC gene expression had a non-significant increase on day 1 and 56 after surgery compared to control group. Caspase-1 expression increased significantly on day 3 post injury versus the control group (P = .009). Moreover, Caspase-1 overexpression, had significant correlations with sperm count (r = -0.555, P = .01) and sperm progressive motility (r = -0.524, P = .02). Inflammasome complex expression increase following SCI induction. This overexpression correlates to low sperm parameters in SCI rats.

  10. Melatonin attenuates oxidative stress, liver damage and hepatocyte apoptosis after bile-duct ligation in rats.

    Science.gov (United States)

    Aktas, Cevat; Kanter, Mehmet; Erboga, Mustafa; Mete, Rafet; Oran, Mustafa

    2014-10-01

    The goal of this study was to evaluate the possible protective effects of melatonin against cholestatic oxidative stress, liver damage and hepatocyte apoptosis in the common rats with bile duct ligation (BDL). A total of 24 male Wistar albino rats were divided into three groups: control, BDL and BDL + received melatonin; each group contains eight animals. Melatonin-treated BDL rats received daily melatonin 100 mg/kg/day via intraperitoneal injection. The application of BDL clearly increased the malondialdehyde (MDA) levels and decreased the superoxide dismutase (SOD) and glutathione (GSH) activities. Melatonin treatment significantly decreased the elevated tissue MDA levels and increased the reduced SOD and GSH enzyme levels in the tissues. The changes demonstrate that the bile duct proliferation and fibrosis in expanded portal tracts include the extension of proliferated bile ducts into lobules, mononuclear cells and neutrophil infiltration into the widened portal areas as observed in the BDL group. The data indicate that melatonin attenuates BDL-induced cholestatic liver injury, bile duct proliferation and fibrosis. The α-smooth muscle actin (α-SMA) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive cells in the BDL were observed to be reduced with the melatonin treatment. These results suggest that administration of melatonin is a potentially beneficial agent to reduce liver damage in BDL by decreasing oxidative stress. © The Author(s) 2012.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    African Journals Online (AJOL)

    MacBook

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

  13. Liver and Bile Duct Cancer—Health Professional Version

    Science.gov (United States)

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

  14. New concept of the buildup factor in bent ducts

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  15. Independent spinal cord atrophy measures correlate to motor and sensory deficits in individuals with spinal cord injury

    DEFF Research Database (Denmark)

    Lundell, Hans Magnus Henrik; Barthelemy, Dorothy; Skimminge, A.

    2011-01-01

    touch and pinprick, and muscle strength. Antero-posterior width (APW), left-right width (LRW) and cross-sectional spinal cord area (SCA) were extracted from MRI at the spinal level of C2. The angular variation of the spinal cord radius over the full circle was also extracted and compared...... with the clinical scores.Results:The motor score was correlated to LRW and the sensory scores were correlated to APW. The scores correlated also well with decreases in spinal cord radius in oblique angles in coherent and non-overlapping sectors for the sensory and motor qualities respectively.Conclusion:APW and LRW...

  16. Solitary intrahepatic bile-duct cyst presenting with Jaundice

    International Nuclear Information System (INIS)

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

    1989-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Della Harigovind

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2004-10-01

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

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

    OpenAIRE

    Razman Jarmin; Shaharin Shaharuddin

    2004-01-01

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

  20. A case of fascioliasis in common bile duct

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-10-15

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

  1. A case of fascioliasis in common bile duct

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  2. Internal radiotherapy for hilar bile duct cancer

    International Nuclear Information System (INIS)

    Ryu, Munemasa; Ogino, Takashi; Konishi, Hiroshi

    1999-01-01

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

  3. 46 CFR 116.610 - Ventilation ducts.

    Science.gov (United States)

    2010-10-01

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

  4. Calcium influx pathways in rat pancreatic ducts

    DEFF Research Database (Denmark)

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

    1996-01-01

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

  5. MR findings in thyroglossal duct cysts

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  6. Depressurization test on hot gas duct

    International Nuclear Information System (INIS)

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

    1989-05-01

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

  7. Whistler instability in a magnetospheric duct

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  8. Acute vanishing bile duct syndrome after therapy with cephalosporin, metronidazole, and clotrimazole: A case report.

    Science.gov (United States)

    Zhao, Zonghao; Bao, Lei; Yu, Xiaolan; Zhu, Chuanlong; Xu, Jing; Wang, Yu; Yin, Ming; Li, Yi; Li, Wenting

    2017-09-01

    Vanishing bile duct syndrome (VBDS) consists of a series of diseases characterized by the loss of >50% bile duct in portal areas. Many factors are associated with VBDS including infections, neoplasms, and drugs. Antibiotic is one of the most frequently reported causes of VBDS. A 29-year-old female was admitted because of liver injury for over 3 months. Tests for viruses that can cause hepatitis and autoantibodies were all negative. She was prescribed with antibiotics approximately a week before liver injury while there was no history of alcohol consumption. Liver biopsy demonstrated a loss of intrahepatic bile duct in most of the portal tracts. This patient was treated with ursodeoxycholic acid, polyene phosphatidylcholine, and bicyclol. Most importantly, the treatments in our hospital were proved by the ethics committee of Department of Infectious Disease, Anhui Provincial Hospital. The symptoms were improved. She is still under treatment. VBDS is rare but can be severe. A liver biopsy offers an important evidence for the diagnosis of VBDS, especially for those with a history of susceptible drugs taking.

  9. Tolerance of bile duct to intraoperative irradiation

    International Nuclear Information System (INIS)

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

    1982-01-01

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

  10. Are Ducted Mini-Splits Worth It?

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-02-01

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

  11. CT findings of thyroglossal duct cyst

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  12. Non-suicidal self-injury in patients with eating disorders: prevalence, forms, functions, and body image correlates.

    Science.gov (United States)

    Pérez, Sandra; Marco, Jos H; Cañabate, Montse

    2018-04-12

    More than one third of patients with eating disorders report NSSI. Moreover, negative attitudes and feelings toward the body, body dissatisfaction, and body image disturbances have been linked to NSSI in community and clinical samples. However, there is a lack of studies exploring NSSI frequency and functions and the specific relationship between multidimensional body image dimensions and NSSI in eating disorder patients. First, we explored the frequency, types, and functions of NSSI in a sample of 226 Spanish female participants with eating disorders (ED). Second, we explored differences in NSSI and body image depending on the ED restrictive-purgative subtype; and third, we explored differences in body dissatisfaction, body image orientation, and body investment in eating disorder patients without NSSI (n = 144), with NSSI in their lifetime (n = 19), and (b) with NSSI in the previous year (n = 63). Of the overall sample, 37.1% (n = 89) had a history of self-injury during their lifetime, and 27.1% (n = 65) had self-injured in the previous year. Among the types of ongoing NSSI, the most frequent were banging (64.6%) and cutting (56.9%). Restrictive vs purgative patients differed on NSSI lifetime, Appearance Evaluation, Body Areas Satisfaction, Body Protection and Feelings and Attitudes toward the Body. Moreover, significant differences were found on Appearance Evaluation, Body Areas Satisfaction, Positive Feelings and Attitudes towards the Body, Body Protection, and Comfort with physical contact, between participants without a history of self-injury and both NSSI groups. Body dissatisfaction and body investment have been found to be variables related to NSSI. Thus, the present study highlights the importance of working on body image in ED patients to reduce the frequency of NSSI. Copyright © 2018 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-04-21

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

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

    Science.gov (United States)

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

    1984-01-01

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

  15. The management of complex pancreatic injuries.

    Science.gov (United States)

    Krige, J E J; Beningfield, S J; Nicol, A J; Navsaria, P

    2005-08-01

    Major injuries of the pancreas are uncommon, but may result in considerable morbidity and mortality because of the magnitude of associated vascular and duodenal injuries or underestimation of the extent of the pancreatic injury. Prognosis is influenced by the cause and complexity of the pancreatic injury, the amount of blood lost, duration of shock, speed of resuscitation and quality and nature of surgical intervention. Early mortality usually results from uncontrolled or massive bleeding due to associated vascular and adjacent organ injuries. Late mortality is a consequence of infection or multiple organ failure. Neglect of major pancreatic duct injury may lead to life-threatening complications including pseudocysts, fistulas, pancreatitis, sepsis and secondary haemorrhage. Careful operative assessment to determine the extent of gland damage and the likelihood of duct injury is usually sufficient to allow planning of further management. This strategy provides a simple approach to the management of pancreatic injuries regardless of the cause. Four situations are defined by the extent and site of injury: (i) minor lacerations, stabs or gunshot wounds of the superior or inferior border of the body or tail of the pancreas (i.e. remote from the main pancreatic duct), without visible duct involvement, are best managed by external drainage; (ii) major lacerations or gunshot or stab wounds in the body or tail with visible duct involvement or transection of more than half the width of the pancreas are treated by distal pancreatectomy; (iii) stab wounds, gunshot wounds and contusions of the head of the pancreas without devitalisation of pancreatic tissue are managed by external drainage, provided that any associated duodenal injury is amenable to simple repair; and (iv) non-reconstructable injuries with disruption of the ampullary-biliary-pancreatic union or major devitalising injuries of the pancreatic head and duodenum in stable patients are best treated by

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  17. Sonographic evaluation of thyroglossal duct cysts in children

    International Nuclear Information System (INIS)

    Ahuja, A.T.; King, A.D.; Metreweli, C.

    2000-01-01

    BACKGROUND AND AIMS: Thyroglossal duct cysts (TDC) in children have a variable sonographic appearance. Some reports have suggested that TDCs appear on ultrasound as well defined, cystic masses with thin walls and posterior enhancement, whereas others have documented a heterogeneous echopattern within these lesions. In our experience, although TDCs in children have a variable ultrasound appearance, the most common appearance is that of a pseudosolid mass closely related to the hyoid bone. In this study we report on 23 patients with thyroglossal duct cysts and document the ultrasonic patterns. PATIENTS AND METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and in whom ultrasound detected a cystic mass related to the hyoid bone, were included in this study. Sonograms of 23 children with TDCs were reviewed. The features evaluated included their location, internal echogenicity, posterior enhancement, the presence of septa, a solid component and a fistulous tract. The echopattern was not correlated with the biopsy results. RESULTS: Three patterns of TDCs were identified: anechoic (13%); pseudosolid (56.5%); and a heterogeneous pattern (30.5%). The majority were midline (82.6%), showed posterior enhancement (56.5%), and had thin walls (82.6%). CONCLUSION: On ultrasound, TDCs in children are not simple cysts but have a complex pattern ranging from a typical anechoic cyst to a pseudosolid appearance (most common). Ahuja, A.T. (2000)

  18. Computational Fluid Dynamics Analysis of Flexible Duct Junction Box Design

    Energy Technology Data Exchange (ETDEWEB)

    Beach, Robert [IBACOS Inc., Pittsburgh, PA (United States); Prahl, Duncan [IBACOS Inc., Pittsburgh, PA (United States); Lange, Rich [IBACOS Inc., Pittsburgh, PA (United States)

    2013-12-01

    IBACOS explored the relationships between pressure and physical configurations of flexible duct junction boxes by using computational fluid dynamics (CFD) simulations to predict individual box parameters and total system pressure, thereby ensuring improved HVAC performance. Current Air Conditioning Contractors of America (ACCA) guidance (Group 11, Appendix 3, ACCA Manual D, Rutkowski 2009) allows for unconstrained variation in the number of takeoffs, box sizes, and takeoff locations. The only variables currently used in selecting an equivalent length (EL) are velocity of air in the duct and friction rate, given the first takeoff is located at least twice its diameter away from the inlet. This condition does not account for other factors impacting pressure loss across these types of fittings. For each simulation, the IBACOS team converted pressure loss within a box to an EL to compare variation in ACCA Manual D guidance to the simulated variation. IBACOS chose cases to represent flows reasonably correlating to flows typically encountered in the field and analyzed differences in total pressure due to increases in number and location of takeoffs, box dimensions, and velocity of air, and whether an entrance fitting is included. The team also calculated additional balancing losses for all cases due to discrepancies between intended outlet flows and natural flow splits created by the fitting. In certain asymmetrical cases, the balancing losses were significantly higher than symmetrical cases where the natural splits were close to the targets. Thus, IBACOS has shown additional design constraints that can ensure better system performance.

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

    NARCIS (Netherlands)

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

    1989-01-01

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

  20. Direct numerical simulation of turbulence and heat transfer in a hexagonal shaped duct

    Science.gov (United States)

    Marin, Oana; Obabko, Aleks; Schlatter, Philipp

    2014-11-01

    Flows in hexagonal shapes frequently occur in nuclear reactor applications, and are also present in honeycomb-shaped settling chambers for e.g. wind tunnels. Whereas wall-bounded turbulence has been studied comprehensively in two-dimensional channels, and to a lesser degree also in square and rectangular ducts and triangles, only very limited data for hexagonal ducts is available, including resistance correlations and mean profiles. Here, we use resolved spectral-element simulations to compute velocity and temperature in fully-developed (periodic) hexagonal duct flow. The Reynolds number, based on the fixed flow rate and the hydraulic diameter, ranges between 2000 and 20000. The temperature assumes constant wall flux or constant wall temperature. First DNS results are focused on the mean characteristics such a head loss, Nusselt number, and critical Reynolds number for sustained turbulence. Profiles, both for mean and fluctuating quantities, are extracted and discussed in the context of square ducts and pipes. Comparisons to existing experiments, RANS and empirical correlations are supplied as well. The results show a complicated and fine-scale pattern of the in-plane secondary flow, which clearly affects the momentum and temperature distribution throughout the cross section.

  1. Extrahepatic bile duct ligation in broiler chickens: ultrastructural study of Ito cell

    Directory of Open Access Journals (Sweden)

    Ekowati Handharyani

    2004-12-01

    Full Text Available The Ito cell (fat-storing cell is a cell lying in perisinusoidal space of liver. The function of Ito cell is expanding from a site of fat-storing site to a center of extracellular matrix metabolism and mediator production in the liver. This study was performed in order to evaluate the Ito cells in cholestatic condition. The artificial cholestatic was conducted by ligation of extrahepatic bile ducts (bile duct ligation = BDL in broilers. The results showed that BDL induced bile congestion, fibrosis, proliferation of Ito cells and intrahepatic bile ductules. Immunohistochemistry demonstrated that Ito cells were scattered throughout the fibrotic areas, and larger in size with more extensive immunoreactivity than those in normal livers. Ultrastructural study demonstrated that Ito cells were closely associated with the production of extracellular collagen fibers. Ito cells actively react against hepatocytic injuries, especially in fibrogenesis of cholestatic livers.

  2. Correlates and determinants of physical activity in persons with spinal cord injury: A review using the International Classification of Functioning, Disability and Health as reference framework.

    Science.gov (United States)

    Fekete, Christine; Rauch, Alexandra

    2012-07-01

    Participation in physical activity (PA) decreases after the onset of a spinal cord injury (SCI) and is generally low in persons with SCI. To provide an overview of findings on correlates/determinants of PA in persons with SCI applying the International Classification of Functioning, Disability and Health (ICF) to analyze and report results. A systematic literature review using the databases MEDLINE, PsycINFO, SSCI, and CINHAL was conducted. Independent variables were extracted and linked to ICF codes. Quality of evidence was rated using internationally accepted standards. Overall, evidence quality of the 25 included studies is low. Environmental Factors were consistently found as correlates of PA, whereas Personal Factors (socio-demographics and psychological constructs) were weakly associated with PA in the SCI population. Associations with Body Functions, Body Structures, Activities and Participation and Health Conditions were less frequently studied. Although quality of evidence of reviewed literature is low, results indicate that rather environmental barriers than the 'classical' socio-demographic factors known from social epidemiology correlate with PA in persons with SCI. There is insufficient evidence to draw conclusions concerning the association of Body Functions and Structures and Activity and Participation with PA. Future research is encouraged to better understand the interplay between functioning, contextual factors, health conditions and PA in SCI to establish a sound basis for intervention planning in this special needs population. In addition, our experience showed that linking study results to the ICF facilitates data analysis and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance.

    Science.gov (United States)

    Ichise, M; Chung, D G; Wang, P; Wortzman, G; Gray, B G; Franks, W

    1994-02-01

    The purposes of this study were: (1) to compare 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT with CT and MRI in chronic traumatic brain injury (TBI) patients and (2) to correlate both functional and structural neuroimaging measurements of brain damage with neuropsychological (NP) performance. Twenty-nine patients (minor TBI, n = 15 and major TBI, n = 14) and 17 normal controls (NC) underwent HMPAO SPECT, CT, MRI and NP testing. Imaging data were analyzed both visually and quantitatively. Nineteen (66%) patients showed 42 abnormalities on SPECT images, whereas 13 (45%) and 10 (34%) patients showed 29 abnormalities on MRI and 24 abnormalities on CT. SPECT detected relatively more abnormalities than CT or MRI in the minor TBI subgroup. The TBI group showed impairment on 11 tests for memory, attention and executive function. Of these, the anterior-posterior ratio (APR) correlated with six tests, whereas the ventricle-to-brain ratio (VBR), a known structural index of a poor NP outcome, correlated with only two tests. In evaluating chronic TBI patients, HMPAO SPECT, as a complement to CT or MRI, may play a useful role by demonstrating brain dysfunction in morphologically intact brain regions and providing objective evidence for some of the impaired NP performance.

  4. Evaluation of the Talar Cartilage in Chronic Lateral Ankle Instability with Lateral Ligament Injury Using Biochemical T2* Mapping: Correlation with Clinical Symptoms.

    Science.gov (United States)

    Hu, Yiwen; Tao, Hongyue; Qiao, Yang; Ma, Kui; Hua, Yinghui; Yan, Xu; Chen, Shuang

    2018-06-19

    This study aims to quantitatively compare T2* measurements of the talar cartilage between chronic lateral ankle instability (LAI) patients with lateral ligament injury and healthy volunteers, and to assess the association of T2* value with American Orthopedic Foot and Ankle Society (AOFAS) score. Nineteen consecutive patients with chronic LAI (LAI group) and 19 healthy individuals (control group) were enrolled. Biochemical magnetic resonance examination of the ankle was performed in all participants using three-dimensional gradient-echo T2* mapping. Total talar cartilage was divided into six subcompartments, including medial anterior (MA), central medial, medial posterior, lateral anterior, central lateral (LC), and lateral posterior regions. T2* values of respective cartilage areas were measured and compared between the two groups using Student t test. AOFAS scoring was performed for clinical evaluation. Then, the association of T2* value with AOFAS score was evaluated by Pearson correlation. The T2* values of total talar cartilage, as well as MA and LC cartilage compartments, in the chronic LAI group were significantly higher than control values (P T2* value of MA in the chronic LAI group was negatively correlated with AOFAS score (r =-0.8089, P T2* measurements. The clinical score correlates highly with T2* value of the MA cartilage compartment, indicating that MA may be the principal cartilage area conferring clinical symptoms. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  6. Radiologic imaging of bile duct changes by clonorchiasis

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  7. Radiologic imaging of bile duct changes by clonorchiasis

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-10-15

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

  8. Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature Reconstrução da via biliar após lesão iatrogênica, proposta de nova técnica: estudo em cães e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Eduardo Crema

    2007-06-01

    Full Text Available PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg, were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg. Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os

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

    Directory of Open Access Journals (Sweden)

    Masakatsu Numata

    2011-08-01

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

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

    Directory of Open Access Journals (Sweden)

    D. L. Pasmanik

    2005-06-01

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

  11. Spectral measurements of gamma radiation streaming through ducts

    International Nuclear Information System (INIS)

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

    1979-01-01

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

  12. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli.

    Science.gov (United States)

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-27

    Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK) staining at all times after bCCI, decreased mu opiate receptor (MOR) staining, maximal at 15 days, increased neuropeptide Y (NPY) staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R) staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  13. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI injury: correlation of anatomic changes and responses to cold stimuli

    Directory of Open Access Journals (Sweden)

    Kline Robert H

    2010-01-01

    Full Text Available Abstract Background Unilateral constrictive sciatic nerve injury (uCCI is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. Results All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK staining at all times after bCCI, decreased mu opiate receptor (MOR staining, maximal at 15 days, increased neuropeptide Y (NPY staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. Conclusions These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  14. SNM holdup assessment of Los Alamos exhaust ducts

    International Nuclear Information System (INIS)

    Marshall, R.S.

    1994-02-01

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

  15. The correlation of acute toxicity and late rectal injury in radiotherapy for cervical carcinoma: Evidence suggestive of consequential late effect (CQLE)

    International Nuclear Information System (INIS)

    Wang, C.-J.; Leung, Stephen Wan; Chen, H.-C.; Sun, L.-M.; Fang, F.-M.; Huang, E.-Y.; Hsiung, C.-Y.; Changchien, C.-C.

    1998-01-01

    Purpose: To correlate the acute toxicity during pelvic irradiation and the development of late rectal injury following radiation therapy for cervical carcinoma. Methods and Materials: Two hundred and twenty patients treated with curative-intent radiation therapy between November 1987 and January 1992 were analyzed. Patients were treated initially with external beam irradiation, 40-44 Gy/20-22 fractions to whole pelvis, followed by high dose rate intracavitary brachytherapy, 7.2 Gy to point A for 3 fractions. Severity of diarrhea during radiation therapy was scored according to six criteria: fecal characteristics, frequency, onset, prescription of antidiarrheal agents, body weight loss during irradiation, and extramedical care needed. Patients were categorized as group ND (no obvious diarrhea), group MD (moderate diarrhea), and group SD (severe diarrhea) for sum score 0-1, 2-5, and ≥6, respectively. The rate of radiation proctitis was expressed, analyzed, and compared with actuarial proctitis-free rate and prevalence. Results: 1) According to the score, 76 (35%), 89 (40%), and 55 (25%) patients were categorized as group ND, group MD, and group SD, respectively. Distribution of patients and treatment characteristics among the three groups appeared similar. Patients treated with a larger field size, ≥16.5 cm 2 , tended to have increased severity of diarrhea. 2) Overall, 103 patients (47%, 103 of 220) developed radiation proctitis. Twenty-one patients were in group ND (28%, 21 of 76), 43 in group MD (48%, 43 of 89), and 39 in group SD (71%, 39 of 55). 3) The five-year actuarial proctitis-free rate was 72, 52, and 29% for group ND, MD, and SD, respectively (p s = 0.229, p = 0.098). 6) Cox's multivariate analysis revealed that severity of diarrhea was the only factor that significantly correlated with the development of radiation proctitis. Conclusion: Patients with increased acute toxicity and diarrhea during radiation therapy of cervical carcinoma significantly

  16. Identification of acoustic wave propagation in a duct line and its application to detection of impact source location based on signal processing

    International Nuclear Information System (INIS)

    Shin, Yong Woo; Kim, Min Soo; Lee, Sang Kwon

    2010-01-01

    For the detection of the impact location in a pipeline system, the correlation method has been the conventional method. For the application of the correlation method, the diameter of a duct should be small so that the acoustic wave inside the duct can propagate with nondispersive characteristics, in the form of, for example, a plane wave. This correlation method calculates the cross-correlation between acoustic waves measured at two acceleration sensors attached to a buried duct. It also gives information about the arrival time delay of an acoustic wave between two sensors. These arrival time delays are used for the estimation of the impact location. However, when the diameter of the duct is large, the acoustic waves inside the duct propagate with dispersive characteristics owing to the reflection of the acoustic wave off of the wall of the duct. This dispersive characteristic is related to the acoustic modes inside a duct. Therefore, the correlation method does not work correctly for the detection of the impact location. This paper proposes new methods of accurately measuring the arrival time delay between two sensors attached to duct line system. This method is based on the time-frequency analyses of the short time Fourier transform (STFT) and continuous wavelet transform (CWT). These methods can discriminate direct waves (non-dispersive waves) and reflective waves (dispersive waves) from the measured wave signals through the time-frequency analysis. The direct wave or the reflective wave is used to estimate the arrival time delay. This delay is used for the identification of the impact location. This systematic method can predict the impact location due to the impact forces of construction equipment with more accuracy than the correlation method

  17. Acoustic Power Transmission Through a Ducted Fan

    Science.gov (United States)

    Envia, Ed

    2016-01-01

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

  18. Impact fracture behavior of HT9 duct

    International Nuclear Information System (INIS)

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

    1994-07-01

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

  19. Mullerian Ducts Anomalies: A Simple View

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  20. T-method duct design. Part 3

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  1. Pressure drop in T's in concentric ducts

    International Nuclear Information System (INIS)

    Shock, R.A.W.

    1983-02-01

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

  2. Hinkley Point A gas duct repairs

    International Nuclear Information System (INIS)

    Curtis, R.F.

    1996-01-01

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

  3. Dynamic response of cracked hexagonal subassembly ducts

    International Nuclear Information System (INIS)

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

    1979-01-01

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

  4. Effect of duct geometry on Wells turbine performance

    International Nuclear Information System (INIS)

    Shaaban, S.; Abdel Hafiz, A.

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-07

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

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

    International Nuclear Information System (INIS)

    Liu Qingyu; Chen Jianyu; Liang Biling; Hu Tao

    2008-01-01

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

  7. Chronic complications of inhalation injury: chest HRCT findings and a correlation with the pulmonary function test in reactive airway dysfunction syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ki Hyeok; Lee, In Sun; Jung, Eun Hee; Ji, Young Gu; Lee, Young Seok [Dankook University Hospital, Cheonan (Korea, Republic of)

    2007-09-15

    To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PET. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PET. Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PET were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis.

  8. Chronic complications of inhalation injury: chest HRCT findings and a correlation with the pulmonary function test in reactive airway dysfunction syndrome

    International Nuclear Information System (INIS)

    Song, Ki Hyeok; Lee, In Sun; Jung, Eun Hee; Ji, Young Gu; Lee, Young Seok

    2007-01-01

    To evaluate the HRCT findings and to correlate the findings with the results of a pulmonary function test (PFT) in patients with reactive airway dysfunction syndrome (RADS). On March 2003, a fire at a boarding house of primary school soccer players caused a multiple casualty disaster. After 8 months, nine boys that presented with chronic cough and dyspnea were treated, and were subjected to follow-up evaluations. Eight patients underwent a chest radiograph, HRCT, and a PET. Two patients with severe symptoms received extended follow-up after 1 year. Two radiologists retrospectively reviewed the chest radiographs and the follow-up HRCT scans. We correlated the HRCT findings with the results of the PET. Six patients with an inhalation injury were diagnosed with RADS. On the chest radiographs, eight patients showed no abnormal findings. On an HRCT scan, four patients showed abnormal findings. The abnormal findings were mosaic air trapping (n = 4), bronchial wall thickening (n = 1), and parenchymal consolidation (n = 1). In all four patients that showed abnormal findings in the HRCT scan, abnormal results of the PET were also seen. The two patients that received extended follow-up showed an improvement of the clinical symptoms, as seen by the PFT, and had a decreased extent and degree of mosaic air trapping, as seen on HRCT. An HRCT scan is an essential modality for the diagnosis and follow-up of patients with RADS. Both a full expiratory and inspiratory HRCT scan must be performed for an accurate diagnosis

  9. Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood.

    Science.gov (United States)

    García-de-la-Asunción, José; García-del-Olmo, Eva; Perez-Griera, Jaume; Martí, Francisco; Galan, Genaro; Morcillo, Alfonso; Wins, Richard; Guijarro, Ricardo; Arnau, Antonio; Sarriá, Benjamín; García-Raimundo, Miguel; Belda, Javier

    2015-09-01

    During lung lobectomy, the operated lung is collapsed and hypoperfused; oxygen deprivation is accompanied by reactive hypoxic pulmonary vasoconstriction. After lung lobectomy, ischaemia present in the collapsed state is followed by expansion-reperfusion and lung injury attributed to the production of reactive oxygen species. The primary objective of this study was to investigate the time course of several markers of oxidative stress simultaneously in exhaled breath condensate and blood and to determine the relationship between oxidative stress and one-lung ventilation time in patients undergoing lung lobectomy. This single-centre, observational, prospective study included 28 patients with non-small-cell lung cancer who underwent lung lobectomy. We measured the levels of hydrogen peroxide, 8-iso-PGF2α, nitrites plus nitrates and pH in exhaled breath condensate (n = 25). The levels of 8-iso-PGF2α and nitrites plus nitrates were also measured in blood (n = 28). Blood samples and exhaled breath condensate samples were collected from all patients at five time points: preoperatively; during one-lung ventilation, immediately before resuming two-lung ventilation; immediately after resuming two-lung ventilation; 60 min after resuming two-lung ventilation and 180 min after resuming two-lung ventilation. Both exhaled breath condensate and blood exhibited significant and simultaneous increases in oxidative-stress markers immediately before two-lung ventilation was resumed. However, all these values underwent larger increases immediately after resuming two-lung ventilation. In both exhaled breath condensate and blood, marker levels significantly and directly correlated with the duration of one-lung ventilation immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation. Although pH significantly decreased in exhaled breath condensate immediately after resuming two-lung ventilation, these pH values were inversely correlated with the

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

    Science.gov (United States)

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

    2018-04-10

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

  11. Hippocampal proton MR spectroscopy as a novel approach in the assessment of radiation injury and the correlation to neurocognitive function impairment: initial experiences

    International Nuclear Information System (INIS)

    Pospisil, Petr; Kazda, Tomas; Bulik, Martin; Dobiaskova, Marie; Burkon, Petr; Hynkova, Ludmila; Slampa, Pavel; Jancalek, Radim

    2015-01-01

    The hippocampus is considered as the main radiosensitive brain structure responsible for postradiotherapy cognitive decline. We prospectively assessed correlation of memory change to hippocampal N-acetylaspartate (h-tNAA) concentration, a neuronal density and viability marker, by 1 H-MR spectroscopy focused on the hippocampus. Patients with brain metastases underwent whole brain radiotherapy (WBRT) to a dose of 30 Gy in ten fractions daily. Pre-radiotherapy 1 H-MR spectroscopy focused on the h-tNAA concentration and memory testing was performed. Memory was evaluated by Auditory Verbal Learning Test (AVLT) and Brief Visuospatial Memory Test-Revised (BVMT-R). Total recall, recognition and delayed recall were reported. The both investigation procedures were repeated 4 months after WBRT and the h-tNAA and memory changes were correlated. Of the 20 patients, ten passed whole protocol. The h-tNAA concentration significantly decreased from pre-WBRT 8.9, 8.86 and 8.88 [mM] in the right, left and both hippocampi to 7.16, 7.65 and 7.4 after WBRT, respectively. In the memory tests a significant decrease was observed in AVLT total-recall, BVMT-R total-recall and BVMT-R delayed-recall. Weak to moderate correlations were observed between left h-tNAA and AVLT recognition and all BVMT-R subtests and between the right h-tNAA and AVLT total-recall. A significant decrease in h-tNAA after WBRT was proven by 1 H-MR spectroscopy as a feasible method for the in vivo investigation of radiation injury. Continuing patient recruitment focusing on other cognitive tests and metabolites is needed

  12. Pressure analysis in ventilation ducts at bituminization facility

    International Nuclear Information System (INIS)

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

    1997-09-01

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

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

    Science.gov (United States)

    2016-09-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  16. Hyperspectral image segmentation of the common bile duct

    Science.gov (United States)

    Samarov, Daniel; Wehner, Eleanor; Schwarz, Roderich; Zuzak, Karel; Livingston, Edward

    2013-03-01

    Over the course of the last several years hyperspectral imaging (HSI) has seen increased usage in biomedicine. Within the medical field in particular HSI has been recognized as having the potential to make an immediate impact by reducing the risks and complications associated with laparotomies (surgical procedures involving large incisions into the abdominal wall) and related procedures. There are several ongoing studies focused on such applications. Hyperspectral images were acquired during pancreatoduodenectomies (commonly referred to as Whipple procedures), a surgical procedure done to remove cancerous tumors involving the pancreas and gallbladder. As a result of the complexity of the local anatomy, identifying where the common bile duct (CBD) is can be difficult, resulting in comparatively high incidents of injury to the CBD and associated complications. It is here that HSI has the potential to help reduce the risk of such events from happening. Because the bile contained within the CBD exhibits a unique spectral signature, we are able to utilize HSI segmentation algorithms to help in identifying where the CBD is. In the work presented here we discuss approaches to this segmentation problem and present the results.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-10-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  19. Duct Remediation Program: Engineered access research and construction

    International Nuclear Information System (INIS)

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

    1992-01-01

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

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  1. Detection of common bile duct stone by hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Itoh, Hisao; Sakai, Toyohiko; Takahashi, Norio

    1991-01-01

    Hepatobiliary scintigraphy and direct X-ray cholangiography were compared in 29 patients with common bile duct (CBD) stones confirmed at surgery. The scintigraphic findings included no visualization of the biliary system (NV), pooling of bile in the biliary system (PB), prolonged transit time over 60 min (PTT), filling defect in the CBD image (FD), and reflux of bile toward the intrahepatic ducts after gallbladder stimulation (RB). The positive rates of NV, PB, PTT, FD, and RB in patients with CBD stones were 7%, 31%, 17%, 48%, and 14%, respectively. One or more of these five findings was found in 83%. Although the NV was a useful finding suggesting complete obstruction of the CBD, it shared little in the diagnosis of CBD stone. The positive rate of the PB was relatively high and it would be a useful finding as an indication of the presence of passage disturbance of the CBD. The PB was usually accompanied by the FD. The PTT had some usefulness in the detection of incomplete obstruction of the CBD in patients with a visualized gallbladder. In patients with no visualization of the gallbladder, however, the transit time tended to be shorter than that of gallbladder visualized patients. Therefore, the judgement of PTT in patients with no visualized gallbladder needed another criteria. The FD was the most frequent among the five findings and the sites of FD correlated well with CBD stones on direct X-ray cholangiography. The FD would be a reliable finding indicating CBD stone or CBD stenosis. Although the RB was a finding limited in patients with a visualized gallbladder, it seemed to be a helpful findings for the detection of CBD stone in patients with a mildly dilated CBD. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-07-01

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

  3. Fluorescent Method for Observing Intravascular Bonghan Duct

    Directory of Open Access Journals (Sweden)

    Byung-Cheon Lee

    2005-12-01

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

  4. Levitated Duct Fan (LDF) Aircraft Auxiliary Generator

    Science.gov (United States)

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

    2011-01-01

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

  5. JET neutral beam duct Optical Interlock

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  7. Forced convection and subcooled flow boiling heat transfer in asymmetrically heated ducts of T-section

    International Nuclear Information System (INIS)

    Abou-Ziyan, Hosny Z.

    2004-01-01

    This paper presents the results of an experimental investigation of heat transfer from the heated bottom side of tee cross-section ducts to an internally flowing fluid. The idea of this work is derived from the cooling of critical areas in the cylinder heads of internal combustion engines. Fully developed single phase forced convection and subcooled flow boiling heat transfer data are reported. Six T-ducts of different width and height aspect ratios are tested with distilled water at velocities of 1, 2 and 3 m/s for bulk temperatures of 60 and 80 deg. C, while the heat flux was varied from about 80 to 700 kW/m 2 . The achieved data cover Reynolds numbers in the range of 5.22 x 10 4 to 2.36 x 10 5 , Prandtl numbers in the range from 2.2 to 3.0, duct width aspect ratio between 2.19 and 3.13 and duct height aspect ratio from 0.69 to 2.0. The results revealed that the increase in either the width or height aspect ratio of the T-ducts enhances the convection heat transfer coefficients and the boiling heat fluxes considerably. The following comparisons are provided for coolant velocity of 2 m/s, bulk temperature of 60 deg. C, wall superheat of 20 K and wall to bulk temperature difference of 20 K. As the width aspect ratio increases by 43%, the convection heat transfer coefficient and the boiling heat flux increase by 27% and 39%, respectively. An increase in the height aspect ratio by 290% enhances the convection heat transfer coefficient and the boiling heat fluxes by 82% and 103%, respectively. When the coolant velocity changes from 1 to 2 m/s, the heat transfer coefficient increases by 60% and the boiling heat flux rises by 62-98% for the various tested ducts. The convection heat transfer coefficient increases by 12% and the boiling heat flux decreases by 31% as the bulk fluid temperature rises from 60 to 80 deg. C. A correlation was developed for Nusselt number as a function of Reynolds number, Prandtl number, viscosity ratio and some aspect ratios of the T-duct

  8. An experimental study on the radiation-induced injury of the rabbit lung: Correlation of soft-tissue radiograph and high- resolution CT findings with pathologic findings

    International Nuclear Information System (INIS)

    Lee, Ki Nam; Nam, Kyung Jin; Park, Byeoung Ho; Jeong, Jin Sook; Lee, Hyung Sik

    1994-01-01

    To describe soft-tissue radiographic and high-resolution CT findings of radiation-induced lung injury of rabbit over time and to correlate them with pathologic findings. 15 rabbits were irradiated in the right lung with one fracture of 2000 cGy. After 4, 6, 12, 20, 24 weeks 3 rabbits in each group were sacrificed and soft-tissue radiographs and high-resolution CT of their lung tissue were obtained. Radiological findings were correlated with pathologic findings. On soft-tissue radiogram, radiation pneumonitis shown as consolidation with air- bronchogram occurred in 3 cases after 6 weeks , and in 1 case after 12 weeks of irradiation. In addition, pneumonic consolidation with adjacent pleural contraction was seen in 2 cases after 12 weeks of irradiation. Fibrotic changes indicated by decreased volume occurred after 20 weeks and combined bronchiectatic change and bronchial wall thickening appeared after 20 weeks(N=1), and 24 weeks(N=3). HRCT findings of radiation pneumonitis were homogeneous, increased attention after 4 weeks(N=3), 6 and 12 weeks(each N=1), patchy consolidation after 6 and 12 weeks(each N=2), discrete consolidation after 12, 20 and 24 weeks(each N=1) and solid consolidation after 20 and 24 weeks(each N=2). Pathologically radiation pneumonitis and pulmonary congestion were seen after 4 and 6 weeks. After 6 weeks, collagen and reticulin fibers were detected along alveolar wall. Mixed radiation pneumonitis and fibrosis were detected after 12 weeks. 20 weeks after irradiation, fibrosis was well defined in interstitium and in 24 weeks, decreased number of alveoli and thickening of bronchial wall were defined. Radiation pneumonitis was provoked 4 weeks after irradiation on rabbit lung and progressed into radiation fibrosis 20 weeks after irradiation on soft-tissue radiographs and high-resolution CT. High-resolution CT is more precise in detecting early radiation pneumonitis and detailed pathologic findings

  9. Development and evaluation of a social cognitive theory-based instrument to assess correlations for physical activity among people with spinal cord injury.

    Science.gov (United States)

    Wilroy, Jereme; Turner, Lori; Birch, David; Leaver-Dunn, Deidre; Hibberd, Elizabeth; Leeper, James

    2018-01-01

    People with spinal cord injury (SCI) are more susceptible to sedentary lifestyles because of the displacement of physical functioning and the copious barriers. Benefits of physical activity for people with SCI include physical fitness, functional capacity, social integration and psychological well-being. The purpose of this study was to develop and test a social cognitive theory-based instrument aimed to predict physical activity among people with SCI. An instrument was developed through the utilization and modification of previous items from the literature, an expert panel review, and cognitive interviewing, and tested among a sample of the SCI population using a cross-sectional design. Statistical analysis included descriptives, correlations, multiple regression, and exploratory factor analysis. The physical activity outcome variable was significantly and positively correlated with self-regulatory efficacy (r = 0.575), task self-efficacy (r = 0.491), self-regulation (r = 0.432), social support (r = 0.284), and outcome expectations (r = 0.247). Internal consistency for the constructs ranged from 0.82 to 0.96. Construct reliability values for the self-regulation (0.95), self-regulatory efficacy (0.96), task self-efficacy (0.94), social support (0.84), and outcome expectations (0.92) each exceeded the 0.70 a priori criteria. The factor analysis was conducted to seek modifications of current instrument to improve validity and reliability. The data provided support for the convergent validity of the five-factor SCT model. This study provides direction for further development of a valid and reliable instrument for predicting physical activity among people with SCI. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Correlation of urinary monocyte chemo-attractant protein-1 with other parameters of renal injury in type-II diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Ibrahim Salwa

    2008-01-01

    Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in the western world. Increased number of interstitial macrophages has been observed in biopsies from patients with DN. Monocyte chemo-attractant protein-1 (MCP-1 is the strongest known chemo-tactic factor for monocytes and is upregulated in DN. We examined urinary levels of MCP-1 in patients with type-2 diabetes mellitus (DM to assess its possible correlation with other para-meters of renal injury. The urinary MCP-1 level was assessed in 75 patients with type-2 DM (25 patients each with no microalbuminuria, with macroalbuminuria and, with renal impairment and compared them with matched healthy control subjects. The HbA1c and estimated glomerular fil-tration rate (eGFR derived from the abbreviated Modification of Diet in Renal Disease (MDRD equation were examined in the study groups in relation to the urinary MCP-1. The urinary MCP-1 level was significantly higher in patients with micro and macroalbuminuria (167.41 ± 50.23 and 630.87 ± 318.10 ng/gm creatinine respectively as compared with normoalbuminuric patients and healthy controls (63.85 ± 21.15 and 61.50 ± 24.81 ng/gm creatinine, p< 0.001. MCP-1 correlated positively with urine albumin/creatinine ratio (ACR (r= 0.75, p< 0.001, HbA1c (r= 0.55, p< 0.001 and inversely with eGFR (r=-0.60, p< 0.001. Our findings suggest that hyperglycemia is associated with increased urinary levels of MCP-1 that is closely linked to renal damage as reflected by proteinuria and eGFR levels. Collectively, these findings suggest that MCP-1 is in-volved in the pathogenesis of diabetic nephropathy through its various stages.

  11. Ultrasonographic-arthroscopic correlation in knee injuries in patients operated on at the Hospital Mexico, during the period from January 1, 2010 until December 31, 2010

    International Nuclear Information System (INIS)

    Zamora Lopez, Rafael Angel

    2012-01-01

    Ultrasound is evaluated as a method of diagnosis for intra-articular pathologies of knee, widely used as a means to rule out injuries to the institutional level. The advantages of ultrasound are mentioned: low cost, availability and is a noninvasive method. In order to implement this study has been to create a question about the real utility of ultrasound in the Hospital Mexico, as further support for the correct diagnosis of knee pathology. A search of clinical records of patients was conducted in the orthopedics and traumatology service with diagnosis of gonalgia, to which was conducted a preoperative ultrasound and, subsequently, have been operated at the Hospital by arthroscopy, during the period 1 January 2010 to December 31, 2010. Subsequently, a comprehensive review of the operative notes was performed, ultrasound reports and records, for the purpose of making an analysis and compare the results of both procedures. This paper has clearly demonstrated poor training in musculoskeletal system of the ultrasound operators. A poor correlation was determined between the arthroscopic results against ultrasound. The need to create care protocols to patients with intra-articular pathology of knee was evidenced. (author) [es

  12. Diagnosis and nonsurgical management of bile leak complicated by biloma after blunt liver injury: report of two cases

    International Nuclear Information System (INIS)

    Backer, A. de; Schepper, A. de; Fierens, H.; Pelckmans, P.; Jorens, P.G.; Vaneerdeweg, W.

    1998-01-01

    We report on two patients with biliary tract injury and associated biloma following blunt abdominal trauma. Both patients underwent emergency surgery because of hemodynamic instability and bloody peritoneal aspiration. Computed tomography in the postoperative days showed severe hepatic parenchymal injury and the presence of hypodense collections with intraparenchymal and subcapsular extension, suggestive for biloma, but otherwise failed to demonstrate the exact location of the bile duct injury. One of them underwent temporary percutaneous drainage. Bile duct injury was well demonstrated on endoscopic retrograde cholangiography (ERCP) and treated by endobiliary stent placement. This report advocates the use of ERCP and endobiliary stenting in the management of biliary injury resulting from liver trauma. (orig.)

  13. Transfer coefficients in a four-cusp duct simulating a typical nuclear reactor channel degraded by accident

    International Nuclear Information System (INIS)

    Souza Dutra, A. de.

    1985-01-01

    An experimental study on forced convection in a four-cusp duct simulating a typical nuclear reactor channel degraded by accident is presented. Transfer coefficients were obtained by using the analogy between heat and mass tranfer, with the naphtalene sublimation technique. The experiment consisted in forcing air past a four-cusp naphthalene moulded duct. Mass transfer coefficients were determined in nondimensional form as Sherwood number. Experimental curves correlating the Sherwood number with a nondimensional length, x + , were obtained for Reynolds number varying from 891 to 30.374. This range covers typical flow rates that are expected to exist in a degraded nuclear reactor core. (Author) [pt

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

    Science.gov (United States)

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

    2012-03-01

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

  15. High expression of L-type amino acid transporter 1 as a prognostic marker in bile duct adenocarcinomas

    International Nuclear Information System (INIS)

    Yanagisawa, Nobuyuki; Hana, Kiyomi; Nakada, Norihiro; Ichinoe, Masaaki; Koizumi, Wasaburo; Endou, Hitoshi; Okayasu, Isao; Murakumo, Yoshiki

    2014-01-01

    Oncocytic L-type amino acid transporter (LAT) 1 may be a prognostic indicator and target of new molecular therapeutic agents against malignancies. To investigate whether LAT1 expression influence the outcomes of patients with bile duct cancer, the expression of LAT1, LAT2, CD98, and Ki-67 was investigated immunohistochemically in 134 surgically resected bile duct adenocarcinomas, including 84 distal extrahepatic bile duct adenocarcinomas, 21 hilar cholangiocarcinomas, 15 intrahepatic cholangiocarcinomas, and 14 ampullary adenocarcinomas. LAT1 expression was weakly correlated with CD98 expression and Ki-67 labeling index (LI). Kaplan–Meier analysis showed a significant difference in prognosis between patients with bile duct adenocarcinomas having LAT1-high and -low scores, whereas LAT2 and CD98 expression and Ki-67 LI were not predictive of poor prognosis. Prognosis tended to be worse in patients having tumors with LAT1-high/LAT2-low than LAT1-low/LAT2-high scores (P = 0.0686). Multivariable analyses revealed that LAT1 expression, surgical margin, pT stage were independent prognostic factors. In conclusion, aberrant overexpression of LAT1 in bile duct adenocarcinoma predicts poor prognosis, suggesting that LAT1 may be a potential target of anticancer therapy

  16. [Injuries of the duodenum].

    Science.gov (United States)

    Korolev, M P; Urakcheev, Sh K; Shlosser, K V

    2012-01-01

    Results of surgical treatment of 69 patients with injuries of the duodenum were analyzed. The most frequent causes of the injury were stab-incised wound of the abdomen (43 patients), gunshot wounds (2 patients), closed injury of the abdomen. Postoperative complications developed in 18 (26%) cases. Lethality was 20.3% (14 patients died). Injuries caused by the closed trauma were considerably more severe than those caused by wounds of the duodenum; lethality was 37.5% and 11.1% respectively. The authors discuss questions of the special diagnostics and surgical strategy for open and closed injuries of the duodenum. Causes of the development of unfavorable outcomes were pyo-septic complications associated with progressing retroperitoneal phlegmons, peritonitis, development of traumatic pancreatitis, incompetent sutures of the duodenum with a formed duodenal fistula. Therefore, the effective prophylactics of incompetent sutures of the duodenum is its decompression with aspiration of the duodenal contents as well as decreased secretion by means of drainage of the bile excreting ducts and medicamental suppression of synthesis of the digestion enzymes of the pancreas and duodenum using Octreatid which allowed considerable decrease of the number of postoperative complications.

  17. Use of Computational Fluid Dynamics for improving freeze-dryers design and process understanding. Part 2: Condenser duct and valve modelling.

    Science.gov (United States)

    Marchisio, Daniele L; Galan, Miquel; Barresi, Antonello A

    2018-05-05

    This manuscript shows how computational models, mainly based on Computational Fluid Dynamics (CFD), can be used to simulate different parts of an industrial freeze-drying equipment and to properly design them; in particular in this part the duct connecting the chamber with the condenser, with its valves, is considered, while the chamber design and its effect on drying kinetics have been investigated in Part 1. Such an approach allows a much deeper process understanding and assessment of the critical aspects of lyophilisation. This methodology will be demonstrated on freeze-drying equipment of different sizes, investigating influence of valve type (butterfly and mushroom) and shape on duct conductance and critical flow conditions. The role of the inlet and boundary conditions considered has been assessed, also by modelling the whole apparatus including chamber and condenser, and the influence of the duct diameter has been discussed; the results show a little dependence of the relationship between critical mass flux and chamber pressure on the duct size. Results concerning the fluid dynamics of a simple disk valve, a profiled butterfly valve and a mushroom valve installed in a medium size horizontal condenser are presented. Also in these cases the maximum allowable flow when sonic flow conditions are reached can be described by a correlation similar to that found valid for empty ducts; for the mushroom valve the parameters are dependent on the valve opening length. The possibility to use the equivalent length concept, and to extend the validity of the results obtained for empty ducts will be also discussed. Finally the presence of the inert gas modifies the conductance of the duct, reducing the maximum flow rate of water that can be removed through it before the flow is choked; this also requires a proper over-sizing of the duct (or duct-butterfly valve system). Copyright © 2018. Published by Elsevier B.V.

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

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

    African Journals Online (AJOL)

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

  20. Ursodeoxycholic acid treatment of vanishing bile duct syndromes

    NARCIS (Netherlands)

    Pusl, Thomas; Beuers, Ulrich

    2006-01-01

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

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

    Science.gov (United States)

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

    2012-07-01

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

  2. Liver and Bile Duct Cancer—Patient Version

    Science.gov (United States)

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

  3. Cystic duct closure by sealing with bipolar electrocoagulation

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  4. Magnetic resonance imaging of Muellerian duct anomalies in children

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  5. Chloride and potassium conductances of cultured human sweat ducts

    DEFF Research Database (Denmark)

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

    1992-01-01

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

  6. Seismic assessment of the Pickering pressure relief duct

    International Nuclear Information System (INIS)

    Ghobarah, A.

    1995-05-01

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

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

    Science.gov (United States)

    Atik-Ugan, Sezen; Saltik, Irfan Levent

    2018-04-01

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

  8. Noninvasive study of anatomic variations of the bile and pancreatic duct using magnetic resonance cholangiopancreatography; Estudio no invasivo de variantes anatomicas de la via biliar y pancreatica mediante colangiopancreatografia por resonancia magnetica (CPRM)

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, E.; Falco, J.; Campo, R.; Martin, J.; Brullet, E. [SDI-UDIAT Corporacio Sanitaria Parc Tauli. Sabadell (Spain); Espinos, J. [Hospital Mutua de Tarrasa (Spain)

    1999-07-01

    To identify anatomic variations of the bile duct and pancreatic duct and papillary anomalies by means of magnetic resonance cholangiopancreatography (MRCP) and determine their correlation with endoscopic retrograde cholangiopancreatography (ERCP) findings. Eighty-five patients were selected by means of a prospective study comparing MRCP and ERCP. Coronal and axial HASTE images and coronal and oblique coronal RARE images were acquired in all the patients. Four of the studies (6%) were excluded because of poor technical quality. Anatomic variations were observed in 26 cases (30.5%), including trifurcation (n=7; 27%), right hepatic duct draining into left hepatic duct (n=2, 7.7%), right hepatic duct draining into common bile duct (n=4; 15.4%), extrahepatic confluence (n=2; 7.7%), medial cystic duct (n=2; 7.7%), parallel cystic duct (n=3; 11.5%), juxtapapillary duodenal diverticulum (n=3; 11.5%) and pancreas divisum (n=3; 11.5%). A good correlation was observed between the MRCP and ERCP findings. The introduction of MRCP into the noninvasive study of biliary disease may be useful in the detection of anatomic variations relevant to laparoscopic surgery and other endoscopic and interventional techniques. (Author) 11 refs.

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  10. Cystic duct remnant mucocele in a liver transplant recipient

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-08-15

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

  11. Cystic duct remnant mucocele in a liver transplant recipient

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  13. Consistent approach to air-cleaning system duct design

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  14. Blood-brain barrier dysfunction following traumatic brain injury: correlation of K(trans) (DCE-MRI) and SUVR (99mTc-DTPA SPECT) but not serum S100B.

    Science.gov (United States)

    Winter, Craig; Bell, Christopher; Whyte, Timothy; Cardinal, John; Macfarlane, David; Rose, Stephen

    2015-07-01

    Damage to the blood-brain barrier (BBB) is an important secondary mechanism that occurs following traumatic brain injury (TBI) and may provide a potential therapeutic target to improve patient outcome. For such a progress to be realised, an accurate assessment of BBB compromise needs to be established. Fourteen patients with TBI were prospectively recruited. Post-traumatic BBB dysfunction was assessed using dynamic contrast-enhanced MRI (DCE-MRI), single-photon emission computerised tomography (SPECT) and serum S100B levels. A statistically significant correlation between standardised uptake value ratio (SUVR) calculated from 99mTc-DTPA SPECT and K(trans) (a volume transfer constant) from DCE-MRI was found for those eight patients who had concurrent scans. The positive correlation persisted when the data were corrected for patient age, number of days following trauma and both parameters combined. We found no statistically significant correlation between either of the imaging modalities and concurrent serum S100B levels. The correlation of SPECT with DCE-MRI suggests that either scan may be used to assess post-traumatic BBB damage. We could not support serum S100B to be an accurate measure of BBB damage when sampled a number of days following injury but the small number of patients, the heterogeneity in TBI patients and the delay following injury makes any firm conclusions regarding S100B and BBB difficult.

  15. Forced convection heat transfer with slurry of phase change material in circular ducts: A phenomenological approach

    International Nuclear Information System (INIS)

    Royon, Laurent; Guiffant, Gerard

    2008-01-01

    A model describing the thermal behaviour of a slurry of phase change material flow in a circular duct is presented. Reactors connected in series are considered for the representation of the circular duct with constant wall temperature. A phenomenological equation is formulated to take account of the heat generation due to phase change in the particles. Results of the simulation present a plateau of temperature along the longitudinal direction, characteristic of the phase change. The effect of different parameters such as the Reynolds number, the weight fraction and the temperature of the cold spring on the length of the plateau is analysed. A correlation resulting from numerical results is proposed for use in the determination of the characteristics of the exchanger for a phase change material slurry

  16. A Plug-and-Play Duct System Evaluation

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-07-01

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

  17. A Plug-and-Play Duct System Evaluation

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-07-10

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

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

    International Nuclear Information System (INIS)

    Guenther, R.W.; Daehnert, W.

    1985-01-01

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

  19. Characterization of Chemically Induced Liver Injuries Using Gene Co-Expression Modules

    Science.gov (United States)

    2014-09-16

    evaluated the periportal fibrosis gene signature in the GEO dataset - GSE13747 [34]. In this dataset, liver fibrosis was induced by bile duct ...dataset, liver fibrosis was induced by bile duct ligation. Figure 10-D shows the observed correlation between log-ratios of periportal fibrosis...at 15 days of exposure obtained from TG-GATEs, and D) liver fibrosis produced by bile duct ligation obtained from GSE13747. doi:10.1371/journal.pone

  20. Experiments and calculations on neutron streaming through bent ducts

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-07-01

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