An algorythmic approach to restoration of the fronto-naso-periorbital skin defects using the forehead flaps.

Science.gov (United States)

Tan, Onder

2010-01-01

The classic forehead flaps, which are designed vertically, two-staged and exteriorised pedicled peninsular flaps, are still a reconstructive option for nasal and periorbital defects. However, some drawbacks such as conspicuous donor-site scar, multi-staged procedure, rather short pedicle, hairy appearance (in narrow foreheads), and inability to use the forehead flap when the donor site is involved are often encountered during surgery. To avoid these issues, three unusual designs of the forehead flap are presented, and also a new algorithm is proposed to guide surgeons in their solutions. Nineteen patients (10 women and nine men) were managed with 21 forehead flaps to restore the nasal, medial canthal and frontal defects caused by skin tumours. The flaps were applied as interpolation island, V-Y island, and transverse peninsular designs in 12, four and three patients, respectively. All donor sites were closed primarily except one, where a split thickness skin graft was used. The average follow-up was 14 months. All flaps survived (totally) but in one partial necrosis developed. Aesthetic and functional recoveries were acceptable in all patients. Based on the algorithm presented, the forehead flaps with their superb anatomic characteristics including rich vascular supply and pliable skin can be safely used in either classic or extraordinary fashion for small to medium sized defects of the nasoorbital and frontal regions.

Directional Acoustic Wave Manipulation by a Porpoise via Multiphase Forehead Structure

Science.gov (United States)

Zhang, Yu; Song, Zhongchang; Wang, Xianyan; Cao, Wenwu; Au, Whitlow W. L.

2017-12-01

Porpoises are small-toothed whales, and they can produce directional acoustic waves to detect and track prey with high resolution and a wide field of view. Their sound-source sizes are rather small in comparison with the wavelength so that beam control should be difficult according to textbook sonar theories. Here, we demonstrate that the multiphase material structure in a porpoise's forehead is the key to manipulating the directional acoustic field. Computed tomography (CT) derives the multiphase (bone-air-tissue) complex, tissue experiments obtain the density and sound-velocity multiphase gradient distributions, and acoustic fields and beam formation are numerically simulated. The results suggest the control of wave propagations and sound-beam formations is realized by cooperation of the whole forehead's tissues and structures. The melon size significantly impacts the side lobes of the beam and slightly influences the main beams, while the orientation of the vestibular sac mainly adjusts the main beams. By compressing the forehead complex, the sound beam can be expanded for near view. The porpoise's biosonar allows effective wave manipulations for its omnidirectional sound source, which can help the future development of miniaturized biomimetic projectors in underwater sonar, medical ultrasonography, and other ultrasonic imaging applications.

Transient post-exercise hyper-perspiration of forehead area | Reza ...

African Journals Online (AJOL)

Information about sweating responses during exercise recovery is insufficient and mostly controversial. In the present study, particular attention is given to sweating behavior at forehead area immediately after exercise. Simultaneous changes of some underlying factors are also addressed. Eight healthy young males ...

Endoscopic Therapeutic Approach for Dysplasia in Inflammatory Bowel Disease

Directory of Open Access Journals (Sweden)

Sung Noh Hong

2017-09-01

Full Text Available Long-standing intestinal inflammation in patients with inflammatory bowel disease (IBD induces dysplastic change in the intestinal mucosa and increases the risk of subsequent colorectal cancer. The evolving endoscopic techniques and technologies, including dye spraying methods and high-definition images, have been replacing random biopsies and have been revealed as more practical and efficient for detection of dysplasia in IBD patients. In addition, they have potential usefulness in detailed characterization of lesions and in the assessment of endoscopic resectability. Most dysplastic lesions without an unclear margin, definite ulceration, non-lifting sign, and high index of malignant change with suspicion for lymph node or distant metastases can be removed endoscopically. However, endoscopic resection of dysplasia in chronic IBD patients is usually difficult because it is often complicated by submucosal fibrosis. In patients with dysplasias that demonstrate submucosa fibrosis or a large size (≥20 mm, endoscopic submucosal dissection (ESD or ESD with snaring (simplified or hybrid ESD is an alternative option and may avoid a colectomy. However, a standardized endoscopic therapeutic approach for dysplasia in IBD has not been established yet, and dedicated specialized endoscopists with interest in IBD are needed to fully investigate recent emerging techniques and technologies.

Duodenal endoscopic full-thickness resection (with video).

Science.gov (United States)

Schmidt, Arthur; Meier, Benjamin; Cahyadi, Oscar; Caca, Karel

2015-10-01

Endoscopic resection of duodenal non-lifting adenomas and subepithelial tumors is challenging and harbors a significant risk of adverse events. We report on a novel technique for duodenal endoscopic full-thickness resection (EFTR) by using an over-the-scope device. Data of 4 consecutive patients who underwent duodenal EFTR were analyzed retrospectively. Main outcome measures were technical success, R0 resection, histologic confirmation of full-thickness resection, and adverse events. Resections were done with a novel, over-the-scope device (full-thickness resection device, FTRD). Four patients (median age 60 years) with non-lifting adenomas (2 patients) or subepithelial tumors (2 patients) underwent EFTR in the duodenum. All lesions could be resected successfully. Mean procedure time was 67.5 minutes (range 50-85 minutes). Minor bleeding was observed in 2 cases; blood transfusions were not required. There was no immediate or delayed perforation. Mean diameter of the resection specimen was 28.3 mm (range 22-40 mm). Histology confirmed complete (R0) full-thickness resection in 3 of 4 cases. To date, 2-month endoscopic follow-up has been obtained in 3 patients. In all cases, the over-the-scope clip was still in place and could be removed without adverse events; recurrences were not observed. EFTR in the duodenum with the FTRD is a promising technique that has the potential to spare surgical resections. Modifications of the device should be made to facilitate introduction by mouth. Prospective studies are needed to further evaluate efficacy and safety for duodenal resections. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Forehead reflectance photoplethysmography to monitor heart rate: preliminary results from neonatal patients

International Nuclear Information System (INIS)

Grubb, M R; Carpenter, J; Crowe, J A; Teoh, J; Hayes-Gill, B R; Marlow, N; Ward, C; Mann, C; Sharkey, D

2014-01-01

Around 5%–10% of newborn babies require some form of resuscitation at birth and heart rate (HR) is the best guide of efficacy. We report the development and first trial of a device that continuously monitors neonatal HR, with a view to deployment in the delivery room to guide newborn resuscitation. The device uses forehead reflectance photoplethysmography (PPG) with modulated light and lock-in detection. Forehead fixation has numerous advantages including ease of sensor placement, whilst perfusion at the forehead is better maintained in comparison to the extremities. Green light (525 nm) was used, in preference to the more usual red or infrared wavelengths, to optimize the amplitude of the pulsatile signal. Experimental results are presented showing simultaneous PPG and electrocardiogram (ECG) HRs from babies (n = 77), gestational age 26–42 weeks, on a neonatal intensive care unit. In babies ⩾32 weeks gestation, the median reliability was 97.7% at ±10 bpm and the limits of agreement (LOA) between PPG and ECG were +8.39 bpm and −8.39 bpm. In babies <32 weeks gestation, the median reliability was 94.8% at ±10 bpm and the LOA were +11.53 bpm and −12.01 bpm. Clinical evaluation during newborn deliveries is now underway. (paper)

Design, Manufacturing, and In Vitro Testing of a Patient-Specific Shape-Memory Expander for Nose Reconstruction With Forehead Flap Technique.

Science.gov (United States)

Borghi, Alessandro; Rodgers, Will; Schievano, Silvia; Ponniah, Allan; O'Hara, Justine; Jeelani, Owase; Dunaway, David

2016-01-01

Forehead skin is widely acknowledged as a good donor site for total nasal reconstruction, thanks to its matching color, texture, and abundant vascularity. The forehead flap technique uses an axial pattern flap forehead skin to replace missing nasal tissue. To increase the amount of available tissue and reduce the size of the tissue defect after flap mobilization, tissue expanders may be used. Although this is a relatively established technique, limitations include reduced moldability of the forehead skin (which is thicker than the nasal skin), and the need for multiple sessions of expansion to achieve a sufficient yield to close the forehead.Shape-memory metals, such as nitinol, can be programmed to "remember" complex shapes. In this work, the methodology for producing a prototype of nitinol tissue expander able to mold the skin in a predetermined patient-specific skin shape is described. A realistic nose mold was manufactured using metal rapid prototyping; nitinol sheet and mesh were molded into nose-shape constructs, having hyperelastic as well as shape-memory capability. Computed tomography scanning was performed to assess the ability of the structure to regain its shape after phase transformation upon cooling within 2% of initial dimensions. The prototypes were implanted in a pig forehead to test its ability to impose a nose shape to the forehead skin.The shape-memory properties of nitinol offer the possibility of producing bespoke tissue expanders able to deliver complex, precisely designed skin envelopes. The hyperelastic properties of nitinol allow constant preprogrammed expansion forces to be generated throughout the expansion process.

Effects of a facial nerve lesion on responses in forehead microvessels to conjunctival irritation and paced breathing.

Science.gov (United States)

Drummond, Peter D

2012-08-16

To investigate parasympathetic influences on the forehead microvasculature, blood flow was monitored bilaterally in seven participants with a unilateral facial nerve lesion during conjunctival irritation with Schirmer's strips and while breathing at 0.15 Hz. Blood flow and slow-wave frequency increased on the intact side of the forehead during Schirmer's test but did not change on the denervated side. However, a 0.15 Hz vascular wave strengthened during paced breathing, particularly on the denervated side. These findings indicate that parasympathetic activity in the facial nerve increases forehead blood flow during minor conjunctival irritation, but may interfere with the 0.15 Hz vascular wave. Copyright © 2012 Elsevier B.V. All rights reserved.

Frontal sinus osteoma: a difficult surgical decision in the era of endoscopic sinus surgery.

Science.gov (United States)

Hazarika, Produl; Zachariah, Plavilayl Koruthu Joyse; Victor, John; Punnoose, Seema E; Sharma, Santosh; Devi, Chitra

2011-01-01

A slow-growing frontal sinus osteoma has been followed up since the year 2001 by clinical, endoscopic, and radiological examination in the Department of Otolaryngology, New Medical Centre Specialty Hospital, Abu Dhabi, for 10 years until the year 2010. The last computed tomography scan of paranasal sinuses was done on April 5, 2010, which revealed increasing size of the osteoma by 38.1 mm; and it has become symptomatic. No specific cause of the sudden change of growth of the osteoma could be evaluated from the history and clinical examination. There was an increase in the frequency of headache and feeling of pressure in the forehead. Choice of surgical approach was difficult in this popular era of endonasal endoscopic sinus approach. A great deal of effort was made after reviewing the literature and consultation with the radiologist and neurosurgeon to accept the bicoronal osteoplastic flap approach. A broad-based posterior frontal sinus is found to be ideal for external approach. Copyright © 2011 Elsevier Inc. All rights reserved.

The effect of venous pulsation on the forehead pulse oximeter wave form as a possible source of error in Spo2 calculation.

Science.gov (United States)

Shelley, Kirk H; Tamai, Doris; Jablonka, Denis; Gesquiere, Michael; Stout, Robert G; Silverman, David G

2005-03-01

Reflective forehead pulse oximeter sensors have recently been introduced into clinical practice. They reportedly have the advantage of faster response times and immunity to the effects of vasoconstriction. Of concern are reports of signal instability and erroneously low Spo(2) values with some of these new sensors. During a study of the plethysmographic wave forms from various sites (finger, ear, and forehead) it was noted that in some cases the forehead wave form became unexpectedly complex in configuration. The plethysmographic signals from 25 general anesthetic cases were obtained, which revealed the complex forehead wave form during 5 cases. We hypothesized that the complex wave form was attributable to an underlying venous signal. It was determined that the use of a pressure dressing over the sensor resulted in a return of a normal plethysmographic wave form. Further examination of the complex forehead wave form reveal a morphology consistent with a central venous trace with atrial, cuspidal, and venous waves. It is speculated that the presence of the venous signal is the source of the problems reported with the forehead sensors. It is believed that the venous wave form is a result of the method of attachment rather than the use of reflective plethysmographic sensors.

Unusual Forehead Tremor in Four Patients with Essential Tremor

OpenAIRE

Gascón-Bayarri, Jordi; Campdelacreu, Jaume; Calopa, Màtil; Jaumà, Serge; Bau, Laura; Povedano, Mònica; Montero, Jordi

2012-01-01

Forehead tremor has only been reported in two patients with essential tremor, one with rhythmic tremor and the other with dystonic tremor. We report 4 new patients with essential tremor who present a 4–6 Hz frontal tremor registered by electromyography and unusual features like frontal tremor preceding limb tremor or unilateral involvement. Frontal tremor is present in some patients with essential tremor, sometimes preceding limb tremor. Treatment with botulinum toxin may be useful.

Unusual Forehead Tremor in Four Patients with Essential Tremor

Directory of Open Access Journals (Sweden)

Jordi Gascón-Bayarri

2012-01-01

Full Text Available Forehead tremor has only been reported in two patients with essential tremor, one with rhythmic tremor and the other with dystonic tremor. We report 4 new patients with essential tremor who present a 4–6 Hz frontal tremor registered by electromyography and unusual features like frontal tremor preceding limb tremor or unilateral involvement. Frontal tremor is present in some patients with essential tremor, sometimes preceding limb tremor. Treatment with botulinum toxin may be useful.

Posterior Ciliary Artery Occlusion Caused by Hyaluronic Acid Injections Into the Forehead: A Case Report.

Science.gov (United States)

Hu, Xiu Zhuo; Hu, Jun Yan; Wu, Peng Sen; Yu, Sheng Bo; Kikkawa, Don O; Lu, Wei

2016-03-01

Although cosmetic facial soft tissue fillers are generally safe and effective, improper injections can lead to devastating and irreversible consequences. We represent the first known case of posterior ciliary artery occlusion caused by hyaluronic acid. A 41-year-old female presented with right visual loss 7 hours after receiving cosmetic hyaluronic acid injections into her forehead. Examination revealed no light perception in the right eye and multiple dark ischemic area of injection over the forehead and nose. The right fundus revealed a pink retina with optic nerve edema. Fluorescein angiogram showed several filling defects in the choroidal circulation and late hyperfluorescence in the choroid. A right posterior ciliary artery occlusion and embolic occlusion of facial artery braches was diagnosed. With hyaluronidase injection, hyperbaric oxygen therapy, oral aspirin, oral acetazolamide and dexamethasone venotransfuse treatment, the patient's forehead and nasal skin improved and vision recovered to hand movements. With proper technique, vascular occlusion is rare following facial filler injection. Vision consequences can be severe if filler emboli enter the ocular circulation. Physicians should be aware of this potential side effect, recognize its presentation, and be knowledgeable of effective management.

The 'Nefertiti lift': a new technique for specific re-contouring of the jawline.

Science.gov (United States)

Levy, Phillip M

2007-12-01

Botulinum toxin type A (BoNTA) is now used extensively for rejuvenation of the forehead, glabellar and periocular regions and there is increasing focus on treatment of the lower face. Although there is well-documented evidence for the efficacy of botulinum toxin in the correction of platysmal bands, little work has been done to explore its potential role in rejuvenation of the jawline. To date, effects in this area have been reported as a consequence of platysmal banding treatment and are inconsistent. Hesitancy to explore treatment may be due to evidence of a greater, more durable response to the toxin in the lower facial muscles as well as reports of increased potential migration and subsequent side effects. This paper describes a new technique using BoNTA (Vistabel); Allergan, Irvine, CA, USA) to drape the skin of the jawline contour and provide the visual effect of a 'mini lift'. Experience with 130 patients with doses of BoNTA up to 20 U is described. Patient satisfaction is extremely high and the specificity of dosing and technique has led to a low incidence of adverse effects. The 'Nefertiti lift' is a minimally invasive, effective and acceptable alternative for those patients seeking an effective way to push back surgery.

Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note.

Science.gov (United States)

Komatsu, Fuminari; Imai, Masaaki; Shigematsu, Hideaki; Aoki, Rie; Oda, Shinri; Shimoda, Masami; Matsumae, Mitsunori

2017-08-25

The authors' initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sphenoid ridge meningioma, and cavernous sinus pituitary adenoma, mainly using 4-mm, 0° and 30° endoscopes and single-shaft instruments. After making a supraorbital keyhole, a 4-mm, 30° endoscope was advanced into the extradural space of the anterior cranial fossa during lifting of the dura mater. Following identification of the sphenoid ridge, orbital roof, and anterior clinoid process, the bone lateral to the orbital roof was drilled off until the dura mater of the anterior aspect of the temporal lobe was exposed. The dura mater of the temporal lobe was incised and opened, exposing the temporal pole under a 4-mm, 0° endoscope. Tumors in or around the temporal pole were safely removed under a superb view through the extradural corridor. The endoscopic extradural supraorbital approach was technically feasible and safe. The anterior trajectory to the temporal pole using the extradural space under endoscopy provided excellent visibility, allowing minimally invasive surgery. Further surgical experience and development of specialized instruments would promote this approach as an alternative surgical option.

Reconstruction of the columella and the tip of the nose with an island-shaped forehead flap

Directory of Open Access Journals (Sweden)

Vulović Dejan

2011-01-01

Full Text Available Background. Posttraumatic and postoperative defects of columella and the tip of the nose are difficult to reconstruct. There are several operative methods described in the literature, and many of them are step-by-step procedures with long duration. The aim of this study was to present one-step procedure for reconstruction of the columella and the tip of the nose with island-shaped arterial forehead flap. Case report. A 45-year old man was submitted to surgical excision of basocellular skin cancer. After the excision, a defect of the columella and tip of the nose the remained, 3 × 2.5 cm in dimensions, with exposed alar cartilages. During the same operation, the defect was covered with an island-shaped arterial forehead flap. Postoperative one-year course was uneventful, without signs of tumor recurrence after one year, and further surgical corrections were unnecessary. Conclusion. Considering the results of our operative technique, we believe that middle island-shaped forehead flap is suitable for reconstruction of the columella and the tip of the nose, due to the following reasons: safe vascularization of flap, similarity of the transferred tissue with the excised one, the procedure is completed in one step, simple surgical technique and uncomplicated healing of a flap-harvesting site.

A study of the long-term effect of malar fat repositioning in face lift surgery: short-term success but long-term failure.

Science.gov (United States)

Hamra, Sam T

2002-09-01

In 1990, the author reported on a series of 403 cases of deep plane face lifts, the first published technique describing the repositioning of the cheek fat, known as malar fat, in face lift surgery. This study examines the long-term results of 20 of the original series in an attempt to determine what areas of the rejuvenated face (specifically, the malar fat) showed long-term improvement. The results were judged by comparing the preoperative and long-term postoperative views in a half-and-half same-side hemiface photograph. The anatomy of the jawline (superficial musculoaponeurotic system [SMAS]), the nasolabial fold (malar fat), and the periorbital diameter were evaluated. The results confirmed that repositioning of the SMAS remained for longer than improvement in the nasolabial fold and that the vertical diameter of the periorbit did not change at all. The early results of malar fat repositioning shown at 1 to 2 years were successful, but the long-term results showed failure of the early improvement, manifested by recurrence of the nasolabial folds. There was, however, continuation of the improved results of the forehead lift and SMAS maneuvers of the original procedure. The conclusion is that only a direct excision will produce a permanent correction of the aging nasolabial fold.

[Acute epidural hematoma of the posterior fossa caused by forehead impact].

Science.gov (United States)

Abe, S; Furukawa, K; Endo, S; Hoshi, S; Kanaya, H

1988-03-01

A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. On admission, a contused wound of the right forehead was noticed. He was restless and had severe pain in the neck and upper extremities. Skull X-ray showed a linear fracture of the frontal bone and computed tomography (CT) scan was normal. He continued to be restless and sudden respiratory arrest and pupillary dilation occurred 10 hours after the admission. A CT scan revealed a lenticular high density area in the left posterior fossa which extended to the supratentorial region. The 4th ventricle was compressed and displaced to the right and also the quadrigeminal and ambient cisterns were not visualized at all. Immediate surgery disclosed a 30 g epidural hematoma of the left posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed.

A Novel Wearable Forehead EOG Measurement System for Human Computer Interfaces

OpenAIRE

Heo, Jeong; Yoon, Heenam; Park, Kwang Suk

2017-01-01

Amyotrophic lateral sclerosis (ALS) patients whose voluntary muscles are paralyzed commonly communicate with the outside world using eye movement. There have been many efforts to support this method of communication by tracking or detecting eye movement. An electrooculogram (EOG), an electro-physiological signal, is generated by eye movements and can be measured with electrodes placed around the eye. In this study, we proposed a new practical electrode position on the forehead to measure EOG ...

A Novel Supra-Brow Combined with Infra-Brow Lift Approach for Asian Women.

Science.gov (United States)

Shu, Maoguo; He, Lin; Su, Yingjun; Shi, Junli; Zhang, Xi; Liu, Xiangyu; Yu, Xueyuan

2016-06-01

Direct brow lift surgery remains popular among Asian women despite its disadvantages. The traditional direct brow lift by a supra-brow incision is not suitable for Asian women because of their unique facial features, such as higher eyebrows, wider upper eyelids, and more orbital fat. Therefore, we designed a novel brow lift technique via a supra-brow combined with an infra-brow approach for Asian women. An area of skin above and below the eyebrow was measured, demarcated, and surgically removed. The redundant orbicularis oculi muscle (OOM) was excised while keeping the frontalis muscle intact. The OOM in the inferior flap was elevated and sutured to the frontalis muscle. In cases of puffy eyelids, orbital fat was partially removed through an infra-brow incision. Finally, a series of modifications were performed to reduce post-operative scarring. A total of 496 patients underwent this surgery from July 2009 to December 2013 and 432 patients were followed up for at least 6 months after surgery. Post-operative scars, in most patients (428/432), were inconspicuous. There were no facial nerve injuries documented and eight patients reported transient forehead numbness. The height of the palpebral fissure was increased but there was no marked increase observed of the distance between the upper eyelid edge and the eyebrow. In follow-up visits, 409 out of 432 patients (94.7 %) were satisfied with their surgical results. This new brow lift technique via a supra-brow combined with an infra-brow approach provided a simple and safe surgical repair of lateral brow ptosis, upper eyelids hooding, and crows' feet in Asian women. The surgical outcomes were predictable and the scars were inconspicuous. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Using a forehead reflectance pulse oximeter to detect changes in sympathetic tone.

Science.gov (United States)

Wendelken, Suzanne M; McGrath, Susan P; Akay, Metin; Blike, George T

2004-01-01

The extreme conditions of combat and multi-casualty rescue often make field triage difficult and put the medic or first responder at risk. In an effort to improve field triage, we have developed an automated remote triage system called ARTEMIS (automated remote triage and emergency management information system) for use in the battlefield or disaster zone. Common to field injuries is a sudden change in arterial pressure resulting from massive blood loss or shock. In effort to stabilize the arterial pressure, the sympathetic system is strongly activated and sympathetic tone is increased. This preliminary research seeks to empirically demonstrate that a forehead reflectance pulse oximeter is a viable sensor for detecting sudden changes in sympathetic tone. We performed the classic supine-standing experiment and collected the raw waveform, the photoplethysmogram (PPG), continuously using a forehead reflectance pulse oximeter. The resulting waveform was processed in Matlab using various spectral analysis techniques (FFT and AR). Our preliminary results show that a relative ratio analysis (low frequency power/high frequency power) for both the raw PPG signal and its derived pulse statistics (height, beat-to-beat interval) is a useful technique for detecting change in sympathetic tone resulting from positional change.

Regional changes in spine posture at lift onset with changes in lift distance and lift style

NARCIS (Netherlands)

Gill, K.P.; Bennet, S.J.; Savelsbergh, G.J.P.; van Dieen, J.H.

2007-01-01

STUDY DESIGN. Repeated measures experiment. OBJECTIVE. To determine the effect of changes in horizontal lift distance on the amount of flexion, at lift onset, in different spine regions when using different lift styles. SUMMARY OF BACKGROUND DATA. By approximating spine bending during lifting as a

Tornado lift

OpenAIRE

Ivanchin, Alexander

2010-01-01

It is shown that one of the causes for tornado is Tornado Lift. At increasing vortex diameter its kinetic energy decreases to keep the moment of momentum constant. A kinetic energy gradient of such vortex is Tornado Lift. Evaluation shows that contribution of Tornado Lift in air lifting in a tornado is comparable to buoyancy according to the order of magnitude.

A hypersonic lift mechanism with decoupled lift and drag surfaces

Science.gov (United States)

Xu, YiZhe; Xu, ZhiQi; Li, ShaoGuang; Li, Juan; Bai, ChenYuan; Wu, ZiNiu

2013-05-01

In the present study, we propose a novel lift mechanism for which the lifting surface produces only lift. This is achieved by mounting a two-dimensional shock-shock interaction generator below the lifting surface. The shock-shock interaction theory in conjunction with a three dimensional correction and checked with computational fluid dynamics (CFD) is used to analyze the lift and drag forces as function of the geometrical parameters and inflow Mach number. Through this study, though limited to only inviscid flow, we conclude that it is possible to obtain a high lift to drag ratio by suitably arranging the shock interaction generator.

Referred pain to the ipsilateral forehead and orbit: An unusual phenomenon during bronchial artery embolization

International Nuclear Information System (INIS)

Ramakantan, Ravi; Ketkar, Manoj; Maddali, Krishna; Deshmukh, Hemant

1999-01-01

Purpose: We report an unusual pattern of referred pain to the ipsilateral forehead and orbit observed during bronchial artery embolization (BAE) for massive hemoptysis due to pulmonary tuberculosis (TB) and postulate possible neural mechanisms for its occurrence.Methods: Seven men, from a series of 194 patients (171 men, 23 women) undergoing BAE (right bronchial artery 4, left 3) with gelatin sponge for control of massive hemoptysis due to pulmonary TB form the subject of this report.Results: Embolization was successful in achieving control of hemoptysis in these patients and there were no complications following the embolization. Transient, moderately severe, ipsilateral supraorbital and/or retroorbital pain occurred only during the injection of the gelatin sponge contrast mixture into the bronchial artery. The pain did not occur during the injection of heparinized saline or ionic contrast medium.Conclusions: Referred pain during BAE is an unusual phenomenon. Acute vessel distension triggering visceral sensations is probably the causative mechanism. Sympathetic afferents from the bronchi coursing through the posterior pulmonary plexus eventually pass to the trigeminal ganglion via the carotid sympathetic chain. The ophthalmic and maxillary divisions of the trigeminal nerve then mediate pain sensation to the ipsilateral forehead and orbit. Similarly, parasympathetic afferents from the pulmonary plexus crossing the nucleus of the spinal tract of the trigeminal nerve may be responsible for interexchange of impulses to the neurons in this nucleus. Sensory fibers of the ophthalmic and maxillary nerves relaying in this nucleus are then involved in this pain being referred to the forehead and orbit.

Normalized lift: an energy interpretation of the lift coefficient simplifies comparisons of the lifting ability of rotating and flapping surfaces.

Science.gov (United States)

Burgers, Phillip; Alexander, David E

2012-01-01

For a century, researchers have used the standard lift coefficient C(L) to evaluate the lift, L, generated by fixed wings over an area S against dynamic pressure, ½ρv(2), where v is the effective velocity of the wing. Because the lift coefficient was developed initially for fixed wings in steady flow, its application to other lifting systems requires either simplifying assumptions or complex adjustments as is the case for flapping wings and rotating cylinders.This paper interprets the standard lift coefficient of a fixed wing slightly differently, as the work exerted by the wing on the surrounding flow field (L/ρ·S), compared against the total kinetic energy required for generating said lift, ½v(2). This reinterpreted coefficient, the normalized lift, is derived from the work-energy theorem and compares the lifting capabilities of dissimilar lift systems on a similar energy footing. The normalized lift is the same as the standard lift coefficient for fixed wings, but differs for wings with more complex motions; it also accounts for such complex motions explicitly and without complex modifications or adjustments. We compare the normalized lift with the previously-reported values of lift coefficient for a rotating cylinder in Magnus effect, a bat during hovering and forward flight, and a hovering dipteran.The maximum standard lift coefficient for a fixed wing without flaps in steady flow is around 1.5, yet for a rotating cylinder it may exceed 9.0, a value that implies that a rotating cylinder generates nearly 6 times the maximum lift of a wing. The maximum normalized lift for a rotating cylinder is 1.5. We suggest that the normalized lift can be used to evaluate propellers, rotors, flapping wings of animals and micro air vehicles, and underwater thrust-generating fins in the same way the lift coefficient is currently used to evaluate fixed wings.

Variable Lifting Index (VLI): A New Method for Evaluating Variable Lifting Tasks.

Science.gov (United States)

Waters, Thomas; Occhipinti, Enrico; Colombini, Daniela; Alvarez-Casado, Enrique; Fox, Robert

2016-08-01

We seek to develop a new approach for analyzing the physical demands of highly variable lifting tasks through an adaptation of the Revised NIOSH (National Institute for Occupational Safety and Health) Lifting Equation (RNLE) into a Variable Lifting Index (VLI). There are many jobs that contain individual lifts that vary from lift to lift due to the task requirements. The NIOSH Lifting Equation is not suitable in its present form to analyze variable lifting tasks. In extending the prior work on the VLI, two procedures are presented to allow users to analyze variable lifting tasks. One approach involves the sampling of lifting tasks performed by a worker over a shift and the calculation of the Frequency Independent Lift Index (FILI) for each sampled lift and the aggregation of the FILI values into six categories. The Composite Lift Index (CLI) equation is used with lifting index (LI) category frequency data to calculate the VLI. The second approach employs a detailed systematic collection of lifting task data from production and/or organizational sources. The data are organized into simplified task parameter categories and further aggregated into six FILI categories, which also use the CLI equation to calculate the VLI. The two procedures will allow practitioners to systematically employ the VLI method to a variety of work situations where highly variable lifting tasks are performed. The scientific basis for the VLI procedure is similar to that for the CLI originally presented by NIOSH; however, the VLI method remains to be validated. The VLI method allows an analyst to assess highly variable manual lifting jobs in which the task characteristics vary from lift to lift during a shift. © 2015, Human Factors and Ergonomics Society.

High-quality endoscope reprocessing decreases endoscope contamination.

Science.gov (United States)

Decristoforo, P; Kaltseis, J; Fritz, A; Edlinger, M; Posch, W; Wilflingseder, D; Lass-Flörl, C; Orth-Höller, D

2018-02-24

Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes, have been described. The rate of microbial endoscope contamination varies dramatically in literature. The aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria. In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture-based and molecular-based analyses. The contamination rate of GI endoscopes was 1.3%-4.6% according to the national guideline, suggesting that 1.3-4.6 patients out of 100 could have had contacts with hygiene-relevant microorganisms through an endoscopic intervention. Comparison of R and CRA sampling showed 1.8% of R versus 4.6% of CRA failing the acceptance criteria in phase I and 1.3% of R versus 3.0% of CRA samples failing in phase II. The most commonly identified indicator organism was Pseudomonas spp., mainly Pseudomonas oleovorans. None of the tested viruses were detected in 40 samples. While AERs in phase I failed (n = 9, 17.6%) mainly due to technical faults, phase II revealed lapses (n = 6, 11.5%) only on account of microbial contamination of the last rinsing water, mainly with Pseudomonas spp. In the present study the contamination rate of endoscopes was low compared with results from other European countries, possibly due to the high quality of endoscope reprocessing, drying and storage. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Endoscopic retrograde cholangiopancreatography and endoscopic ...

African Journals Online (AJOL)

An approach to suspected gallstone pancreatitis'based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCp became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on ...

Normalized Lift: An Energy Interpretation of the Lift Coefficient Simplifies Comparisons of the Lifting Ability of Rotating and Flapping Surfaces

Science.gov (United States)

Burgers, Phillip; Alexander, David E.

2012-01-01

For a century, researchers have used the standard lift coefficient CL to evaluate the lift, L, generated by fixed wings over an area S against dynamic pressure, ½ρv 2, where v is the effective velocity of the wing. Because the lift coefficient was developed initially for fixed wings in steady flow, its application to other lifting systems requires either simplifying assumptions or complex adjustments as is the case for flapping wings and rotating cylinders. This paper interprets the standard lift coefficient of a fixed wing slightly differently, as the work exerted by the wing on the surrounding flow field (L/ρ·S), compared against the total kinetic energy required for generating said lift, ½v2. This reinterpreted coefficient, the normalized lift, is derived from the work-energy theorem and compares the lifting capabilities of dissimilar lift systems on a similar energy footing. The normalized lift is the same as the standard lift coefficient for fixed wings, but differs for wings with more complex motions; it also accounts for such complex motions explicitly and without complex modifications or adjustments. We compare the normalized lift with the previously-reported values of lift coefficient for a rotating cylinder in Magnus effect, a bat during hovering and forward flight, and a hovering dipteran. The maximum standard lift coefficient for a fixed wing without flaps in steady flow is around 1.5, yet for a rotating cylinder it may exceed 9.0, a value that implies that a rotating cylinder generates nearly 6 times the maximum lift of a wing. The maximum normalized lift for a rotating cylinder is 1.5. We suggest that the normalized lift can be used to evaluate propellers, rotors, flapping wings of animals and micro air vehicles, and underwater thrust-generating fins in the same way the lift coefficient is currently used to evaluate fixed wings. PMID:22629326

Normalized lift: an energy interpretation of the lift coefficient simplifies comparisons of the lifting ability of rotating and flapping surfaces.

Directory of Open Access Journals (Sweden)

Phillip Burgers

Full Text Available For a century, researchers have used the standard lift coefficient C(L to evaluate the lift, L, generated by fixed wings over an area S against dynamic pressure, ½ρv(2, where v is the effective velocity of the wing. Because the lift coefficient was developed initially for fixed wings in steady flow, its application to other lifting systems requires either simplifying assumptions or complex adjustments as is the case for flapping wings and rotating cylinders.This paper interprets the standard lift coefficient of a fixed wing slightly differently, as the work exerted by the wing on the surrounding flow field (L/ρ·S, compared against the total kinetic energy required for generating said lift, ½v(2. This reinterpreted coefficient, the normalized lift, is derived from the work-energy theorem and compares the lifting capabilities of dissimilar lift systems on a similar energy footing. The normalized lift is the same as the standard lift coefficient for fixed wings, but differs for wings with more complex motions; it also accounts for such complex motions explicitly and without complex modifications or adjustments. We compare the normalized lift with the previously-reported values of lift coefficient for a rotating cylinder in Magnus effect, a bat during hovering and forward flight, and a hovering dipteran.The maximum standard lift coefficient for a fixed wing without flaps in steady flow is around 1.5, yet for a rotating cylinder it may exceed 9.0, a value that implies that a rotating cylinder generates nearly 6 times the maximum lift of a wing. The maximum normalized lift for a rotating cylinder is 1.5. We suggest that the normalized lift can be used to evaluate propellers, rotors, flapping wings of animals and micro air vehicles, and underwater thrust-generating fins in the same way the lift coefficient is currently used to evaluate fixed wings.

A comparative study on accuracy of liquid crystal forehead, digital electronic axillary, infrared tympanic with glass-mercury rectal thermometer in infants and young children.

Science.gov (United States)

Kongpanichkul, A; Bunjongpak, S

2000-09-01

This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.

New endoscope shaft for endoscopic transsphenoidal pituitary surgery.

NARCIS (Netherlands)

Lindert, E.J. van; Grotenhuis, J.A.

2005-01-01

OBJECTIVE: To describe a new endoscope shaft developed for suction-aspiration during endoscopic transsphenoidal pituitary surgery. METHODS: A custom-made shaft for a Wolf endoscope (Richard Wolf GmbH, Knittlingen, Germany) was developed with a height of 10 mm and a width of 5 mm, allowing an

Study on process design of partially-balanced, hydraulically lifting vertical ship lift

Science.gov (United States)

Xin, Shen; Xiaofeng, Xu; Lu, Zhang; Bing, Zhu; Fei, Li

2017-11-01

The hub ship lift in Panjin is the first navigation structure in China for the link between the inland and open seas, which adopts a novel partially-balanced, hydraulically lifting ship lift; it can meet such requirements as fast and sharp water level change in open sea, large draft of a yacht, and launching of a ship reception chamber; its balancing weight system can effectively reduce the load of the primary lifting cylinder, and optimize the force distribution of the ship reception chamber. The paper provides an introduction to main equipment, basic principles, main features and system composition of a ship lift. The unique power system and balancing system of the completed ship lift has offered some experience for the construction of the tourism-type ship lifts with a lower lifting height.

Clinical endoscopic management and outcome of post-endoscopic sphincterotomy bleeding.

Directory of Open Access Journals (Sweden)

Wei-Chen Lin

Full Text Available Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016. The blood biochemistry, comorbidities, indication for sphincterotomy, severity of bleeding, endoscopic features of bleeder, and type of endoscopic therapy were analyzed. Post-endoscopic sphincterotomy bleeding occurred in 65 (12.6% patients. Forty-five patients had immediate bleeding and 20 patients had delayed bleeding. The multivariate analysis of risk factors associated with post-endoscopic sphincterotomy bleeding were liver cirrhosis (P = 0.029, end-stage renal disease (P = 0.038, previous antiplatelet drug use (P<0.001, and duodenal ulcer (P = 0.023. The complications of pancreatitis and cholangitis were higher in the bleeding group, with statistical significance. Delayed bleeding occurred within 1 to 7 days (mean, 2.5 days, and 60% (12/20 of the patients received endoscopic evaluation. In the delayed bleeding group, the successful hemostasis rate was 71.4% (5/7, and 65% (13/20 of the patients had ceased bleeding without endoscopic hemostasis therapy. Comparison of different therapeutic modalities showed that cholangitis was higher in patients who received epinephrine spray (P = 0.042 and pancreatitis was higher in patients who received epinephrine injection and electrocoagulation (P = 0.041 and P = 0.039 respectively. Clinically, post-endoscopic sphincterotomy bleeding and further endoscopic hemostasis therapy increase the complication rate of pancreatitis and cholangitis. Realizing the effectiveness of each

Safe lifting in patients with chronic low back pain : Comparing FCE lifting task and NIOSH lifting guideline

NARCIS (Netherlands)

Kuijer, Wietske; Dijkstra, Pieter U.; Brouwer, Sandra; Reneman, Michiel F.; Groothoff, Johan W.; Geertzen, Jan H. B.

2006-01-01

Introduction: Both the floor-to-waist lifting task of the Isernhagen Work Systems Functional Capacity Evaluation (IWS FCE) and recommended weight limit (RWL) of the NIOSH produce safe lifting weights and are used world-wide nowadays. It is unknown whether they produce similar safe lifting weights.

Lifting index of the niosh lifting equation and low back pain

Directory of Open Access Journals (Sweden)

Eliana Remor Teixeira

2011-09-01

Full Text Available The purpose of this study is to assess the relationship of the Lifting Index obtained through the application of the NIOSH Lifting Equation and the incidence of low back pain among forty-eight workers involved in manual lifting tasks. It was applied the equation in eleven tasks and the workers were interviewed. The most unfavorable conditions presented themselves in the lifting destination. The variables that most contributed to the inadequate values of the Lifting Index were: the horizontal location, the lifting frequency and the vertical distance, beyond the high weight of the load. The incidence of low back pain in the last twelve months was 19%, whereas the incidence of work-related low back pain in the same period was 10%. In 72.7% of the tasks evaluated the Composite Lifting Index was more than three, which are considered as high ergonomic risk.

Scoping the scope: endoscopic evaluation of endoscope working channels with a new high-resolution inspection endoscope (with video).

Science.gov (United States)

Barakat, Monique T; Girotra, Mohit; Huang, Robert J; Banerjee, Subhas

2018-02-06

Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of endoscope reprocessing. We inspected working channels of all 68 endoscopes at our academic institution using a novel flexible inspection endoscope. Inspections were recorded and videos reviewed by 3 investigators to evaluate and rate channel damage and/or debris. Working channel rinsates were obtained from all endoscopes, and adenosine triphosphate (ATP) bioluminescence was measured. Overall endoscope working channel damage was rated as minimal and/or mild and was consistent with expected wear and tear (median 1.59 on our 5-point scale). Our predominant findings included superficial scratches (98.5%) and scratches with adherent peel (76.5%). No channel perforations, stains, or burns were detected. The extent of damage was not predicted by endoscope age. Minor punctate debris was common, and a few small drops of fluid were noted in 42.6% of endoscopes after reprocessing and drying. The presence of residual fluid predicted higher ATP bioluminescence values. The presence of visualized working channel damage or debris was not associated with elevated ATP bioluminescence values. The flexible inspection endoscope enables high-resolution imaging of endoscope working channels and offers endoscopy units an additional modality for endoscope surveillance, potentially complementing bacterial cultures and ATP values. Our study, conducted in a busy academic endoscopy unit, indicated predominately mild damage to endoscope working channels, which did not correlate with elevated ATP values. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights

Lift truck safety review

Energy Technology Data Exchange (ETDEWEB)

Cadwallader, L.C.

1997-03-01

This report presents safety information about powered industrial trucks. The basic lift truck, the counterbalanced sit down rider truck, is the primary focus of the report. Lift truck engineering is briefly described, then a hazard analysis is performed on the lift truck. Case histories and accident statistics are also given. Rules and regulations about lift trucks, such as the US Occupational Safety an Health Administration laws and the Underwriter`s Laboratories standards, are discussed. Safety issues with lift trucks are reviewed, and lift truck safety and reliability are discussed. Some quantitative reliability values are given.

Lift truck safety review

International Nuclear Information System (INIS)

Cadwallader, L.C.

1997-03-01

This report presents safety information about powered industrial trucks. The basic lift truck, the counterbalanced sit down rider truck, is the primary focus of the report. Lift truck engineering is briefly described, then a hazard analysis is performed on the lift truck. Case histories and accident statistics are also given. Rules and regulations about lift trucks, such as the US Occupational Safety an Health Administration laws and the Underwriter's Laboratories standards, are discussed. Safety issues with lift trucks are reviewed, and lift truck safety and reliability are discussed. Some quantitative reliability values are given

Endoscopic root canal treatment.

Science.gov (United States)

Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

2009-10-01

To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

Normalized Lift: An Energy Interpretation of the Lift Coefficient Simplifies Comparisons of the Lifting Ability of Rotating and Flapping Surfaces

OpenAIRE

Burgers, Phillip; Alexander, David E.

2012-01-01

For a century, researchers have used the standard lift coefficient C(L) to evaluate the lift, L, generated by fixed wings over an area S against dynamic pressure, ½ρv(2), where v is the effective velocity of the wing. Because the lift coefficient was developed initially for fixed wings in steady flow, its application to other lifting systems requires either simplifying assumptions or complex adjustments as is the case for flapping wings and rotating cylinders.This paper interprets the standar...

Tailored botulinum toxin type A injections in aesthetic medicine: consensus panel recommendations for treating the forehead based on individual facial anatomy and muscle tone

Directory of Open Access Journals (Sweden)

Anido J

2017-10-01

Full Text Available Javier Anido,1 Daniel Arenas,2 Cristina Arruabarrena,3 Alfonso Domínguez-Gil,4 Carlos Fajardo,5 Mar Mira,6 Javier Murillo,7 Natalia Ribé,8 Helga Rivera,9 Sofia Ruiz del Cueto,6 Helder Silvestre,10 Marisa Tirado11 1A-Clinic, Madrid, 2Hospital Cruz Roja, Madrid, 3Clinic Cristina Arruabarrena, San Sebastiá, 4Salamanca University, Salamanca, 5Clinic Fajardo, Malaga, 6Clinic Mira+Cueto, Madrid, 7Clinic CIR, Seville, 8Institute Natalia Ribé, Barcelona, 9Clinic Helga Rivera, Vigo, Spain; 10Clinic Europa, Lisbon, Portugal; 11Clinic Derma Alemar, Castellón, Spain Background: Facial lines and wrinkles are strongly influenced by individual differences in anatomy and muscle activity and no single injection protocol will suit all patients. However, there is only limited information in the published literature on how to develop a tailored approach to botulinum toxin treatment.Methods: An expert panel of physicians was convened to establish a consensus on developing an individualized approach to treatment of the forehead with incobotulinumtoxinA. Separate treatment protocols were developed for men and women and subdivided by background level of muscle activity: kinetic, hyperkinetic, and hypertonic. Each muscle tone category was then further subdivided to take account of individual characteristics that can influence treatment.Results: Consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is described for men and women with a wide range of forehead presentations. For each presentation, units of toxin as well as the precise location of injection points were defined by creating a 12-zone map of the forehead.Conclusion: These recommendations depart from traditional consensus documents by providing detailed incobotulinumtoxinA injection protocols for the forehead based on the major parameters that differ between patients, including muscular anatomy, size, and

Face-Lift

Science.gov (United States)

... or sun damage, you might also consider a skin-resurfacing procedure. A face-lift can be done in combination with some other cosmetic procedures, such as a brow lift or eyelid surgery. Why it's done As you get older, your facial skin changes — sagging and becoming loose. This can make ...

Lift-and-fill face lift: integrating the fat compartments.

Science.gov (United States)

Rohrich, Rod J; Ghavami, Ashkan; Constantine, Fadi C; Unger, Jacob; Mojallal, Ali

2014-06-01

Recent discovery of the numerous fat compartments of the face has improved our ability to more precisely restore facial volume while rejuvenating it through differential superficial musculoaponeurotic system treatment. Incorporation of selective fat compartment volume restoration along with superficial musculoaponeurotic system manipulation allows for improved control in recontouring while addressing one of the key problems in facial aging, namely, volume deflation. This theory was evaluated by assessing the contour changes from simultaneous face "lifting" and "filling" through fat compartment-guided facial fat transfer. A review of 100 face-lift patients was performed. All patients had an individualized component face lift with fat grafting to the nasolabial fold, deep malar, and high/lateral malar fat compartment locations. Photographic analysis using a computer program was conducted on oblique facial views preoperatively and postoperatively, to obtain the most projected malar contour point. Two independent observers visually evaluated the malar prominence and nasolabial fold improvements based on standardized photographs. Nasolabial fold improved by at least one grade in 81 percent and by over one grade in 11 percent. Malar prominence average projection increase was 13.47 percent and the average amount of lift was 12.24 percent. The malar prominence score improved by at least one grade in 62 percent of the patients postoperatively, and 9 percent had a greater than one grade improvement. Twenty-eight percent of the patients had a convex malar prominence postoperatively compared with 6 percent preoperatively. Malar prominence improved by at least one grade in 63 percent and by over one grade in 10 percent. The lift-and-fill face lift merges two key concepts in facial rejuvenation: (1) effective tissue manipulation by means of lifting and tightening in differential vectors according to original facial asymmetry and shape; and (2) selective fat compartment filling

Painless lump over the forehead which turned painful: an unusual presentation of hepatocellular carcinoma

Directory of Open Access Journals (Sweden)

S P Susheela

2015-05-01

Full Text Available Hepatocellular carcinoma (HCC is one of the most common malignancies and is known to most often present with symptomatology pertaining to local hepatic disease. Although HCC is known to metastasize to lungs, abdominal lymph nodes, adrenal glands and the vertebral column, it is rather rare to come across patients with skull metastasis. The manifestation of a solitary frontal bone metastasis leading to a painless lump over the forehead as the initial presenting feature of HCC is highly unusual. This case report pertains to a 40-year-old male patient who had initially observed a painless lump over his forehead that was gradually increasing in size over a span of 3 months. He sought medical attention when, after several months, the "painless lump" suddenly became painful. Investigations revealed the involvement of both the outer and the inner table of the frontal bone, and a biopsy revealed the histopathology to be that of HCC. On further investigation, he was found to have systemic disseminated disease involving both the left and right lungs and vertebrae and treatment was initiated with sorafenib. Despite an initial partial response, the patient subsequently succumbed to hepatic failure. This case report illustrates the fact that HCC can silently progress, and even lead to dissemination and distant metastases before becoming clinically evident.

Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

Science.gov (United States)

Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

2017-10-01

Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

Lift scheduling organization : Lift Concept for Lemminkainen

OpenAIRE

Mingalimov, Iurii

2015-01-01

The purpose of the work was to make a simple schedule for the main contractors and clients to check and control workflow connected with lifts. It gathers works with electricity, construction, engineering networks, installing equipment and commissioning works. The schedule was carried out during working on the building site Aino in Saint Petersburg in Lemminkӓinen. The duration of work was 5 months. The lift concept in Lemminkӓinen is very well controlled in comparison with other buil...

Surgical Excision with Forehead Flap as Single Modality Treatment for Basal Cell Cancer of Central Face: Single Institutional Experience of 50 Cases

Directory of Open Access Journals (Sweden)

Jagdeep Rao

2014-01-01

Full Text Available Basal cell carcinoma (BCC is the most common skin cancer worldwide. The WHO has defined it as “a locally invasive, slowly spreading tumor which rarely metastasizes, arising in the epidermis or hair follicles and in which the peripheral cells usually simulate the basal cells of the epidermis.” Here we discuss the management of BCCs of central face with surgical excision and reconstruction with forehead flap as single modality treatment. Material and Methods. This is a retrospective review of 50 patients who underwent surgical excision of BCC involving the facial region followed by primary reconstruction using forehead flaps at a single institution. There were 20 males and 30 females, mean age of 59 years. Results. No recurrence at primary site was observed during the follow-up of 1–4 yrs. There was no ectropion or exposure sequela. However, epiphora was evident. Size of lesions ranged from 2 to 6 cm. Keloid formation was seen in 2 (4% patients. Functional and cosmetic outcomes were satisfactory. Conclusion. For the face, the best reconstructive effort eventually fails in the face of tumor recurrence. The forehead flap represents one of the best methods for repair of extensive facial defects. Complete tumor extirpation, the primary event, is the key.

Lifting strength in two-person teamwork.

Science.gov (United States)

Lee, Tzu-Hsien

2016-01-01

This study examined the effects of lifting range, hand-to-toe distance, and lifting direction on single-person lifting strengths and two-person teamwork lifting strengths. Six healthy males and seven healthy females participated in this study. Two-person teamwork lifting strengths were examined in both strength-matched and strength-unmatched groups. Our results showed that lifting strength significantly decreased with increasing lifting range or hand-to-toe distance. However, lifting strengths were not affected by lifting direction. Teamwork lifting strength did not conform to the law of additivity for both strength-matched and strength-unmatched groups. In general, teamwork lifting strength was dictated by the weaker of the two members, implying that weaker members might be exposed to a higher potential danger in teamwork exertions. To avoid such overexertion in teamwork, members with significantly different strength ability should not be assigned to the same team.

Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature.

Science.gov (United States)

Gülbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend

2018-03-01

In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have passed, the authors now performed again a systematic review to determine the real scientific current state of the art on the use of thread-lift sutures. A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database and using the Medical Subject Headings search term "Rhytidoplasty." "Rhytidoplasty" and the following entry terms were included by this Medical Subject Headings term: "facelift," "facelifts," "face Lift," "Face Lifts," "Lift," "Face," "Lifts," "Platysmotomy," "Platysmotomies," "Rhytidectomy," "Rhytidectomies," "Platysmaplasty," "and "Platysmaplasties." The Medical Subject Headings term "Rhytidoplasty" was combined with the following search terms: "Barbed suture," "Thread lift," "APTOS," "Suture suspension," "Percutaneous," and "Silhouette suture." RefWorks was used to filter duplicates. Three of the authors (H.A.G., B.C., and B.L.) performed the search independently. The initial search with all search terms resulted in 188 articles. After filtering the duplicates and the articles about open procedures, a total of 41 articles remained. Of these, the review articles, case reports, and letters to the editor were subsequently excluded, as were reports dealing with nonbarbed sutures, such as Vicryl and Prolene with Gore-Tex. This resulted in a total of 12 articles, seven additional articles since the five articles reviewed by Villa et al. The authors' review demonstrated that, within the past decade, little or no substantial evidence has been added to the peer-reviewed literature to support or sustain the promising statement about thread-lift sutures as made by Villa et al. in 2006 in terms of

The Effect of Lifting Speed on Cumulative and Peak Biomechanical Loading for Symmetric Lifting Tasks

Directory of Open Access Journals (Sweden)

Kasey O. Greenland

2013-06-01

Conclusion: Based on peak values, BCF is highest for fast speeds, but the BCF cumulative loading is highest for slow speeds, with the largest difference between fast and slow lifts. This may imply that a slow lifting speed is at least as hazardous as a fast lifting speed. It is important to consider the duration of lift when determining risks for back and shoulder injuries due to lifting and that peak values alone are likely not sufficient.

Scaling of lifting forces in relation to object size in whole body lifting

NARCIS (Netherlands)

Kingma, I.; van Dieen, J.H.; Toussaint, H.M.

2005-01-01

Subjects prepare for a whole body lifting movement by adjusting their posture and scaling their lifting forces to the expected object weight. The expectancy is based on visual and haptic size cues. This study aimed to find out whether lifting force overshoots related to object size cues disappear or

Forehead Skin Blood Flow in Normal Neonates during Active and Quiet Sleep, Measured with a Diode Laser Doppler Instrument

NARCIS (Netherlands)

Suichies, H.E.; Aarnoudse, J.G.; Okken, A.; Jentink, H.W.; de Mul, F.F.M.; Greve, Jan

1988-01-01

Changes in forehead skin blood flow during active and quiet sleep were determined in 16 healthy neonates using a recently developed semi-conductor laser Doppler flow meter without light conducting fibres. Measurements were carried out at a postnatal age varying from 5 hours to 7 days. The two sleep

Current Innovations in Endoscopic Therapy for the Management of Colorectal Cancer: From Endoscopic Submucosal Dissection to Endoscopic Full-Thickness Resection

Directory of Open Access Journals (Sweden)

Shintaro Fujihara

2014-01-01

Full Text Available Endoscopic submucosal dissection (ESD is accepted as a minimally invasive treatment for colorectal cancer. However, due to technical difficulties and an increased rate of complications, ESD is not widely used in the colorectum. In some cases, endoscopic treatment alone is insufficient for disease control, and laparoscopic surgery is required. The combination of laparoscopic surgery and endoscopic resection represents a new frontier in cancer treatment. Recent developments in advanced polypectomy and minimally invasive surgical techniques will enable surgeons and endoscopists to challenge current practice in colorectal cancer treatment. Endoscopic full-thickness resection (EFTR of the colon offers the potential to decrease the postoperative morbidity and mortality associated with segmental colectomy while enhancing the diagnostic yield compared to current endoscopic techniques. However, closure is necessary after EFTR and natural transluminal endoscopic surgery (NOTES. Innovative methods and new devices for EFTR and suturing are being developed and may potentially change traditional paradigms to achieve minimally invasive surgery for colorectal cancer. The present paper aims to discuss the complementary role of ESD and the future development of EFTR. We focus on the possibility of achieving EFTR using the ESD method and closing devices.

New heavy-lift system under construction

Energy Technology Data Exchange (ETDEWEB)

2009-07-01

Heavy-lift availability is at a premium, and the market is eager for alternatives to meet the demand. An alternative heavy-lift solution from SeaMetric - which has two multi-purpose heavy-lift vessels under construction in China - will be available in the first quarter of 2011. The TML system is based on buoyancy and ballast tanks, with four lifting arms mounted on two identical vessels, each vessel measuring 140 x 40 x 10.75 metres. To perform a lift, one TML with lifting arms is positioned on each side of the object. Using seawater pumps, lift force is created by de ballasting the buoyancy tanks and at the same time ballasting the ballast tanks. (AG). tab., ills

CFD Study of a New Annular Lift Fan Configuration with High Lift Efficiency

Directory of Open Access Journals (Sweden)

Yun Jiang

2017-03-01

Full Text Available A new annular lift fan configuration that has very high lift efficiency is explored by using a numerical scheme. The inlet lip radius and diffuser angle are maximized by semicircle duct walls and the location of the lift fan is moved from the throat to the diffuser area to maximize the diffusion effect of the ducted fan. The improved lift fan achieves the figure of merit of 0.772 and the power loading of 9.03 lbs/hp without ground effect, very close to the theoretical limit. Under the ground effect, the figure of merit reaches 0.822 with the power loading of 9.62 lbs/hp. The improved lift efficiency deteriorates the transition characteristics with higher momentum drag and pitching moment. However, with the aid of jet thrusts directly providing part of the lift during transition, the peak of momentum drag and pitching moment can be lowered. A total thrust to weight ratio of 0.7 is enough for all of the requirements in transition and in hover and for the maximum speed of 0.75 Mach in cruise flight.

Endoscopic submucosal dissection

DEFF Research Database (Denmark)

Pimentel-Nunes, Pedro; Dinis-Ribeiro, Mário; Ponchon, Thierry

2015-01-01

evidence). 2 ESGE recommends endoscopic resection with a curative intent for visible lesions in Barrett's esophagus (strong recommendation, moderate quality evidence). ESD has not been shown to be superior to EMR for excision of mucosal cancer, and for that reason EMR should be preferred. ESD may...... RECOMMENDATIONS: 1 ESGE recommends endoscopic en bloc resection for superficial esophageal squamous cell cancers (SCCs), excluding those with obvious submucosal involvement (strong recommendation, moderate quality evidence). Endoscopic mucosal resection (EMR) may be considered in such lesions when...

Endoscopic Devices for Obesity.

Science.gov (United States)

Sampath, Kartik; Dinani, Amreen M; Rothstein, Richard I

2016-06-01

The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity.

endoscope-i: an innovation in mobile endoscopic technology transforming the delivery of patient care in otolaryngology.

Science.gov (United States)

Mistry, N; Coulson, C; George, A

2017-11-01

Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting. Areas covered: This article gives a detailed overview of the endoscope-i system together with its applications. A review and comparison of alternative devices on the market offering smartphone adapted endoscopic viewing systems is also presented. Expert commentary: The endoscope-i fulfils unmet needs by providing a compact, highly portable, simple to use endoscopic viewing system which is cost-effective and which makes use of smartphone technology most clinicians have in their pocket. The system allows real-time feedback to the patient and has the potential to transform the way that healthcare is delivered in ENT as well as having applications further afield.

Bindi tattoo on forehead: success with modified R-20 technique using low fluence q-switched nd yag laser: a case report.

Science.gov (United States)

Zawar, Vijay; Sarda, Aarti; De, Abhishek

2014-01-01

Bindi tattoo on the forehead, is one of the cultural practice in Indian women from rural areas. Many patients are not pleased with the appearance of their tattoo and thus seek removal. The development of quality-switched lasers has revolutionized the removal of unwanted tattoos. However, despite multiple treatment sessions, the efficacy is often found to be limited. We herein report a case of green-blue bindi tattoo which failed to clear after 8 sessions of Q-switched Nd YAG laser. The tattoo significantly cleared with R-20 method using low fluence Q-switched Nd YAG Laser. R-20 technique seems to be an effective method of tattoo removal and might be a boon for patients who are reluctant to pursue laser treatment because of fear of expenditure, side effects and uncertainty of result. We report efficacy of R-20 technique for a bindi tattoo on forehead.

Endoscopic management of colorectal adenomas.

Science.gov (United States)

Meier, Benjamin; Caca, Karel; Fischer, Andreas; Schmidt, Arthur

2017-01-01

Colorectal adenomas are well known precursors of invasive adenocarcinoma. Colonoscopy is the gold standard for adenoma detection. Colonoscopy is far more than a diagnostic tool, as it allows effective treatment of colorectal adenomas. Endoscopic resection of colorectal adenomas has been shown to reduce the incidence and mortality of colorectal cancer. Difficult resection techniques are available, such as endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic full-thickness resection. This review aims to provide an overview of the different endoscopic resection techniques and their indications, and summarizes the current recommendations in the recently published guideline of the European Society of Gastrointestinal Endoscopy.

How Do Wings Generate Lift?

Indian Academy of Sciences (India)

ideas to get expressions for lift and moment that are remarkably accurate. The pressure ... ating a lift force, leads to a nose-up or nose-down moment also. .... venient to use for a fluid since we would like to deal with a flow .... energy to get lift?

Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: A cadaveric feasibility study.

Science.gov (United States)

Chan, Jason Y K; Leung, Iris; Navarro-Alarcon, David; Lin, Weiyang; Li, Peng; Lee, Dennis L Y; Liu, Yun-hui; Tong, Michael C F

2016-03-01

To evaluate the feasibility of a unique prototype foot-controlled robotic-enabled endoscope holder (FREE) in functional endoscopic sinus surgery. Cadaveric study. Using human cadavers, we investigated the feasibility, advantages, and disadvantages of the robotic endoscope holder in performing endoscopic sinus surgery with two hands in five cadaver heads, mimicking a single nostril three-handed technique. The FREE robot is relatively easy to use. Setup was quick, taking less than 3 minutes from docking the robot at the head of the bed to visualizing the middle meatus. The unit is also relatively small, takes up little space, and currently has four degrees of freedom. The learning curve for using the foot control was short. The use of both hands was not hindered by the presence of the endoscope in the nasal cavity. The tremor filtration also aided in the smooth movement of the endoscope, with minimal collisions. The FREE endoscope holder in an ex-vivo cadaver test corroborated the feasibility of the robotic prototype, which allows for a two-handed approach to surgery equal to a single nostril three-handed technique without the holder that may reduce operating time. Further studies will be needed to evaluate its safety profile and use in other areas of endoscopic surgery. NA. Laryngoscope, 126:566-569, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Learning endoscopic resection in the esophagus

NARCIS (Netherlands)

van Vilsteren, Frederike G. I.; Pouw, Roos E.; Herrero, Lorenza Alvarez; Bisschops, Raf; Houben, Martin; Peters, Frans T. M.; Schenk, B. E.; Weusten, Bas L. A. M.; Schoon, Erik J.; Bergman, Jacques J. G. H. M.

Background: Endoscopic resection is the cornerstone of endoscopic management of esophageal early neoplasia. However, endoscopic resection is a complex technique requiring knowledge and expertise. Our aims were to identify the most important learning points in performing endoscopic resection in a

Architecture of the sperm whale forehead facilitates ramming combat

Directory of Open Access Journals (Sweden)

Olga Panagiotopoulou

2016-04-01

Full Text Available Herman Melville’s novel Moby Dick was inspired by historical instances in which large sperm whales (Physeter macrocephalus L. sank 19th century whaling ships by ramming them with their foreheads. The immense forehead of sperm whales is possibly the largest, and one of the strangest, anatomical structures in the animal kingdom. It contains two large oil-filled compartments, known as the “spermaceti organ” and “junk,” that constitute up to one-quarter of body mass and extend one-third of the total length of the whale. Recognized as playing an important role in echolocation, previous studies have also attributed the complex structural configuration of the spermaceti organ and junk to acoustic sexual selection, acoustic prey debilitation, buoyancy control, and aggressive ramming. Of these additional suggested functions, ramming remains the most controversial, and the potential mechanical roles of the structural components of the spermaceti organ and junk in ramming remain untested. Here we explore the aggressive ramming hypothesis using a novel combination of structural engineering principles and probabilistic simulation to determine if the unique structure of the junk significantly reduces stress in the skull during quasi-static impact. Our analyses indicate that the connective tissue partitions in the junk reduce von Mises stresses across the skull and that the load-redistribution functionality of the former is insensitive to moderate variation in tissue material parameters, the thickness of the partitions, and variations in the location and angle of the applied load. Absence of the connective tissue partitions increases skull stresses, particularly in the rostral aspect of the upper jaw, further hinting of the important role the architecture of the junk may play in ramming events. Our study also found that impact loads on the spermaceti organ generate lower skull stresses than an impact on the junk. Nevertheless, whilst an impact on the

Architecture of the sperm whale forehead facilitates ramming combat.

Science.gov (United States)

Panagiotopoulou, Olga; Spyridis, Panagiotis; Mehari Abraha, Hyab; Carrier, David R; Pataky, Todd C

2016-01-01

Herman Melville's novel Moby Dick was inspired by historical instances in which large sperm whales (Physeter macrocephalus L.) sank 19th century whaling ships by ramming them with their foreheads. The immense forehead of sperm whales is possibly the largest, and one of the strangest, anatomical structures in the animal kingdom. It contains two large oil-filled compartments, known as the "spermaceti organ" and "junk," that constitute up to one-quarter of body mass and extend one-third of the total length of the whale. Recognized as playing an important role in echolocation, previous studies have also attributed the complex structural configuration of the spermaceti organ and junk to acoustic sexual selection, acoustic prey debilitation, buoyancy control, and aggressive ramming. Of these additional suggested functions, ramming remains the most controversial, and the potential mechanical roles of the structural components of the spermaceti organ and junk in ramming remain untested. Here we explore the aggressive ramming hypothesis using a novel combination of structural engineering principles and probabilistic simulation to determine if the unique structure of the junk significantly reduces stress in the skull during quasi-static impact. Our analyses indicate that the connective tissue partitions in the junk reduce von Mises stresses across the skull and that the load-redistribution functionality of the former is insensitive to moderate variation in tissue material parameters, the thickness of the partitions, and variations in the location and angle of the applied load. Absence of the connective tissue partitions increases skull stresses, particularly in the rostral aspect of the upper jaw, further hinting of the important role the architecture of the junk may play in ramming events. Our study also found that impact loads on the spermaceti organ generate lower skull stresses than an impact on the junk. Nevertheless, whilst an impact on the spermaceti organ would

Helicopter Toy and Lift Estimation

Science.gov (United States)

Shakerin, Said

2013-01-01

A $1 plastic helicopter toy (called a Wacky Whirler) can be used to demonstrate lift. Students can make basic measurements of the toy, use reasonable assumptions and, with the lift formula, estimate the lift, and verify that it is sufficient to overcome the toy's weight. (Contains 1 figure.)

Lambda-Lifting in Quadratic Time

DEFF Research Database (Denmark)

Danvy, Olivier; Schultz, Ulrik Pagh

2002-01-01

Lambda-lifting is a program transformation that is used in compilers, partial evaluators, and program transformers. In this article, we show how to reduce its complexity from cubic time to quadratic time, and we present a flow-sensitive lambda-lifter that also works in quadratic time. Lambda-lifting...... that yields the cubic factor in the traditional formulation of lambda-lifting, which is due to Johnsson. This search is carried out by computing a transitive closure. To reduce the complexity of lambda-lifting, we partition the call graph of the source program into strongly connected components, based...... of lambda-lifting from O(n^3) to O(n^2) . where n is the size of the program. Since a lambda-lifter can output programs of size O(n^2), our algorithm is asympotically optimal....

Lambda-Lifting in Quadratic Time

DEFF Research Database (Denmark)

Danvy, Olivier; Schultz, Ulrik Pagh

2003-01-01

Lambda-lifting is a program transformation that is used in compilers, partial evaluators, and program transformers. In this article, we show how to reduce its complexity from cubic time to quadratic time, and we present a flow-sensitive lambda-lifter that also works in quadratic time. Lambda-lifting...... that yields the cubic factor in the traditional formulation of lambda-lifting, which is due to Johnsson. This search is carried out by computing a transitive closure. To reduce the complexity of lambda-lifting, we partition the call graph of the source program into strongly connected components, based...... of lambda-lifting from O(n^3) to O(n^2) . where n is the size of the program. Since a lambda-lifter can output programs of size O(n^2), our algorithm is asympotically optimal....

Lambda-Lifting in Quadratic Time

DEFF Research Database (Denmark)

Danvy, Olivier; Schultz, Ulrik Pagh

2004-01-01

Lambda-lifting is a program transformation that is used in compilers, partial evaluators, and program transformers. In this article, we show how to reduce its complexity from cubic time to quadratic time, and we present a flow-sensitive lambda-lifter that also works in quadratic time. Lambda-lifting...... that yields the cubic factor in the traditional formulation of lambda-lifting, which is due to Johnsson. This search is carried out by computing a transitive closure. To reduce the complexity of lambda-lifting, we partition the call graph of the source program into strongly connected components, based...... of lambda-lifting from O(n^3) to O(n^2) . where n is the size of the program. Since a lambda-lifter can output programs of size O(n^2), our algorithm is asympotically optimal....

Endoscopic submucosal dissection for locally recurrent colorectal lesions after previous endoscopic mucosal resection.

Science.gov (United States)

Zhou, Pinghong; Yao, Liqing; Qin, Xinyu; Xu, Meidong; Zhong, Yunshi; Chen, Weifeng

2009-02-01

The objective of this study was to determine the efficacy and safety of endoscopic submucosal dissection for locally recurrent colorectal cancer after previous endoscopic mucosal resection. A total of 16 patients with locally recurrent colorectal lesions were enrolled. A needle knife, an insulated-tip knife and a hook knife were used to resect the lesion along the submucosa. The rate of the curative resection, procedure time, and incidence of complications were evaluated. Of 16 lesions, 15 were completely resected with endoscopic submucosal dissection, yielding an en bloc resection rate of 93.8 percent. Histologic examination confirmed that lateral and basal margins were cancer-free in 14 patients (87.5 percent). The average procedure time was 87.2 +/- 60.7 minutes. None of the patients had immediate or delayed bleeding during or after endoscopic submucosal dissection. Perforation in one patient (6.3 percent) was the only complication and was managed conservatively. The mean follow-up period was 15.5 +/- 6.8 months; none of the patients experienced lesion residue or recurrence. Endoscopic submucosal dissection appears to be effective for locally recurrent colorectal cancer after previous endoscopic mucosal resection, making it possible to resect whole lesions and provide precise histologic information.

Endoscopic therapy of neoplasia related to Barrett's esophagus and endoscopic palliation of esophageal cancer.

Science.gov (United States)

Vignesh, Shivakumar; Hoffe, Sarah E; Meredith, Kenneth L; Shridhar, Ravi; Almhanna, Khaldoun; Gupta, Akshay K

2013-04-01

Barrett's esophagus (BE) is the most important identifiable risk factor for the progression to esophageal adenocarcinoma. This article reviews the current endoscopic therapies for BE with high-grade dysplasia and intramucosal cancer and briefly discusses the endoscopic palliation of advanced esophageal cancer. The diagnosis of low-grade or high-grade dysplasia (HGD) is based on several cytologic criteria that suggest neoplastic transformation of the columnar epithelium. HGD and carcinoma in situ are regarded as equivalent. The presence of dysplasia, particularly HGD, is also a risk factor for synchronous and metachronous adenocarcinoma. Dysplasia is a marker of adenocarcinoma and also has been shown to be the preinvasive lesion. Esophagectomy has been the conventional treatment for T1 esophageal cancer and, although debated, is an appropriate option in some patients with HGD due to the presence of occult cancer in over one-third of patients. Endoscopic ablative modalities (eg, photodynamic therapy and cryoablation) and endoscopic resection techniques (eg, endoscopic mucosal resection) have demonstrated promising results. The significant morbidity and mortality of esophagectomy makes endoscopic treatment an attractive potential option.

Decoding Facial Esthetics to Recreate an Esthetic Hairline: A Method Which Includes Forehead Curvature.

Science.gov (United States)

Garg, Anil K; Garg, Seema

2017-01-01

The evidence suggests that our perception of physical beauty is based on how closely the features of one's face reflect phi (the golden ratio) in their proportions. By that extension, it must certainly be possible to use a mathematical parameter to design an anterior hairline in all faces. To establish a user-friendly method to design an anterior hairline in cases of male pattern alopecia. We need a flexible measuring tape and skin marker. A reference point A (glabella) is taken in between eyebrows. Mark point E, near the lateral canthus, 8 cm horizontal on either side from the central point A. A mid-frontal point (point B) is marked 8 cm from point A on the forehead in a mid-vertical plane. The frontotemporal points (C and C') are marked on the frontotemporal area, 8 cm in a horizontal plane from point B and 8 cm in a vertical plane from point E. The temporal peak points (D and D') are marked on the line joining the frontotemporal point C to the lateral canthus point E, slightly more than halfway toward lateral canthus, usually 5 cm from the frontotemporal point C. This line makes an anterior border of the temporal triangle. We have conducted a study with 431 cases of male pattern alopecia. The average distance of the mid-frontal point from glabella was 7.9 cm. The patient satisfaction reported was 94.7%. Our method gives a skeletal frame of the anterior hairline with minimal criteria, with no need of visual imagination and experience of the surgeon. It automatically takes care of the curvature of the forehead and is easy to use for a novice surgeon.

Endoscope-Assisted Transoral Fixation of Mandibular Condyle Fractures: Submandibular Versus Transoral Endoscopic Approach.

Science.gov (United States)

Hwang, Na-Hyun; Lee, Yoon-Hwan; You, Hi-Jin; Yoon, Eul-Sik; Kim, Deok-Woo

2016-07-01

In recent years, endoscope-assisted transoral approach for condylar fracture treatment has attracted much attention. However, the surgical approach is technically challenging: the procedure requires specialized instruments and the surgeons experience a steep learning curve. During the transoral endoscopic (TE) approach several instruments are positioned through a narrow oral incision making endoscope maneuvering very difficult. For this reason, the authors changed the entry port of the endoscope from transoral to submandibular area through a small stab incision. The aim of this study is to assess the advantage of using the submandibular endoscopic intraoral approach (SEI).The SEI approach requires intraoral incision for fracture reduction and fixation, and 4 mm size submandibular stab incision for endoscope and traction wires. Fifteen patients with condyle neck and subcondyle fractures were operated under the submandibular approach and 15 patients with the same diagnosis were operated under the standard TE approach.The SEI approach allowed clear visualization of the posterior margin of the ramus and condyle, and the visual axis was parallel to the condyle ramus unit. The TE approach clearly shows the anterior margin of the condyle and the sigmoid notch. The surgical time of the SEI group was 128 minutes and the TE group was 120 minutes (P >0.05). All patients in the TE endoscope group were fixated with the trocar system, but only 2 lower neck fracture patients in the SEI group required a trocar. The other 13 subcondyle fractures were fixated with an angulated screw driver (P <0.05). There were no differences in complication and surgical outcomes.The submandibular endoscopic approach has an advantage of having more space with good visualization, and facilitated the use of an angulated screw driver.

Endoscopic resection of subepithelial tumors.

Science.gov (United States)

Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; Caca, Karel

2014-12-16

Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

Optimization of lift gas allocation in a gas lifted oil field as non-linear optimization problem

Directory of Open Access Journals (Sweden)

Roshan Sharma

2012-01-01

Full Text Available Proper allocation and distribution of lift gas is necessary for maximizing total oil production from a field with gas lifted oil wells. When the supply of the lift gas is limited, the total available gas should be optimally distributed among the oil wells of the field such that the total production of oil from the field is maximized. This paper describes a non-linear optimization problem with constraints associated with the optimal distribution of the lift gas. A non-linear objective function is developed using a simple dynamic model of the oil field where the decision variables represent the lift gas flow rate set points of each oil well of the field. The lift gas optimization problem is solved using the emph'fmincon' solver found in MATLAB. As an alternative and for verification, hill climbing method is utilized for solving the optimization problem. Using both of these methods, it has been shown that after optimization, the total oil production is increased by about 4. For multiple oil wells sharing lift gas from a common source, a cascade control strategy along with a nonlinear steady state optimizer behaves as a self-optimizing control structure when the total supply of lift gas is assumed to be the only input disturbance present in the process. Simulation results show that repeated optimization performed after the first time optimization under the presence of the input disturbance has no effect in the total oil production.

Lift conference | 5-7 February

CERN Multimedia

2014-01-01

Since 2006, Lift Events explore the business and social implications of new technologies through the organisation of international event series and open innovation programs in Europe, Asia and America. The next conference will be held on 5-7 February in Geneva.   (Image: © Lift Conference) The Lift Conference is one of the leading conferences on innovation in Europe and a key annual meeting for individuals and organizations wishing to understand and anticipate trends and innovation. Held every year in February in Geneva (5-7 February 2014), the Lift Conference is a three-day event consisting of talks, interactive workshops, exhibitions, and discussions bringing together over 1’000 participants from all society’s sectors and industries in a dynamic and informal environment with the aim to learn, connect, share and leverage innovation opportunities.   Extraordinary speakers will take to the stage at Lift14: Porter Erisman, former VP of Alibaba.com turned...

Lift production through asymmetric flapping

Science.gov (United States)

Jalikop, Shreyas; Sreenivas, K. R.

2009-11-01

At present, there is a strong interest in developing Micro Air Vehicles (MAV) for applications like disaster management and aerial surveys. At these small length scales, the flight of insects and small birds suggests that unsteady aerodynamics of flapping wings can offer many advantages over fixed wing flight, such as hovering-flight, high maneuverability and high lift at large angles of attack. Various lift generating mechanims such as delayed stall, wake capture and wing rotation contribute towards our understanding of insect flight. We address the effect of asymmetric flapping of wings on lift production. By visualising the flow around a pair of rectangular wings flapping in a water tank and numerically computing the flow using a discrete vortex method, we demonstrate that net lift can be produced by introducing an asymmetry in the upstroke-to-downstroke velocity profile of the flapping wings. The competition between generation of upstroke and downstroke tip vortices appears to hold the key to understanding this lift generation mechanism.

Direct lifts of coupled cell networks

Science.gov (United States)

Dias, A. P. S.; Moreira, C. S.

2018-04-01

In networks of dynamical systems, there are spaces defined in terms of equalities of cell coordinates which are flow-invariant under any dynamical system that has a form consistent with the given underlying network structure—the network synchrony subspaces. Given a network and one of its synchrony subspaces, any system with a form consistent with the network, restricted to the synchrony subspace, defines a new system which is consistent with a smaller network, called the quotient network of the original network by the synchrony subspace. Moreover, any system associated with the quotient can be interpreted as the restriction to the synchrony subspace of a system associated with the original network. We call the larger network a lift of the smaller network, and a lift can be interpreted as a result of the cellular splitting of the smaller network. In this paper, we address the question of the uniqueness in this lifting process in terms of the networks’ topologies. A lift G of a given network Q is said to be direct when there are no intermediate lifts of Q between them. We provide necessary and sufficient conditions for a lift of a general network to be direct. Our results characterize direct lifts using the subnetworks of all splitting cells of Q and of all split cells of G. We show that G is a direct lift of Q if and only if either the split subnetwork is a direct lift or consists of two copies of the splitting subnetwork. These results are then applied to the class of regular uniform networks and to the special classes of ring networks and acyclic networks. We also illustrate that one of the applications of our results is to the lifting bifurcation problem.

Vertical vector face lift.

Science.gov (United States)

Somoano, Brian; Chan, Joanna; Morganroth, Greg

2011-01-01

Facial rejuvenation using local anesthesia has evolved in the past decade as a safer option for patients seeking fewer complications and minimal downtime. Mini- and short-scar face lifts using more conservative incision lengths and extent of undermining can be effective in the younger patient with lower face laxity and minimal loose, elastotic neck skin. By incorporating both an anterior and posterior approach and using an incision length between the mini and more traditional face lift, the Vertical Vector Face Lift can achieve longer-lasting and natural results with lesser cost and risk. Submentoplasty and liposuction of the neck and jawline, fundamental components of the vertical vector face lift, act synergistically with superficial musculoaponeurotic system plication to reestablish a more youthful, sculpted cervicomental angle, even in patients with prominent jowls. Dramatic results can be achieved in the right patient by combining with other procedures such as injectable fillers, chin implants, laser resurfacing, or upper and lower blepharoplasties. © 2011 Wiley Periodicals, Inc.

Wind tower service lift

Science.gov (United States)

Oliphant, David; Quilter, Jared; Andersen, Todd; Conroy, Thomas

2011-09-13

An apparatus used for maintaining a wind tower structure wherein the wind tower structure may have a plurality of legs and may be configured to support a wind turbine above the ground in a better position to interface with winds. The lift structure may be configured for carrying objects and have a guide system and drive system for mechanically communicating with a primary cable, rail or other first elongate member attached to the wind tower structure. The drive system and guide system may transmit forces that move the lift relative to the cable and thereby relative to the wind tower structure. A control interface may be included for controlling the amount and direction of the power into the guide system and drive system thereby causing the guide system and drive system to move the lift relative to said first elongate member such that said lift moves relative to said wind tower structure.

A new robotic-assisted flexible endoscope with single-hand control: endoscopic submucosal dissection in the ex vivo porcine stomach.

Science.gov (United States)

Iwasa, Tsutomu; Nakadate, Ryu; Onogi, Shinya; Okamoto, Yasuharu; Arata, Jumpei; Oguri, Susumu; Ogino, Haruei; Ihara, Eikichi; Ohuchida, Kenoki; Akahoshi, Tomohiko; Ikeda, Tetsuo; Ogawa, Yoshihiro; Hashizume, Makoto

2018-04-17

Difficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD). Study 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope. Study 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist. The RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.

JWST Lifting System

Science.gov (United States)

Tolleson, William

2012-01-01

A document describes designing, building, testing, and certifying a customized crane (Lifting Device LD) with a strong back (cradle) to facilitate the installation of long wall panels and short door panels for the GHe phase of the James Webb Space Telescope (JWST). The LD controls are variable-frequency drive controls designed to be adjustable for very slow and very-short-distance movements throughout the installation. The LD has a lift beam with an electric actuator attached at the end. The actuator attaches to a rectangular strong back (cradle) for lifting the long wall panels and short door panels from a lower angle into the vertical position inside the chamber, and then rotating around the chamber for installation onto the existing ceiling and floor. The LD rotates 360 (in very small increments) in both clockwise and counterclockwise directions. Eight lifting pads are on the top ring with 2-in. (.5-cm) eye holes spaced evenly around the ring to allow for the device to be suspended by three crane hoists from the top of the chamber. The LD is operated by remote controls that allow for a single, slow mode for booming the load in and out, with slow and very slow modes for rotating the load.

Submucosal tunnel endoscopy: Peroral endoscopic myotomy and peroral endoscopic tumor resection

Science.gov (United States)

Eleftheriadis, Nikolas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Maselli, Roberta; Santi, Grace

2016-01-01

Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction (EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection (POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors (submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. PMID

Business Profile of Boat Lift Net and Stationary Lift Net Fishing Gear in Morodemak Waters Central Java

Science.gov (United States)

Hapsari, Trisnani D.; Jayanto, Bogi B.; Fitri, Aristi D. P.; Triarso, I.

2018-02-01

Lift net is one of the fishing gears that is used widely in the Morodemak coastal fishing port (PPP) for catching pelagic fish. The yield of fish captured by these fishing gear has high economic value, such as fish belt (Trichiurus sp), squids (Loligo sp) and anchovies (Stelophorus sp). The aims of this research were to determine the technical aspects of boat lift net and stationary lift net fishing gear in Morodemak Waters Demak Regency; to find out the financial aspect of those fishing gears and to analyze the financial feasibility by counting PP, NPV, IRR, and B/C ratio criteria. This research used case study method with descriptive analysis. The sampling method was purposive sampling with 22 fishermen as respondents. The result of the research showed that the average of boat lift net acceptance was Rp 388,580,000. The financial analysis of fisheries boat lift net with the result of NPV Rp 836,149,272, PP 2.44 years, IRR value 54%, and B/C ratio 1.73. The average of stationary lift net acceptance was Rp 27,750,000. The financial analysis lift net with the result of NPV Rp 37,937,601; PP 1.96 years, IRR value 86%, and B/C ratio 1.32. This research had a positive NPV value, B/C ratio >1, and IRR > discount rate (12 %). This study concluded that the fishery business of boat lift net and stationary lift net in Morodemak coastal fishing port (PPP) was worth running.

A comparative analysis of lumbar spine mechanics during barbell- and crate-lifting: implications for occupational lifting task assessments.

Science.gov (United States)

Zehr, Jackie D; Carnegie, Danielle R; Welsh, Timothy N; Beach, Tyson A C

2018-03-19

To compare the effects of object handled and handgrip used on lumbar spine motion and loading during occupational lifting task simulations. Eight male and eight female volunteers performed barbell and crate lifts with a pronated (barbell) and a neutral (crate) handgrip. The mass of barbells/crates lifted was identical across the objects and fixed at 11.6 and 9.3 kg for men and women, respectively. The initial heights of barbells/crates were individualized to mid-shank level. Body segment kinematics and foot-ground reaction kinetics were collected, and then input into an electromyography-assisted dynamic biomechanical model to quantify lumbar spine motion and loading. Lumbar compression and net lumbosacral moment magnitudes were 416 N and 17 Nm lower when lifting a barbell than when lifting a crate (p  0.392) or flexion/extension velocities (p > 0.085). Crate- and barbell-lifting tasks can be used interchangeably if assessing lifting mechanics based on peak spine motion variables. If assessments are based on the spine loading responses to task demands, however, then crate- and barbell-lifting tasks cannot be used interchangeably.

Occupational lifting of heavy loads and preterm birth:

DEFF Research Database (Denmark)

Runge, Stine Bjerrum; Pedersen, Jacob Krabbe; Svendsen, Susanne Wulff

2013-01-01

To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day.......To examine the association between occupational lifting during pregnancy and preterm birth. The risk of preterm birth was estimated for total burden lifted per day and number of medium and heavy loads lifted per day....

Endoscopic approaches to treatment of achalasia

Science.gov (United States)

Friedel, David; Modayil, Rani; Iqbal, Shahzad; Grendell, James H.

2013-01-01

Endoscopic therapy for achalasia is directed at disrupting or weakening the lower esophageal sphincter (LES). The two most commonly utilized endoscopic interventions are large balloon pneumatic dilation (PD) and botulinum toxin injection (BTI). These interventions have been extensively scrutinized and compared with each other as well as with surgical disruption (myotomy) of the LES. PD is generally more effective in improving dysphagia in achalasia than BTI, with the latter reserved for infirm older people, and PD may approach treatment results attained with myotomy. However, PD may need to be repeated. Small balloon dilation and endoscopic stent placement for achalasia have only been used in select centers. Per oral endoscopic myotomy is a newer endoscopic modality that will likely change the treatment paradigm for achalasia. It arose from the field of natural orifice transluminal endoscopic surgery and represents a scarless endoscopic approach to Heller myotomy. This is a technique that requires extensive training and preparation and thus there should be rigorous accreditation and monitoring of outcomes to ensure safety and efficacy. PMID:23503707

Thread-Lift Sutures : Still in the Lift? A Systematic Review of the Literature

NARCIS (Netherlands)

Gulbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend

Background: In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have

Thread-Lift Sutures : Still in the Lift? A Systematic Review of the Literature

NARCIS (Netherlands)

Gülbitti, Haydar Aslan; Colebunders, Britt; Pirayesh, Ali; Bertossi, Dario; van der Lei, Berend

2018-01-01

BACKGROUND: In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have

[Endoscopic extraction of gallbladder calculi].

Science.gov (United States)

Kühner, W; Frimberger, E; Ottenjann, R

1984-06-29

Endoscopic extraction of gallbladder stones were performed, as far as we know for the first time, in three patients with combined choledochocystolithiasis. Following endoscopic papillotomy (EPT) and subsequent mechanical lithotripsy of multiple choledochal concrements measuring up to 3 cm the gallbladder stones were successfully extracted with a Dormia basket through the cystic duct. The patients have remained free of complications after the endoscopic intervention.

Endoscopic findings following retroperitoneal pancreas transplantation.

Science.gov (United States)

Pinchuk, Alexey V; Dmitriev, Ilya V; Shmarina, Nonna V; Teterin, Yury S; Balkarov, Aslan G; Storozhev, Roman V; Anisimov, Yuri A; Gasanov, Ali M

2017-07-01

An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications. Endoscopic stenting of the main pancreatic duct with plastic stents and three-stage endoscopic hemostasis were conducted to correct the identified complications. Endoscopic methods showed high efficiency in the timely diagnosis and adequate correction of complications after retroperitoneal pancreas transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

NARCIS (Netherlands)

F.J.C. van den Broek (Frank); E.J.R. de Graaf (Eelco); M.G.W. Dijkgraaf (Marcel); J.B. Reitsma (Johannes); J. Haringsma (Jelle); R. Timmer (Robin); B.L. Weusten (Bas); M.F. Gerhards (Michael); E.C. Consten (Esther); M.P. Schwartz (Matthijs); M.J. Boom (Maarten); E.J. Derksen (Erik); A.B. Bijnen (Bart); P.H.P. Davids (Paul); C. Hoff (Christiaan); H.M. van Dullemen (Hendrik); G.D.N. Heine (Dimitri); K. van der Linde (Klaas); J.M. Jansen (Jeroen); R.C.H. Mallant-Hent (Rosalie); R. Breumelhof (Ronald); H. Geldof (Han); J.C. Hardwick (James); P. Doornebosch (Pascal); A.C.T.M. Depla (Annekatrien); M.F. Ernst (Miranda); I.P. van Munster (Ivo); I.H.J.T. de Hingh (Ignace); E.J. Schoon (Erik); W.A. Bemelman (Willem); P. Fockens (Paul); E. Dekker (Evelien)

2009-01-01

textabstractBackground: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does

Comparing the effectiveness of laser vs. conventional endoforehead lifting.

Science.gov (United States)

Chang, Cheng-Jen; Yu, De-Yi; Chang, Shu-Ying; Hsiao, Yen-Chang

2018-04-01

The objective of this study was to compare the efficacy and safety of laser versus conventional endoforehead lifting. Over a period of 12 years (January 2000-January 2012), a total of 110 patients with hyperactive muscles over the frontal region have been collected for a retrospective study. The SurgiLase 150XJ CO 2 laser system, in conjunction with the flexible FIBERLASE, was used. The endoscope was 4 mm in diameter with an angle of 30°. The primary efficacy measurement was the assessment of the final outcome for using laser vs. conventional methods. Both groups were observed at three weeks, six weeks and six months after surgery. The most common complication in early convalescence (three weeks) was swelling. This was followed by local paraesthesia, ecchymosis, localized hematomas and scar with alopecia. All these problems disappeared completely after the 6-month study period. Based on a chi-square analysis, there were clinically and statistically significant differences favouring the laser endoforehead surgery in the operative time, early and late complications. All patients achieved significant improvement after both laser and conventional endoforehead surgery in the final outcome. However, the early and late complications indicated a greater difference in the laser group.

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

NARCIS (Netherlands)

van den Broek, Frank J. C.; de Graaf, Eelco J. R.; Dijkgraaf, Marcel G. W.; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L. A. M.; Gerhards, Michael F.; Consten, Esther C. J.; Schwartz, Matthijs P.; Boom, Maarten J.; Derksen, Erik J.; Bijnen, A. Bart; Davids, Paul H. P.; Hoff, Christiaan; van Dullemen, Hendrik M.; Heine, G. Dimitri N.; van der Linde, Klaas; Jansen, Jeroen M.; Mallant-Hent, Rosalie C. H.; Breumelhof, Ronald; Geldof, Han; Hardwick, James C. H.; Doornebosch, Pascal G.; Depla, Annekatrien C. T. M.; Ernst, Miranda F.; van Munster, Ivo P.; de Hingh, Ignace H. J. T.; Schoon, Erik J.; Bemelman, Willem A.; Fockens, Paul; Dekker, Evelien; Reitsma, J.

2009-01-01

Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require

Wingless Flight: The Lifting Body Story

Science.gov (United States)

Reed, R. Dale; Lister, Darlene (Editor); Huntley, J. D. (Editor)

1997-01-01

Wingless Flight tells the story of the most unusual flying machines ever flown, the lifting bodies. It is my story about my friends and colleagues who committed a significant part of their lives in the 1960s and 1970s to prove that the concept was a viable one for use in spacecraft of the future. This story, filled with drama and adventure, is about the twelve-year period from 1963 to 1975 in which eight different lifting-body configurations flew. It is appropriate for me to write the story, since I was the engineer who first presented the idea of flight-testing the concept to others at the NASA Flight Research Center. Over those twelve years, I experienced the story as it unfolded day by day at that remote NASA facility northeast of los Angeles in the bleak Mojave Desert. Benefits from this effort immediately influenced the design and operational concepts of the winged NASA Shuttle Orbiter. However, the full benefits would not be realized until the 1990s when new spacecraft such as the X-33 and X-38 would fully employ the lifting-body concept. A lifting body is basically a wingless vehicle that flies due to the lift generated by the shape of its fuselage. Although both a lifting reentry vehicle and a ballistic capsule had been considered as options during the early stages of NASA's space program, NASA initially opted to go with the capsule. A number of individuals were not content to close the book on the lifting-body concept. Researchers including Alfred Eggers at the NASA Ames Research Center conducted early wind-tunnel experiments, finding that half of a rounded nose-cone shape that was flat on top and rounded on the bottom could generate a lift-to-drag ratio of about 1.5 to 1. Eggers' preliminary design sketch later resembled the basic M2 lifting-body design. At the NASA Langley Research Center, other researchers toyed with their own lifting-body shapes. Meanwhile, some of us aircraft-oriented researchers at the, NASA Flight Research Center at Edwards Air

Endoscopic full-thickness resection: Current status.

Science.gov (United States)

Schmidt, Arthur; Meier, Benjamin; Caca, Karel

2015-08-21

Conventional endoscopic resection techniques such as endoscopic mucosal resection or endoscopic submucosal dissection are powerful tools for treatment of gastrointestinal neoplasms. However, those techniques are restricted to superficial layers of the gastrointestinal wall. Endoscopic full-thickness resection (EFTR) is an evolving technique, which is just about to enter clinical routine. It is not only a powerful tool for diagnostic tissue acquisition but also has the potential to spare surgical therapy in selected patients. This review will give an overview about current EFTR techniques and devices.

Specialist Endoscopists Are Associated with a Decreased Risk of Incomplete Polyp Resection During Endoscopic Mucosal Resection in the Colon.

Science.gov (United States)

Tavakkoli, Anna; Law, Ryan J; Bedi, Aarti O; Prabhu, Anoop; Hiatt, Tadd; Anderson, Michelle A; Wamsteker, Erik J; Elmunzer, B Joseph; Piraka, Cyrus R; Scheiman, James M; Elta, Grace H; Kwon, Richard S

2017-09-01

Endoscopic experience is known to correlate with outcomes of endoscopic mucosal resection (EMR), particularly complete resection of the polyp tissue. Whether specialist endoscopists can protect against incomplete polypectomy in the setting of known risk factors for incomplete resection (IR) is unknown. We aimed to characterize how specialist endoscopists may help to mitigate the risk of IR of large sessile polyps. This is a retrospective cohort study of patients who underwent EMR at the University of Michigan from January 1, 2006, to November 15, 2015. The primary outcome was endoscopist-reported polyp tissue remaining at the end of the initial EMR attempt. Specialist endoscopists were defined as endoscopists who receive tertiary referrals for difficult colonoscopy cases and completed at least 20 EMR colonic polyp resections over the study period. A total of 257 patients with 269 polyps were included in the study. IR occurred in 40 (16%) cases. IR was associated with polyp size ≥ 40 mm [adjusted odds ratio (aOR) 3.31, 95% confidence interval (CI) 1.38-7.93], flat/laterally spreading polyps (aOR 2.61, 95% CI 1.24-5.48), and difficulty lifting the polyp (aOR 11.0, 95% CI 2.66-45.3). A specialist endoscopist performing the initial EMR was protective against IR, even in the setting of risk factors for IR (aOR 0.13, 95% CI 0.04-0.41). IR is associated with polyp size ≥ 40 mm, flat and/or laterally spreading polyps, and difficulty lifting the polyp. A specialist endoscopist initiating the EMR was protective of IR.

Novel methods for endoscopic training.

Science.gov (United States)

Gessner, C E; Jowell, P S; Baillie, J

1995-04-01

The development of past, present, and future endoscopic training methods is described. A historical perspective of endoscopy training guidelines and devices is used to demonstrate support for the use of novel endoscopic training techniques. Computer simulation of endoscopy, interactive learning, and virtual reality applications in endoscopy and surgery are reviewed. The goals of endoscopic simulation and challenges facing investigators in this field are discussed, with an emphasis on current and future research.

Wavelets and the Lifting Scheme

DEFF Research Database (Denmark)

la Cour-Harbo, Anders; Jensen, Arne

The objective of this article is to give a concise introduction to the discrete wavelet transform (DWT) based on a technique called lifting. The lifting technique allows one to give an elementary, but rigorous, definition of the DWT, with modest requirements on the reader. A basic knowledge...... of linear algebra and signal processing will suffice. The lifting based definition is equivalent to the usual filer bank based definition of the DWT. The article does not discuss applications in any detail. The reader is referred to other articles in this collection....

Wavelets and the lifting scheme

DEFF Research Database (Denmark)

la Cour-Harbo, Anders; Jensen, Arne

2012-01-01

The objective of this article is to give a concise introduction to the discrete wavelet transform (DWT) based on a technique called lifting. The lifting technique allows one to give an elementary, but rigorous, definition of the DWT, with modest requirements on the reader. A basic knowledge...... of linear algebra and signal processing will suffice. The lifting based definition is equivalent to the usual filer bank based definition of the DWT. The article does not discuss applications in any detail. The reader is referred to other articles in this collection....

Wavelets and the lifting scheme

DEFF Research Database (Denmark)

la Cour-Harbo, Anders; Jensen, Arne

2009-01-01

The objective of this article is to give a concise introduction to the discrete wavelet transform (DWT) based on a technique called lifting. The lifting technique allows one to give an elementary, but rigorous, definition of the DWT, with modest requirements on the reader. A basic knowledge...... of linear algebra and signal processing will suffice. The lifting based definition is equivalent to the usual filer bank based definition of the DWT. The article does not discuss applications in any detail. The reader is referred to other articles in this collection....

Heterotic weight lifting

International Nuclear Information System (INIS)

Gato-Rivera, B.; Schellekens, A.N.

2010-01-01

We describe a method for constructing genuinely asymmetric (2,0) heterotic strings out of N=2 minimal models in the fermionic sector, whereas the bosonic sector is only partly build out of N=2 minimal models. This is achieved by replacing one minimal model plus the superfluous E 8 factor by a non-supersymmetric CFT with identical modular properties. This CFT generically lifts the weights in the bosonic sector, giving rise to a spectrum with fewer massless states. We identify more than 30 such lifts, and we expect many more to exist. This yields more than 450 different combinations. Remarkably, despite the lifting of all Ramond states, it is still possible to get chiral spectra. Even more surprisingly, these chiral spectra include examples with a certain number of chiral families of SO(10), SU(5) or other subgroups, including just SU(3)xSU(2)xU(1). The number of families and mirror families is typically smaller than in standard Gepner models. Furthermore, in a large number of different cases, spectra with three chiral families can be obtained. Based on a first scan of about 10% of the lifted Gepner models we can construct, we have collected more than 10,000 distinct spectra with three families, including examples without mirror fermions. We present an example where the GUT group is completely broken to the standard model, but the resulting and inevitable fractionally charged particles are confined by an additional gauge group factor.

Heterotic weight lifting

Energy Technology Data Exchange (ETDEWEB)

Gato-Rivera, B. [NIKHEF Theory Group, Kruislaan 409, 1098 SJ Amsterdam (Netherlands); Instituto de Fisica Fundamental, CSIC, Serrano 123, Madrid 28006 (Spain); Schellekens, A.N., E-mail: t58@nikhef.n [NIKHEF Theory Group, Kruislaan 409, 1098 SJ Amsterdam (Netherlands); Instituto de Fisica Fundamental, CSIC, Serrano 123, Madrid 28006 (Spain); IMAPP, Radboud Universiteit, Nijmegen (Netherlands)

2010-03-21

We describe a method for constructing genuinely asymmetric (2,0) heterotic strings out of N=2 minimal models in the fermionic sector, whereas the bosonic sector is only partly build out of N=2 minimal models. This is achieved by replacing one minimal model plus the superfluous E{sub 8} factor by a non-supersymmetric CFT with identical modular properties. This CFT generically lifts the weights in the bosonic sector, giving rise to a spectrum with fewer massless states. We identify more than 30 such lifts, and we expect many more to exist. This yields more than 450 different combinations. Remarkably, despite the lifting of all Ramond states, it is still possible to get chiral spectra. Even more surprisingly, these chiral spectra include examples with a certain number of chiral families of SO(10), SU(5) or other subgroups, including just SU(3)xSU(2)xU(1). The number of families and mirror families is typically smaller than in standard Gepner models. Furthermore, in a large number of different cases, spectra with three chiral families can be obtained. Based on a first scan of about 10% of the lifted Gepner models we can construct, we have collected more than 10,000 distinct spectra with three families, including examples without mirror fermions. We present an example where the GUT group is completely broken to the standard model, but the resulting and inevitable fractionally charged particles are confined by an additional gauge group factor.

Endoscopic medial maxillectomy breaking new frontiers.

Science.gov (United States)

Mohanty, Sanjeev; Gopinath, M

2013-07-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management of benign sino-nasal tumours. We present our experience of endoscopic medial maxillectomy in the management of sinonasal pathologies.

Endoscopic management of bleeding peptic ulcers

International Nuclear Information System (INIS)

Farooqi, J.I.; Farooqi, R.J.

2001-01-01

Peptic ulcers account for more than half of the cases of non variceal upper gastrointestinal (GI) bleeding and therefore, are the focus of most of the methods of endoscopic hemostasis. Surgical intervention is now largely reserved for patients in whom endoscopic hemostasis has failed. A variety of endoscopic techniques have been employed to stop bleeding and reduce the risk of rebleeding, with no major differences in outcome between these methods. These include injection therapy, fibrin injection, heater probe, mono polar electrocautery, bipolar electrocautery, lasers and mechanical hemo clipping. The most important factor in determining outcome after gastrointestinal bleeding is rebleeding or persistent bleeding. The endoscopic appearance of an ulcer, however, provides the most useful prognostic information for bleeding. Recurrent bleeding after initial endoscopic hemostasis occurs in 15-20% of patients with a bleeding peptic ulcer. The best approach to these patients remains controversial; the current options are repeat endoscopic therapy with the same or a different technique, emergency surgery or semi elective surgery after repeat endoscopic hemostasis. The combination of epinephrine injection with thermal coagulation may be more effective than epinephrine injection alone. Newer modalities such as fibrin injection or the application of hemo clips appear promising and comparative studies are awaited. (author)

Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

Science.gov (United States)

Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

2014-01-01

Per-oral endoscopic myotomy (POEM) represents a natural orifice endoscopic surgery (NOTES) approach to laparoscopy Heller myotomy (LHM). POEM is arguably the most successful clinical application of NOTES. The growth of POEM from a single center in 2008 to approximately 60 centers worldwide in 2014 with several thousand procedures having been performed attests to the success of POEM. Initial efficacy, safety and acid reflux data suggest at least equivalence of POEM to LHM, the previous gold standard for achalasia therapy. Adjunctive techniques used in the West include impedance planimetry for real-time intraprocedural luminal assessment and endoscopic suturing for challenging mucosal defect closures during POEM. The impact of POEM extends beyond the realm of esophageal motility disorders as it is rapidly popularizing endoscopic submucosal dissection in the West and spawning offshoots that use the submucosal tunnel technique for a host of new indications ranging from resection of tumors to pyloromyotomy for gastroparesis. PMID:25548473

Endoscopic tissue diagnosis of cholangiocarcinoma.

LENUS (Irish Health Repository)

Harewood, Gavin C

2008-09-01

The extremely poor outcome in patients with cholangiocarcinoma, in large part, reflects the late presentation of these tumors and the challenging nature of establishing a tissue diagnosis. Establishing a diagnosis of cholangiocarcinoma requires obtaining evidence of malignancy from sampling of the epithelium of the biliary tract, which has proven to be challenging. Although endoscopic ultrasound-guided fine needle aspiration performs slightly better than endoscopic retrograde cholangiopancreatography in diagnosing cholangiocarcinoma, both endoscopic approaches demonstrate disappointing performance characteristics.

Lambda-lifting in Quadratic Time

DEFF Research Database (Denmark)

Danvy, O.; Schultz, U.P.

2004-01-01

-lifting transforms a block-structured program into a set of recursive equations, one for each local function in the source program. Each equation carries extra parameters to account for the free variables of the corresponding local function and of all its callees. It is the search for these extra parameters......Lambda-lifting is a program transformation that is used in compilers, partial evaluators, and program transformers. In this article, we show how to reduce its complexity from cubic time to quadratic time, and we present a flow-sensitive lambda-lifter that also works in quadratic time. Lambda...... that yields the cubic factor in the traditional formulation of lambda-lifting, which is due to Johnsson. This search is carried out by computing a transitive closure. To reduce the complexity of lambda-lifting, we partition the call graph of the source program into strongly connected components, based...

Current Status of Peroral Endoscopic Myotomy

Science.gov (United States)

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders. PMID:29397656

Current Status of Peroral Endoscopic Myotomy.

Science.gov (United States)

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

Current Status of Peroral Endoscopic Myotomy

Directory of Open Access Journals (Sweden)

Young Kwan Cho

2018-01-01

Full Text Available Peroral endoscopic myotomy (POEM has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

Win a lift to the future!

CERN Multimedia

CERN Bulletin

2010-01-01

The Communication Group is organising a competition offering people at CERN the chance to submit their ideas and win a ticket to the Lift10 Conference, which will be held in Geneva from 5 to7 May.   Lift is a community of technology "pioneers", created in 2006. It now involves more than 4,000 people from over 60 countries, who meet regularly in Europe and in Asia to explore the social implications of new technologies and the major shifts ahead. CERN is one of the academic partners of the next Lift conference, whose theme is "Connected people”. For this occasion, 10 free tickets to the conference will be awarded to the "CERNois" who come up with the best answers to the question: “How would you contribute to Lift10?” Those taking part in the competition can choose from among the following categories: - run workshop(s); - cover the conference on a blog; - coordinate a discussion during the breaks; - organize a lift@home ...

Modeling lift operations with SASmacr Simulation Studio

Science.gov (United States)

Kar, Leow Soo

2016-10-01

Lifts or elevators are an essential part of multistorey buildings which provide vertical transportation for its occupants. In large and high-rise apartment buildings, its occupants are permanent, while in buildings, like hospitals or office blocks, the occupants are temporary or users of the buildings. They come in to work or to visit, and thus, the population of such buildings are much higher than those in residential apartments. It is common these days that large office blocks or hospitals have at least 8 to 10 lifts serving its population. In order to optimize the level of service performance, different transportation schemes are devised to control the lift operations. For example, one lift may be assigned to solely service the even floors and another solely for the odd floors, etc. In this paper, a basic lift system is modelled using SAS Simulation Studio to study the effect of factors such as the number of floors, capacity of the lift car, arrival rate and exit rate of passengers at each floor, peak and off peak periods on the system performance. The simulation is applied to a real lift operation in Sunway College's North Building to validate the model.

Masculinity and Lifting Accidents among Danish Ambulance Personnel

DEFF Research Database (Denmark)

Hansen, Claus D.; Nielsen, Kent J

Background Work injuries related to lifting are the most prevalent among ambulance personnel (AP) despite the introduction of ‘assistive technologies’ (AT) that help reduce situations of manual lifting. One third of the AP report using AT only ‘sometimes’ and 10% report having lifted a patient...... alone. Aim This presentation investigates whether failure to use AT is linked to male ambulance workers’ gender identity? Is lifting patients alone a way of performing masculinity for AP’s? Method Data is taken from MARS, a panel study of AP workers in Denmark (n = 1606). Information from questionnaires...... measuring traditional male role norms (MRNI), safety attitudes and safety behavior will be linked to company register information on work injuries categorized as lifting accidents. Logistic regression is used to analyse associations between masculinity, lifting behavior, and lifting accidents. Results...

AFC-Enabled Simplified High-Lift System Integration Study

Science.gov (United States)

Hartwich, Peter M.; Dickey, Eric D.; Sclafani, Anthony J.; Camacho, Peter; Gonzales, Antonio B.; Lawson, Edward L.; Mairs, Ron Y.; Shmilovich, Arvin

2014-01-01

The primary objective of this trade study report is to explore the potential of using Active Flow Control (AFC) for achieving lighter and mechanically simpler high-lift systems for transonic commercial transport aircraft. This assessment was conducted in four steps. First, based on the Common Research Model (CRM) outer mold line (OML) definition, two high-lift concepts were developed. One concept, representative of current production-type commercial transonic transports, features leading edge slats and slotted trailing edge flaps with Fowler motion. The other CRM-based design relies on drooped leading edges and simply hinged trailing edge flaps for high-lift generation. The relative high-lift performance of these two high-lift CRM variants is established using Computational Fluid Dynamics (CFD) solutions to the Reynolds-Averaged Navier-Stokes (RANS) equations for steady flow. These CFD assessments identify the high-lift performance that needs to be recovered through AFC to have the CRM variant with the lighter and mechanically simpler high-lift system match the performance of the conventional high-lift system. Conceptual design integration studies for the AFC-enhanced high-lift systems were conducted with a NASA Environmentally Responsible Aircraft (ERA) reference configuration, the so-called ERA-0003 concept. These design trades identify AFC performance targets that need to be met to produce economically feasible ERA-0003-like concepts with lighter and mechanically simpler high-lift designs that match the performance of conventional high-lift systems. Finally, technical challenges are identified associated with the application of AFC-enabled highlift systems to modern transonic commercial transports for future technology maturation efforts.

Ling classification describes endoscopic progressive process of achalasia and successful peroral endoscopy myotomy prevents endoscopic progression of achalasia.

Science.gov (United States)

Zhang, Wen-Gang; Linghu, En-Qiang; Chai, Ning-Li; Li, Hui-Kai

2017-05-14

To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type I ( n = 119), IIa ( n = 106), IIb ( n = 60), IIc ( n = 60), or III ( n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared. Symptom duration increased significantly with increasing Ling classification (from I to III) ( P achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM (Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.

21 CFR 884.4100 - Endoscopic electrocautery and accessories.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endoscopic electrocautery and accessories. 884... Surgical Devices § 884.4100 Endoscopic electrocautery and accessories. (a) Identification. An endoscopic electrocautery is a device used to perform female sterilization under endoscopic observation. It is designed to...

Can a new behaviorally oriented training process to improve lifting technique prevent occupationally related back injuries due to lifting?

Science.gov (United States)

Lavender, Steven A; Lorenz, Eric P; Andersson, Gunnar B J

2007-02-15

A prospective randomized control trial. To determine the degree to which a new behavior-based lift training program (LiftTrainer; Ascension Technology, Burlington, VT) could reduce the incidence of low back disorder in distribution center jobs that require repetitive lifting. Most studies show programs aimed at training lifting techniques to be ineffective in preventing low back disorders, which may be due to their conceptual rather than behavioral learning approach. A total of 2144 employees in 19 distribution centers were randomized into either the LiftTrainer program or a video control group. In the LiftTrainer program, participants were individually trained in up to 5, 30-minute sessions while instrumented with motion capture sensors to quantify the L5/S1 moments. Twelve months following the initial training, injury data were obtained from company records. Survival analyses (Kaplan-Meier) indicated that there was no difference in injury rates between the 2 training groups. Likewise, there was no difference in the turnover rates. However, those with a low (<30 Nm) average twisting moment at the end of the first session experienced a significantly (P < 0.005) lower rate of low back disorder than controls. While overall the LiftTrainer program was not effective, those with twisting moments below 30 Nm reported fewer injuries, suggesting a shift in focus for "safe" lifting programs.

Lambda-Lifting in Quadratic Time

DEFF Research Database (Denmark)

Danvy, Olivier; Schultz, Ulrik Pagh

2002-01-01

Lambda-lifting is a program transformation used in compilers and in partial evaluators and that operates in cubic time. In this article, we show how to reduce this complexity to quadratic time. Lambda-lifting transforms a block-structured program into a set of recursive equations, one for each...... local function in the source program. Each equation carries extra parameters to account for the free variables of the corresponding local function and of all its callees. It is the search for these extra parameters that yields the cubic factor in the traditional formulation of lambda-lifting, which...... is not needed. We therefore simplify the search for extra parameters by treating each strongly connected component instead of each function as a unit, thereby reducing the time complexity of lambda-lifting from O(n 3 log n)toO(n2 log n), where n is the size of the program. Since a lambda-lifter can output...

Maximum acceptable weight of lift reflects peak lumbosacral extension moments in a functional capacity evaluation test using free style, stoop and squat lifting.

Science.gov (United States)

Kuijer, P P F M; van Oostrom, S H; Duijzer, K; van Dieën, J H

2012-01-01

It is unclear whether the maximum acceptable weight of lift (MAWL), a common psychophysical method, reflects joint kinetics when different lifting techniques are employed. In a within-participants study (n = 12), participants performed three lifting techniques--free style, stoop and squat lifting from knee to waist level--using the same dynamic functional capacity evaluation lifting test to assess MAWL and to calculate low back and knee kinetics. We assessed which knee and back kinetic parameters increased with the load mass lifted, and whether the magnitudes of the kinetic parameters were consistent across techniques when lifting MAWL. MAWL was significantly different between techniques (p = 0.03). The peak lumbosacral extension moment met both criteria: it had the highest association with the load masses lifted (r > 0.9) and was most consistent between the three techniques when lifting MAWL (ICC = 0.87). In conclusion, MAWL reflects the lumbosacral extension moment across free style, stoop and squat lifting in healthy young males, but the relation between the load mass lifted and lumbosacral extension moment is different between techniques. Tests of maximum acceptable weight of lift (MAWL) from knee to waist height are used to assess work capacity of individuals with low-back disorders. This article shows that the MAWL reflects the lumbosacral extension moment across free style, stoop and squat lifting in healthy young males, but the relation between the load mass lifted and lumbosacral extension moment is different between techniques. This suggests that standardisation of lifting technique used in tests of the MAWL would be indicated if the aim is to assess the capacity of the low back.

33 CFR 118.85 - Lights on vertical lift bridges.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Lights on vertical lift bridges... BRIDGES BRIDGE LIGHTING AND OTHER SIGNALS § 118.85 Lights on vertical lift bridges. (a) Lift span lights. The vertical lift span of every vertical lift bridge shall be lighted so that the center of the...

77 FR 20558 - Federal Motor Vehicle Safety Standards; Platform Lifts for Motor Vehicles; Platform Lift...

Science.gov (United States)

2012-04-05

... unrelated to the barrier's safety. Lift-U also questioned the agency's statement that it could be difficult... DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration 49 CFR Part 571 [Docket No. NHTSA-2012-0039] RIN 2127-AJ93 Federal Motor Vehicle Safety Standards; Platform Lifts for...

Fuel Cell Hydroge Manifold for Lift Trucks

DEFF Research Database (Denmark)

Hosseinzadeh, Elham

. Battery driven lift trucks are being used more and more in different companies to reduce their emissions. However, battery driven lift trucks need long time to recharge and may be out of work for a long time. Fuel cell driven lift trucks diminish this problem and are therefore getting more attention...

Endoscopic management of hilar biliary strictures

Science.gov (United States)

Singh, Rajiv Ranjan; Singh, Virendra

2015-01-01

Hilar biliary strictures are caused by various benign and malignant conditions. It is difficult to differentiate benign and malignant strictures. Postcholecystectomy benign biliary strictures are frequently encountered. Endoscopic management of these strictures is challenging. An endoscopic method has been advocated that involves placement of increasing number of stents at regular intervals to resolve the stricture. Malignant hilar strictures are mostly unresectable at the time of diagnosis and only palliation is possible.Endoscopic palliation is preferred over surgery or radiological intervention. Magnetic resonance cholangiopancreaticography is quite important in the management of these strictures. Metal stents are superior to plastic stents. The opinion is divided over the issue of unilateral or bilateral stenting.Minimal contrast or no contrast technique has been advocated during endoscopic retrograde cholangiopancreatography of these patients. The role of intraluminal brachytherapy, intraductal ablation devices, photodynamic therapy, and endoscopic ultrasound still remains to be defined. PMID:26191345

Endoscopes with latest technology and concept.

Science.gov (United States)

Gotoh

2003-09-01

Endoscopic imaging systems that perform as the "eye" of the operator during endoscopic surgical procedures have developed rapidly due to various technological developments. In addition, since the most recent turn of the century robotic surgery has increased its scope through the utilization of systems such as Intuitive Surgical's da Vinci System. To optimize the imaging required for precise robotic surgery, a unique endoscope has been developed, consisting of both a two dimensional (2D) image optical system for wider observation of the entire surgical field, and a three dimensional (3D) image optical system for observation of the more precise details at the operative site. Additionally, a "near infrared radiation" endoscopic system is under development to detect the sentinel lymph node more readily. Such progress in the area of endoscopic imaging is expected to enhance the surgical procedure from both the patient's and the surgeon's point of view.

Using verbal instructions to influence lifting mechanics - Does the directive "lift with your legs, not your back" attenuate spinal flexion?

Science.gov (United States)

Beach, Tyson A C; Stankovic, Tatjana; Carnegie, Danielle R; Micay, Rachel; Frost, David M

2018-02-01

"Use your legs" is commonly perceived as sound advice to prevent lifting-related low-back pain and injuries, but there is limited evidence that this directive attenuates the concomitant biomechanical risk factors. Body segment kinematic data were collected from 12 men and 12 women who performed a laboratory lifting/lowering task after being provided with different verbal instructions. The main finding was that instructing participants to lift "without rounding your lower back" had a greater effect on the amount of spine flexion they exhibited when lifting/lowering than instructing them to lift "with your legs instead of your back" and "bend your knees and hips". It was concluded that if using verbal instructions to discourage spine flexion when lifting, the instructions should be spine- rather than leg-focused. Copyright © 2017 Elsevier Ltd. All rights reserved.

CERN takes off at Lift11

CERN Multimedia

Katarina Anthony

2011-01-01

CERN was especially featured at the Lift11 conference, held in Geneva early this month. Tara Shears delivered a keynote speech at the event, while Paul Oortman Gerlings (DGS-SEE) and Erik van der Bij (BE-CO) – winners of the Bulletin’s Lift11 competition – organised the CERN workshop.   Paul Oortman Gerlings takes questions at CERN's Lift11 workshop. Lift11 was an opportunity for CERN to reach today’s innovators and developers. “The event was filled with people eager to learn new ideas, who were not afraid to ask questions,” says Tara Shears, physicist from the LHCb Collaboration who presented an update on the status of the LHC. “People were amazed by what goes on inside CERN, by our science, our facilities – even by the way we carry out our day-to-day work. It is a branch of fundamental research that really seems to inspire everyone.” A small Lift11 group had the chance to take a tour of CERN, ...

Endoscopic transmission of Helicobacter pylori

NARCIS (Netherlands)

Tytgat, G. N.

1995-01-01

The contamination of endoscopes and biopsy forceps with Helicobacter pylori occurs readily after endoscopic examination of H. pylori-positive patients. Unequivocal proof of iatrogenic transmission of the organism has been provided. Estimates for transmission frequency approximate to 4 per 1000

Visual perception of fatigued lifting actions.

Science.gov (United States)

Fischer, Steven L; Albert, Wayne J; McGarry, Tim

2012-12-01

Fatigue-related changes in lifting kinematics may expose workers to undue injury risks. Early detection of accumulating fatigue offers the prospect of intervention strategies to mitigate such fatigue-related risks. In a first step towards this objective, this study investigated whether fatigue detection was accessible to visual perception and, if so, what was the key visual information required for successful fatigue discrimination. Eighteen participants were tasked with identifying fatigued lifts when viewing 24 trials presented using both video and point-light representations. Each trial comprised a pair of lifting actions containing a fresh and a fatigued lift from the same individual presented in counter-balanced sequence. Confidence intervals demonstrated that the frequency of correct responses for both sexes exceeded chance expectations (50%) for both video (68%±12%) and point-light representations (67%±10%), demonstrating that fatigued lifting kinematics are open to visual perception. There were no significant differences between sexes or viewing condition, the latter result indicating kinematic dynamics as providing sufficient information for successful fatigue discrimination. Moreover, results from single viewer investigation reported fatigue detection (75%) from point-light information describing only the kinematics of the box lifted. These preliminary findings may have important workplace applications if fatigue discrimination rates can be improved upon through future research. Copyright © 2012 Elsevier B.V. All rights reserved.

Project LIFT: Year 1 Report

Science.gov (United States)

Norton, Michael; Piccinino, Kelly

2014-01-01

Research for Action (RFA) is currently in the second year of a five-year external evaluation of the Project Leadership and Investment for Transformation (LIFT) Initiative in the Charlotte-Mecklenburg School District (CMS). Project LIFT is a public-private partnership between CMS and the local philanthropic and business communities in Charlotte,…

Gynaecological Endoscopic Surgical Education and Assessment. A diploma programme in gynaecological endoscopic surgery.

Science.gov (United States)

Campo, Rudi; Wattiez, Arnaud; Tanos, Vasilis; Di Spiezio Sardo, Attilio; Grimbizis, Grigoris; Wallwiener, Diethelm; Brucker, Sara; Puga, Marco; Molinas, Roger; O'Donovan, Peter; Deprest, Jan; Van Belle, Yves; Lissens, Ann; Herrmann, Anja; Tahir, Mahmood; Benedetto, Chiara; Siebert, Igno; Rabischong, Benoit; De Wilde, Rudy Leon

2016-04-01

In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA), recognises the necessity of this structured approach and implements two separated stages in its learning strategy. In the first stage, a skill certificate on theoretical knowledge and specific practical psychomotor skills is acquired through a high stake exam; in the second stage, a clinical programme is completed to achieve surgical competence and receive the corresponding diploma. Three diplomas can be awarded: (a) the Bachelor in Endoscopy; (b) the Minimally Invasive Gynaecological Surgeon (MIGS); and (c) the Master level. The Master level is sub-divided into two separate diplomas: the Master in Laparoscopic Pelvic Surgery and the Master in Hysteroscopy. The complexity of modern surgery has increased the demands and challenges to surgical education and the quality control. This programme is based on the best available scientific evidence and it counteracts the problem of the traditional surgical apprentice tutor model. It is seen as a major step toward standardization of endoscopic surgical training in general. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sensorimotor memory biases weight perception during object lifting

Directory of Open Access Journals (Sweden)

Vonne evan Polanen

2015-12-01

Full Text Available When lifting an object, the brain uses visual cues and an internal object representation to predict its weight and scale fingertip forces accordingly. Once available, tactile information is rapidly integrated to update the weight prediction and refine the internal object representation. If visual cues cannot be used to predict weight, force planning relies on implicit knowledge acquired from recent lifting experience, termed sensorimotor memory. Here, we investigated whether perception of weight is similarly biased according to previous lifting experience and how this is related to force scaling. Participants grasped and lifted series of light or heavy objects in a semi-randomized order and estimated their weights. As expected, we found that forces were scaled based on previous lifts (sensorimotor memory and these effects increased depending on the length of recent lifting experience. Importantly, perceptual weight estimates were also influenced by the preceding lift, resulting in lower estimations after a heavy lift compared to a light one. In addition, the weight estimations were negatively correlated with the magnitude of planned force parameters. This perceptual bias was only found if the current lift was light, but not heavy since the magnitude of sensorimotor memory effects had, according to Weber’s law, relatively less impact on heavy compared to light objects. A control experiment tested the importance of active lifting in mediating these perceptual changes and showed that when weights are passively applied on the hand, no effect of previous sensory experience is found on perception. These results highlight how fast learning of novel object lifting dynamics can shape weight perception and demonstrate a tight link between action planning and perception control. If predictive force scaling and actual object weight do not match, the online motor corrections, rapidly implemented to downscale forces, will also downscale weight estimation in

Endoscopic Medial Maxillectomy Breaking New Frontiers

OpenAIRE

Mohanty, Sanjeev; Gopinath, M.

2011-01-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management ...

Breast lift

Science.gov (United States)

... and areola may be moved. Sometimes, women have breast augmentation (enlargement with implants) when they have a breast lift. Why the ... MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed ...

Endoscopic management of intraoperative small bowel laceration during natural orifice translumenal endoscopic surgery: a blinded porcine study.

Science.gov (United States)

Fyock, Christopher J; Forsmark, Chris E; Wagh, Mihir S

2011-01-01

Natural orifice translumenal endoscopic surgery (NOTES) has recently gained great enthusiasm, but there is concern regarding the ability to endoscopically manage complications purely via natural orifices. To assess the feasibility of endoscopically managing enteral perforation during NOTES using currently available endoscopic accessories. Twelve pigs underwent transgastric or transcolonic endoscopic exploration. Full-thickness enterotomies were intentionally created to mimic accidental small bowel lacerations during NOTES. These lacerations were then closed with endoclips. In the blinded arm of the study, small bowel repair was performed by a second blinded endoscopist. Adequate closure of the laceration was confirmed with a leak test. Primary access sites were closed with endoclips or T-anchors. At necropsy, the peritoneal cavity was inspected for abscesses, bleeding, or damage to surrounding structures. The enterotomy site was examined for adequacy of closure, adhesions, or evidence of infection. Fifteen small bowel lacerations were performed in 12 animals. Successful closure was achieved in all 10 cases in the nonblinded arm. Survival animals had an uncomplicated postoperative course and all enterotomy sites were well healed without evidence of necrosis, adhesions, abscess, or bleeding at necropsy. Leak test was negative in all animals. In the blinded arm, both small intestinal lacerations could not be identified by the blinded endoscopist. Necropsy revealed open small bowel lacerations. Small intestinal injuries are difficult to localize with currently available flexible endoscopes and accessories. Endoscopic clips, however, may be adequate for closure of small bowel lacerations if the site of injury is known.

Lower complexity bounds for lifted inference

DEFF Research Database (Denmark)

Jaeger, Manfred

2015-01-01

instances of the model. Numerous approaches for such “lifted inference” techniques have been proposed. While it has been demonstrated that these techniques will lead to significantly more efficient inference on some specific models, there are only very recent and still quite restricted results that show...... the feasibility of lifted inference on certain syntactically defined classes of models. Lower complexity bounds that imply some limitations for the feasibility of lifted inference on more expressive model classes were established earlier in Jaeger (2000; Jaeger, M. 2000. On the complexity of inference about...... that under the assumption that NETIME≠ETIME, there is no polynomial lifted inference algorithm for knowledge bases of weighted, quantifier-, and function-free formulas. Further strengthening earlier results, this is also shown to hold for approximate inference and for knowledge bases not containing...

Lifting devices in nuclear facilities

International Nuclear Information System (INIS)

The rule is valid for lifts, cranes, winches, rail travel trolleys, load lifting devices and fuel element changing devices for light-water reactors, insofar as these are used in plants to produce or to fission nuclear fuels or to process irradiated nuclear fuels or in the storage or other use of nuclear fuels. (LH) [de

Sikkerhedsbestemmelser for beskæringsarbejde fra lift

DEFF Research Database (Denmark)

Jakobsen, Ole Sejr; Theilby, Frans

2010-01-01

Brug af lift til beskæring og fældning af træer er blevet udbredt i den grønne sektor. Som bruger er det vigtigt at kende den lift, man har valgt, og at arbejdet med motorsav foregår efter Arbejdstilsynets regler og anbefalinger.......Brug af lift til beskæring og fældning af træer er blevet udbredt i den grønne sektor. Som bruger er det vigtigt at kende den lift, man har valgt, og at arbejdet med motorsav foregår efter Arbejdstilsynets regler og anbefalinger....

Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review

NARCIS (Netherlands)

Martimo, Kari-Pekka; Verbeek, Jos; Karppinen, Jaro; Furlan, Andrea D.; Takala, Esa-Pekka; Kuijer, P. Paul F. M.; Jauhiainen, Merja; Viikari-Juntura, Eira

2008-01-01

To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting. Medline, Embase, CENTRAL, Cochrane Back Group's specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to

Occupational lifting and pelvic pain during pregnancy:

DEFF Research Database (Denmark)

Larsen, Pernille Stemann; Strandberg-Larsen, Katrine; Juhl, Mette

2013-01-01

OBJECTIVES: Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim...... of this study was to examine the association between occupational lifting and pelvic pain during pregnancy. METHODS: The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting...... (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression. RESULTS: Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg...

Maximum Acceptable Weight of Lift reflects peak lumbosacral extension moments in a Functional Capacity Evaluation test using free style, stoop, and squat lifting

NARCIS (Netherlands)

Kuijer, P.P.F.M.; van Oostrom, S.H.; Duijzer, K.; van Dieen, J.H.

2012-01-01

It is unclear whether the maximum acceptable weight of lift (MAWL), a common psychophysical method, reflects joint kinetics when different lifting techniques are employed. In a within-participants study (n = 12), participants performed three lifting techniques - free style, stoop and squat lifting

Maximum acceptable weight of lift reflects peak lumbosacral extension moments in a functional capacity evaluation test using free style, stoop and squat lifting

NARCIS (Netherlands)

Kuijer, P. P. F. M.; van Oostrom, S. H.; Duijzer, K.; van Dieën, J. H.

2012-01-01

It is unclear whether the maximum acceptable weight of lift (MAWL), a common psychophysical method, reflects joint kinetics when different lifting techniques are employed. In a within-participants study (n = 12), participants performed three lifting techniques - free style, stoop and squat lifting

Back injury prevention: a lift team success story.

Science.gov (United States)

Hefti, Kelly S; Farnham, Richard J; Docken, Lisa; Bentaas, Ruth; Bossman, Sharon; Schaefer, Jill

2003-06-01

Work related back injuries among hospital personnel account for high volume, high cost workers' compensation claims. These injuries can be life altering experiences, affecting both the personal and professional lives of injured workers. Lifting must be viewed as a skill involving specialized training and mandated use of mechanical equipment, rather than as a random task performed by numerous health care providers. The use of a lift team specially trained in body mechanics, lifting techniques, and the use of mandated mechanical equipment can significantly affect injury data, financial outcomes, and employee satisfaction. The benefits of a lift team extend beyond the effect on injury and financial outcomes--they can be used for recruitment and retention strategies, and team members serve as mentors to others by demonstrating safe lifting techniques. Ultimately, a lift team helps protect a valuable resource--the health care worker.

Containment vessel bottom head transport and lifting technique

International Nuclear Information System (INIS)

Zheng Donghong; Tian Shiyong; Hu Dequan; Xiao Hongtao

2013-01-01

The challengeable transport and lifting techniques and high safety assurance measures are needed for the onsite construction of the AP1000 containment vessel bottom head (CVBH), which is a large component with heavy weight, big size, high center of gravity, and easy to deformation. During transport, the infra structural road foundation is heavily loaded with big turning radius, and the requirement for synchronization of transport vehicles is strict. During lifting, the crane lifting capacities are high, requirement for the lifting and rigging tools is strict, nuclear island being put into place is difficult, and the crane operating foundation is heavily loaded. The transport and lifting techniques and safety assurance measures for CVBH are elaborated in detail, so as to provide a reference for the follow-up transport and lifting of large components of nuclear island. (authors)

Towards automated visual flexible endoscope navigation.

Science.gov (United States)

van der Stap, Nanda; van der Heijden, Ferdinand; Broeders, Ivo A M J

2013-10-01

The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now forms a barrier in the extension of flexible endoscope applications. Automating the navigation of endoscopes could be a solution for this problem. This paper summarizes the current state of the art in image-based navigation algorithms. The objectives are to find the most promising navigation system(s) to date and to indicate fields for further research. A systematic literature search was performed using three general search terms in two medical-technological literature databases. Papers were included according to the inclusion criteria. A total of 135 papers were analyzed. Ultimately, 26 were included. Navigation often is based on visual information, which means steering the endoscope using the images that the endoscope produces. Two main techniques are described: lumen centralization and visual odometry. Although the research results are promising, no successful, commercially available automated flexible endoscopy system exists to date. Automated systems that employ conventional flexible endoscopes show the most promising prospects in terms of cost and applicability. To produce such a system, the research focus should lie on finding low-cost mechatronics and technologically robust steering algorithms. Additional functionality and increased efficiency can be obtained through software development. The first priority is to find real-time, robust steering algorithms. These algorithms need to handle bubbles, motion blur, and other image artifacts without disrupting the steering process.

New F-theory lifts

International Nuclear Information System (INIS)

Collinucci, Andres

2009-01-01

In this note, a procedure is developed to explicitly construct non-trivial F-theory lifts of perturbative IIB orientifold models on Calabi-Yau complete intersections in toric varieties. This procedure works on Calabi-Yau orientifolds where the involution coordinate can have arbitrary projective weight, as opposed to the well-known hypersurface cases where it has half the weight of the equation defining the CY threefold. This opens up the possibility of lifting more general setups, such as models that have O3-planes.

Relative importance of expertise, lifting height and weight lifted on posture and lumbar external loading during a transfer task in manual material handling.

Science.gov (United States)

Plamondon, André; Larivière, Christian; Delisle, Alain; Denis, Denys; Gagnon, Denis

2012-01-01

The objective of this study was to measure the effect size of three important factors in manual material handling, namely expertise, lifting height and weight lifted. The effect of expertise was evaluated by contrasting 15 expert and 15 novice handlers, the effect of the weight lifted with a 15-kg box and a 23-kg box and the effect of lifting height with two different box heights: ground level and a 32 cm height. The task consisted of transferring a series of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables (moments) while expertise had low impact. On the other hand, expertise showed a significant effect of posture variables on the lumbar spine and knees. All three factors are important, but for a reduction of external back loading, the focus should be on the lifting height and weight lifted. The objective was to measure the effect size of three important factors in a transfer of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables but expertise was a major determinant in back posture.

A Real-Time Lift Detection Strategy for a Hip Exoskeleton.

Science.gov (United States)

Chen, Baojun; Grazi, Lorenzo; Lanotte, Francesco; Vitiello, Nicola; Crea, Simona

2018-01-01

Repetitive lifting of heavy loads increases the risk of back pain and even lumbar vertebral injuries to workers. Active exoskeletons can help workers lift loads by providing power assistance, and therefore reduce the moment and force applied on L5/S1 joint of human body when performing lifting tasks. However, most existing active exoskeletons for lifting assistance are unable to automatically detect user's lift movement, which limits the wide application of active exoskeletons in factories. In this paper, we propose a simple but effective lift detection strategy for exoskeleton control. This strategy uses only exoskeleton integrated sensors, without any extra sensors to capture human motion intentions. This makes the lift detection system more practical for applications in manufacturing environments. Seven healthy subjects participated in this research. Three different sessions were carried out, two for training and one for testing the algorithm. In the two training sessions, subjects were asked to wear a hip exoskeleton, controlled in transparent mode, and perform repetitive lifting and a locomotion circuit; lifting was executed with different techniques. The collected data were used to train the lift detection model. In the testing session, the exoskeleton was controlled in order to deliver torque to assist the lifting action, based on the lift detection made by the trained algorithm. The across-subject average accuracy of lift detection during online test was 97.97 ± 1.39% with subject-dependent model. Offline, the algorithm was trained with data acquired from all subjects to verify its performance for subject-independent detection, and an accuracy of 97.48 ± 1.53% was achieved. In addition, timeliness of the algorithm was quantitatively evaluated and the time delay was exoskeleton in assisting subjects in performing load lifting tasks. These results validate the promise of applying the proposed lift detection strategy for exoskeleton control aiming at lift

Effect of endoscopic transpapillary biliary drainage with/without endoscopic sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with biliary stricture (E-BEST): a protocol for a multicentre randomised controlled trial.

Science.gov (United States)

Kato, Shin; Kuwatani, Masaki; Sugiura, Ryo; Sano, Itsuki; Kawakubo, Kazumichi; Ono, Kota; Sakamoto, Naoya

2017-08-11

The effect of endoscopic sphincterotomy prior to endoscopic biliary stenting to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis remains to be fully elucidated. The aim of this study is to prospectively evaluate the non-inferiority of non-endoscopic sphincterotomy prior to stenting for naïve major duodenal papilla compared with endoscopic sphincterotomy prior to stenting in patients with biliary stricture. We designed a multicentre randomised controlled trial, for which we will recruit 370 patients with biliary stricture requiring endoscopic biliary stenting from 26 high-volume institutions in Japan. Patients will be randomly allocated to the endoscopic sphincterotomy group or the non-endoscopic sphincterotomy group. The main outcome measure is the incidence of pancreatitis within 2 days of initial transpapillary biliary drainage. Data will be analysed on completion of the study. We will calculate the 95% confidence intervals (CIs) of the incidence of pancreatitis in each group and analyse weather the difference in both groups with 95% CIs is within the non-inferiority margin (6%) using the Wald method. This study has been approved by the institutional review board of Hokkaido University Hospital (IRB: 016-0181). Results will be submitted for presentation at an international medical conference and published in a peer-reviewed journal. The University Hospital Medical Information Network ID: UMIN000025727 Pre-results. © 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.

Maximum Acceptable Weight of Lift reflects peak lumbosacral extension moments in a Functional Capacity Evaluation test using free style, stoop, and squat lifting

OpenAIRE

Kuijer, P.P.F.M.; van Oostrom, S.H.; Duijzer, K.; van Dieen, J.H.

2012-01-01

It is unclear whether the maximum acceptable weight of lift (MAWL), a common psychophysical method, reflects joint kinetics when different lifting techniques are employed. In a within-participants study (n = 12), participants performed three lifting techniques - free style, stoop and squat lifting from knee to waist level - using the same dynamic functional capacity evaluation lifting test to assess MAWL and to calculate low back and knee kinetics. We assessed which knee and back kinetic para...

New techniques in gastrointestinal endoscopic surgery

Directory of Open Access Journals (Sweden)

Rafael Antonio Luengas Tello

2012-09-01

Full Text Available Gastrointestinal endoscopic surgery has been making great progress since the seventies in the management paradigms of conditions such as gastrointestinal bleeding, polyp resection and diagnostic and therapeutic management of the biliary tract. The current challenge is the development of techniques that allow endoscopic treatment of emerging diseases such as cancer, morbid obesity, gastro-esophageal reflux and achalasia. This article reports on new techniques and expectations for the future in the endoscopic management of these diseases.

[Natural Orifice Transluminal Endoscopic Surgery (NOTES)].

Science.gov (United States)

Kim, Yong Sik; Kim, Chul Young; Chun, Hoon Jai

2008-03-01

Recently, the field of gastrointestinal endoscopy is developing rapidly. Once limited to the gastroinstestinal lumen, the endoscopic technology is now breaking the barriers and extending its boundary to peritoneal and pleural space. In 2004, Dr. Kalloo, a gastroenterologist, observed intraperitoneal organs of a pig using a conventional endoscope through the stomach wall. Since then, new endoscopic technique of intraperitoneal intervention with transluminal approach named the Natural Orifice Transluminal Endoscopic Surgery or NOTES has been introduced. NOTES reaches the target organ by inserting the endoscope through a natural orifice (e.g. mouth, anus, vagina, urethra) and entering the peritoneal lumen by means of making an incision on the luminal wall. After a series of successful experiences in animal studies, NOTES are now being tried on human subjects. There are still many obstacles to overcome, but bright future for this new technology is expected because of its proposed advantages of less pain, lower complication rate, short recovery time, and scarless access. In this review, we plan to learn about NOTES.

[Tracheotomy-endoscop for dilatational percutaneous tracheotomy (TED)].

Science.gov (United States)

Klemm, Eckart

2006-09-01

While surgical tracheotomies are currently performed using state-of-the-art operative techniques, percutaneous dilatational tracheostomy (PDT) is in a rapidly evolving state with regard to its technology and the number of techniques available. This has resulted in a range of new complications that are difficult to quantify on a scientific basis, given the fact that more than half of the patients who are tracheotomized in intensive care units die from their underlying disease. The new Tracheotomy Endoscope (TED) is designed to help prevent serious complications in dilatational tracheotomies and facilitate their management. The endoscope has been specifically adapted to meet the require-ments of percutaneous dilatational tracheotomies. It is fully compatible with all current techniques of PDT. The method is easy to learn. The percutaneous dilatational tracheotomy with the Tracheotomy Endoscope is a seven-step procedure: Advantages of the Tracheotomy Endoscope: Injuries to the posterior tracheal wall ar impossible (tracheoesophageal fistulas, pneumothorax). Minor bleeding sites on the tracheal mucosa can be controlled with a specially curved suction-coagulation tube introudeced through the Tracheotomy Endoscope. In cases with heavy bleeding and a risk of aspiration, the rigid indwelling Tracheotomy Endoscope provides a secure route for reintubating the patient with a cuffed endotracheal tube. It also allows for rapid conversion to an open surgical procedure if necessary. All the parts are easy to clean and are autoclavable. This type of endoscopically guided PDT creates an optimal link between the specialties of intensive care medicine and otorhinolaryngology. The Tracheotomy Endoscope (TED) increases the standard of safety in PDT.

Gastroesophageal reflux disease. Scintigraphic, endoscopic and histologic considerations

Energy Technology Data Exchange (ETDEWEB)

Kault, B.; Halvorsen, T.; Petersen, H.; Grette, K.; Myrvold, H.E.

1986-01-01

Radionucleotide scintigraphy and esophagoscopy with biopsy were carried out in 101 patients with symptoms strongly suggestive of gastroesophageal reflux (GER) disease. GER was visualized by scintigraphy in 86.1% of the patients. Endoscopic and histologic esophagitis were found in 68.1% and 58.4% of the patients, respectively, whereas both examinations taken together showed evidence of esophagitis in 82%. Histologic evidence of esophagitis was found in nearly all patients with severe endoscopic changes, and in 43.7% of the patients with no endoscopic abnormality. Scintigraphic reflux was demonstrated more frequently in the patients with severe endoscopic esophagitis (97.5%) than in those with no or only mild endoscopic changes (78.6%). Scintigraphic reflux was found in 91.5% and 78.5% of the patients with and without histologic evidence of esophagitis. 15 of the 18 patients (83.3%) without endoscopic and histologic abnormalities in the esophagus had scintigraphic evidence of reflux. The present study strongly supports the clinical significance of scintigraphy in GER disease and confirms that esophageal biopsy specimens increase the sensitivity of endoscopic evaluation. 31 refs.

The Cumulative Lifting Index (CULI) for the Revised NIOSH Lifting Equation: Quantifying Risk for Workers With Job Rotation.

Science.gov (United States)

Garg, Arun; Kapellusch, Jay M

2016-08-01

The objectives were to: (a) develop a continuous frequency multiplier (FM) for the Revised NIOSH Lifting Equation (RNLE) as a function of lifting frequency and duration of a lifting task, and (b) describe the Cumulative Lifting Index (CULI), a methodology for estimating physical exposure to workers with job rotation. The existing FM for the RNLE (FME) does not differentiate between task duration >2 hr and <8 hr, which makes quantifying physical exposure to workers with job rotation difficult and presents challenges to job designers. Using the existing FMs for 1, 2, and 8 hr of task durations, we developed a continuous FM (FMP) that extends to 12 hr per day. We simulated 157,500 jobs consisting of two tasks each and, using different combinations of Frequency Independent Lifting Index, lifting frequency and duration of lifting. Biomechanical stresses were estimated using the CULI, time-weighted average (TWA), and peak exposure. The median difference between FME and FMP was ±1% (range: 0%-15%). Compared to CULI, TWA underestimated risk of low-back pain (LBP) for 18% to 30% of jobs, and peak exposure for an assumed 8-hr work shift overestimated risk of LBP for 20% to 25% of jobs. Peak task exposure showed 90% agreement with CULI but ignored one of two tasks. The CULI partially addressed the underestimation of physical exposure using the TWA approach and overestimation of exposure using the peak-exposure approach. The proposed FM and CULI may provide more accurate physical exposure estimates, and therefore estimated risk of LBP, for workers with job rotation. © 2016, Human Factors and Ergonomics Society.

21 CFR 880.5500 - AC-powered patient lift.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5500 AC-powered patient lift. (a) Identification. An AC-powered lift is an electrically powered device either fixed or mobile, used to lift and transport patients in the horizontal or other...

Low-back loading in lifting two loads beside the body compared to lifting one load in front of the body

NARCIS (Netherlands)

Faber, G.S.; Kingma, I.; Bakker, A.J.; van Dieen, J.H.

2009-01-01

Low-back load during manual lifting is considered an important risk factor for the occurrence of low-back pain. Splitting a load, so it can be lifted beside the body (one load in each hand), instead of in front of the body, can be expected to reduce low-back load. Twelve healthy young men lifted 10

Effects of a Belt on Intra-Abdominal Pressure during Weight Lifting.

Science.gov (United States)

1988-03-01

potentially injurious b compressive forces on spinal discs during lifting. To investigate the effects of a standard lifting belt on lAP and lifting mechanics... injurious compressive forces on spinal discs during lifting. To investigate the effects of a standard lifting belt on IAP and lifting ! mechanics... weightlifting (7,9). Both olympic and power lifters have used lifting belts for many years, yet virtually no research has been reported which examines

Pig lift applications in offshore dry completion wells; Aplicacao do pig lift em pocos offshore de completacao seca

Energy Technology Data Exchange (ETDEWEB)

Lima, Paulo C.R.; Faria, Rogerio Costa; Almeida, Alcino Resende [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

2000-07-01

Production increases of 10% to 130% have been obtained with pig lift installations on offshore oil wells in the Cacao Field, southeast Brazil. At the present time 3 wells out of 5 are being produced with pig lift. These deep, highly deviated wells with little space on the platform to the required surface equipment presented a challenge to pig lift technology. However, these difficulties were overcame and the benefits obtained helped to maintain the economical attractiveness of the platform. (author)

[PACS-based endoscope image acquisition workstation].

Science.gov (United States)

Liu, J B; Zhuang, T G

2001-01-01

A practical PACS-based Endoscope Image Acquisition Workstation is here introduced. By a Multimedia Video Card, the endoscope video is digitized and captured dynamically or statically into computer. This workstation realizes a variety of functions such as the endoscope video's acquisition and display, as well as the editing, processing, managing, storage, printing, communication of related information. Together with other medical image workstation, it can make up the image sources of PACS for hospitals. In addition, it can also act as an independent endoscopy diagnostic system.

Endoscopic treatment of vesicoureteral reflux in pediatric patients

Directory of Open Access Journals (Sweden)

Jong Wook Kim

2013-04-01

Full Text Available Endoscopic treatment is a minimally invasive treatment for managing patients with vesicoureteral reflux (VUR. Although several bulking agents have been used for endoscopic treatment, dextranomer/hyaluronic acid is the only bulking agent currently approved by the U.S. Food and Drug Administration for treating VUR. Endoscopic treatment of VUR has gained great popularity owing to several obvious benefits, including short operative time, short hospital stay, minimal invasiveness, high efficacy, low complication rate, and reduced cost. Initially, the success rates of endoscopic treatment have been lower than that of open antireflux surgery. However, because injection techniques have been developed, a recent study showed higher success rates of endoscopic treatment than open surgery in the treatment of patients with intermediate- and high-grade VUR. Despite the controversy surrounding its effectiveness, endoscopic treatment is considered a valuable treatment option and viable alternative to long-term antibiotic prophylaxis.

A Practical Approach To Lift-Off

Science.gov (United States)

Jones, Susan K.; Chapman, Richard C.; Pavelchek, Edward K.

1987-08-01

Lift-off technology provides an alternate metal patterning technology to that of subtractive etching. In this raper, we describe an image reversal process which provides a practical means for reliably producing resist stencils which are required for successful lift-off in a 2.0 μm metal pitch CMOS process, as well as for experimental submicron processing. Experimental data and PROSIM simulations are presented to show the effects of patterning exposure dose, flood exposure dose, develop time, and focus parameters on resist linewidths as well as for control of resist retrograde (undercut) sidewall angles. Deposition and subsequent lift-off of Al/Cu alloys and sandwich metallizations is demonstrated. Because the image reversal process enables pattern definition at the top of the resist film, it is demonstrated that thicker resist films can be used to produce finer resolution of lift-off stencils over topography than would have been expected without resorting to multilayer resist structures.

Endoscopic versus surgical drainage treatment of calcific chronic pancreatitis.

Science.gov (United States)

Jiang, Li; Ning, Deng; Cheng, Qi; Chen, Xiao-Ping

2018-04-21

Endoscopic therapy and surgery are both conventional treatments to remove pancreatic duct stones that developed during the natural course of chronic pancreatitis. However, few studies comparing the effect and safety between surgery drainage and endoscopic drainage (plus Extracorporeal Shock Wave Lithotripsy, ESWL).The aim of this study was to compare the benefits between endoscopic and surgical drainage of the pancreatic duct for patients with calcified chronic pancreatitis. A total of 86 patients were classified into endoscopic/ESWL (n = 40) or surgical (n = 46) treatment groups. The medical records of these patients were retrospectively analyzed. Pain recurrence and hospital stays were similar between the endoscopic/ESWL treatment and surgery group. However, endoscopic/ESWL treatment yielded significantly lower medical expense and less complications compared with the surgical treatment. In selective patients, endoscopic/ESWL treatment could achieve comparable efficacy to the surgical treatment. With lower medical expense and less complications, endoscopic/ESWL treatment would be much preferred to be the initial treatment of choice for patients with calcified chronic pancreatitis. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Endoscopic and keyhole endoscope-assisted neurosurgical approaches: a qualitative survey on technical challenges and technological solutions.

Science.gov (United States)

Marcus, Hani J; Cundy, Thomas P; Hughes-Hallett, Archie; Yang, Guang-Zhong; Darzi, Ara; Nandi, Dipankar

2014-10-01

The literature reflects a resurgence of interest in endoscopic and keyhole endoscope-assisted neurosurgical approaches as alternatives to conventional microsurgical approaches in carefully selected cases. The aim of this study was to assess the technical challenges of neuroendoscopy, and the scope for technological innovations to overcome these barriers. All full members of the Society of British Neurosurgeons (SBNS) were electronically invited to participate in an online survey. The open-ended structured survey asked three questions; firstly, whether the surgeon presently utilises or has experience with endoscopic or endoscope-assisted approaches; secondly, what they consider to be the major technical barriers to adopting such approaches; and thirdly, what technological advances they foresee improving safety and efficacy in the field. Responses were subjected to a qualitative research method of multi-rater emergent theme analysis. Three clear themes emerged: 1) surgical approach and better integration with image-guidance systems (20%), 2) intra-operative visualisation and improvements in neuroendoscopy (49%), and 3) surgical manipulation and improvements in instruments (74%). The analysis of responses to our open-ended survey revealed that although opinion was varied three major themes could be identified. Emerging technological advances such as augmented reality, high-definition stereo-endoscopy, and robotic joint-wristed instruments may help overcome the technical difficulties associated with neuroendoscopic approaches. Results of this qualitative survey provide consensus amongst the technology end-user community such that unambiguous goals and priorities may be defined. Systems integrating these advances could improve the safety and efficacy of endoscopic and endoscope-assisted neurosurgical approaches.

Asymptomatic Esophageal Varices Should Be Endoscopically Treated

Directory of Open Access Journals (Sweden)

Nib Soehendra

1998-01-01

Full Text Available Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

Endoscopic Management of an Intramural Sinus Leak After Per- Oral Endoscopic Myotomy

Science.gov (United States)

Al Taii, Haider; Confer, Bradley; Gabbard, Scott; Kroh, Matthew; Jang, Sunguk; Rodriguez, John; Parsi, Mansour A.; Vargo, John J.; Ponsky, Jeffrey

2016-01-01

Per-oral endoscopic myotomy (POEM) was developed less than a decade ago for the treatment of achalasia. Its minimally invasive approach and the favorable short-term outcome have led to rapid adoption of the technique throughout the world. As with any new technique, there will be adverse events, and it is important that effective treatments for these adverse events be discussed. We present a case of successful endoscopic management of an intramural sinus leak after a POEM procedure using tandem fully covered esophageal stents. PMID:27921057

On the Efficiency of Individualized Theta/Beta Ratio Neurofeedback Combined with Forehead EMG Training in ADHD Children

Directory of Open Access Journals (Sweden)

Olga M. Bazanova

2018-01-01

Full Text Available Background: Neurofeedback training (NFT to decrease the theta/beta ratio (TBR has been used for treating hyperactivity and impulsivity in attention deficit hyperactivity disorder (ADHD; however, often with low efficiency. Individual variance in EEG profile can confound NFT, because it may lead to influencing non-relevant activity, if ignored. More importantly, it may lead to influencing ADHD-related activities adversely, which may even result in worsening ADHD symptoms. Electromyogenic (EMG signal resulted from forehead muscles can also explain the low efficiency of the NFT in ADHD from both practical and psychological point-of-view. The first aim of this study was to determine EEG and EMG biomarkers most related to the main ADHD characteristics, such as impulsivity and hyperactivity. The second aim was to confirm our hypothesis that the efficiency of the TBR NFT can be increased by individual adjustment of the frequency bands and simultaneous training on forehead muscle tension.Methods: We recruited 94 children diagnosed with ADHD (ADHD and 23 healthy controls (HC. All participants were male and aged between six and nine. Impulsivity and attention were assessed with Go/no-Go task and delayed gratification task, respectively; and 19-channel EEG and forehead EMG were recorded. Then, the ADHD group was randomly subdivided into (1 standard, (2 individualized, (3 individualized+EMG, and (4 sham NFT (control groups. The groups were compared based on TBR and EEG alpha activity, as well as hyperactivity and impulsivity three times: pre-NFT, post-NFT and 6 months after the NFT (follow-up.Results: ADHD children were characterized with decreased individual alpha peak frequency, alpha bandwidth and alpha amplitude suppression magnitude, as well as with increased alpha1/alpha2 (a1/a2 ratio and scalp muscle tension when c (η2 ≥ 0.212. All contingent TBR NFT groups exhibited significant NFT-related decrease in TBR not evident in the control group. Moreover

On the Efficiency of Individualized Theta/Beta Ratio Neurofeedback Combined with Forehead EMG Training in ADHD Children.

Science.gov (United States)

Bazanova, Olga M; Auer, Tibor; Sapina, Elena A

2018-01-01

Background: Neurofeedback training (NFT) to decrease the theta/beta ratio (TBR) has been used for treating hyperactivity and impulsivity in attention deficit hyperactivity disorder (ADHD); however, often with low efficiency. Individual variance in EEG profile can confound NFT, because it may lead to influencing non-relevant activity, if ignored. More importantly, it may lead to influencing ADHD-related activities adversely, which may even result in worsening ADHD symptoms. Electromyogenic (EMG) signal resulted from forehead muscles can also explain the low efficiency of the NFT in ADHD from both practical and psychological point-of-view. The first aim of this study was to determine EEG and EMG biomarkers most related to the main ADHD characteristics, such as impulsivity and hyperactivity. The second aim was to confirm our hypothesis that the efficiency of the TBR NFT can be increased by individual adjustment of the frequency bands and simultaneous training on forehead muscle tension. Methods: We recruited 94 children diagnosed with ADHD (ADHD) and 23 healthy controls (HC). All participants were male and aged between six and nine. Impulsivity and attention were assessed with Go/no-Go task and delayed gratification task, respectively; and 19-channel EEG and forehead EMG were recorded. Then, the ADHD group was randomly subdivided into (1) standard, (2) individualized, (3) individualized+EMG, and (4) sham NFT (control) groups. The groups were compared based on TBR and EEG alpha activity, as well as hyperactivity and impulsivity three times: pre-NFT, post-NFT and 6 months after the NFT (follow-up). Results: ADHD children were characterized with decreased individual alpha peak frequency, alpha bandwidth and alpha amplitude suppression magnitude, as well as with increased alpha1/alpha2 (a1/a2) ratio and scalp muscle tension when c (η 2 ≥ 0.212). All contingent TBR NFT groups exhibited significant NFT-related decrease in TBR not evident in the control group. Moreover

Fronto-orbital feminization technique. A surgical strategy using fronto-orbital burring with or without eggshell technique to optimize the risk/benefit ratio.

Science.gov (United States)

Villepelet, A; Jafari, A; Baujat, B

2018-05-04

The demand for facial feminization is increasing in transsexual patients. Masculine foreheads present extensive supraorbital bossing with a more acute glabellar angle, whereas female foreheads show softer features. The aim of this article is to describe our surgical technique for fronto-orbital feminization. The mask-lift technique is an upper face-lift. It provides rejuvenation by correcting collapsed features, and fronto-orbital feminization through burring of orbital rims and lateral canthopexies. Depending on the size of the frontal sinus and the thickness of its anterior wall, frontal remodeling is achieved using simple burring or by means of the eggshell technique. Orbital remodeling comprises a superolateral orbital opening, a reduction of ridges and a trough at the lateral orbital rim to support the lateral canthopexy. Frontal, corrugator and procerus myectomies, plus minimal scalp excision, complete the surgery. Our technique results in significant, natural-looking feminization. No complications were observed in our series of patients. The eggshell technique is an alternative to bone flap on over-pneumatized sinus. Fronto-orbital feminization fits into a wider surgical strategy. It can be associated to rhinoplasty, genioplasty, mandibular angle remodeling, face lift and laryngoplasty. Achieving facial feminization in 2 or 3 stages improves psychological and physiological tolerance. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Endoscopic versus open bursectomy of lateral malleolar bursitis.

Science.gov (United States)

Choi, Jae Hyuck; Lee, Kyung Tai; Lee, Young Koo; Kim, Dong Hyun; Kim, Jeong Ryoul; Chung, Woo Chull; Cha, Seung Do

2012-06-01

Compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis. Prospective evaluation of 21 patients (22 ankles) undergoing either open or endoscopic excision of lateral malleolar bursitis. The median age was 64 (38-79) years old. The median postoperative follow-up was 15 (12-18) months. Those patients undergoing endoscopic excision showed a higher satisfaction rate (excellent 9, good 2) than open excision (excellent 4, good 3, fair 1). The wounds also healed earlier in the endoscopic group although the operation time was slightly longer. One patient in the endoscopic group had recurrence of symptoms but complications in the open group included one patient with skin necrosis, one patient with wound dehiscence, and two patients of with superficial peroneal nerve injury. Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favorable results compared to the open resection. Therapeutic studies-Investigating the result of treatment, Level II.

Ultrasound-assisted endoscopic partial plantar fascia release.

Science.gov (United States)

Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

2013-01-01

Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure.

Waste Package Lifting Calculation

International Nuclear Information System (INIS)

H. Marr

2000-01-01

The objective of this calculation is to evaluate the structural response of the waste package during the horizontal and vertical lifting operations in order to support the waste package lifting feature design. The scope of this calculation includes the evaluation of the 21 PWR UCF (pressurized water reactor uncanistered fuel) waste package, naval waste package, 5 DHLW/DOE SNF (defense high-level waste/Department of Energy spent nuclear fuel)--short waste package, and 44 BWR (boiling water reactor) UCF waste package. Procedure AP-3.12Q, Revision 0, ICN 0, calculations, is used to develop and document this calculation

Null lifts and projective dynamics

Energy Technology Data Exchange (ETDEWEB)

Cariglia, Marco, E-mail: marco@iceb.ufop.br

2015-11-15

We describe natural Hamiltonian systems using projective geometry. The null lift procedure endows the tangent bundle with a projective structure where the null Hamiltonian is identified with a projective conic and induces a Weyl geometry. Projective transformations generate a set of known and new dualities between Hamiltonian systems, as for example the phenomenon of coupling-constant metamorphosis. We conclude outlining how this construction can be extended to the quantum case for Eisenhart–Duval lifts.

Contrast-enhanced endoscopic ultrasonography

DEFF Research Database (Denmark)

Reddy, Nischita K; Ioncica, Ana Maria; Saftoiu, Adrian

2011-01-01

Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...

Is endoscopic nodular gastritis associated with premalignant lesions?

Science.gov (United States)

Niknam, R; Manafi, A; Maghbool, M; Kouhpayeh, A; Mahmoudi, L

2015-06-01

Nodularity on the gastric mucosa is occasionally seen in general practice. There is no consensus about the association of nodular gastritis and histological premalignant lesions. This study is designed to investigate the prevalence of histological premalignant lesions in dyspeptic patients with endoscopic nodular gastritis. Consecutive patients with endoscopic nodular gastritis were compared with an age- and sex-matched control group. Endoscopic nodular gastritis was defined as a miliary nodular appearance of the gastric mucosa on endoscopy. Biopsy samples of stomach tissue were examined for the presence of atrophic gastritis, intestinal metaplasia, and dysplasia. The presence of Helicobacter pylori infection was determined by histology. From 5366 evaluated patients, a total of 273 patients with endoscopic nodular gastritis and 1103 participants as control group were enrolled. H. pylori infection was detected in 87.5% of the patients with endoscopic nodular gastritis, whereas 73.8% of the control group were positive for H. pylori (p gastritis were significantly higher than in the control group. Prevalence of atrophic gastritis and complete intestinal metaplasia were also more frequent in patients with endoscopic nodular gastritis than in the control group. Dysplasia, incomplete intestinal metaplasia and H. pylori infection are significantly more frequent in patients with endoscopic nodular gastritis. Although further studies are needed before a clear conclusion can be reached, we suggest that endoscopic nodular gastritis might serve as a premalignant lesion and could be biopsied in all patients for the possibility of histological premalignancy, in addition to H. pylori infection.

'Natural Gas lift', a New Tool for Nigeria

International Nuclear Information System (INIS)

Lucas, C. D.

2003-01-01

Gas lift is the most common means of artificial lift in the Niger Delta and has been widely applied worldwide. The advent of remote monitoring and control devises (RMC) has added a new option in artificiallift, 'natural gas lift'. 'Natural gas lift' is an extension RMC in which a gas zone and one or more oil zones are produced through the same tubing string, using the gas enhance the production of the oil zones. The flow of gas is maintained in the optimal range using down hole chokes that are controlled from the surface. The gas flow rate is monitored using downhole pressure and .temperature gauges. The use of 'natural gas lift' has the advantages of gas lift but without the cost associated with gas lift; gas supply wells, compression etc. This is especially critical in areas that are remote from other facilities or in subsea completions where access to the wells is limited. Stacked reservoirs and frequent inclusion of both oil and gas reservoirs in the same field, as found in the Niger Delta, makes Nigeria a prime candidate for this technology. An example of this production from the North Sea will be presented along with a potential application using data from the Niger Delta. Design elements of the monitoring and control systems will be covered and the advantages and drawbacks of this application will be discussed

The Design of Wheelchair Lifting Mechanism and Control System

Institute of Scientific and Technical Information of China (English)

ZHAO Cong; WANG Zheng-xing; JIANG Shi-hong; ZHANG Li; LIU Zheng-yu

2014-01-01

In order to achieve a wheelchair lift function, this paper designs a tri-scissors mechanism. Through the so-called H-type transmission and L-type swing rod, the three scissors mechanisms lift in the same rate with only one liner motor while ensuring the stability of the lift. Finite element analysis in ANSYS is performed to verify the material strength. The control system with Sunplus SCM achieves the voice control of wheelchair walking and lifting.

A technical review of flexible endoscopic multitasking platforms.

Science.gov (United States)

Yeung, Baldwin Po Man; Gourlay, Terence

2012-01-01

Further development of advanced therapeutic endoscopic techniques and natural orifice translumenal endoscopic surgery (NOTES) requires a powerful flexible endoscopic multitasking platform. Medline search was performed to identify literature relating to flexible endoscopic multitasking platform from year 2004-2011 using keywords: Flexible endoscopic multitasking platform, NOTES, Instrumentation, Endoscopic robotic surgery, and specific names of various endoscopic multitasking platforms. Key articles from articles references were reviewed. Flexible multitasking platforms can be classified as either mechanical or robotic. Purely mechanical systems include the dual channel endoscope (DCE) (Olympus), R-Scope (Olympus), the EndoSamurai (Olympus), the ANUBIScope (Karl-Storz), Incisionless Operating Platform (IOP) (USGI), and DDES system (Boston Scientific). Robotic systems include the MASTER system (Nanyang University, Singapore) and the Viacath (Hansen Medical). The DCE, the R-Scope, the EndoSamurai and the ANUBIScope have integrated visual function and instrument manipulation function. The IOP and DDES systems rely on the conventional flexible endoscope for visualization, and instrument manipulation is integrated through the use of a flexible, often lockable, multichannel access device. The advantage of the access device concept is that it allows optics and instrument dissociation. Due to the anatomical constrains of the pharynx, systems are designed to have a diameter of less than 20 mm. All systems are controlled by traction cable system actuated either by hand or by robotic machinery. In a flexible system, this method of actuation inevitably leads to significant hysteresis. This problem will be accentuated with a long endoscope such as that required in performing colonic procedures. Systems often require multiple operators. To date, the DCE, the R-Scope, the IOP, and the Viacath system have data published relating to their application in human. Alternative forms of

Isolated neck-lifting procedure: isolated stork lift.

Science.gov (United States)

Barbarino, Sheila C; Wu, Allan Y; Morrow, David M

2013-04-01

Many patients desire cosmetic improvement of neck laxity when consulting with a plastic surgeon about their face. Neck laxity and loss of the cervicomental angle can be due to multiple components of aging such as skin quality/elasticity, loss of platysma muscle tone, and submental fat accumulation. Traditionally, the procedure of choice for patients with an aging lower face and neck is a cervicofacial rhytidectomy. However, occasionally, a patient wishes to have no other facial surgery than an improvement of their excessive skin of the anterior, lateral, and/or posterior neck. In other instances, a patient may present with having had a face/neck-lifting procedure that left objectionable vertical/diagonal lines at the lateral neck. In both these instances, a surgeon should consider an isolated stork lift (ISL) procedure. An ISL procedure avoids and/or corrects problematic vertical/diagonal lateral neck folds by "walking" the excess skin flaps around the posterior inferior occipital hairline bilaterally, bringing the flaps together at the lateral and posterior neck, which sometimes involves a midline posterior dart excision of the dog ear. A patient presenting with excessive skin of the neck (anterior, lateral, and/or posterior) and/or residual vertical/diagonal skin folds is an excellent candidate for the ISL. The ISL procedure was performed on 273 patients over a 2-year period at The Morrow Institute. Patients were included if they had excessive skin of the anterior, lateral, and/or posterior neck and/or diagonal/vertical lateral bands and did not desire a full face-lifting procedure. Patients were excluded from this study if they would not accept having longer hair in order to cover the scar along the posterior inferior occipital hairline or a midline T-flap skin closure scar at the base of the posterior midline neck. Under a combination of local anesthesia and IV sedation, a postauricular face-lift incision was made that was extended in a circumoccipital fashion

Usefulness of combined percutaneous-endoscopic rendezvous techniques after failed therapeutic endoscopic retrograde cholangiography in the era of endoscopic ultrasound guided rendezvous.

Science.gov (United States)

Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Kim, Soon Sun; Lim, Sun Gyo; Won, Je Hwan

2017-12-01

The rendezvous approach is a salvage technique after failure of endoscopic retrograde cholangiography (ERC). In certain circumstances, percutaneous-endoscopic rendezvous (PE-RV) is preferred, and endoscopic ultrasound-guided rendezvous (EUS-RV) is difficult to perform. We aimed to evaluate PE-RV outcomes, describe the PE-RV techniques, and identify potential indications for PE-RV over EUS-RV.Retrospective analysis was conducted of a prospectively designed ERC database between January 2005 and December 2016 at a tertiary referral center including cases where PE-RV was used as a salvage procedure after ERC failure.During the study period, PE-RV was performed in 42 cases after failed therapeutic ERC; 15 had a surgically altered enteric anatomy. The technical success rate of PE-RV was 92.9% (39/42), with a therapeutic success rate of 88.1% (37/42). Potential indications for PE-RV over EUS-RV were identified in 23 cases, and either PE-RV or EUS-RV could have effectively been used in 19 cases. Endoscopic bile duct access was successfully achieved with PE-RV in 39 cases with accessible biliary orifice using one of PE-RV cannulation techniques (classic, n = 11; parallel, n = 19; and adjunctive maneuvers, n = 9).PE-RV uses a unique technology and has clinical indications that distinguish it from EUS-RV. Therefore, PE-RV can still be considered a useful salvage technique for the treatment of biliary obstruction after ERC failure.

[Origin of lifting and lowering theory and its herb pair study].

Science.gov (United States)

Guo, Zhao-Juan; Yuan, Yi-Ping; Kong, Li-Ting; Jia, Xiao-Yu; Wang, Ning-Ning; Dai, Ying; Zhai, Hua-Qiang

2017-08-01

Lifting and lowering theory is one of the important basis for guiding clinical medication. Through the study of ancient books and literature, we learned that lifting and lowering theory was originated in Huangdi Neijing, practiced more in the Shanghan Zabing Lun, established in Yixue Qiyuan, and developed in Compendium of Materia Medica and now. However, lifting and lowering theory is now mostly stagnated in the theoretical stage, with few experimental research. In the clinical study, the guiding role of lifting and lowering theory to prescriptions?mainly includes opposite?role?of lift and lower medicine property, mutual promotion of lift and lower medicine property, main role of lift medicine property and main role of lower medicine property. Under the guidance of lifting and lowering theory, the herb pair compatibility include herb combination of lift medicine property, herb combination of lift and lower medicine property and herb combination of lower medicine property. Modern biological technology was used in this study to carry out experimental research on the lifting and lowering theory, revealing the scientific connotation of it, which will help to promote clinical rational drug use. Copyright© by the Chinese Pharmaceutical Association.

Balancing the shortcomings of microscope and endoscope: endoscope-assisted technique in microsurgical removal of recurrent epidermoid cysts in the posterior fossa.

Science.gov (United States)

Ebner, F H; Roser, F; Thaher, F; Schittenhelm, J; Tatagiba, M

2010-10-01

We report about endoscope-assisted surgery of epidermoid cysts in the posterior fossa focusing on the application of neuro-endoscopy and the clinical outcome in cases of recurrent epidermoid cysts. 25 consecutively operated patients with an epidermoid cyst in the posterior fossa were retrospectively analysed. Surgeries were performed both with an operating microscope (OPMI Pentero or NC 4, Zeiss Company, Oberkochen, Germany) and endoscopic equipment (4 mm rigid endoscopes with 30° and 70° optics; Karl Storz Company, Tuttlingen, Germany) under continuous intraoperative monitoring. Surgical reports and DVD-recordings were evaluated for identification of adhesion areas and surgical details. 7 (28%) of the 25 patients were recurrences of previously operated epidermoid cysts. Mean time to recurrence was 17 years (8-22 years). In 5 cases the endoscope was used as an adjunctive tool for inspection/endoscope-assisted removal of remnants. The effective time of use of the endoscope was limited to the end stage of the procedure, but was very effective. In a modern operative setting and with the necessary surgical experience recurrent epidermoid cysts may be removed with excellent clinical results. The combined use of microscope and endoscope offers relevant advantages in demanding anatomic situations. © Georg Thieme Verlag KG Stuttgart · New York.

Endoscopic Radiofrequency Ablation-Assisted Resection of Juvenile Nasopharyngeal Angiofibroma: Comparison with Traditional Endoscopic Technique.

Science.gov (United States)

McLaughlin, Eamon J; Cunningham, Michael J; Kazahaya, Ken; Hsing, Julianna; Kawai, Kosuke; Adil, Eelam A

2016-06-01

To evaluate the feasibility of radiofrequency surgical instrumentation for endoscopic resection of juvenile nasopharyngeal angiofibroma (JNA) and to test the hypothesis that endoscopic radiofrequency ablation-assisted (RFA) resection will have superior intraoperative and/or postoperative outcomes as compared with traditional endoscopic (TE) resection techniques. Case series with chart review. Two tertiary care pediatric hospitals. Twenty-nine pediatric patients who underwent endoscopic transnasal resection of JNA from January 2000 to December 2014. Twenty-nine patients underwent RFA (n = 13) or TE (n = 16) JNA resection over the 15-year study period. Mean patient age was not statistically different between the 2 groups (P = .41); neither was their University of Pittsburgh Medical Center classification stage (P = .79). All patients underwent preoperative embolization. Mean operative times were not statistically different (P = .29). Mean intraoperative blood loss and the need for a transfusion were also not statistically different (P = .27 and .47, respectively). Length of hospital stay was not statistically different (P = .46). Recurrence rates did not differ between groups (P = .99) over a mean follow-up period of 2.3 years. There were no significant differences between RFA and TE resection in intraoperative or postoperative outcome parameters. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Taking NOTES: translumenal flexible endoscopy and endoscopic surgery.

Science.gov (United States)

Willingham, Field F; Brugge, William R

2007-09-01

To review the current state of natural orifice surgery and examine the concerns, challenges, and opportunities presented by translumenal research. Translumenal endoscopic procedures have been the focus of extensive research. Researchers have reported natural orifice translumenal endoscopic surgery in a swine model in several areas involving the abdominal cavity. Diagnostic procedures have included endoscopic peritoneoscopy, liver biopsy, lymphadenectomy, and abdominal exploration. Several gynecologic procedures including tubal ligation, oophorectomy, and partial hysterectomy have been demonstrated using current commercial endoscopes. Gastrointestinal surgical procedures, including gastrojejunostomy, cholecystectomy, splenectomy, and distal pancreatectomy have been performed successfully via transgastric and/or transcolonic approaches. There have been no studies of natural orifice translumenal endoscopic surgery procedures published in humans. While fundamental questions about the emerging technology have not been scrutinized, limitations of the large animal model will pose a challenge to the development of large randomized trials. While natural orifice translumenal endoscopic surgery may represent a paradigm shift and may offer significant benefits to patients, rigorous testing of the techniques is lacking and current data have been drawn from case series.

Thermally stimulating mechanically-lifted well production

Energy Technology Data Exchange (ETDEWEB)

Richardson, E.A.; Hinson, R.A.

1984-06-19

A well which is producing slowly by artificial lift can be economically heated by first inflowing a nitrogen-generating solution, to form a pool of reacting liquid near the uppermost opening into the reservoir, then inflowing more solution while artificially-lifting liquid from near the lowermost opening into the reservoir at a rate substantially equalling the inflow rate.

Numerical Study of Transition of an Annular Lift Fan Aircraft

OpenAIRE

Yun Jiang; Bo Zhang

2016-01-01

The present study aimed at studying the transition of annular lift fan aircraft through computational fluid dynamics (CFD) simulations. The oscillations of lift and drag, the optimization for the figure of merit, and the characteristics of drag, yawing, rolling and pitching moments in transition are studied. The results show that a two-stage upper and lower fan lift system can generate oscillations of lift and drag in transition, while a single-stage inner and outer fan lift system can elimin...

Bilayer lift-off process for aluminum metallization

Science.gov (United States)

Wilson, Thomas E.; Korolev, Konstantin A.; Crow, Nathaniel A.

2015-01-01

Recently published reports in the literature for bilayer lift-off processes have described recipes for the patterning of metals that have recommended metal-ion-free developers, which do etch aluminum. We report the first measurement of the dissolution rate of a commercial lift-off resist (LOR) in a sodium-based buffered commercial developer that does not etch aluminum. We describe a reliable lift-off recipe that is safe for multiple process steps in patterning thin (recipe consists of an acid cleaning of the substrate, the bilayer (positive photoresist/LOR) deposition and development, the sputtering of the aluminum film along with a palladium capping layer and finally, the lift-off of the metal film by immersion in the LOR solvent. The insertion into the recipe of postexposure and sequential develop-bake-develop process steps are necessary for an acceptable undercut. Our recipe also eliminates any need for accompanying sonication during lift-off that could lead to delamination of the metal pattern from the substrate. Fine patterns were achieved for both 100-nm-thick granular aluminum/palladium bilayer bolometers and 500-nm-thick aluminum gratings with 6-μm lines and 4-μm spaces.

Study on dynamic lifting characteristics of control rod drive mechanism

International Nuclear Information System (INIS)

Shen Xiaoyao

2012-01-01

Based on the equations of the electric circuit and the magnetic circuit and analysis of the dynamic lifting process for the control rod drive mechanism (CRDM), coupled magnetic-electric-mechanical equations both for the static status and the dynamic status are derived. The analytical method is utilized to obtain the current and the time when the lift starts. The numerical simulation method of dynamic analysis recommended by ASME Code is utilized to simulate the dynamic lifting process of CRDM, and the dynamic features of the system with different design gaps are studied. Conclusions are drawn as: (1) the lifting-start time increases with the design gap, and the time for the lifting process is longer with larger gaps; (2) the lifting velocity increases with time; (3) the lifting acceleration increases with time, and with smaller gaps, the impact acceleration is larger. (author)

Endoscopic approach to the infratemporal fossa

Directory of Open Access Journals (Sweden)

Ahmed Youssef

2014-06-01

Conclusions: Endoscopic endonasal transpterygoid approach is considered one of the most useful surgical solutions to manage selected tumors that involve the infratemporal fossa. A good understanding of the endoscopic anatomy of infratemporal fossa allows safe and complete resection of lesions arising or extending to infratemporal fossa.

[Endoscopic ultrasound guided rendezvous for biliary drainage].

Science.gov (United States)

Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

2015-04-27

Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

Elimination of high titre HIV from fibreoptic endoscopes.

Science.gov (United States)

Hanson, P J; Gor, D; Jeffries, D J; Collins, J V

1990-06-01

Concern about contamination of fibreoptic endoscopes with human immunodeficiency virus (HIV) has generated a variety of disruptive and possibly unnecessary infection control practices in endoscopy units. Current recommendations on the cleaning and disinfection of endoscopes have been formulated without applied experimental evidence of the effective removal of HIV from endoscopes. To study the kinetics of elimination of HIV from endoscope surfaces, we artificially contaminated the suction-biopsy channels of five Olympus GIF XQ20 endoscopes with high titre HIV in serum. The air and water channels of two instruments were similarly contaminated. Contamination was measured by irrigating channels with viral culture medium and collecting 3 ml at the distal end for antigen immunoassay. Endoscopes were then cleaned manually in neutral detergent according to the manufacturer's recommendations and disinfected in 2% alkaline glutaraldehyde (Cidex, Surgikos) for two, four, and ten minutes. Contamination with HIV antigens was measured before and after cleaning and after each period of disinfection. Initial contamination comprised 4.8 x 10(4) to 3.5 x 10(6) pg HIV antigen/ml. Cleaning in detergent achieved a reduction to 165 pg/ml (99.93%) on one endoscope and to undetectable levels (100%) on four. After two minutes in alkaline glutaraldehyde all samples were negative and remained negative after the longer disinfection times. Air and water channels, where contaminated, were tested after 10 minutes' disinfection and were negative. These findings underline the importance of cleaning in removing HIV from endoscope and indicate that the use of dedicated equipment and long disinfection times are unnecessary.

Significance of endoscopic screening and endoscopic resection for esophageal cancer in patients with hypopharyngeal cancer

International Nuclear Information System (INIS)

Morimoto, Masahiro; Nishiyama, Kinji; Nakamura, Satoaki

2010-01-01

The efficacy of endoscopic screening for esophageal cancer in patients with hypopharyngeal cancer remains controversial and its impact on prognosis has not been adequately discussed. We studied the use of endoscopic screening to detect esophageal cancer in hypopharyngeal cancer patients by analyzing the incidence, stage and prognosis. We included 64 patients with hypopharyngeal cancer who received radical radiotherapy at our institute. Chromoendoscopic esophageal examinations with Lugol dye solution were routinely performed at and after treatment for hypopharyngeal cancer. Twenty-eight esophageal cancers were detected in 28 (41%) patients (18 synchronous and 10 metachronous cancers). Of the 28 cancers, 23 were stage 0 or I cancer and 15 of these were treated with endoscopic resection. Local control was achieved in all of these 23 stage 0 or I cancers. The 5-year overall survival rates with esophageal cancer were 83% in stage 0, 47% in stage I and 0% in stage IIA-IVB. This study showed a strikingly high incidence of esophageal cancer in hypopharyngeal cancer patients. We suppose that the combination of early detection by chromoendoscopic examination and endoscopic resection for associated esophageal cancer in hypopharyngeal cancer patients improve prognosis and maintain quality of life. (author)

Limits of the endoscopic transnasal transtubercular approach.

Science.gov (United States)

Gellner, Verena; Tomazic, Peter V

2018-06-01

The endoscopic transnasal trans-sphenoidal transtubercular approach has become a standard alternative approach to neurosurgical transcranial routes for lesions of the anterior skull base in particular pathologies of the anterior tubercle, sphenoid plane, and midline lesions up to the interpeduncular cistern. For both the endoscopic and the transcranial approach indications must strictly be evaluated and tailored to the patients' morphology and condition. The purpose of this review was to evaluate the evidence in literature of the limitations of the endoscopic transtubercular approach. A PubMed/Medline search was conducted in January 2018 entering following keywords. Upon initial screening 7 papers were included in this review. There are several other papers describing the endoscopic transtubercular approach (ETTA). We tried to list the limitation factors according to the actual existing literature as cited. The main limiting factors are laterally extending lesions in relation to the optic canal and vascular encasement and/or unfavorable tumor tissue consistency. The ETTA is considered as a high level transnasal endoscopic extended skull base approach and requires excellent training, skills and experience.

Analysis of lifting beam and redesigned lifting lugs for 241-AZ-01A decant pump

International Nuclear Information System (INIS)

Coverdell, B.L.

1994-01-01

This supporting document details calculations for the proper design of a lifting beam and redesigned lifting lugs for the 241AZO1A decant pump. This design is in accordance with Standard Architectural-Civil Design Criteria, Design Loads for Facilities (DOE-RL 1989) and is safety class three. The design and fabrication is in accordance with American Institute of Steel Construction, Manual of Steel Construction, (AISC, 1989) and the Hanford Hoisting and Rigging Manual (DOE-RL 1993)

Laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy in people undergoing laparoscopic cholecystectomy for stones in the gallbladder and bile duct.

Science.gov (United States)

Vettoretto, Nereo; Arezzo, Alberto; Famiglietti, Federico; Cirocchi, Roberto; Moja, Lorenzo; Morino, Mario

2018-04-11

The management of gallbladder stones (lithiasis) concomitant with bile duct stones is controversial. The more frequent approach is a two-stage procedure, with endoscopic sphincterotomy and stone removal from the bile duct followed by laparoscopic cholecystectomy. The laparoscopic-endoscopic rendezvous combines the two techniques in a single-stage operation. To compare the benefits and harms of endoscopic sphincterotomy and stone removal followed by laparoscopic cholecystectomy (the single-stage rendezvous technique) versus preoperative endoscopic sphincterotomy followed by laparoscopic cholecystectomy (two stages) in people with gallbladder and common bile duct stones. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE Ovid, Embase Ovid, Science Citation Index Expanded Web of Science, and two trials registers (February 2017). We included randomised clinical trials that enrolled people with concomitant gallbladder and common bile duct stones, regardless of clinical status or diagnostic work-up, and compared laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy procedures in people undergoing laparoscopic cholecystectomy. We excluded other endoscopic or surgical methods of intraoperative clearance of the bile duct, e.g. non-aided intraoperative endoscopic retrograde cholangiopancreatography or laparoscopic choledocholithotomy (surgical incision of the common bile duct for removal of bile duct stones). We used standard methodological procedures recommended by Cochrane. We included five randomised clinical trials with 517 participants (257 underwent a laparoscopic-endoscopic rendezvous technique versus 260 underwent a sequential approach), which fulfilled our inclusion criteria and provided data for analysis. Trial participants were scheduled for laparoscopic cholecystectomy because of suspected cholecysto-choledocholithiasis. Male/female ratio was 0.7; age of men and women ranged from 21 years to 87

Endoscopic inspection of steam turbines

International Nuclear Information System (INIS)

Maliniemi, H.; Muukka, E.

1990-01-01

For over ten years, Imatran Voima Oy (IVO) has developed, complementary inspection methods for steam turbine condition monitoring, which can be applied both during operation and shutdown. One important method used periodically during outages is endoscopic inspection. The inspection is based on the method where the internal parts of the turbine is inspected through access borings with endoscope and where the magnified figures of the internal parts is seen on video screen. To improve inspection assurance, an image-processing based pattern recognition method for cracks has been developed for the endoscopic inspection of turbine blades. It is based on the deduction conditions derived from the crack shape. The computer gives an alarm of a crack detection and prints a simulated image of the crack, which is then checked manually

Endoscopic Palliation for Pancreatic Cancer

Directory of Open Access Journals (Sweden)

Mihir Bakhru

2011-04-01

Full Text Available Pancreatic cancer is devastating due to its poor prognosis. Patients require a multidisciplinary approach to guide available options, mostly palliative because of advanced disease at presentation. Palliation including relief of biliary obstruction, gastric outlet obstruction, and cancer-related pain has become the focus in patients whose cancer is determined to be unresectable. Endoscopic stenting for biliary obstruction is an option for drainage to avoid the complications including jaundice, pruritus, infection, liver dysfunction and eventually failure. Enteral stents can relieve gastric obstruction and allow patients to resume oral intake. Pain is difficult to treat in cancer patients and endoscopic procedures such as pancreatic stenting and celiac plexus neurolysis can provide relief. The objective of endoscopic palliation is to primarily address symptoms as well improve quality of life.

Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease

DEFF Research Database (Denmark)

Ainsworth, A P; Rafaelsen, S R; Wamberg, P A

2004-01-01

BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163...

Nordic noir and lifted localities

DEFF Research Database (Denmark)

Hansen, Kim Toft

What I do here is to draw attention to a particular visual quality of recent Nordic noir and to relate the visuality of TV-drama to what I – with a term borrowed from Roland Robertson – dub lifted localites.......What I do here is to draw attention to a particular visual quality of recent Nordic noir and to relate the visuality of TV-drama to what I – with a term borrowed from Roland Robertson – dub lifted localites....

Reduction of Dynamic Loads in Mine Lifting Installations

Science.gov (United States)

Kuznetsov, N. K.; Eliseev, S. V.; Perelygina, A. Yu

2018-01-01

Article is devoted to a problem of decrease in the dynamic loadings arising in transitional operating modes of the mine lifting installations leading to heavy oscillating motions of lifting vessels and decrease in efficiency and reliability of work. The known methods and means of decrease in dynamic loadings and oscillating motions of the similar equipment are analysed. It is shown that an approach based on the concept of the inverse problems of dynamics can be effective method of the solution of this problem. The article describes the design model of a one-ended lifting installation in the form of a two-mass oscillation system, in which the inertial elements are the mass of the lifting vessel and the reduced mass of the engine, reducer, drum and pulley. The simplified mathematical model of this system and results of an efficiency research of an active way of reduction of dynamic loadings of lifting installation on the basis of the concept of the inverse problems of dynamics are given.

Searching for ski-lift injury: an uphill struggle?

Science.gov (United States)

Smartt, Pam; Chalmers, David

2010-03-01

Injuries arising from ski-lift malfunction are rare. Most arise from skier error when embarking or disembarking, or from improper lift operation. A search of the literature failed to uncover any studies focusing specifically on ski-lift injuries. The purpose of this study was to identify and characterise ski-lift injury resulting in hospitalisation and comment on barriers to reporting and reporting omissions. New Zealand hospitalised injury discharges 2000-2005 formed the primary dataset. To aid case identification these data were linked to ACC compensated claims for the same period and the data searched for all hospitalised cases of injury arising from ski-lifts. 44 cases were identified representing 2% of snow-skiing/snowboarding cases. 28 cases (64%) were male and 16 (36%) female, the average age was 32 yrs (range 5-73 yrs). The majority of cases were snow-skiers (35 cases, 80%). Most of the injuries were serious, or potentially so, with 1 case of traumatic pneumothorax, one of pulmonary embolism (after jumping from a ski-lift) and 28 cases sustaining fractures (six to the neck-of-femur, one to the lumbar spine and one to the pubis). ICISS scores for all cases ranged from 1.00 to 0.8182 (probability of dying in hospital 0-18.18%). Only 14 (32%) cases could be easily identified from ICD-10-AM e-codes and activity codes in the discharge summary. The ICD-10-AM external cause code for ski-lift injury V98 ("other specified transport accidents") was only assigned to 39% of cases. The type of ski-lift could only be determined in 24 cases (55%). Copyright 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Alteration of Skin Mechanical Properties in Patients Undergoing Botulinum Toxin Type A Injections of Forehead Rhytides.

Science.gov (United States)

Min, Peiru; Zhang, Zheng; Grassetti, Luca; Perdanasari, Aurelia Trisliana; Torresetti, Matteo; Pu, Zheming; Zhang, Yan; Han, Sheng; Marsili, Riccardo; Zhang, Yi Xin; di Benedetto, Giovanni; Lazzeri, Davide

2016-06-01

Although application of botulinum toxin type A (BTX-A) for the treatment of forehead rhytides has become very popular, the effects of its intramuscular injections on the skin mechanical properties remain unclear. We prospectively investigated the alterations in the mechanical properties of the skin of patients who received intramuscular injections of botulinum toxin A (BTX-A) for forehead rhytides and compared two injection doses. Of the 42 enrolled patients, one randomly assigned half received intramuscular injections of two units (group I), and the other half received four units (group II) of BTX-A in each injection point. The baseline and post-treatment skin mechanical parameters, including gross elasticity (R2), net elasticity (R5), viscoelastic ratio (R6) and biological elasticity (R7), were measured using the Cutometer(®) and compared. Treatment with BTX-A resulted in significant overall alterations in the mechanical properties of skin at the injection sites of both treatment groups during the 16-week period, and no significant differences were observed between groups. Significant decreases in biological elasticity, net elasticity and viscoelasticity properties were observed at 2 weeks follow-up and began to recover at that time. All of the skin mechanical properties recovered to baseline levels by 16 weeks of follow-up in both dosage groups, which indicates that the higher dosage (4 units) did not delay relapse compared to the two-unit dosage. We concluded that intramuscular injections of BTX-A significantly regulated the gross elasticity, net elasticity, functional elasticity and viscoelastic elasticity at the injection point over a radius of 1.5 cm at 2, 4 and 8 weeks follow-up. The alteration in the skin measurements had completely diminished by the 16-week follow-up. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or

Endoscopic management of bile leaks after laparoscopic ...

African Journals Online (AJOL)

Endoscopic management of bile leaks after laparoscopic cholecystectomy. ... endoscopic management at a median of 12 days (range 2 - 104 days) after surgery. Presenting features included intra-abdominal collections with pain in 58 cases ...

21 CFR 880.5510 - Non-AC-powered patient lift.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5510 Non-AC-powered patient lift. (a) Identification. A non-AC-powered patient lift is a hydraulic, battery, or mechanically powered device, either fixed or mobile, used to lift and transport a...

Does team lifting increase the variability in peak lumbar compression in ironworkers?

Science.gov (United States)

Faber, Gert; Visser, Steven; van der Molen, Henk F; Kuijer, P Paul F M; Hoozemans, Marco J M; Van Dieën, Jaap H; Frings-Dresen, Monique H W

2012-01-01

Ironworkers frequently perform heavy lifting tasks in teams of two or four workers. Team lifting could potentially lead to a higher variation in peak lumbar compression forces than lifts performed by one worker, resulting in higher maximal peak lumbar compression forces. This study compared single-worker lifts (25-kg, iron bar) to two-worker lifts (50-kg, two iron bars) and to four-worker lifts (100-kg, iron lattice). Inverse dynamics was used to calculate peak lumbar compression forces. To assess the variability in peak lumbar loading, all three lifting tasks were performed six times. Results showed that the variability in peak lumbar loading was somewhat higher in the team lifts compared to the single-worker lifts. However, despite this increased variability, team lifts did not result in larger maximum peak lumbar compression forces. Therefore, it was concluded that, from a biomechanical point of view, team lifting does not result in an additional risk for low back complaints in ironworkers.

Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

Directory of Open Access Journals (Sweden)

Eun Jeong Gong

2016-09-01

Full Text Available Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions.

Endoscopic Management of Tumor Bleeding from Inoperable Gastric Cancer

Science.gov (United States)

Kim, Young-Il

2015-01-01

Tumor bleeding is not a rare complication in patients with inoperable gastric cancer. Endoscopy has important roles in the diagnosis and primary treatment of tumor bleeding, similar to its roles in other non-variceal upper gastrointestinal bleeding cases. Although limited studies have been performed, endoscopic therapy has been highly successful in achieving initial hemostasis. One or a combination of endoscopic therapy modalities, such as injection therapy, mechanical therapy, or ablative therapy, can be used for hemostasis in patients with endoscopic stigmata of recent hemorrhage. However, rebleeding after successful hemostasis with endoscopic therapy frequently occurs. Endoscopic therapy may be a treatment option for successfully controlling this rebleeding. Transarterial embolization or palliative surgery should be considered when endoscopic therapy fails. For primary and secondary prevention of tumor bleeding, proton pump inhibitors can be prescribed, although their effectiveness to prevent bleeding remains to be investigated. PMID:25844339

The Effect of Midline Corset Platysmaplasty on Degree of Face-lift Flap Elevation During Concomitant Deep-Plane Face-lift: A Cadaveric Study.

Science.gov (United States)

Jacono, Andrew A; Malone, Melanie H

2016-05-01

The evaluation of the effects of midline platysmaplasty concomitant with rhytidectomy. To determine whether midline platysmaplasty limits the degree of lift during deep-plane face-lift. Deep-plane rhytidectomy was performed on 10 cadaveric hemifaces. The redundant skin for excision after performing the face-lift was measured with and without midline platymaplasty. Deep-plane rhytidectomy. The redundant skin was measured preauricularly in the vertical and horizontal dimension, and postauricularly after deep-plane face-lift and after adding a midline platysmaplasty. Concomitant midline platysmaplasty significantly reduced the amount of lift during concomitant deep-plane rhytidectomy preauricularly in the vertical dimension by 40.5% (from 37.0 mm excess skin redraped to 22.0 mm) and postauricularly by 23.9% (from 40.6 mm excess skin redraped to 30.9 mm) (P jawline and midface during rhytidectomy. NA.

Antibiotic prophylaxis for patients undergoing elective endoscopic ...

African Journals Online (AJOL)

Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. M Brand, D Bisoz. Abstract. Background. Antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is controversial. We set out to assess the current antibiotic prescribing practice among ...

Endoscopic Instruments and Electrosurgical Unit for Colonoscopic Polypectomy

OpenAIRE

Park, Hong Jun

2016-01-01

Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characte...

Reinforced orbitotemporal lift: contribution to midface rejuvenation.

Science.gov (United States)

Renó, Waldir Teixeira

2003-02-01

The changes in the aging face occur from progressive ptosis of the skin, fat, and muscle, in conjunction with bone absorption and cartilage atrophy. In the orbital region, hollowness and compartmentalization occur. Conventional face lift procedures correct only the skin flaccidity, and superficial musculoaponeurotic system techniques reposition the skin and platysma without repositioning the middle third of the face, creating an artificial jawline. Subperiosteal rhytidectomy disrupts the anatomy of the periorbita, which gives the patient a certain scarecrow aspect. Composite rhytidectomy associated with brow lift and blepharoplasty may offer better results, with improvement in the malar and orbital regions. The reinforced orbitotemporal lift (ROTEL) is a new procedure in a face lift that allows the orbicularis oculi muscle and all the structures connected to it to be elevated and stretched and the orbitotemporal skin to be raised, repositioning these structures and ending orbital compartmentalization. The result is an impressive improvement in the malar-orbitotemporal region, resulting in a natural and youthful appearance.

Spherical projections and liftings in geometric tomography

DEFF Research Database (Denmark)

Goodey, Paul; Kiderlen, Markus; Weil, Wolfgang

2011-01-01

We consider a variety of integral transforms arising in Geometric Tomography. It will be shown that these can be put into a common framework using spherical projection and lifting operators. These operators will be applied to support functions and surface area measures of convex bodies and to rad......We consider a variety of integral transforms arising in Geometric Tomography. It will be shown that these can be put into a common framework using spherical projection and lifting operators. These operators will be applied to support functions and surface area measures of convex bodies...... and to radial functions of star bodies. We then investigate averages of lifted projections and show that they correspond to self-adjoint intertwining operators. We obtain formulas for the eigenvalues of these operators and use them to ascertain circumstances under which tomographic measurements determine...... the original bodies. This approach via mean lifted projections leads us to some unexpected relationships between seemingly disparate geometric constructions....

Post-endoscopic biliary sphincterotomy bleeding: an interventional radiology approach.

LENUS (Irish Health Repository)

Dunne, Ruth

2013-12-01

Endoscopic sphincterotomy is an integral component of endoscopic retrograde cholangiopancreatography. Post-sphincterotomy hemorrhage is a recognized complication. First line treatment involves a variety of endoscopic techniques performed at the time of sphincterotomy. If these are not successful, transcatheter arterial embolization or open surgical vessel ligation are therapeutic considerations.

Heavy Lift for Exploration: Options and Utilization

Science.gov (United States)

Creech, Steve; Sumrall, Phil

2010-01-01

Every study of exploration capabilities since the Apollo Program has recommended the renewal of a heavy lift launch capability for the United States. NASA is aggressively pursuing that capability. This paper will discuss several aspects of that effort and the potential uses for that heavy lift capability. The need for heavy lift was cited most recent in the findings of the Review of U.S. Human Space Flight Plans Committee. Combined with considerations of launch availability and on-orbit operations, the Committee finds that exploration will benefit from the availability of a heavy-lift vehicle, the report said. In addition, heavy lift would enable the launching of large scientific observatories and more capable deep-space missions. It may also provide benefit in national security applications. The most recent focus of NASA s heavy lift effort is the Ares V cargo launch vehicle, which is part of the Constellation Program architecture for human exploration beyond low Earth orbit (LEO). The most recent point-of-departure configuration of the Ares V was approved during the Lunar Capabilities concept Review (LCCR) in 2008. The Ares V first stage propulsion system consists of a core stage powered by six commercial liquid hydrogen/liquid oxygen (LH2/LOX) RS-68 engines, flanked by two 5.5-segment solid rocket boosters (SRBs) based on the 5-segment Ares I first stage. The boosters use the same Polybutadiene Acrylonitrile (PBAN) propellant as the Space Shuttle. Atop the core stage is the Earth departure stage (EDS), powered by a single J-2X upper stage engine based on the Ares I upper stage engine. The 33-foot-diameter payload shroud can enclose a lunar lander, scientific instruments, or other payloads. Since LCCR, NASA has continued to refine the design through several successive internal design cycles. In addition, NASA has worked to quantify the broad national consensus for heavy lift in ways that, to the extent possible, meet the needs of the user community.

Motor of Lift RSG-GAS Performance Analysis after Repair

International Nuclear Information System (INIS)

Asep-Saepuloh; Yayan-Andriyanto; Yuyut-Suraniyanto

2006-01-01

The out of order an equipment is ordinary natural process happened, above all the equipment be used continually with very old time, as for as out of order can be resulted from kinds of cause. Lift motor out of order can be result by motor is broken or happened the body shorten then affected do not function it the lift, so until done rewinding process. The rewinding is furl to repeat at motor coils. Motor of Lift represent main activator machine turning around shares pulley. Lift Motor will work if there is called in normal operation condition or the moment manual switch if done maintenance. Motor used at lift is motor three phases with two speeds that is low speed and high speed. Rewinding process must be done removed the motor from Lift machine and have to be done by professional workshop. In during function test take place, temperature at coil reach 70 o C (exceeding boundary permitted). After done installation addition thermal at motor coil hence his temperature become normal that is only reach 50 o C. (author)

Endoscopic electrosurgical papillotomy and manometry in biliary tract disease.

Science.gov (United States)

Geenen, J E; Hogan, W J; Shaffer, R D; Stewart, E T; Dodds, W J; Arndorfer, R C

1977-05-09

Endoscopic papillotomy was performed in 13 patients after cholecystectomy for retained or recurrent common bile duct calculi (11 patients) and a clinical picture suggesting papillary stenosis (two patients). Following endoscopic papillotomy, ten of the 11 patients spontaneously passed common bile duct (CBD) stones verified on repeated endoscopic retrograde cholangiopancreatography (ERCP) study. One patient failed to pass a large CBD calculus; one patient experienced cholangitis three months after in inadequate papillotomy and required operative intervention. Endoscopic papillotomy substantially decreased the pressure gradient existing between the CBD and the duodenum in all five patients studied with ERCP manometry. Endoscopic papillotomy is a relatively safe and effective procedure for postcholecystectomy patients with retained or recurrent CBD stones. The majority of CBD stones will pass spontaneously if the papillotomy is adequate.

TCA High Lift Preliminary Assessment

Science.gov (United States)

Wyatt, G. H.; Polito, R. C.; Yeh, D. T.; Elzey, M. E.; Tran, J. T.; Meredith, Paul T.

1999-01-01

This paper presents a TCA (Technology Concept Airplane) High lift Preliminary Assessment. The topics discussed are: 1) Model Description; 2) Data Repeatability; 3) Effect of Inboard L.E. (Leading Edge) Flap Span; 4) Comparison of 14'x22' TCA-1 With NTF (National Transonic Facility) Modified Ref. H; 5) Comparison of 14'x22' and NTF Ref. H Results; 6) Effect of Outboard Sealed Slat on TCA; 7) TCA Full Scale Build-ups; 8) Full Scale L/D Comparisons; 9) TCA Full Scale; and 10) Touchdown Lift Curves. This paper is in viewgraph form.

Huge biloma after endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy

Directory of Open Access Journals (Sweden)

Harith M. Alkhateeb

2015-01-01

Conclusions: (1 Following endoscopic retrograde cholangiopancreatography, a patient’s complaints should not be ignored. (2 A massive biloma can occur due to such procedures. (3 Conservative treatment with minimal invasive technique can prove to be effective.

Evaluation of ceiling lifts: transfer time, patient comfort and staff perceptions.

Science.gov (United States)

Alamgir, Hasanat; Li, Olivia Wei; Yu, Shicheng; Gorman, Erin; Fast, Catherine; Kidd, Catherine

2009-09-01

Mechanical lifting devices have been developed to reduce healthcare worker injuries related to patient handling. The purpose of this study was to evaluate ceiling lifts in comparison to floor lifts based on transfer time, patient comfort and staff perceptions in three long-term care facilities with varying ceiling lift coverage. The time required to transfer or reposition patients along with patient comfort levels were recorded for 119 transfers. Transfers performed with ceiling lifts required on average less time (bed to chair transfers: 156.9 seconds for ceiling lift, 273.6 seconds for floor lift) and were found to be more comfortable for patients. In the three facilities, 143 healthcare workers were surveyed on their perceptions of patient handling tasks and equipment. For both transferring and repositioning tasks, staff preferred to use ceiling lifts and also found them to be less physically demanding. Further investigation is needed on repositioning tasks to ensure safe practice.

Method for radiometric calibration of an endoscope's camera and light source

Science.gov (United States)

Rai, Lav; Higgins, William E.

2008-03-01

An endoscope is a commonly used instrument for performing minimally invasive visual examination of the tissues inside the body. A physician uses the endoscopic video images to identify tissue abnormalities. The images, however, are highly dependent on the optical properties of the endoscope and its orientation and location with respect to the tissue structure. The analysis of endoscopic video images is, therefore, purely subjective. Studies suggest that the fusion of endoscopic video images (providing color and texture information) with virtual endoscopic views (providing structural information) can be useful for assessing various pathologies for several applications: (1) surgical simulation, training, and pedagogy; (2) the creation of a database for pathologies; and (3) the building of patient-specific models. Such fusion requires both geometric and radiometric alignment of endoscopic video images in the texture space. Inconsistent estimates of texture/color of the tissue surface result in seams when multiple endoscopic video images are combined together. This paper (1) identifies the endoscope-dependent variables to be calibrated for objective and consistent estimation of surface texture/color and (2) presents an integrated set of methods to measure them. Results show that the calibration method can be successfully used to estimate objective color/texture values for simple planar scenes, whereas uncalibrated endoscopes performed very poorly for the same tests.

Duodenal diverticular bleeding: an endoscopic challenge

Directory of Open Access Journals (Sweden)

Eduardo Valdivielso-Cortázar

Full Text Available Duodenal diverticula are an uncommon cause of upper gastrointestinal bleeding. Until recently, it was primarily managed with surgery, but advances in the field of endoscopy have made management increasingly less invasive. We report a case of duodenal diverticular bleeding that was endoscopically managed, and review the literature about the various endoscopic therapies thus far described.

Evaluation of robotically controlled advanced endoscopic instruments

NARCIS (Netherlands)

Reilink, Rob; Kappers, Astrid M.L.; Stramigioli, Stefano; Misra, Sarthak

Background Advanced flexible endoscopes and instruments with multiple degrees of freedom enable physicians to perform challenging procedures such as the removal of large sections of mucosal tissue. However, these advanced endoscopes are difficult to control and require several physicians to

Effects of squat lift training and free weight muscle training on maximum lifting load and isolinetic peak torque of young adults without impairments.

Science.gov (United States)

Yeung, S S; Ng, G Y

2000-06-01

Manual lifting is a frequent cause of back injury, and there is no evidence as to which training mode can provide the best training effect for lifting performance and muscle force. The purpose of this study was to examine the effects of a squat lift training and a free weight muscle training program on the maximum lifting load and isokinetic peak torque in subjects without known neuromuscular or musculoskeletal impairments. Thirty-six adults (20 male, 16 female) without known neuromuscular or musculoskeletal impairments participated. The subjects' mean age was 21.25 years (SD=1.16, range=20-24). Subjects were divided into 3 groups. Subjects in group 1 (n=12) performed squat lift training. Subjects in group 2 (n=12) participated in free weight resistance training of their shoulder abductors, elbow flexors, knee extensors and trunk extensors. Subjects in group 3 (n=12) served as controls. The maximum lifting load and isokinetic peak torques of the trunk extensors, knee extensors, elbow flexors, and shoulder abductors of each subject were measured before and after the study. Training was conducted on alternate days for 4 weeks, with an initial load of 80% of each subject's maximum capacity and with the load increased by 5% weekly. All groups were comparable for all measured variables before the study. After 4 weeks, subjects in groups 1 and 2 demonstrated more improvement in maximum lifting load and isokinetic peak torque of the back extensors compared with the subjects in group 3, but the 2 training groups were not different. The findings demonstrate that both squat lift and free weight resistance training are equally effective in improving the lifting load and isokinetic back extension performance of individuals without impairments.

Prediction of peak back compressive forces as a function of lifting speed and compressive forces at lift origin and destination - a pilot study.

Science.gov (United States)

Greenland, Kasey O; Merryweather, Andrew S; Bloswick, Donald S

2011-09-01

To determine the feasibility of predicting static and dynamic peak back-compressive forces based on (1) static back compressive force values at the lift origin and destination and (2) lifting speed. Ten male subjects performed symmetric mid-sagittal floor-to-shoulder, floor-to-waist, and waist-to-shoulder lifts at three different speeds (slow, medium, and fast), and with two different loads (light and heavy). Two-dimensional kinematics and kinetics were captured. Linear regression analyses were used to develop prediction equations, the amount of predictability, and significance for static and dynamic peak back-compressive forces based on a static origin and destination average (SODA) back-compressive force. Static and dynamic peak back-compressive forces were highly predicted by the SODA, with R(2) values ranging from 0.830 to 0.947. Slopes were significantly different between slow and fast lifting speeds (p assessments at the origin and destination of a lifting task. This could be valuable for enhancing job design and analysis in the workplace and for large-scale studies where a full analysis of each lifting task is not feasible.

EMG Processing Based Measures of Fatigue Assessment during Manual Lifting

Directory of Open Access Journals (Sweden)

E. F. Shair

2017-01-01

Full Text Available Manual lifting is one of the common practices used in the industries to transport or move objects to a desired place. Nowadays, even though mechanized equipment is widely available, manual lifting is still considered as an essential way to perform material handling task. Improper lifting strategies may contribute to musculoskeletal disorders (MSDs, where overexertion contributes as the highest factor. To overcome this problem, electromyography (EMG signal is used to monitor the workers’ muscle condition and to find maximum lifting load, lifting height and number of repetitions that the workers are able to handle before experiencing fatigue to avoid overexertion. Past researchers have introduced several EMG processing techniques and different EMG features that represent fatigue indices in time, frequency, and time-frequency domain. The impact of EMG processing based measures in fatigue assessment during manual lifting are reviewed in this paper. It is believed that this paper will greatly benefit researchers who need a bird’s eye view of the biosignal processing which are currently available, thus determining the best possible techniques for lifting applications.

EMG Processing Based Measures of Fatigue Assessment during Manual Lifting

Science.gov (United States)

Marhaban, M. H.; Abdullah, A. R.

2017-01-01

Manual lifting is one of the common practices used in the industries to transport or move objects to a desired place. Nowadays, even though mechanized equipment is widely available, manual lifting is still considered as an essential way to perform material handling task. Improper lifting strategies may contribute to musculoskeletal disorders (MSDs), where overexertion contributes as the highest factor. To overcome this problem, electromyography (EMG) signal is used to monitor the workers' muscle condition and to find maximum lifting load, lifting height and number of repetitions that the workers are able to handle before experiencing fatigue to avoid overexertion. Past researchers have introduced several EMG processing techniques and different EMG features that represent fatigue indices in time, frequency, and time-frequency domain. The impact of EMG processing based measures in fatigue assessment during manual lifting are reviewed in this paper. It is believed that this paper will greatly benefit researchers who need a bird's eye view of the biosignal processing which are currently available, thus determining the best possible techniques for lifting applications. PMID:28303251

Cost Benefit Analysis of Boat Lifts

Science.gov (United States)

2014-09-01

associated with commercial boat lifts were obtained through a market survey based on products advertised for sale to the general public. The information...from the market survey and knowledge of specific boat maintenance items susceptible to cost reduction using a boat lift were then compared to identify...transferred to the Boat Inventory Manager ( BIM ). Custodians are responsible for maintaining boats and small craft in good working order at all times

[Current Status of Endoscopic Resection of Early Gastric Cancer in Korea].

Science.gov (United States)

Jung, Hwoon Yong

2017-09-25

Endoscopic resection (Endoscopic mucosal resection [EMR] and endoscopic submucosal dissection [ESD]) is already established as a first-line treatment modality for selected early gastric cancer (EGC). In Korea, the number of endoscopic resection of EGC was explosively increased because of a National Cancer Screening Program and development of devices and techniques. There were many reports on the short-term and long-term outcomes after endoscopic resection in patients with EGC. Long-term outcome in terms of recurrence and death is excellent in both absolute and selected expanded criteria. Furthermore, endoscopic resection might be positioned as primary treatment modality replacing surgical gastrectomy. To obtain these results, selection of patients, perfect en bloc procedure, thorough pathological examination of resected specimen, accurate interpretation of whole process of endoscopic resection, and rational strategy for follow-up is necessary.

SAGD gas lift completions and optimization : a field case study at Surmont

Energy Technology Data Exchange (ETDEWEB)

Handfield, T.C.; Nations, T.; Noonan, S.G. [ConocoPhillips Co., Houston, TX (United States)

2008-10-15

Gas lift completions for steam assisted gravity drainage (SAGD) producers are unique. Because of the extreme temperatures of the downhole environment, conventional gas lift valves and mandrels with a packer completion cannot be used. Most gas lifts enter the production stream downhole through open-ended tubing or nozzles, which if not properly sized could result in operational issues, such as fluid/gas slugging and pressure instabilities which negatively effect the overall lift efficiency. ConocoPhillips performed a study in 2006 to design a gas lift system for the Surmont SAGD development that would allow better control of lift gas into the production string. The wells completed with gas lift were placed on production in 2007. This paper discussed the data collection effort and analysis completed to determine the efficiency of the two types of gas lift nozzles used in the completions. It also presented the methodology for optimization of SAGD gas lift systems and recommendations for future improvement. Background information on the Surmont oil sands project, located southeast of Fort McMurray in the Athabasca oil sands was included along with a historical perspective of the SAGD Surmont gas lift experience followed by a discussion of the Surmont initial gas lift design. Last, the paper discussed the Surmont gas lift start-up and optimization. It was concluded that installation of backcheck valves in coil tubing used for gas lift may mitigate plugging issues on initial start-up and following periods of shut-down. 5 refs., 10 figs.

Toward a new nanoLIFT transfer process

International Nuclear Information System (INIS)

Mezel, C.; Hallo, L.; Breil, J.; Souquet, A.; Guillemot, F.; Bourgeade, A.; Hebert, D.; Saut, O.

2010-01-01

The Laser Induced Forward Transfer (LIFT) is a direct-write technique used to print biological materials such as living cells or molecules. During the LIFT process, the biomaterial to be printed is deposited on a target submitted to a nanosecond laser shot, and the ejecta are collected onto a receiving substrate. Despite the several advantages of this technique (control of the propelled quantity, no spoiling of the substrate), it remains difficult to be employed due to the high sensitivity of its control parameters. Recently, Duocastella published some experimental results which exhibit the real-time jet formation process, under conditions similar to those present in the LIFT process. In the first Section, a typical experimental setup for LIFT process is presented. Then, simulations of Duocastella's and Guillemot's experiments are carried out to model the jet formation in water when irradiated by an ultraviolet nanosecond laser pulse. The 2D axisymmetric hydrodynamic code CHIC (Code d'Hydrodynamique et d'Implosion du CELIA) is used for these simulations with included equations of state (EOS) to take into account the behavior of water under standard conditions. Finally, an improvement of the LIFT technique which consists in using femtosecond lasers instead of nanosecond ones, is presented. It would allow to process smaller bioelements and to control the jet diameter, as it is directly related to the laser beam waist.

Endoscopic Management of Peri-Pancreatic Fluid Collections.

Science.gov (United States)

Yip, Hon Chi; Teoh, Anthony Yuen Bun

2017-09-15

In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.

Airfoil design: Finding the balance between design lift and structural stiffness

DEFF Research Database (Denmark)

Bak, Christian; Gaudern, Nicholas; Zahle, Frederik

2014-01-01

When upscaling wind turbine blades there is an increasing need for high levels of structural efficiency. In this paper the relationships between the aerodynamic characteristics; design lift and lift-drag ratio; and the structural characteristics were investigated. Using a unified optimization setup......, the design lift coefficient increases if the box length reduces and at the same time the relative thickness increases. Even though the conclusions are specific to the airfoil design approach used, the study indicated that an increased design lift required slightly higher relative thickness compared...... to airfoils with lower design lift to maintain the flapwise stiffness. Also, the study indicated that the lift-drag ratio as a function of flapwise stiffness was relatively independent of the airfoil design with a tendency that the lift-drag ratio decreased for large box lengths. The above conclusions were...

Airfoil design: Finding the balance between design lift and structural stiffness

International Nuclear Information System (INIS)

Bak, Christian; Gaudern, Nicholas; Zahle, Frederik; Vronsky, Tomas

2014-01-01

When upscaling wind turbine blades there is an increasing need for high levels of structural efficiency. In this paper the relationships between the aerodynamic characteristics; design lift and lift-drag ratio; and the structural characteristics were investigated. Using a unified optimization setup, airfoils were designed with relative thicknesses between 18% and 36%, a structural box height of 85% of the relative thickness, and varying box widths in chordwise direction between 20% and 40% of the chord length. The results from these airfoil designs showed that for a given flapwise stiffness, the design lift coefficient increases if the box length reduces and at the same time the relative thickness increases. Even though the conclusions are specific to the airfoil design approach used, the study indicated that an increased design lift required slightly higher relative thickness compared to airfoils with lower design lift to maintain the flapwise stiffness. Also, the study indicated that the lift-drag ratio as a function of flapwise stiffness was relatively independent of the airfoil design with a tendency that the lift-drag ratio decreased for large box lengths. The above conclusions were supported by an analysis of the three airfoil families Riso-C2, DU and FFA, where the lift-drag ratio as a function of flapwise stiffness was decreasing, but relatively independent of the airfoil design, and the design lift coefficient was varying depending on the design philosophy. To make the analysis complete also design lift and lift- drag ratio as a function of edgewise and torsional stiffness were shown

Soccer Ball Lift Coefficients via Trajectory Analysis

Science.gov (United States)

Goff, John Eric; Carre, Matt J.

2010-01-01

We performed experiments in which a soccer ball was launched from a machine while two high-speed cameras recorded portions of the trajectory. Using the trajectory data and published drag coefficients, we extracted lift coefficients for a soccer ball. We determined lift coefficients for a wide range of spin parameters, including several spin…

Frontoplastia endoscópica: três anos de experiência Endoscopic frontoplasty: 3-year experience

Directory of Open Access Journals (Sweden)

Lucas Gomes Patrocínio

2006-10-01

Full Text Available A frontoplastia endoscópica (FE representa um significativo avanço para a elevação das sobrancelhas, tendo substituído a técnica coronal clássica. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de FE no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. PACIENTES E MÉTODOS: De janeiro de 2001 a janeiro de 2004, 67 pacientes foram submetidos à FE, sendo que 7 à "técnica dos triângulos". As idades variaram entre 38 a 59 anos (média de 48,3 anos, sendo 65 (97% do sexo feminino. RESULTADOS: Destes, 56 pacientes apresentaram resultado satisfatório, 2 apresentaram déficit estético notado pelo cirurgião e pelo paciente. Dos 7 pacientes submetidos à "técnica dos triângulos", todos apresentaram resultado satisfatório. Todos apresentaram melhora da ptose lateral do terço lateral e glabelar das sobrancelhas e diminuição das rugas verticais e frontais. A cirurgia revisional foi necessária em 2 pacientes nos quais ocorreu recorrência da ptose. Houve um paciente que apresentou paralisia do ramo frontal do nervo facial unilateral. Com a "técnica dos triângulos", 5 pacientes apresentaram cicatriz visível no local das incisões. CONCLUSÃO: A FE é uma técnica que produz resultados satisfatórios na grande maioria dos casos, com baixo índice de complicações.Endoscopic forehead lift (EFL represents a significant progress, even replacing the classic coronal and pretriquial techniques. AIM: To demonstrate a series of cases and to evaluate results and complications with EFL in the Department of Otorhinolaryngology of the Federal University of Uberlândia. MATERIALS AND METHODS: From January 2001 to January 2004, 67 patients were submitted to EFL, and 7 of these were submitted to the so called "triangles technique". Their ages ranged between 38 and 59 years; and 65 (97% were females. RESULTS: Of these, 56 patients presented satisfactory result and 2 presented aesthetic

Endoscopic management of peripancreatic fluid collections.

Science.gov (United States)

Goyal, Jatinder; Ramesh, Jayapal

2015-07-01

Peripancreatic fluid collections are a well-known complication of pancreatitis and can vary from fluid-filled collections to entirely necrotic collections. Although most of the fluid-filled pseudocysts tend to resolve spontaneously with conservative management, intervention is necessary in symptomatic patients. Open surgery has been the traditional treatment modality of choice though endoscopic, laparoscopic and transcutaneous techniques offer alternative drainage approaches. During the last decade, improvement in endoscopic ultrasound technology has enabled real-time access and drainage of fluid collections that were previously not amenable to blind transmural drainage. This has initiated a trend towards use of this modality for treatment of pseudocysts. In this review, we have summarised the existing evidence for endoscopic drainage of peripancreatic fluid collections from published studies.

Neurologic disorders associated with weight lifting and bodybuilding.

Science.gov (United States)

Busche, Kevin

2009-02-01

Weight lifting and other forms of strength training are becoming more common because of an increased awareness of the need to maintain individual physical fitness. Emergency room data indicate that injuries caused by weight training have become more universal over time, likely because of increased participation rates. Neurologic injuries can result from weight lifting and related practices. Although predominantly peripheral nervous system injuries have been described, central nervous system disease may also occur. This article illustrates the types of neurologic disorders associated with weight lifting.

Utilidad del colgajo frontal en la reconstrucción nasal Usefulness of the forehead flap in the nasal reconstruction

Directory of Open Access Journals (Sweden)

Julio César Gálvez Chávez

2009-03-01

Full Text Available INTRODUCCIÓN. La nariz constituye el centro estético de la cara y cualquier deformidad en ella afecta de modo importante a la armonía facial. Este estudio tuvo como objetivo caracterizar las experiencias en reconstrucción nasal con colgajo frontal en pacientes con defectos anatómicos de la nariz, como consecuencia fundamentalmente de una cirugía oncológica. MÉTODOS. Se realizó un estudio descriptivo, prospectivo, para caracterizar la experiencia de la reconstrucción nasal con colgajo frontal en pacientes con defectos nasales, atendidos en el Hospital «Hermanos Ameijeiras» y en el Instituto Nacional de Oncología y Radiobiología, entre junio de 1999 y mayo de 2007. RESULTADOS. Destacó que el motivo más frecuente de reconstrucción fue la lesión neoplásica, con igual número de pacientes afectados por carcinoma basocelular y epidermoide. El ala nasal fue la zona más afectada y se presentó recidiva tumoral en 5 pacientes. En todos los casos se pudo crear una cubierta externa al defecto y el diseño oblicuo fue el más utilizado. Se reconstruyó la cubierta interna nasal fundamentalmente con injerto de piel total y el soporte nasal, mayormente con injertos cartilaginosos de la concha auricular. Todos los colgajos frontales se mantuvieron vitales después de su desconexión en el segundo tiempo quirúrgico. El cierre directo de la zona donante fue el más utilizado y en algunos casos se logró con la utilización de expansión tisular. Se realizó un tercer tiempo de remodelación en los pacientes que lo necesitaron. Las complicaciones no afectaron al resultado final de la reconstrucción. CONCLUSIONES. Se demostró la utilidad y vigencia del colgajo frontal en la reconstrucción nasal.ABSTRACT INTRODUCTION. The nose is the aesthetic center of the face and any deformity in it significantly affects facial harmony. This study was aimed at characterizing the experiences in nasal reconstruction with forehead flap in patients with

Nasal encephalocele: endoscopic excision with anesthetic consideration.

Science.gov (United States)

Abdel-Aziz, Mosaad; El-Bosraty, Hussam; Qotb, Mohamed; El-Hamamsy, Mostafa; El-Sonbaty, Mohamed; Abdel-Badie, Hazem; Zynabdeen, Mustapha

2010-08-01

Nasal encephalocele may presents as a nasal mass, its treatment is surgical and it should be done early in life. When removal is indicated, there are multiple surgical approaches; including lateral rhinotomy, a transnasal approach and a coronal flap approach. However, the treatment of a basal intranasal encephalocele using transnasal endoscopic approach could obviates the possible morbidity associated with other approaches. The aim of this study was to evaluate the efficacy of endoscopic removal of intranasal encephalocele, also to document the role of anesthetist in the operative and postoperative periods. Nine cases with nasal encephalocele were included in this study; CT and/or MRI were used in their examination. The lesions were removed via transnasal endoscopic approach. Preoperative evaluation, intervention and postoperative follow-up were presented with discussion of anesthesia used for those children. The lesions of all patients were removed successfully with no recurrence through the follow-up period of at least 21 months. No cases showed morbidity or mortality intra- or post-operatively. Endoscopic excision of intranasal encephalocele is an effective method with high success rate. Anesthetist plays an important role in the operative and postoperative period, even during the endoscopic follow up; sedation of the children is usually needed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Transanal endoscopic microsurgery: a New Zealand experience.

Science.gov (United States)

Bloomfield, Ian; Van Dalen, Roelof; Lolohea, Simione; Wu, Linus

2017-12-03

Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted. Supportive follow-up data were sourced from patient records and from local centres around New Zealand. A total of 137 procedures were performed over the study period, with five being repeat procedures. Procedures were mostly performed for benign lesions (66.4%) with an overall complication rate of 15.3%, only five of which were Clavien-Dindo grade III (3.6%). Our local recurrence rate after resection of benign lesions was 5.1%. Our data set demonstrates the TEMS procedure to be safe compared to radical resection (total mesorectal excision) for sessile rectal lesions. Close endoscopic follow-up is recommended, especially for close or incomplete margins. Good therapeutic results can be obtained for appropriately selected early malignant lesions. TEMS provides better oncological results than endoscopic mucosal resection or transanal excision. © 2017 Royal Australasian College of Surgeons.

Per-oral endoscopic myotomy (POEM) for esophageal achalasia.

Science.gov (United States)

Pescarus, Radu; Shlomovitz, Eran; Swanstrom, Lee L

2014-01-01

Per-oral endoscopic myotomy (POEM) is a new minimally invasive endoscopic treatment for achalasia. Since the first modern human cases were published in 2008, around 2,000 cases have been performed worldwide. This technique requires advanced endoscopic skills and a learning curve of at least 20 cases. POEM is highly successful with over 90 % improvement in dysphagia while offering patients the advantage of a low impact endoscopic access. The main long-term complication is gastroesophageal reflux (GER) with an estimated incidence of 35 %, similar to the incidence of GER post-laparoscopic Heller with fundoplication. Although POEM represents a paradigm shift in the treatment of achalasia, more long-term data are clearly needed to further define its role in the treatment algorithm of this rare disease.

Lifting Safety: Tips To Help Prevent Back Injuries

Science.gov (United States)

... Prevent Back Injuries Lifting Safety: Tips to Help Prevent Back Injuries Share Print Back injuries are common problems at work, home, and play. They can be caused by accidents or improper lifting technique. Below are tips to ...

Evaluation of ceiling lifts in health care settings: patient outcome and perceptions.

Science.gov (United States)

Alamgir, Hasanat; Li, Olivia Wei; Gorman, Erin; Fast, Catherine; Yu, Shicheng; Kidd, Catherine

2009-09-01

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the "year" variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation. Copyright (c) 2009, SLACK Incorporated.

Lift mechanics of downhill skiing and snowboarding.

Science.gov (United States)

Wu, Qianhong; Igci, Yesim; Andreopoulos, Yiannis; Weinbaum, Sheldon

2006-06-01

This study is conducted to develop a simplified mathematical model to describe the lift mechanics of downhill skiing and snowboarding, where the lift contributions due to both the transiently trapped air and the compressed solid phase (snow crystals) are determined. To our knowledge, this is the first time that anyone has attempted to realistically estimate the relative contribution of the transiently trapped air to the total lift in skiing and snowboarding. The model uses Shimizu's empirical relation to predict the local variation in Darcy permeability due to the compression of the solid phase. The forces and moments on the skier or snowboarder are used to predict the angle of attack of the planing surface, the penetration depth at the leading edge, and the shift in the center of pressure for two typical snow types, fresh and wind-packed snow. We present numerical solutions for snowboarding and asymptotic analytic solutions for skiing for the case where there are no edging or turning maneuvers. The force and moment balance are then used to develop a theory for control and stability in response to changes in the center of mass as the individual shifts his/her weight. Our model predicts that for fine-grained, windpacked snow that when the velocity (U) of the snowboarder or skier is 20 m.s, approximately 50% of the total lift force is generated by the trapped air for snowboarding and 40% for skiing. For highly permeable fresh powder snow, the lift contribution from the pore air pressure drops substantially. This paper develops a new theoretical framework for analyzing the lift mechanics and stability of skis and snowboards that could have important applications in future ski and snowboard design.

Lift hysteresis at stall as an unsteady boundary-layer phenomenon

Science.gov (United States)

Moore, Franklin K

1956-01-01

Analysis of rotating stall of compressor blade rows requires specification of a dynamic lift curve for the airfoil section at or near stall, presumably including the effect of lift hysteresis. Consideration of the magnus lift of a rotating cylinder suggests performing an unsteady boundary-layer calculation to find the movement of the separation points of an airfoil fixed in a stream of variable incidence. The consideration of the shedding of vorticity into the wake should yield an estimate of lift increment proportional to time rate of change of angle of attack. This increment is the amplitude of the hysteresis loop. An approximate analysis is carried out according to the foregoing ideas for a 6:1 elliptic airfoil at the angle of attack for maximum lift. The assumptions of small perturbations from maximum lift are made, permitting neglect of distributed vorticity in the wake. The calculated hysteresis loop is counterclockwise. Finally, a discussion of the forms of hysteresis loops is presented; and, for small reduced frequency of oscillation, it is concluded that the concept of a viscous "time lag" is appropriate only for harmonic variations of angle of attack with time at mean conditions other than maximum lift.

New developments in endoscopic treatment of chronic pancreatitis.

Science.gov (United States)

Didden, P; Bruno, M; Poley, J W

2012-12-01

The aim of endoscopic therapy of chronic pancreatitis (CP) is to treat pain by draining the pancreatic duct or managing loco-regional complications. Recent decennia were characterized by continuous improvement of endoscopic techniques and devices, resulting in a better clinical outcome. Novel developments now also provide the opportunity to endoscopically treat refractory CP-related complications. Especially suboptimal surgical candidates could potentially benefit from these new developments, consequently avoiding invasive surgery. The use of fully covered self-expandable metal stents (SEMS) has been explored in pancreatic and CP-related biliary duct strictures, resistant to conventional treatment with plastic endoprotheses. Furthermore, endosonography-guided transmural drainage of the main pancreatic duct via duct-gastrostomy is an alternative treatment option in selected cases. Pancreatic pseudocysts represent an excellent indication for endoscopic therapy with some recent case series demonstrating effective drainage with the use of a fully covered SEMS. Although results of these new endoscopic developments are promising, high quality randomized trials are required to determine their definite role in the management of chronic pancreatitis.

Surgical management of failed endoscopic treatment of pancreatic disease.

Science.gov (United States)

Evans, Kimberly A; Clark, Colby W; Vogel, Stephen B; Behrns, Kevin E

2008-11-01

Endoscopic therapy of acute and chronic pancreatitis has decreased the need for operative intervention. However, a significant proportion of patients treated endoscopically require definitive surgical management for persistent symptoms. Our aim was to determine which patients are likely to fail with endoscopic therapy, and to assess the clinical outcome of surgical management. Patients were identified using ICD-9 codes for pancreatic disease as well as CPT codes for endoscopic therapy followed by surgery. Patients with documented acute or chronic pancreatitis treated endoscopically prior to surgical therapy were included (N = 88). The majority of patients (65%) exhibited chronic pancreatitis due to alcohol abuse. Common indicators for surgery were: persistent symptoms, anatomy not amenable to endoscopic treatment and unresolved common bile duct or pancreatic duct strictures. Surgical salvage procedures included internal drainage of a pseudocyst or an obstructed pancreatic duct (46%), debridement of peripancreatic fluid collections (25%), and pancreatic resection (31%). Death occurred in 3% of patients. The most common complications were hemorrhage (16%), wound infection (13%), and pulmonary complications (11%). Chronic pancreatitis with persistent symptoms is the most common reason for pancreatic surgery following endoscopic therapy. Surgical salvage therapy can largely be accomplished by drainage procedures, but pancreatic resection is common. These complex procedures can be performed with acceptable mortality but also with significant risk for morbidity.

Calibration procedures of the Tore-Supra infrared endoscopes

Science.gov (United States)

Desgranges, C.; Jouve, M.; Balorin, C.; Reichle, R.; Firdaouss, M.; Lipa, M.; Chantant, M.; Gardarein, J. L.; Saille, A.; Loarer, T.

2018-01-01

Five endoscopes equipped with infrared cameras working in the medium infrared range (3-5 μm) are installed on the controlled thermonuclear fusion research device Tore-Supra. These endoscopes aim at monitoring the plasma facing components surface temperature to prevent their overheating. Signals delivered by infrared cameras through endoscopes are analysed and used on the one hand through a real time feedback control loop acting on the heating systems of the plasma to decrease plasma facing components surface temperatures when necessary, on the other hand for physics studies such as determination of the incoming heat flux . To ensure these two roles a very accurate knowledge of the absolute surface temperatures is mandatory. Consequently the infrared endoscopes must be calibrated through a very careful procedure. This means determining their transmission coefficients which is a delicate operation. Methods to calibrate infrared endoscopes during the shutdown period of the Tore-Supra machine will be presented. As they do not allow determining the possible transmittances evolution during operation an in-situ method is presented. It permits the validation of the calibration performed in laboratory as well as the monitoring of their evolution during machine operation. This is possible by the use of the endoscope shutter and a dedicated plasma scenario developed to heat it. Possible improvements of this method are briefly evoked.

Reconstruction of the forehead acoustic properties in an Indo-Pacific humpback dolphin (Sousa chinensis), with investigation on the responses of soft tissue sound velocity to temperature.

Science.gov (United States)

Song, Zhongchang; Zhang, Yu; Berggren, Per; Wei, Chong

2017-02-01

Computed tomography (CT) imaging and ultrasound experimental measurements were combined to reconstruct the acoustic properties (density, velocity, and impedance) of the head from a deceased Indo-Pacific humpback dolphin (Sousa chinensis). The authors extracted 42 soft forehead tissue samples to estimate the sound velocity and density properties at room temperature, 25.0  °C. Hounsfield Units (HUs) of the samples were read from CT scans. Linear relationships between the tissues' HUs and velocity, and HUs and density were revealed through regression analyses. The distributions of the head acoustic properties at axial, coronal, and sagittal cross sections were reconstructed, suggesting that the forehead soft tissues were characterized by low-velocity in the melon, high-velocity in the muscle and connective tissues. Further, the sound velocities of melon, muscle, and connective tissue pieces were measured under different temperatures to investigate tissues' velocity response to temperature. The results demonstrated nonlinear relationships between tissues' sound velocity and temperature. This study represents a first attempt to provide general information on acoustic properties of this species. The results could provide meaningful information for understanding the species' bioacoustic characteristics and for further investigation on sound beam formation of the dolphin.

Quadratic Interpolation and Linear Lifting Design

Directory of Open Access Journals (Sweden)

Joel Solé

2007-03-01

Full Text Available A quadratic image interpolation method is stated. The formulation is connected to the optimization of lifting steps. This relation triggers the exploration of several interpolation possibilities within the same context, which uses the theory of convex optimization to minimize quadratic functions with linear constraints. The methods consider possible knowledge available from a given application. A set of linear equality constraints that relate wavelet bases and coefficients with the underlying signal is introduced in the formulation. As a consequence, the formulation turns out to be adequate for the design of lifting steps. The resulting steps are related to the prediction minimizing the detail signal energy and to the update minimizing the l2-norm of the approximation signal gradient. Results are reported for the interpolation methods in terms of PSNR and also, coding results are given for the new update lifting steps.

Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

Science.gov (United States)

Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

2017-02-01

Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

Repair of an Endoscopic Retrograde Cholangiopancreatography-Related Large Duodenal Perforation Using Double Endoscopic Band Ligation and Endoclipping

Directory of Open Access Journals (Sweden)

Keunmo Kim

2017-03-01

Full Text Available Endoscopic closure techniques have been introduced for the repair of duodenal wall perforations that occur during endoscopic retrograde cholangiopancreatography (ERCP. We report a case of successful repair of a large duodenal wall perforation by using double endoscopic band ligation (EBL and an endoclip. Lateral duodenal wall perforation occurred during ERCP in a 93-year-old woman with acute calculous cholangitis. We switched to a forward endoscope that had a transparent band apparatus. A 2.0-cm oval-shaped perforation was found at the lateral duodenal wall. We repaired the perforation by sequentially performing double EBL and endoclipping. The first EBL was performed at the proximal edge of the perforation orifice, and two-thirds of the perforation were repaired. The second EBL, which also included the contents covered under the first EBL, repaired the defect almost completely. Finally, to account for the possible presence of a residual perforation, an endoclip was applied at the distal end of the perforation. The detection and closure of the perforation were completed within 10 minutes. We suggest that double EBL is an effective method for closure.

Middle Cerebral Artery, Ophthalmic Artery, and Multibranch Retinal Vessel Occlusion After Cosmetic Autologous Fat Transfer to Forehead.

Science.gov (United States)

Roshandel, Danial; Soheilian, Masoud; Pakravan, Mohammad; Aghayan, Sara; Peyman, Gholam A

2015-05-01

A 65-year-old woman with left hemiparesis and sudden loss of visual acuity in her right eye presented a few hours after cosmetic injection of autologous fat to her forehead. Right eye visual acuity was no light perception. Funduscopy revealed widespread retinal whitening and multibranch retinal vessel occlusion. Fluorescein angiography showed markedly delayed choroidal and retinal filling together with occlusion of multiple branches of retinal arteries and veins. On magnetic resonance imaging of the brain, multiple lesions compatible with recent infarction were detected. The authors diagnosed multibranch retinal artery and vein occlusion in the right ophthalmic and middle cerebral arteries due to fat emboli. This case emphasizes the need to reevaluate the safety of such aesthetic procedures, particularly in the facial zone to prevent devastating complications. Copyright 2015, SLACK Incorporated.

Evaluation of the tip-bending response in clinically used endoscopes

NARCIS (Netherlands)

Rozeboom, Esther; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo Adriaan Maria Johannes

Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current

Evaluation of the tip-bending response in clinically used endoscopes

NARCIS (Netherlands)

Rozeboom, Esther D.; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo A. M. J.

2016-01-01

Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current

LIFT11 linnas

Index Scriptorium Estoniae

2010-01-01

Tallinn 2011 programmi kuuluva installatsioonide festivali "Lift11" avalikule ideekonkursile esitati 129 tööd, välja valiti 17. Tutvustatakse Maarja Kase ja Ralf Lõokese tööd "L", Tomomi Hayashi tööd "Merele!", Toomas Paaveri, Teele Pehki ja Triin Talki tööd "Kalarand"

Lifting bloody footwear impressions using alginate casts followed by chemical enhancement.

Science.gov (United States)

Wiesner, Sarena; Izraeli, Elad; Shor, Yaron; Domb, Avi

2013-05-01

A method for lifting bloody footwear impressions using alginate casts and enhancing the lifted impressions with amido black is presented. On rough or dark substrates, background interferences may conceal significant details of footwear impressions. Illumination with alternative light sources and chemically enhancing the bloody footwear impressions may reveal additional details, but sometimes, lifting footwear impressions prior to enhancing is the only way to expose hidden details (by using blood reagents not adequate on the original). Several cast formulations were tested for lifting the footwear impressions. The best results were achieved using Aroma fine®. Enhancement of the footwear impressions was attempted with several reagents prior to lifting, during the casting process, and on the lifted footwear impressions. Applying amido black to footwear impressions lifted with alginate produced the sharpest and most detailed footwear impressions. Alginate castings followed by chemical enhancement with amido black may produce high-quality footwear impressions for comparison. © 2013 American Academy of Forensic Sciences.

Micromotor endoscope catheter for in vivo, ultrahigh-resolution optical coherence tomography

Science.gov (United States)

Herz, P. R.; Chen, Y.; Aguirre, A. D.; Schneider, K.; Hsiung, P.; Fujimoto, J. G.; Madden, K.; Schmitt, J.; Goodnow, J.; Petersen, C.

2004-10-01

A distally actuated, rotational-scanning micromotor endoscope catheter probe is demonstrated for ultrahigh-resolution in vivo endoscopic optical coherence tomography (OCT) imaging. The probe permits focus adjustment for visualization of tissue morphology at varying depths with improved transverse resolution compared with standard OCT imaging probes. The distal actuation avoids nonuniform scanning motion artifacts that are present with other probe designs and can permit a wider range of imaging speeds. Ultrahigh-resolution endoscopic imaging is demonstrated in a rabbit with micromotor endoscope catheter probe promises to improve OCT imaging performance in future endoscopic imaging applications.

Accuracy of pulse oximetry in detection of oxygen saturation in patients admitted to the intensive care unit of heart surgery: comparison of finger, toe, forehead and earlobe probes.

Science.gov (United States)

Seifi, Sohila; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Najafi, Farid

2018-01-01

Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery. In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses. Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes. The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery. Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018-03-19 with reference IRCT20100913004736N22. "Retrospectively registered."

Endoscopic and Photodynamic Therapy of Cholangiocarcinoma.

Science.gov (United States)

Meier, Benjamin; Caca, Karel

2016-12-01

Most patients with cholangiocarcinoma (CCA) have unresectable disease. Endoscopic bile duct drainage is one of the major objectives of palliation of obstructive jaundice. Stent implantation using endoscopic retrograde cholangiography is considered to be the standard technique. Unilateral versus bilateral stenting is associated with different advantages and disadvantages; however, a standard approach is still not defined. As there are various kinds of stents, there is an ongoing discussion on which stent to use in which situation. Palliation of obstructive jaundice can be augmented through the use of photodynamic therapy (PDT). Studies have shown a prolonged survival for the combinations of PDT and different stent applications as well as combinations of PDT and additional systemic chemotherapy. More well-designed studies are needed to better evaluate and standardize endoscopic treatment of unresectable CCA.

Factors associated with high physical exertion during manual lifting

DEFF Research Database (Denmark)

Andersen, Lars L.; Sundstrup, Emil; Brandt, Mikkel

2018-01-01

BACKGROUND: High physical exertion during work is a risk factor for back pain and long-term sickness absence. OBJECTIVE: To investigate which factors are associated with physical exertion during manual lifting. METHODS: From 14 workplaces across Denmark, 200 blue-collar workers reported perceived...... physical exertion (Borg-CR10) during manual lifting from floor to table height of 5, 10, 20 and 30 kg at the beginning and end of the working day. The workers also responded to a questionnaire and went through testing of isometric back muscle strength. Associations were modelled using logistic regression...... during manual lifting in blue-collar workers. These factors should be considered when planning work with manual lifting for individual workers....

Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series.

Science.gov (United States)

Ecker, J; Perera, N; Ebert, J

2015-02-01

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques. © The Author(s) 2014.

Endoscopic laser-urethroplasty

Science.gov (United States)

Gilbert, Peter

2006-02-01

The objective was to prove the advantage of endoscopic laser-urethroplasty over internal urethrotomy in acquired urethral strictures. Patients and Method: From January, 1996 to June, 2005, 35 patients with a mean age of 66 years were submitted to endoscopic laser-urethroplasty for strictures of either the bulbar (30) or membranous (5) urethra. The operations were carried out under general anesthesia. First of all, the strictures were incised at the 4, 8 and 12 o'clock position by means of a Sachse-urethrotom. Then the scar flap between the 4 and 8 o'clock position was vaporized using a Nd:YAG laser, wavelength 1060 nm and a 600 pm bare fiber, the latter always being in contact with the tissue. The laser worked at 40W power in continuous mode. The total energy averaged 2574 J. An indwelling catheter was kept in place overnight and the patients were discharged the following day. Urinalysis, uroflowmetry and clinical examination were performed at two months after surgery and from then on every six months. Results: No serious complications were encountered. Considering a mean follow-up of 18 months, the average peak flow improved from 7.3 ml/s preoperatively to 18.7 mVs postoperatively. The treatment faded in 5 patients ( 14.3% ) who finally underwent open urethroplasty. Conclusions: Endoscopic laser-urethroplasty yields better short-term results than internal visual urethrotomy. Long-term follow-up has yet to confirm its superiority in the treatment of acquired urethral strictures.

UF{sub 6} cylinder lifting equipment enhancements

Energy Technology Data Exchange (ETDEWEB)

Hortel, J.M. [Martin Marietta Energy Systems, Inc., Piketon, OH (United States)

1991-12-31

This paper presents numerous enhancements that have been made to the Portsmouth lifting equipment to ensure the safe handling of cylinders containing liquid uranium hexafluoride (UF{sub 6}). The basic approach has been to provide redundancy to all components of the lift path so that any one component failure would not cause the load to drop or cause any undesirable movement.

TMI-2 reactor vessel plenum final lift

International Nuclear Information System (INIS)

Wilson, D.C.

1986-01-01

Removal of the plenum assembly from the TMI-2 reactor vessel was necessary to gain access to the core region for defueling. The plenum was lifted from the reactor vessel by the polar crane using three specially designed pendant assemblies. It was then transferred in air to the flooded deep end of the refueling canal and lowered onto a storage stand where it will remain throughout the defueling effort. The lift and transfer were successfully accomplished on May 15, 1985 in just under three hours by a lift team located in a shielded area within the reactor building. The success of the program is attributed to extensive mockup and training activities plus thorough preparations to address potential problems. 54 refs

Endoscopic surgery of the nose and paranasal sinus.

Science.gov (United States)

Palmer, Orville; Moche, Jason A; Matthews, Stanley

2012-05-01

Mucosal preservation is of paramount importance in the diagnosis and surgical management of the sinonasal tract. The endoscope revolutionized the practice of endoscopic nasal surgery. As a result, external sinus surgery is performed less frequently today, and more emphasis is placed on functional endoscopy and preservation of normal anatomy. Endoscopic surgery of the nose and paranasal sinus has provided improved surgical outcomes and has shortened the length of stay in hospital. It has also become a valuable teaching tool. Copyright © 2012 Elsevier Inc. All rights reserved.

Current Status of Peroral Endoscopic Myotomy

OpenAIRE

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic ...

FREIGHT CONTAINER LIFTING STANDARD

Energy Technology Data Exchange (ETDEWEB)

POWERS DJ; SCOTT MA; MACKEY TC

2010-01-13

This standard details the correct methods of lifting and handling Series 1 freight containers following ISO-3874 and ISO-1496. The changes within RPP-40736 will allow better reading comprehension, as well as correcting editorial errors.

Two-dimensional unsteady lift problems in supersonic flight

Science.gov (United States)

Heaslet, Max A; Lomax, Harvard

1949-01-01

The variation of pressure distribution is calculated for a two-dimensional supersonic airfoil either experiencing a sudden angle-of-attack change or entering a sharp-edge gust. From these pressure distributions the indicial lift functions applicable to unsteady lift problems are determined for two cases. Results are presented which permit the determination of maximum increment in lift coefficient attained by an unrestrained airfoil during its flight through a gust. As an application of these results, the minimum altitude for safe flight through a specific gust is calculated for a particular supersonic wing of given strength and wing loading.

Lifted Java: A Minimal Calculus for Translation Polymorphism

DEFF Research Database (Denmark)

Ingesman, Matthias Diehn; Ernst, Erik

2011-01-01

To support roles and similar notions involving multiple views on an object, languages like Object Teams and CaesarJ include mechanisms known as lifting and lowering. These mechanisms connect pairs of objects of otherwise unrelated types, and enables programmers to consider such a pair almost...... of translation polymorphism has not been proved. This paper presents a simple model that extends Featherweight Java with the core operations of translation polymorphism, provides a Coq proof that its type system is sound, and shows that the ambiguity problem associated with the so-called smart lifting mechanism...... can be eliminated by a very simple semantics for lifting....

How to lift a box that is too large to fit between the knees

NARCIS (Netherlands)

Kingma, I.; Faber, G.S.; van Dieen, J.H.

2010-01-01

Many studies compared lifting techniques such as stoop and squat lifting. Results thus far show that when lifting a wide load, high back loads result, irrespective of the lifting technique applied. This study compared four lifting techniques in 11 male subjects lifting wide loads. One of these

Clinical Comparison of Sinus Lift via Summers Osteotomy and Piezosurgery

Directory of Open Access Journals (Sweden)

Mehrdad Radvar

2017-12-01

Full Text Available Introduction: Sinus lift is a process that could be performed by two methods. In the closed sinus lift, hybrid materials enter a suitable position through a created cavity. Afterwards, the materials are pressed without damaging the sinus membrane, and the implants are usually placed at the same time. Closed sinus lift is carried out via osteotomy and piezosurgery, and each of the techniques has certain advantages and limitations. The present study aimed to compare the clinical results of closed sinus lift using the summers osteotomy and piezosurgery. Materials and Methods: In this study, 20 patients requiring dental implants in the posterior segment of the maxilla via sinus lift surgery were randomly divided into two groups. The first group received piezosurgery, and the second group underwent summers osteotomy for sinus lift. Postoperative Schneiderian membrane perforation, inflammation, pain, bone gain, and bone loss were compared between the groups six months after the surgery using Mann-Whitney U test and two-sample t-test. Results: In the groups receiving piezosurgery and summers osteotomy, mean sinus lift was 3.6±0.9 and 4.0±2.2 mm, pain score was 1.1±1.2 and 0.9±0.8, bone gain was 2.2±0.8 and 3.1±1.3 mm, and crestal bone loss was 1.1±1.2 and 0.9±0.8 mm, respectively. Moreover, no Schneiderian membrane perforation was observed in the two methods, and the differences between the groups were not considered significant (P>0.05. Conclusion: According to the results, the clinical outcomes of piezosurgery in sinus lift are similar to those of summers osteotomy. Therefore, piezosurgery could be a proper alternative to summers osteotomy in sinus lift surgery.

Performance and Vibration Analyses of Lift-Offset Helicopters

Directory of Open Access Journals (Sweden)

Jeong-In Go

2017-01-01

Full Text Available A validation study on the performance and vibration analyses of the XH-59A compound helicopter is conducted to establish techniques for the comprehensive analysis of lift-offset compound helicopters. This study considers the XH-59A lift-offset compound helicopter using a rigid coaxial rotor system as a verification model. CAMRAD II (Comprehensive Analytical Method of Rotorcraft Aerodynamics and Dynamics II, a comprehensive analysis code, is used as a tool for the performance, vibration, and loads analyses. A general free wake model, which is a more sophisticated wake model than other wake models, is used to obtain good results for the comprehensive analysis. Performance analyses of the XH-59A helicopter with and without auxiliary propulsion are conducted in various flight conditions. In addition, vibration analyses of the XH-59A compound helicopter configuration are conducted in the forward flight condition. The present comprehensive analysis results are in good agreement with the flight test and previous analyses. Therefore, techniques for the comprehensive analysis of lift-offset compound helicopters are appropriately established. Furthermore, the rotor lifts are calculated for the XH-59A lift-offset compound helicopter in the forward flight condition to investigate the airloads characteristics of the ABC™ (Advancing Blade Concept rotor.

Endoscopic Management of a Primary Duodenal Carcinoid Tumor

Directory of Open Access Journals (Sweden)

Albin Abraham

2012-03-01

Full Text Available Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.

Advances in endoscopic surgery for small animal reproduction.

Science.gov (United States)

Katic, N; Dupré, G

2016-09-01

Although endoscopic surgery entered its "golden era" in the mid-1980s, it is still advancing at a tremendous pace. Novel surgical techniques and devices are continuously developed and applied, and new indications (and/or contraindications) for the use of endoscopic surgery are routinely reported in the literature and subjected to systematic assessments. Although endoscopic surgery (laparoscopy in particular) has already become established as the gold standard in human medicine, it has yet to be proven as a viable alternative to open surgery in the field of veterinary medicine. The advantages of minimally invasive surgery include better intra-operative visualization, reduced postoperative pain, reduced scar formation and increased postoperative mobility. Therefore, it is reasonable to expect that the application of this will continue to expand. Small animal reproduction, a field within the broad discipline of veterinary medicine, has already recognized and begun to reap the benefits of endoscopic surgery. Herein, we retrospectively review the most recent successful novel applications of endoscopic surgery in the small animal reproduction system to provide small animal reproductive surgeons with important knowledge to help improve their own veterinarian medical practice. © 2016 Blackwell Verlag GmbH.

Update on endoscopic pancreatic function testing

Institute of Scientific and Technical Information of China (English)

Tyler Stevens; Mansour A Parsi

2011-01-01

Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditionalfluid analysis.

Endoscopic sleeve gastroplasty: the learning curve.

Science.gov (United States)

Hill, Christine; El Zein, Mohamad; Agnihotri, Abhishek; Dunlap, Margo; Chang, Angela; Agrawal, Alison; Barola, Sindhu; Ngamruengphong, Saowanee; Chen, Yen-I; Kalloo, Anthony N; Khashab, Mouen A; Kumbhari, Vivek

2017-09-01

 Endoscopic sleeve gastroplasty (ESG) is gaining traction as a minimally invasive bariatric treatment. Concern that the learning curve may be slow, even among those proficient in endoscopic suturing, is a barrier to widespread implementation of the procedure. Therefore, we aimed to define the learning curve for ESG in a single endoscopist experienced in endoscopic suturing who participated in a 1-day ESG training program.  Consecutive patients who underwent ESG between February 2016 and November 2016 were included. The performing endoscopist, who is proficient in endoscopic suturing for non-ESG procedures, participated in a 1-day ESG training session before offering ESG to patients. The outcome measurements were length of procedure (LOP) and number of plications per procedure. Nonlinear regression was used to determine the learning plateau and calculate the learning rate.  Twenty-one consecutive patients (8 males), with mean age 47.7 ± 11.2 years and mean body mass index 41.8 ± 8.5 kg/m 2 underwent ESG. LOP decreased significantly across consecutive procedures, with a learning plateau at 101.5 minutes and a learning rate of 7 cases ( P  = 0.04). The number of plications per procedure also decreased significantly across consecutive procedures, with a plateau at 8 sutures and a learning rate of 9 cases ( P  < 0.001). Further, the average time per plication decreased significantly with consecutive procedures, reaching a plateau at 9 procedures ( P  < 0.001).  Endoscopists experienced in endoscopic suturing are expected to achieve a reduction in LOP and number of plications per procedure in successive cases, with progress plateauing at 7 and 9 cases, respectively.

CFD Study of an Annular-Ducted Fan Lift System for VTOL Aircraft

Directory of Open Access Journals (Sweden)

Yun Jiang

2015-09-01

Full Text Available The present study aimed at assessing a novel annular-ducted fan lift system for VTOL aircraft through computational fluid dynamics (CFD simulations. The power and lift efficiency of the lift fan system in hover mode, the lift and drag in transition mode, the drag and flight speed of the aircraft in cruise mode and the pneumatic coupling of the tip turbine and jet exhaust were studied. The results show that the annular-ducted fan lift system can have higher lift efficiency compared to the rotor of the Apache helicopter; the smooth transition from vertical takeoff to cruise flight needs some extra forward thrust to overcome a low peak of drag; the aircraft with the lift fan system enclosed during cruise flight theoretically may fly faster than helicopters and tiltrotors based on aerodynamic drag prediction, due to the elimination of rotor drag and compressibility effects on the rotor blade tips; and pneumatic coupling of the tip turbine and jet exhaust of a 300 m/s velocity can provide enough moment to spin the lift fan. The CFD results provide insight for future experimental study of the annular-ducted lift fan VTOL aircraft.

Functional residual capacity increase during laparoscopic surgery with abdominal wall lift

Directory of Open Access Journals (Sweden)

Hiroshi Ueda

Full Text Available Abstract Background and objectives: The number of laparoscopic surgeries performed is increasing every year and in most cases the pneumoperitoneum method is used. One alternative is the abdominal wall lifting method and this study was undertaken to evaluate changes of functional residual capacity during the abdominal wall lift procedure. Methods: From January to April 2013, 20 patients underwent laparoscopic cholecystectomy at a single institution. All patients were anesthetized using propofol, remifentanil and rocuronium. FRC was measured automatically by Engstrom Carestation before the abdominal wall lift and again 15 minutes after the start of the procedure. Results: After abdominal wall lift, there was a significant increase in functional residual capacity values (before abdominal wall lift 1.48 × 103 mL, after abdominal wall lift 1.64 × 103 mL (p < 0.0001. No complications such as desaturation were observed in any patient during this study. Conclusions: Laparoscopic surgery with abdominal wall lift may be appropriate for patients who have risk factors such as obesity and respiratory disease.

Endoscopic removal of a dislocated tomour prothesis from the stomach

International Nuclear Information System (INIS)

Rueckauer, K.; Dinkel, E.

1985-01-01

Endoscopic pertubation of oesophagogustric neoplasms is an established method of palliative treatment. The dislocated plastic prosthesis may be removed with difficulties from the stomach endoscopically. A simple technique for endoscopic removal of the prosthesis is described. The tube can be precisely centred within the oesophageal lumen by use of an intestinal decompression tube and additional guidance by the endoscopic retraction forceps. Thus gross damge of the exophytic tumor tissue with bleeding or perforation sequelae can be avoided. Injury to the patient does not exceed that caused by an ordinary gastroscopy. (orig.) [de

The Revolutionary Vertical Lift Technology (RVLT) Project

Science.gov (United States)

Yamauchi, Gloria K.

2018-01-01

The Revolutionary Vertical Lift Technology (RVLT) Project is one of six projects in the Advanced Air Vehicles Program (AAVP) of the NASA Aeronautics Research Mission Directorate. The overarching goal of the RVLT Project is to develop and validate tools, technologies, and concepts to overcome key barriers for vertical lift vehicles. The project vision is to enable the next generation of vertical lift vehicles with aggressive goals for efficiency, noise, and emissions, to expand current capabilities and develop new commercial markets. The RVLT Project invests in technologies that support conventional, non-conventional, and emerging vertical-lift aircraft in the very light to heavy vehicle classes. Research areas include acoustic, aeromechanics, drive systems, engines, icing, hybrid-electric systems, impact dynamics, experimental techniques, computational methods, and conceptual design. The project research is executed at NASA Ames, Glenn, and Langley Research Centers; the research extensively leverages partnerships with the US Army, the Federal Aviation Administration, industry, and academia. The primary facilities used by the project for testing of vertical-lift technologies include the 14- by 22-Ft Wind Tunnel, Icing Research Tunnel, National Full-Scale Aerodynamics Complex, 7- by 10-Ft Wind Tunnel, Rotor Test Cell, Landing and Impact Research facility, Compressor Test Facility, Drive System Test Facilities, Transonic Turbine Blade Cascade Facility, Vertical Motion Simulator, Mobile Acoustic Facility, Exterior Effects Synthesis and Simulation Lab, and the NASA Advanced Supercomputing Complex. To learn more about the RVLT Project, please stop by booth #1004 or visit their website at https://www.nasa.gov/aeroresearch/programs/aavp/rvlt.

Endoscopic retrograde cholangiopancreatography, endoscopic esphinterotomy and laparoscopic cholecystectomy in a patient with choledocolitiasis and cholelitiasis

International Nuclear Information System (INIS)

Riveron Quevedo, Kelly; Irsula Ballaga, Vladimir; Gonzalez Ulloa, Lianne; Deborah LLorca, Armando

2012-01-01

The case report of a 30 year-old presumably healthy patient, who attended the Gastroenterology Department from 'Dr Juan Bruno Zayas Alfonso' Teaching General Hospital in Santiago de Cuba, and suffering from biliary cholic, ictero, choluria, nausea, vomit and loss of appetite is presented. The complementary examinations confirmed the choledocolitiasis and cholelitiasis diagnosis, reason why it was necessary to carry out a endoscopic retrograde cholangiopancreatography, endoscopic esphinterotomy and ambulatory laparoscopic cholecystectomy, in a single anesthetic injection. The postoperative clinical course was favorable and she was discharged without complications 24 hours before the intervention

Coblation-assisted endonasal endoscopic resection of juvenile nasopharyngeal angiofibroma.

Science.gov (United States)

Ye, L; Zhou, X; Li, J; Jin, J

2011-09-01

Juvenile nasopharyngeal angiofibroma may be successfully resected using endoscopic techniques. However, the use of coblation technology for such resection has not been described. This study aimed to document cases of Fisch class I juvenile nasopharyngeal angiofibroma with limited nasopharyngeal and nasal cavity extension, which were completely resected using an endoscopic coblation technique. We retrospectively studied 23 patients with juvenile nasopharyngeal angiofibroma who underwent resection with either traditional endoscopic instruments (n = 12) or coblation (n = 11). Intra-operative blood loss and overall operative time were recorded. The mean tumour resection time for coblation and traditional endoscopic instruments was 87 and 136 minutes, respectively (t = 9.962, p angiofibroma (Fisch class I), with good surgical margins and minimal blood loss.

Endoscope disinfection and its pitfalls--requirement for retrograde surveillance cultures.

Science.gov (United States)

Buss, A J; Been, M H; Borgers, R P; Stokroos, I; Melchers, W J; Peters, F T; Limburg, A J; Degener, J E

2008-04-01

Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to trace disinfection problems to individual endoscopes or washer-disinfectors. Our surveillance protocol included anterograde and retrograde sampling, a decision algorithm, genetic fingerprinting, and scanning electron microscopy. Over a period of 29 months we found an increasing number of patient-ready endoscopes testing positive for Candida species other than albicans, especially C. parapsilosis. These yeasts were also isolated from the washer-disinfectors. The number of positive tests for Candida species varied from 1 out of 21 to 14 out of 27 samples from nine frequently used endoscopes. The number of colony-forming units per milliliter ranged from 1 - 10 to 3000 for endoscopes and 0.002 to 0.06 for the washer disinfectors. DNA fingerprinting was not able to discriminate different strains within C. parapsilosis. Our protocol was able to detect a structural problem in the endoscope disinfection process. Retrograde sampling was crucial for this purpose, because it has much higher sensitivity than anterograde sampling. Endoscopes with damaged working channels are probably the source of the contamination problem with Candida species.

A Haptic Guided Robotic System for Endoscope Positioning and Holding.

Science.gov (United States)

Cabuk, Burak; Ceylan, Savas; Anik, Ihsan; Tugasaygi, Mehtap; Kizir, Selcuk

2015-01-01

To determine the feasibility, advantages, and disadvantages of using a robot for holding and maneuvering the endoscope in transnasal transsphenoidal surgery. The system used in this study was a Stewart Platform based robotic system that was developed by Kocaeli University Department of Mechatronics Engineering for positioning and holding of endoscope. After the first use on an artificial head model, the system was used on six fresh postmortem bodies that were provided by the Morgue Specialization Department of the Forensic Medicine Institute (Istanbul, Turkey). The setup required for robotic system was easy, the time for registration procedure and setup of the robot takes 15 minutes. The resistance was felt on haptic arm in case of contact or friction with adjacent tissues. The adaptation process was shorter with the mouse to manipulate the endoscope. The endoscopic transsphenoidal approach was achieved with the robotic system. The endoscope was guided to the sphenoid ostium with the help of the robotic arm. This robotic system can be used in endoscopic transsphenoidal surgery as an endoscope positioner and holder. The robot is able to change the position easily with the help of an assistant and prevents tremor, and provides a better field of vision for work.

Lifting Wing in Constructing Tall Buildings —Aerodynamic Testing

Directory of Open Access Journals (Sweden)

Ian Skelton

2014-05-01

Full Text Available This paper builds on previous research by the authors which determined the global state-of-the-art of constructing tall buildings by surveying the most active specialist tall building professionals around the globe. That research identified the effect of wind on tower cranes as a highly ranked, common critical issue in tall building construction. The research reported here presents a design for a “Lifting Wing,” a uniquely designed shroud which potentially allows the lifting of building materials by a tower crane in higher and more unstable wind conditions, thereby reducing delay on the programmed critical path of a tall building. Wind tunnel tests were undertaken to compare the aerodynamic performance of a scale model of a typical “brick-shaped” construction load (replicating a load profile most commonly lifted via a tower crane against the aerodynamic performance of the scale model of the Lifting Wing in a range of wind conditions. The data indicate that the Lifting Wing improves the aerodynamic performance by a factor of up to 50%.

Testing two novel stump-lifting heads in a final felling Norway spruce stand

Energy Technology Data Exchange (ETDEWEB)

Kaerhae, K. (Metsaeteho Oy, Helsinki (Finland)), Email: kalle.karha@metsateho.fi; Mutikainen, A. (TTS Research, Rajamaeki (Finland)), Email: arto.mutikainen@tts.fi

2009-07-01

The use of stump and root wood chips has increased very rapidly in the 21st century in Finland: in the year 2000, the total consumption of stump wood chips for energy generation was 10 GWh, while in 2008 it was around 1.2 TWh. Metsaeteho Oy and TTS Research tested two new stump-lifting devices for lifting stumps in a final felling Norway spruce (picea abies) stand. In the time study with the Vaekevae Stump Processor lifting head, the productivity of stump lifting was 7,5 m3 / E{sub 0}-hour when lifting spruce stumps with a diameter of 30 cm from clayey soil, and 8.3 m3 /E{sub 0}-hour when lifting spruce stumps from sandy soil. When lifting stumps with a diameter of 40 cm, the stump-lifting productivity was 9.0 m3 /E{sub 0}-h (clay) and 10,5 m3 / E{sub 0}-h (sand). The results of this relatively restricted test indicated that the Vaekevae Stump Processor is s reliable and effective stump-lifting head that enables the harvesting of high-quality stump raw material for energy generation. The stump lifting productivity of the other lifting head (Jaervinen) was lower than that of the Vaekevae Strump Processor. Some development suggestions for the Jaervinen lifting head were presented and discussed. (orig.)

Safe and successful endoscopic initial treatment and long-term eradication of gastric varices by endoscopic ultrasound-guided Histoacryl (N-butyl-2-cyanoacrylate) injection

OpenAIRE

Gubler, Christoph; Bauerfeind, Peter

2014-01-01

OBJECTIVE: Optimal endoscopic treatment of gastric varices is still not standardized nowadays. Actively bleeding varices may prohibit a successful endoscopic injection therapy of Histoacryl® (N-butyl-2-cyanoacrylate). Since 2006, we have treated gastric varices by standardized endoscopic ultrasound (EUS) guided Histoacryl injection therapy without severe adverse events. MATERIAL AND METHODS: We present a large single-center cohort over 7 years with a standardized EUS-guided sclerotherapy o...

Endoscopic anatomy of the orbital floor and maxillary sinus.

Science.gov (United States)

Moore, Corey C; Bromwich, Matthew; Roth, Kathy; Matic, Damir B

2008-01-01

Endoscopic repair of orbital blow-out fractures could become a predictable and efficient treatment alternative to traditional methods. However, maxillary sinus endoscopy provides a complex and disorienting view of the orbital floor. To be a useful and consistent technique for providing access to the orbital floor, specific knowledge of maxillary endoscopic anatomy is required. The purpose of the study was to provide an anatomic description of the orbital floor via the endoscopic approach. Objectives include defining consistent landmarks for use in endoscopic repair of orbital floor fractures. Using 0- and 30-degree rigid endoscopes, 6 fresh cadavers (12 maxillary sinuses) were examined via a standard Caldwell-Luc approach. Computed tomographic scans, plastic molds, and digital images were used to compare observable averages within bony anatomy. Potential bony landmarks were correlated with soft-tissue anatomy in fresh specimens. The maxillary ostium, orbital floor, and lateral ethmoid air cells were visualized, and their structures were described. Observations were made in relation to the anatomy of the orbital floor and maxillary sinus, including fracture pattern and force transmission pathways. An "orbitomaxillary" sinus bony thickening was identified and described for the first time. This study provides the basis for further refinement of surgical technique and opens the door for future clinical trials using endoscopic repair.

In-Use Evaluation of Peracetic Acid for High-Level Disinfection of Endoscopes.

Science.gov (United States)

Chenjiao, Wu; Hongyan, Zhang; Qing, Gu; Xiaoqi, Zhong; Liying, Gu; Ying, Fang

2016-01-01

Many high-level disinfectants have been used for disinfection of endoscopes such as 2% glutaraldehyde (GA), 0.55% ortho-phthalaldehyde (OPA), and peracetic acid (PAA). Both GA and OPA are widely used in disinfection of endoscopes and have been previously discussed, but there is little research on the practical use of PAA as an endoscope disinfectant. An experimental model of a flexible gastrointestinal endoscope being contaminated with 9 strains of microorganism was designed. After the cleaning and disinfecting procedure was completed, we evaluated the biocidal activity (850 ppm PAA, 2% GA, and 0.55% OPA) on our flexible gastrointestinal endoscope model. We also evaluated sterilization effectiveness of PAA on other bacteria, including some antibiotic-resistant bacteria (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile). The residual bacterial colony count number of the PAA-disinfected endoscope was significantly lower than that of the GA- and OPA-disinfected endoscopes. The biocidal effect and efficiency of the endoscope disinfection by PAA appeared to be better than either the GA- or OPA-disinfected endoscope. PAA has demonstrated a good sterilization effect on other bacterial species; of particular note are common antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile. The results of this study demonstrate that PAA is a fast and effective high-level disinfectant for use in the reprocessing of flexible endoscopes.

Transanal endoscopic microsurgery.

Science.gov (United States)

Smart, Christopher J; Cunningham, Chris; Bach, Simon P

2014-02-01

Transanal endoscopic microsurgery (TEMS) is a well established method of accurate resection of specimens from the rectum under binocular vision. This review examines its role in the treatment of benign conditions of the rectum and the evidence to support its use and compliment existing endoscopic treatments. The evolution of TEMS in early rectal cancer and the concepts and outcomes of how it has been utilised to treat patients so far are presented. The bespoke nature of early rectal cancer treatment is changing the standard algorithms of rectal cancer care. The future of TEMS in the organ preserving treatment of early rectal cancer is discussed and how as clinicians we are able to select the correct patients for neoadjuvant or radical treatments accurately. The role of radiotherapy and outcomes from combination treatment using TEMS are presented with suggestions for areas of future research. Copyright © 2014. Published by Elsevier Ltd.

Approaching time is important for assessment of endoscopic surgical skills.

Science.gov (United States)

Tokunaga, Masakazu; Egi, Hiroyuki; Hattori, Minoru; Yoshimitsu, Masanori; Sumitani, Daisuke; Kawahara, Tomohiro; Okajima, Masazumi; Ohdan, Hideki

2012-05-01

This study aimed to verify whether the approaching time (the time taken to reach the target point from another point, a short distance apart, during point-to-point movement in endoscopic surgery), assessed using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), could distinguish the skill level of surgeons. Expert surgeons (who had performed more than 50 endoscopic surgeries) and novice surgeons (who had no experience in performing endoscopic surgery) were tested using the HUESAD. The approaching time, total time, and intermediate time (total time--approaching time) were measured and analyzed using the trajectory of the tip of the instrument. The approaching time and total time were significantly shorter in the expert group than in the novice group (p time did not significantly differ between the groups (p > 0.05). The approaching time, which is a component of the total time, is very mportant in the measurement of the total time to assess endoscopic surgical skills. Further, the approaching time was useful for skill assessment by the HUESAD for evaluating the skill of surgeons performing endoscopic surgery.

Lift11 / Ingrid Ruudi

Index Scriptorium Estoniae

Ruudi, Ingrid, 1978-

2010-01-01

23. augustist 11. oktoobrini 2010 toimuvast konkursist, mille eesmärk on leida kultuuripealinna üritusena toimuva linnainstallatsioonide festivali "Lift11" tarvis installatsioonide ideekavandeid. Festivali kuraatorid on kunstiteadlased Maarin Mürk ja Ingrid Ruudi ning arhitektid Margit Aule ja Margit Argus

Systems workplace for endoscopic surgery.

Science.gov (United States)

Irion, K M; Novak, P

2000-01-01

With the advent of minimally invasive surgery (MIS) a decade ago, the requirements for operating rooms (OR) and their equipment have been increased. Compared with conventional open surgery, the new endoscopic techniques require additional tools. Television systems, for video-assisted image acquisition and visualisation, including cameras, monitors and light systems, as well as insufflators, pumps, high-frequency units, lasers and motorised therapy units, are nowadays usually made available on carts during endoscopic surgery. In conjunction with a set of endoscopic instruments, these high-tech units allow new operating techniques to be performed. The benefit for patients has become clear in recent years; however, the technical complexity of OR has also increased considerably. To minimise this problem for the OR personnel, the MIS concept 'OR1' (Operating Room 1) was developed and implemented. OR1 is a fully functional and integrated multi-speciality surgical suite for MIS. The centrepieces of the OR1 are the Storz Communication Bus (SCB) and the advanced image and data archiving system (Aida) from Karl Storz, Tuttlingen, Germany. Both components allow monitoring, access and networking of the MIS equipment and other OR facilities, as well as the acquisition, storage and display of image, patient and equipment data during the endoscopic procedure. A central user interface allows efficient, simplified operation and online clinical images. Due to the system integration, the handling of complex equipment is considerably simplified, logistical procedures in the OR are improved, procedure times are shorter and, particularly noteworthy, operative risk can be reduced through simplified device operation.

Endoscopic and laparoscopic treatment of gastroesophageal reflux.

Science.gov (United States)

Watson, David I; Immanuel, Arul

2010-04-01

Gastroesophageal reflux is extremely common in Western countries. For selected patients, there is an established role for the surgical treatment of reflux, and possibly an emerging role for endoscopic antireflux procedures. Randomized trials have compared medical versus surgical management, laparoscopic versus open surgery and partial versus total fundoplications. However, the evidence base for endoscopic procedures is limited to some small sham-controlled studies, and cohort studies with short-term follow-up. Laparoscopic fundoplication has been shown to be an effective antireflux operation. It facilitates quicker convalescence and is associated with fewer complications, but has a similar longer term outcome compared with open antireflux surgery. In most randomized trials, antireflux surgery achieves at least as good control of reflux as medical therapy, and these studies support a wider application of surgery for the treatment of moderate-to-severe reflux. Laparoscopic partial fundoplication is an effective surgical procedure with fewer side effects, and it may achieve high rates of patient satisfaction at late follow-up. Many of the early endoscopic antireflux procedures have failed to achieve effective reflux control, and they have been withdrawn from the market. Newer procedures have the potential to fashion a surgical fundoplication. However, at present there is insufficient evidence to establish the safety and efficacy of endoscopic procedures for the treatment of gastroesophageal reflux, and no endoscopic procedure has achieved equivalent reflux control to that achieved by surgical fundoplication.

Comparison of Methods of Teaching Children Proper Lifting ...

African Journals Online (AJOL)

Objective: This study was designed to determine the effects of three teaching methods on children\\'s ability to demonstrate and recall their mastery of proper lifting techniques. Method: Ninety-three primary five and six public school children who had no knowledge of proper lifting technique were assigned into three equal ...

EFFECT OF HEEL LIFTS ON PATELLOFEMORAL JOINT STRESS DURING RUNNING.

Science.gov (United States)

Mestelle, Zachary; Kernozek, Thomas; Adkins, Kelly S; Miller, Jessica; Gheidi, Naghmeh

2017-10-01

Patellofemoral pain is a debilitating injury for many recreational runners. Excessive patellofemoral joint stress may be the underlying source of pain and interventions often focus on ways to reduce patellofemoral joint stress. Heel lifts have been used as an intervention within Achilles tendon rehabilitation programs and to address leg length discrepancies. The purpose of this study was to examine the effect of running with heel lifts on patellofemoral joint stress, patellofemoral stress impulse, quadriceps force, step length, cadence, and other related kinematic and spatiotemporal variables. A repeated-measures research design. Sixteen healthy female runners completed five running trials in a controlled laboratory setting with and without 11mm heel lifts inserted in a standard running shoe. Kinetic and kinematic data were used in combination with a static optimization technique to estimate individual muscle forces. These data were inserted into a patellofemoral joint model which was used to estimate patellofemoral joint stress and other variables during running. When running with heel lifts, peak patellofemoral joint stress and patellofemoral stress impulse were reduced by a 4.2% (p=0.049) and 9.3% (p=0.002). Initial center of pressure was shifted anteriorly 9.1% when running with heel lifts (p0.05) were shown between conditions. Heel lift use resulted in decreased patellofemoral joint stress and impulse without associated changes in step length or frequency, or other variables shown to influence patellofemoral joint stress. The center of pressure at initial contact was also more anterior using heel lifts. The use of heel lifts may have therapeutic benefits for runners with patellofemoral pain if the primary goal is to reduce patellofemoral joint stress. 3b.

THE SHAPING OF SOME LIFTING AND TRANSPORTATION SYSTEMS, USING AUTODESK INVENTOR

Directory of Open Access Journals (Sweden)

URSE Cătălin

2011-11-01

Full Text Available The paper presents, through the use of Autodesk Inventor software package, several mechanisms from the structure of lifting and transportation machines, in this case lifting system with winch operated by screw,lifting system type with muffle with hook, respectively bridge crane type.

Laser-induced forward transfer (LIFT) of congruent voxels

Science.gov (United States)

Piqué, Alberto; Kim, Heungsoo; Auyeung, Raymond C. Y.; Beniam, Iyoel; Breckenfeld, Eric

2016-06-01

Laser-induced forward transfer (LIFT) of functional materials offers unique advantages and capabilities for the rapid prototyping of electronic, optical and sensor elements. The use of LIFT for printing high viscosity metallic nano-inks and nano-pastes can be optimized for the transfer of voxels congruent with the shape of the laser pulse, forming thin film-like structures non-lithographically. These processes are capable of printing patterns with excellent lateral resolution and thickness uniformity typically found in 3-dimensional stacked assemblies, MEMS-like structures and free-standing interconnects. However, in order to achieve congruent voxel transfer with LIFT, the particle size and viscosity of the ink or paste suspensions must be adjusted to minimize variations due to wetting and drying effects. When LIFT is carried out with high-viscosity nano-suspensions, the printed voxel size and shape become controllable parameters, allowing the printing of thin-film like structures whose shape is determined by the spatial distribution of the laser pulse. The result is a new level of parallelization beyond current serial direct-write processes whereby the geometry of each printed voxel can be optimized according to the pattern design. This work shows how LIFT of congruent voxels can be applied to the fabrication of 2D and 3D microstructures by adjusting the viscosity of the nano-suspension and laser transfer parameters.

Advances in Engineering Software for Lift Transportation Systems

Science.gov (United States)

Kazakoff, Alexander Borisoff

2012-03-01

In this paper an attempt is performed at computer modelling of ropeway ski lift systems. The logic in these systems is based on a travel form between the two terminals, which operates with high capacity cabins, chairs, gondolas or draw-bars. Computer codes AUTOCAD, MATLAB and Compaq-Visual Fortran - version 6.6 are used in the computer modelling. The rope systems computer modelling is organized in two stages in this paper. The first stage is organization of the ground relief profile and a design of the lift system as a whole, according to the terrain profile and the climatic and atmospheric conditions. The ground profile is prepared by the geodesists and is presented in an AUTOCAD view. The next step is the design of the lift itself which is performed by programmes using the computer code MATLAB. The second stage of the computer modelling is performed after the optimization of the co-ordinates and the lift profile using the computer code MATLAB. Then the co-ordinates and the parameters are inserted into a program written in Compaq Visual Fortran - version 6.6., which calculates 171 lift parameters, organized in 42 tables. The objective of the work presented in this paper is an attempt at computer modelling of the design and parameters derivation of the rope way systems and their computer variation and optimization.

Combined endoscopic approaches to the cardiac sphincter achalasia treatment

Directory of Open Access Journals (Sweden)

V. N. Klimenko

2015-12-01

Full Text Available Aim. To assess combined endoscopic approaches to the cardiac sphincter achalasia treatment. Results. There are preliminary results of treatment and methods of carrying out of combined endoscopic pneumocardiodilatation and injections of botulotoxin type A ‘Disport’ at achalasia cardia are described in the article. Aethio-pathogenetic aspects in the development of achalasia cardia, action of botulotoxin type A and balloon pneumocardiodilatation of the esophagus, were described. And modern roentgen-endoscopic classification of achalasia cardia was given. Prognostic estimation scale of possibility to implement further combined endoscopic or surgical treatment is defined and is being in subsequent working out. Conclusion. Described clinical cases most brightly demonstrate variety of clinical achalasia cardia manifestations and also determine of the earlier display of surgical treatment.

Effect of hydrogen addition on autoignited methane lifted flames

KAUST Repository

Choin, Byung Chul; Chung, Suk-Ho

2012-01-01

Autoignited lifted flames in laminar jets with hydrogen-enriched methane fuels have been investigated experimentally in heated coflow air. The results showed that the autoignited lifted flame of the methane/hydrogen mixture, which had an initial

ALARA review for the deactivation of 105-N Lift Station

International Nuclear Information System (INIS)

Nellesen, A.L.

1997-01-01

This ALARA review provides a description of the engineering and administrative controls used to manage personnel exposure and to control contamination levels and airborne radioactivity concentrations, while removing water, sludge, stabilizing surfaces, and all other associated work involved in the deactivation of the 105-N Lift Station. The lift station was used as a sump and received contaminated water from the 105-N Fuel Storage Basin weirs and contaminated drains in the 105-N Building. During operation water from the lift station was pumped to the 1310-N and 1325-N cribs. Deactivation of the lift station is a critical step in completing the deactivation of N-Area

Contrast-enhanced endoscopic ultrasonography

DEFF Research Database (Denmark)

Reddy, Nischita K; Ioncică, Ana Maria; Săftoiu, Adrian

2011-01-01

Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...... cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler...

Evaluation of flexible endoscope steering using haptic guidance

NARCIS (Netherlands)

Reilink, Rob; Stramigioli, Stefano; Kappers, Astrid M L; Misra, Sarthak

Background: Steering the tip of a flexible endoscope relies on the physician's dexterity and experience. For complex flexible endoscopes, conventional controls may be inadequate. Methods: A steering method based on a multi-degree-of-freedom haptic device is presented. Haptic cues are generated based

Evaluation of flexible endoscope steering using haptic guidance

NARCIS (Netherlands)

Reilink, Rob; Stramigioli, Stefano; Kappers, Astrid M.L.; Misra, Sarthak

2011-01-01

Background - Steering the tip of a flexible endoscope relies on the physician’s dexterity and experience. For complex flexible endoscopes, conventional controls may be inadequate. Methods - A steering method based on a multi-degree-of-freedom haptic device is presented. Haptic cues are generated

[Endoscopic sphincterotomy in choledocholithiasis and an intact gallbladder].

Science.gov (United States)

Vladimirov, B; Petkov, R; Viiachki, I; Damianov, D; Iarŭmov, N

1996-01-01

Endoscopic sphincterotomy (ES) with extraction of calculi is a basic method of treating choledocholithiasis in post-cholecystectomy patients (8, 9). Endoscopic treatment contributes to a considerable reduction of the indications for reoperation. The existing views concerning ES done in patients with preserved gallbladder, especially in the era of laparoscopic surgery, are still conflicting (3, 6). There are several options: cholecystectomy with removal of calculi in the common bile duct by ES in a subsequent stage, or vice versa-primary ES with ensuring cholecystectomy. The undertaking of independent surgical or endoscopic treatment is likewise practicable (2, 6).

Endoscopic Management of Bile Leakage after Liver Transplantation

Science.gov (United States)

Oh, Dongwook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-01-01

Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Methods Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. Results In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. Conclusions ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients. PMID:25717048

Technology insight: endoscopic submucosal dissection of gastrointestinal neoplasms.

Science.gov (United States)

Yamamoto, Hironori

2007-09-01

Gastrointestinal neoplasms can be cured by local resection as long as the lesions are in the early stage and have not metastasized. Endoscopic resection is a minimally invasive treatment for early-stage gastrointestinal neoplasms, and endoscopic submucosal dissection (ESD) is one type of endoscopic resection that has been developed in the past 10 years. For ESD to be a reliable, curative treatment for gastrointestinal neoplasms, it is necessary for the endoscopist to detect the lesion early, make a precise pretreatment diagnosis, ensure that the patient has the correct indication for endoscopic resection, and have the skill to perform ESD. For early lesion detection, endoscopists should pay attention to subtle changes in the surface structure, the color of the mucosa and the visibility of underlying submucosal vessels. Chromoendoscopy and magnifying endoscopy are useful for determining the margin of the lesions for pretreatment diagnosis, and endoscopic ultrasonography and magnifying endoscopy are useful for determining the depth of invasion. For ESD to be successful, local injection of sodium hyaluronate helps maintain mucosal elevation during dissection. Selecting the appropriate knife, using transparent hoods wisely, employing a good strategy that uses gravity, and having good control of bleeding are all needed to make ESD reliable.

Advances in the endoscopic management of pancreatic collections.

Science.gov (United States)

Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J

2015-04-16

Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.

iLift: A health behavior change support system for lifting and transfer techniques to prevent lower-back injuries in healthcare.

Science.gov (United States)

Kuipers, Derek A; Wartena, Bard O; Dijkstra, Boudewijn H; Terlouw, Gijs; van T Veer, Job T B; van Dijk, Hylke W; Prins, Jelle T; Pierie, Jean Pierre E N

2016-12-01

Lower back problems are a common cause of sick leave of employees in Dutch care homes and hospitals. In the Netherlands over 40% of reported sick leave is due to back problems, mainly caused by carrying out heavy work. The goal of the iLift project was to develop a game for nursing personnel to train them in lifting and transfer techniques. The main focus was not on testing for the effectiveness of the game itself, but rather on the design of the game as an autogenous trigger and its place in a behavioral change support system. In this article, the design and development of such a health behavior change support system is addressed, describing cycles of design and evaluation. (a) To define the problem space, use context and user context, focus group interviews were conducted with Occupational Therapists (n=4), Nurses (n=10) and Caregivers (n=12) and a thematic analysis was performed. We interviewed experts (n=5) on the subject of lifting and transferring techniques. (b) A design science research approach resulted in a playable prototype. An expert panel conducted analysis of video-recorded playing activities. (c) Field experiment: We performed a dynamic analysis in order to investigate the feasibility of the prototype through biometric data from player sessions (n=620) by healthcare professionals (n=37). (a) Occupational Therapists, Nurses and Caregivers did not recognise a lack of knowledge with training in lifting and transferring techniques. All groups considered their workload, time pressure and a culturally determined habit to place the patient's well being above their own as the main reason not to apply appropriate lifting and transferring techniques. This led to a shift in focus from a serious game teaching lifting and transferring techniques to a health behavior change support system containing a game with the intention to influence behavior. (b) Building and testing (subcomponents of) the prototype resulted in design choices regarding players perspective

Estimation of unsteady lift on a pitching airfoil from wake velocity surveys

Science.gov (United States)

Zaman, K. B. M. Q.; Panda, J.; Rumsey, C. L.

1993-01-01

The results of a joint experimental and computational study on the flowfield over a periodically pitched NACA0012 airfoil, and the resultant lift variation, are reported in this paper. The lift variation over a cycle of oscillation, and hence the lift hysteresis loop, is estimated from the velocity distribution in the wake measured or computed for successive phases of the cycle. Experimentally, the estimated lift hysteresis loops are compared with available data from the literature as well as with limited force balance measurements. Computationally, the estimated lift variations are compared with the corresponding variation obtained from the surface pressure distribution. Four analytical formulations for the lift estimation from wake surveys are considered and relative successes of the four are discussed.

[Endoscopic realignment for post-traumatic rupture of posterior urethra].

Science.gov (United States)

Tazi, Hicham; Ouali, Mohammed; Lrhorfi, My Hfid; Moudouni, Saïd; Tazi, Karim; Lakrissa, Ahmed

2003-12-01

To analyse the long-term results of treatment of posterior urethral disruptions with endoscopic realignment, and to assess the efficacy, simplicity and benefit of this technique. Between 1989 and 2001, thirty six patients were treated by endoscopic realignment for traumatic rupture of the posterior urethra. The analysis of the results took in consideration the quality of urinary stream, the continence and the erectile function. With a mean follow-up of thirty four months (12 to 72 months), the 36 patients treated by endoscopic realignment are continent and urinate with a satisfactory urine output. This result was obtained after internal urethrotomy in 13 patients (36.1%), and after transperineal urethroplasty in two patients. Only 7 patients (19.4%) developed an impotence. The endoscopic realignment can be considered like initial treatment of all post-traumatic rupture of the posterior urethra. This simple and little aggressive technique doesn't compromise the recourse to another type of ulterior treatment and resulted in negligible morbidity. The secondary urethral strictures are short and accessible to an endoscopic urethrotomy.

Three-dimensional motion analysis of the lumbar spine during "free squat" weight lift training.

Science.gov (United States)

Walsh, James C; Quinlan, John F; Stapleton, Robert; FitzPatrick, David P; McCormack, Damian

2007-06-01

Heavy weight lifting using a squat bar is a commonly used athletic training exercise. Previous in vivo motion studies have concentrated on lifting of everyday objects and not on the vastly increased loads that athletes subject themselves to when performing this exercise. Athletes significantly alter their lumbar spinal motion when performing squat lifting at heavy weights. Controlled laboratory study. Forty-eight athletes (28 men, 20 women) performed 6 lifts at 40% maximum, 4 lifts at 60% maximum, and 2 lifts at 80% maximum. The Zebris 3D motion analysis system was used to measure lumbar spine motion. Exercise was performed as a "free" squat and repeated with a weight lifting support belt. Data obtained were analyzed using SAS. A significant decrease (P free squat or when lifting using a support belt in any of the groups studied. Weight lifting using a squat bar causes athletes to significantly hyperextend their lumbar spines at heavier weights. The use of a weight lifting support belt does not significantly alter spinal motion during lifting.

First-Order Twistor Lifts

Directory of Open Access Journals (Sweden)

Simões BrunoAscenso

2010-01-01

Full Text Available The use of twistor methods in the study of Jacobi fields has proved quite fruitful, leading to a series of results. L. Lemaire and J. C. Wood proved several properties of Jacobi fields along harmonic maps from the two-sphere to the complex projective plane and to the three- and four-dimensional spheres, by carefully relating the infinitesimal deformations of the harmonic maps to those of the holomorphic data describing them. In order to advance this programme, we prove a series of relations between infinitesimal properties of the map and those of its twistor lift. Namely, we prove that isotropy and harmonicity to first order of the map correspond to holomorphicity to first order of its lift into the twistor space, relatively to the standard almost complex structures and . This is done by obtaining first-order analogues of classical twistorial constructions.

First-Order Twistor Lifts

Directory of Open Access Journals (Sweden)

Bruno Ascenso Simões

2010-01-01

Full Text Available The use of twistor methods in the study of Jacobi fields has proved quite fruitful, leading to a series of results. L. Lemaire and J. C. Wood proved several properties of Jacobi fields along harmonic maps from the two-sphere to the complex projective plane and to the three- and four-dimensional spheres, by carefully relating the infinitesimal deformations of the harmonic maps to those of the holomorphic data describing them. In order to advance this programme, we prove a series of relations between infinitesimal properties of the map and those of its twistor lift. Namely, we prove that isotropy and harmonicity to first order of the map correspond to holomorphicity to first order of its lift into the twistor space, relatively to the standard almost complex structures J1 and J2. This is done by obtaining first-order analogues of classical twistorial constructions.

Shape memory alloy resetable spring lift for pedestrian protection

Science.gov (United States)

Barnes, Brian M.; Brei, Diann E.; Luntz, Jonathan E.; Strom, Kenneth; Browne, Alan L.; Johnson, Nancy

2008-03-01

Pedestrian protection has become an increasingly important aspect of automotive safety with new regulations taking effect around the world. Because it is increasingly difficult to meet these new regulations with traditional passive approaches, active lifts are being explored that increase the "crush zone" between the hood and rigid under-hood components as a means of mitigating the consequences of an impact with a non-occupant. Active lifts, however, are technically challenging because of the simultaneously high forces, stroke and quick timing resulting in most of the current devices being single use. This paper introduces the SMArt (Shape Memory Alloy ReseTable) Spring Lift, an automatically resetable and fully reusable device, which couples conventional standard compression springs to store the energy required for a hood lift, with Shape Memory Alloys actuators to achieve both an ultra high speed release of the spring and automatic reset of the system for multiple uses. Each of the four SMArt Device subsystems, lift, release, lower and reset/dissipate, are individually described. Two identical complete prototypes were fabricated and mounted at the rear corners of the hood, incorporated within a full-scale vehicle testbed at the SMARTT (Smart Material Advanced Research and Technology Transfer) lab at University of Michigan. Full operational cycle testing of a stationary vehicle in a laboratory setting confirms the ultrafast latch release, controlled lift profile, gravity lower to reposition the hood, and spring recompression via the ratchet engine successfully rearming the device for repeat cycles. While this is only a laboratory demonstration and extensive testing and development would be required for transition to a fielded product, this study does indicate that the SMArt Lift has promise as an alternative approach to pedestrian protection.

The Naso-labial and lateral forehead flaps as a single stage: A case report and review of literature

Directory of Open Access Journals (Sweden)

Adigun I

2008-01-01

Full Text Available We present here the case of a patient with a major traumatic nasal loses who had a near-total nasal reconstruction as a single-stage procedure. A 35 year-old civil servant who was involved in a road traffic injury about two years before presentation. He sustained extensive and multiple facial injuries with complete loss of nasal cover and lining. Reconstruction was performed by using superiorly based, bilateral, nasolabial flaps to line the floor and the nasal septum, and a paramedian forehead flap for skin cover. The patient did well postoperatively and was discharged home on the 7 th postoperative day. If the principles concerning cover, support, and lining are adhered to, excellent functional and aesthetic results can be achieved as we have obtained in our patient.

Study of lifting operation of a tripod foundation for offshore wind turbine

Science.gov (United States)

Zhu, H.; Li, L.; Ong, M. C.

2017-12-01

This study addresses numerical analysis of the installation of a tripod foundation using a heavy lift vessel (HLV). Limiting sea states are firstly predicted in the frequency domain based on crane tip vertical motions using linear transfer functions. Then, numerical modelling and simulations are carried out in the time domain to analyse the coupled dynamic system taking into consideration of the nonlinearities of the system. In time-domain analysis, two lifting phases are brought into focus, i.e., the lift-off and the lowering phases. For the lift-off phase, two scenarios are considered, i.e., lift-off from the own deck of the HLV and lift-off from a transport barge. Moreover, comparative studies using two types of installation vessels, a floating vessel and a Jack-up, are investigated for the lowering process. Critical responses including the motions of the tripod and the lift wire tensions are presented and compared under various environmental and loading conditions.

Knees Lifted High

Centers for Disease Control (CDC) Podcasts

The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Knees Lifted High gives children fun ideas for active outdoor play.

Mannesmann Demag crawler cranes give plants a big lift

International Nuclear Information System (INIS)

Anon.

1987-01-01

Preassembly of large reactor components reduces construction costs, but creates the need for cranes with larger lifting capacities. A German company is extending its range with a new crawler crane which will lift up to 1600t. (author)

A Simple Method for High-Lift Propeller Conceptual Design

Science.gov (United States)

Patterson, Michael; Borer, Nick; German, Brian

2016-01-01

In this paper, we present a simple method for designing propellers that are placed upstream of the leading edge of a wing in order to augment lift. Because the primary purpose of these "high-lift propellers" is to increase lift rather than produce thrust, these props are best viewed as a form of high-lift device; consequently, they should be designed differently than traditional propellers. We present a theory that describes how these props can be designed to provide a relatively uniform axial velocity increase, which is hypothesized to be advantageous for lift augmentation based on a literature survey. Computational modeling indicates that such propellers can generate the same average induced axial velocity while consuming less power and producing less thrust than conventional propeller designs. For an example problem based on specifications for NASA's Scalable Convergent Electric Propulsion Technology and Operations Research (SCEPTOR) flight demonstrator, a propeller designed with the new method requires approximately 15% less power and produces approximately 11% less thrust than one designed for minimum induced loss. Higher-order modeling and/or wind tunnel testing are needed to verify the predicted performance.

Outcomes following Purely Endoscopic Endonasal Resection of Pituitary adenomas

Directory of Open Access Journals (Sweden)

Rezaul Amin

2013-01-01

Full Text Available Background: The use of endoscope for the management of pituitary adenoma is not new. The better magnification and illumination provided by the endoscope gives better outcome than microscopic pituitary surgery. Objective: To find out the benefits of endoscope in relation to microscopic surgery. Materials and Methods: We performed 45 cases of pituitary adenoma surgery by endoscopic endonasal approach from July 2008 to July 2010. Results: Forty five cases underwent endoscopic transsphenoidal approach. Gross total removal was done in 35 cases and subtotal removal was done in 10 cases. Residual tumours were seen in 10 cases (22% in postoperative follow-up MRI scan. Visual improvement was satisfactory, and hormonal improvement of functional adenoma was nice. Postoperative visual acuity and visual field were improved in 75% cases. There were 37% cases of temporary diabetes insipidus and about 4.5% cases of permanent diabetes insipidus. The average duration of follow-up was 20 months. One patient required reexploration to correct visual deterioration in the immediate postoperative period. There were 4.5% cases of CSF leak and 6.6% mortality. Mortality was due to electrolyte imbalance and improper management of infection and hydrocephalus. Conclusion: Endoscopic endonasal pituitary surgery now has become a gold standard surgery for most of the pituitary adenomas because of its better advantages in relation to microscopic surgery and less complications and less hospital stay.

Endoscopical appearances of nonsteroidal anti inflammatory drug (NSAID- enteropathy

Directory of Open Access Journals (Sweden)

Marcellus Simadibrata

2005-12-01

Full Text Available Non Steroidal Anti Inflammatory Drugs (NSAID have been associated with a sudden and sustained rise in the incidence of gastrointestinal ulcer complications. The aim of the study was to reveal the endoscopical abnormalities found in the duodenum & proximal jejunum due to NSAID. Thirty eight patients taking NSAID for their arthritis or rheumatism were included in this study. Gastro-duodeno-jejunoscopy was done with Olympus PCF-10. The endoscopical appearances of NSAID entero gastropathy were evaluated with a scoring system. The NSAID-entero-gastropathy appearances were endoscopically seen as hyperemia, erosion and ulcer. From all patient recruited, 7.9% complaint of diarrhea and 71.1% complaint of dyspepsia. Endoscopically, in the duodenal bulb we found 79% cases of hyperemia, 39.5% cases of erosion and 7.9% cases of ulcer. In the second part (descending part of the duodenum we found 28.9% cases of hyperemia, 15.8% cases of erosion and 2.6% case of ulcer. In the jejunum, we found 7.9% cases of hyperemia, 2.6% case of erosion and no ulcer. It is concluded that the most frequent abnormal endoscopical appearances in NSAID- enteropathy was hyperemia. The most frequent site of NSAID-enteropathy abnormal findings was in the duodenal bulb. (Med J Indones 2005; 14: 225-9Keywords: NSAID-enteropathy, endoscopical appearances.

Landmark-based augmented reality system for paranasal and transnasal endoscopic surgeries.

Science.gov (United States)

Thoranaghatte, Ramesh; Garcia, Jaime; Caversaccio, Marco; Widmer, Daniel; Gonzalez Ballester, Miguel A; Nolte, Lutz-P; Zheng, Guoyan

2009-12-01

In this paper we present a landmark-based augmented reality (AR) endoscope system for endoscopic paranasal and transnasal surgeries along with fast and automatic calibration and registration procedures for the endoscope. Preoperatively the surgeon selects natural landmarks or can define new landmarks in CT volume. These landmarks are overlaid, after proper registration of preoperative CT to the patient, on the endoscopic video stream. The specified name of the landmark, along with selected colour and its distance from the endoscope tip, is also augmented. The endoscope optics are calibrated and registered by fast and automatic methods. Accuracy of the system is evaluated in a metallic grid and cadaver set-up. Root mean square (RMS) error of the system is 0.8 mm in a controlled laboratory set-up (metallic grid) and was 2.25 mm during cadaver studies. A novel landmark-based AR endoscope system is implemented and its accuracy is evaluated. Augmented landmarks will help the surgeon to orientate and navigate the surgical field. Studies prove the capability of the system for the proposed application. Further clinical studies are planned in near future. Copyright (c) 2009 John Wiley & Sons, Ltd.

Modified endoscopic medial maxillectomy for zygomatic implant salvage.

Science.gov (United States)

Schwartz, Joseph S; Tajudeen, Bobby A; Adappa, Nithin D; Palmer, James N

2016-01-01

Odontogenic chronic rhinosinusitis (CRS) is an epidemiologically important disease process due, in part, to the increasingly commonplace use of dental restorative procedures such as zygomatic implantation. Traditional management of this clinical entity typically entails extraction of the infected hardware via an open or endoscopic approach. We describe a novel management strategy of odontogenic CRS following bilateral zygomatic implantation for oral rehabilitation that we surgically salvaged via a modified endoscopic medial maxillectomy. We describe the presentation and management of a case of metachronous development of bilateral CRS subsequent to zygomatic implantation. The patient's postoperative course was characterized by marked endoscopic, radiologic, and symptomatic improvement as measured by the 22-item Sino-Nasal Outcome Test. We describe a novel treatment strategy for the management of odontogenic sinusitis resulting from erroneous zygomatic implant placement. Modified endoscopic medial maxillectomy in this clinical context facilitates mucosal normalization of the affected sinus, while permitting preservation of oral function through salvage of the displaced implant.

Endoscopic Radial Artery Harvest for Coronary Artery Bypass Surgery

Directory of Open Access Journals (Sweden)

Kuan-Ming Chiu

2006-01-01

Conclusion: Endoscopic harvest of the radial artery is technically demanding, but excellent results can be achieved. The endoscopic approach can provide suitable conduits in a less invasive way than the open harvest technique.

Back muscle strength, lifting, and stooped working postures.

Science.gov (United States)

Poulsen, E; Jørgensen, K

1971-09-01

When lifting loads and working in a forward stooped position, the muscles of the back rather than the ligaments and bony structures of the spine should overcome the gravitational forces. Formulae, based on measurements of back muscle strength, for prediction of maximal loads to be lifted, and for the ability to sustain work in a stooped position, have been worked out and tested in practical situations. From tests with 50 male and female subjects the simplest prediction formulae for maximum loads were: max. load = 1.10 x isometric back muscle strength for men; and max. load = 0.95 x isometric back muscle strength - 8 kg for women. Some standard values for maximum lifts and permissible single and repeated lifts have been calculated for men and women separately and are given in Table 1. From tests with 65 rehabilitees it was found that the maximum isometric strength of the back muscles measured at shoulder height should exceed 2/3 of the body weight, if fatigue and/or pain in the back muscles is to be avoided during work in a standing stooped position.

An Extensional Characterization of Lambda-Lifting and Lambda-Dropping

DEFF Research Database (Denmark)

Danvy, Olivier

1999-01-01

Lambda-lifting and lambda-dropping respectively transform a block-structured functional program into recursive equations and vice versa. Lambda-lifting was developed in the early 80’s, whereas lambda-dropping is more recent. Both are split into an analysis and a transformation. Published work......, however, has only concentrated on the analysis parts. We focus here on the transformation parts and more precisely on their correctness, which appears never to have been proven. To this end, we define extensional versions of lambda-lifting and lambda-dropping and establish their correctness with respect...

Development of a Marine Propeller With Nonplanar Lifting Surfaces

DEFF Research Database (Denmark)

Andersen, Poul; Friesch, Jürgen; Kappel, Jens J.

2005-01-01

The principle of non-planar lifting surfaces is applied to the design of modern aircraft wings to obtain better lift to drag ratios. Whereas a pronounced fin or winglet at the wingtip has been developed for aircraft, the application of the nonplanar principle to marine propellers, dealt...... with in this paper, has led to the KAPPEL propeller with blades curved toward the suction side integrating the fin or winglet into the propeller blade. The combined theoretical, experimental, and practical approach to develop and design marine propellers with nonplanar lifting surfaces has resulted in propellers...

An Extensional Characterization of Lambda-Lifting and Lambda-Dropping

DEFF Research Database (Denmark)

Danvy, Olivier

1998-01-01

Lambda-lifting and lambda-dropping respectively transform a block-structured functional program into recursive equations and vice versa. Lambda-lifting was developed in the early 80’s, whereas lambda-dropping is more recent. Both are split into an analysis and a transformation. Published work......, however, has only concentrated on the analysis parts. We focus here on the transformation parts and more precisely on their correctness, which appears never to have been proven. To this end, we define extensional versions of lambda-lifting and lambda-dropping and establish their correctness with respect...

Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma.

Science.gov (United States)

Kamel, Reda H; Abdel Fattah, Ahmed F; Awad, Ayman G

2014-12-01

Maxillary sinus inverted papilloma entails medial maxillectomy and is associated with high incidence of recurrence. To study the impact of prior surgery on recurrence rate after transnasal endoscopic medial maxillectomy. Eighteen patients with primary and 33 with recurrent maxillary sinus inverted papilloma underwent transnasal endoscopic medial maxillectomy. Caldwell-Luc operation was the primary surgery in 12 patients, transnasal endoscopic resection in 20, and midfacial degloving technique in one. The follow-up period ranged between 2 to 19.5 years with an average of 8.8 years. Recurrence was detected in 8/51 maxillary sinus inverted papilloma patients (15.7 %), 1/18 of primary cases (5.5 %), 7/33 of recurrent cases (21.2 %); 3/20 of the transnasal endoscopic resection group (15%) and 4/12 of the Caldwell-Luc group (33.3%). Redo transnasal endoscopic medial maxillectomy was followed by a single recurrence in the Caldwell-Luc group (25%), and no recurrence in the other groups. Recurrence is more common in recurrent maxillary sinus inverted papilloma than primary lesions. Recurrent maxillary sinus inverted papilloma after Caldwell-Luc operation has higher incidence of recurrence than after transnasal endoscopic resection.

Direct cost comparison of totally endoscopic versus open ear surgery.

Science.gov (United States)

Patel, N; Mohammadi, A; Jufas, N

2018-02-01

Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

Measurement and characterization of lift forces on drops and bubbles in microchannels

Science.gov (United States)

Stan, Claudiu; Guglielmini, Laura; Ellerbee, Audrey; Caviezel, Daniel; Whitesides, George; Stone, Howard

2013-11-01

The transverse motion of drops and bubbles within liquids flowing in pipes and channels is determined by the combination of several types of hydrodynamic lift forces with external forces. In microfluidic channels, lift forces have been used to position and sort particles with high efficiency and high accuracy. We measured lift forces on drops and bubbles and discriminated between different lift mechanisms under conditions characterized by low particle capillary numbers (0.0003 bubbles. We will present new experimental data that supports a dynamic interfacial mechanism for the second type of lift force, and discuss possible avenues for creating an analytical model for it.

New flexible endoscope for otologic application

Science.gov (United States)

Marchan, Mark L.

1993-07-01

Endoscopy has become an important procedure in many medical specialties. For the Otologist, however, space limitations within the ear have restricted development of endoscopic procedures. The desire for minimally invasive techniques in Otology has demonstrated itself through the work of numerous physicians who have performed procedures ranging from diagnostic inspection of the middle ear to viewing the interior of the cochlea. To assist in performing such endoscopic procedures, Xomed-Treace has developed a line of flexible fiberoptic endoscopes for use by the Otologist. These scopes combine illumination and imaging fiber bundles within a small diameter unit ranging in size from 0.8 mm to 1.2 mm. The 1.2 mm scope is produced with an angled, rigid stainless steel sheath. The 0.8 mm scope is flexible with the ability to articulate 120 degree(s) in one direction. The fiberscopes have been designed for the Otologist to produce a good resolution image while allowing ease of operation through ergonomics and consideration of the surgical anatomy.

21 CFR 876.4300 - Endoscopic electrosurgical unit and accessories.

Science.gov (United States)

2010-04-01

... Endoscopic electrosurgical unit and accessories. (a) Identification. An endoscopic electrosurgical unit and... device includes the electrosurgical generator, patient plate, electric biopsy forceps, electrode, flexible snare, electrosurgical alarm system, electrosurgical power supply unit, electrical clamp, self...

Lifting device for drilling rods

Energy Technology Data Exchange (ETDEWEB)

Radzivilovich, L L; Laptev, A G; Lipkovich, V A

1982-01-01

A lifter is proposed for drilling rods including a spacer stand with rotating bracket, boom with by-pass rollers, spacing and lifting hydrocylinders with rods and flexible tie mechanism. In order to improve labor productivity by improving maneuverability and to increase the maintenance zone, the lifter is equipped with a hydrocylinder of advance and a cross piece which is installed with the possibility of forward and rotational movement on the stand, and in which by means of the hydrocylinder of advance a boom is attached. Within the indicated boom there is a branch of the flexible tie mechanism with end attached with the possibility of regulation over the length on a rotating bracket, while the rod of the lifting hydrocylinder is connected to the cross piece.

The application of percutaneous endoscopic colostomy to the management of obstructed defecation.

Science.gov (United States)

Heriot, A G; Tilney, H S; Simson, J N L

2002-05-01

We describe the case of a 52-year woman with a 17-year history of obstructed defecation in whom all other standard treatments had failed and the patient had refused a colostomy. Her symptoms were controlled by percutaneous endoscopic colostomy with antegrade colonic irrigation. A percutaneous endoscopic colostomy tube was placed in the sigmoid colon endoscopically using a colonoscope and the patient irrigated two liters of water through the percutaneous endoscopic colostomy twice each day and was able to successfully evacuate her rectum without excess straining or discomfort. Percutaneous endoscopic colostomy is an alternative option to colostomy in the management of obstructed defecation.

Testing lifting systems in nuclear facilities

International Nuclear Information System (INIS)

Kling, H.; Laug, R.

1984-01-01

Lifting systems in nuclear facilities must be inspected at regular intervals after having undergone their first acceptance test. These inspections are frequently carried out by service firms which not only employ the skilled personnel required for such jobs but also make available the necessary test equipment. The inspections in particular include a number of sophisticated load tests for which test load systems have been developed to allow lifting systems to be tested so that reactor specific boundary conditions are taken into account. In view of the large number of facilities to be inspected, the test load system is a modular system. (orig.) [de

Cooperative control system of the floating cranes for the dual lifting

Directory of Open Access Journals (Sweden)

Mihee Nam

2018-01-01

Full Text Available This paper proposes a dual lifting and its cooperative control system with two different kinds of floating cranes. The Mega-erection and Giga-erection in the ship building are used to handle heavier and wider blocks and modules as ships and off-shore platforms are enlarged. However, there is no equipment to handle such Tera-blocks. In order to overcome the limit on performance of existing floating cranes, the dual lifting is proposed in this research. In the dual lifting, two floating cranes are well-coordinated to add up the lift capabilities of both cranes without any loss such that virtually a single crane is lifting, maneuvering and unloading. Two main constraints for the dual lifting are as follows: First, two barges of floating cranes should be constrained as a rigid body not to cause a relative motion between two barges and main hooks of the two cranes should be controlled as main hooks of a single crane. In order words, it is necessary to develop the cooperative control of two floating cranes in order to sustain a center of gravity of the module and minimize the tilting angle during the lifting and unloading by the two floating cranes. Two floating cranes are handled as a master-slave system. The master crane is able to gather information about all working conditions and make a decision to control the individual hook speed, which communicates the slave crane by TCP/IP. The developed control system has been embedded in the real floating crane systems and the dual lifting has been demonstrated five times at SHI shipyard in 2015. The moving angles of the lifting module are analyzed and verified to be suitable for hoisting control. It is verified that the dual lifting can be applied for many heavier and wider blocks and modules to shorten the construction time of ships and off-shore platforms.

Implementation of remote video auditing with feedback and compliance for manual-cleaning protocols of endoscopic retrograde cholangiopancreatography endoscopes.

Science.gov (United States)

Armellino, Donna; Cifu, Kelly; Wallace, Maureen; Johnson, Sherly; DiCapua, John; Dowling, Oonagh; Jacobs, Mitchel; Browning, Susan

2018-05-01

A pilot initiative to assess the use of remote video auditing in monitoring compliance with manual-cleaning protocols for endoscopic retrograde cholangiopancreatography (ERCP) endoscopes was performed. Compliance with manual-cleaning steps following the initiation of feedback was measured. A video feed of the ERCP reprocessing room was provided to remote auditors who scored items of an ERCP endoscope manual-cleaning checklist. Compliance feedback was provided in the form of reports and reeducation. Outcomes were reported as checklist compliance. The use of remote video auditing to document manual processing is a feasible approach and feedback and reeducation increased manual-cleaning compliance from 53.1% (95% confidence interval, 34.7-71.6) to 98.9% (95.0% confidence interval, 98.1-99.6). Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Endoscopic treatment of esophageal achalasia.

Science.gov (United States)

Esposito, Dario; Maione, Francesco; D'Alessandro, Alessandra; Sarnelli, Giovanni; De Palma, Giovanni D

2016-01-25

Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection. Even though few patients can be cured with only one treatment and repeat procedure might be needed, long term relief from dysphagia can be obtained in about 90% of cases with either surgical interventions such as laparoscopic Heller myotomy or with endoscopic techniques such pneumatic dilatation or, more recently, with per-oral endoscopic myotomy. Age, sex, and manometric type by HRM are also predictors of responsiveness to treatment. Older patients, females and type II achalasia are better after treatment compared to younger patients, males and type III achalasia. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies.

Endoscopic treatment of esophageal achalasia

Science.gov (United States)

Esposito, Dario; Maione, Francesco; D’Alessandro, Alessandra; Sarnelli, Giovanni; De Palma, Giovanni D

2016-01-01

Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection. Even though few patients can be cured with only one treatment and repeat procedure might be needed, long term relief from dysphagia can be obtained in about 90% of cases with either surgical interventions such as laparoscopic Heller myotomy or with endoscopic techniques such pneumatic dilatation or, more recently, with per-oral endoscopic myotomy. Age, sex, and manometric type by HRM are also predictors of responsiveness to treatment. Older patients, females and type II achalasia are better after treatment compared to younger patients, males and type III achalasia. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies. PMID:26839644

Modeling of load lifting process with unknown center of gravity position

Science.gov (United States)

Kamanin, Y. N.; Zhukov, M. I.; Panichkin, A. V.; Redelin, R. A.

2018-03-01

The article proposes a new type of lifting beams that allows one to lift loads where the position of the center of gravity is unknown beforehand. The benefit of implementing this type of traverse is confirmed by the high demand for this product from the industrial enterprises and lack of their availability on the market. In conducted studies, the main kinematic and dynamic dependencies of the load lifting process with an unknown position of the center of gravity were described allowing for design and verification calculations of the traverse with flexible slings and an adjustable bail to be carried out. The obtained results can be useful to engineers and employees of enterprises engaged in the design and manufacturing of the lifting equipment and scientists doing research in “Carrying and lifting machines”.

Characterization of Oscillatory Lift in MFC Airfoils

OpenAIRE

Lang Jr, Joseph Reagle

2014-01-01

The purpose of this research is to characterize the response of an airfoil with an oscillatory morphing, Macro-fiber composite (MFC) trailing edge. Correlation of the airfoil lift with the oscillatory input is presented. Modal analysis of the test airfoil and apparatus is used to determine the frequency response function. The effects of static MFC inputs on the FRF are presented and compared to the unactuated airfoil. The transfer function is then used to determine the lift component du...

Surgical stress response: does endoscopic surgery confer an advantage?

DEFF Research Database (Denmark)

Kehlet, H

1999-01-01

of postoperative pulmonary function and less hypoxemia with endoscopic operation. The slight modification of surgical stress responses by endoscopic surgery is in contrast to the common, though not universal, demonstration of less pain, shorter hospital stay, and less morbidity after endoscopic surgery...... operations where differences are more likely to be found. The clinical consequences of these findings in relation to all over surgical outcome remain to be defined, but effective pain treatment, stress reduction by other techniques, and provision of an active rehabilitation program with early mobilization...

Face-Lift Satisfaction Using the FACE-Q.

Science.gov (United States)

Sinno, Sammy; Schwitzer, Jonathan; Anzai, Lavinia; Thorne, Charles H

2015-08-01

Face lifting is one of the most common operative procedures for facial aging and perhaps the procedure most synonymous with plastic surgery in the minds of the lay public, but no verifiable documentation of patient satisfaction exists in the literature. This study is the first to examine face-lift outcomes and patient satisfaction using a validated questionnaire. One hundred five patients undergoing a face lift performed by the senior author (C.H.T.) using a high, extended-superficial musculoaponeurotic system with submental platysma approximation technique were asked to complete anonymously the FACE-Q by e-mail. FACE-Q scores were assessed for each domain (range, 0 to 100), with higher scores indicating greater satisfaction with appearance or superior quality of life. Fifty-three patients completed the FACE-Q (50.5 percent response rate). Patients demonstrated high satisfaction with facial appearance (mean ± SD, 80.7 ± 22.3), and quality of life, including social confidence (90.4 ± 16.6), psychological well-being (92.8 ± 14.3), and early life impact (92.2 ± 16.4). Patients also reported extremely high satisfaction with their decision to undergo face lifting (90.5 ± 15.9). On average, patients felt they appeared 6.9 years younger than their actual age. Patients were most satisfied with the appearance of their nasolabial folds (86.2 ± 18.5), cheeks (86.1 ± 25.4), and lower face/jawline (86.0 ± 20.6), compared with their necks (78.1 ± 25.6) and area under the chin (67.9 ± 32.3). Patients who responded in this study were extremely satisfied with their decision to undergo face lifting and the outcomes and quality of life following the procedure.

Lifted linear phase filter banks and the polyphase-with-advance representation

Energy Technology Data Exchange (ETDEWEB)

Brislawn, C. M. (Christopher M.); Wohlberg, B. E. (Brendt E.)

2004-01-01

A matrix theory is developed for the noncausal polyphase-with-advance representation that underlies the theory of lifted perfect reconstruction filter banks and wavelet transforms as developed by Sweldens and Daubechies. This theory provides the fundamental lifting methodology employed in the ISO/IEC JPEG-2000 still image coding standard, which the authors helped to develop. Lifting structures for polyphase-with-advance filter banks are depicted in Figure 1. In the analysis bank of Figure 1(a), the first lifting step updates x{sub 0} with a filtered version of x{sub 1} and the second step updates x{sub 1} with a filtered version of x{sub 0}; gain factors 1/K and K normalize the lowpass- and highpass-filtered output subbands. Each of these steps is inverted by the corresponding operations in the synthesis bank shown in Figure 1(b). Lifting steps correspond to upper- or lower-triangular matrices, S{sub i}(z), in a cascade-form decomposition of the polyphase analysis matrix, H{sub a}(z). Lifting structures can also be implemented reversibly (i.e., losslessly in fixed-precision arithmetic) by rounding the lifting updates to integer values. Our treatment of the polyphase-with-advance representation develops an extensive matrix algebra framework that goes far beyond the results of. Specifically, we focus on analyzing and implementing linear phase two-channel filter banks via linear phase lifting cascade schemes. Whole-sample symmetric (WS) and half-sample symmetric (HS) linear phase filter banks are characterized completely in terms of the polyphase-with-advance representation. The theory benefits significantly from a number of new group-theoretic structures arising in the polyphase-with-advance matrix algebra from the lifting factorization of linear phase filter banks.

2005 ACGIH Lifting TLV: Employee-Friendly Presentation and Guidance for Professional Judgment

Energy Technology Data Exchange (ETDEWEB)

Splittstoesser, Riley [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); O' Farrell, Daniel Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hill, John [Savannah River Site (SRS), Aiken, SC (United States); McMahon, Terrence [SLAC National Accelerator Lab., Menlo Park, CA (United States); Sastry, Nikhil [SLAC National Accelerator Lab., Menlo Park, CA (United States); Tiemeier, Mark [SLAC National Accelerator Lab., Menlo Park, CA (United States)

2017-05-22

The American Council of Governmental Industrial Hygienists (ACGIH) Lifting Threshold Limit Values (TLVs) provide a tool to reduce incidence of low back and shoulder injuries. However, application of the TLV is too complicated for floor-level workers and relies on professional judgment to assess commonly encountered tasks. This paper presents an Employee-Friendly Simplified Format of the TLV that has been adapted from Table 1 of the Lifting TLV presented in the 2005 TLVs and BEIs Based on the Documentation of the Threshold Limit Values for Chemical Substances and Physical Agents & Biological Exposure Indices. This simplified format can be employed by floor-level workers to self-assess lifting tasks. The Ergonomics Project Team also provides research-based guidance for applying professional judgment consistent with standard industry practice: Extended Work Shifts – Reduce weight by 20% for shifts lasting 8 to 12 hours; Constrained Lower Body Posture – Reduce weight by 25% when lifting in such postures; Infrequently Performed Lifts – Lift up to 15 lbs. ≤3 lifts per hour within the zones marked “No safe limit for repetitive lifting” in the TLVs Table 1; Asymmetry beyond 30° – Reduce weight by 10 lbs. for lifts with up to 60° asymmetry from sagittal plane.

Temporary endoscopic metallic stent for idiopathic esophageal achalasia.

Science.gov (United States)

Coppola, Franco; Gaia, Silvia; Rolle, Emanuela; Recchia, Serafino

2014-02-01

Idiopathic achalasia is a motor disorder of the esophagus of unknown etiology caused by loss of motor neurons determining an altered motility. It may determine severe symptoms such as progressive dysphagia, regurgitations, and pulmonary aspirations. Many therapeutic options may be offered to patients with achalasia, from surgery to endoscopic treatments such as pneumatic dilation, botulinum injection, peroral endoscopic myotomy, or endoscopic stenting. Recently, temporary placement of a stent was proposed by Cheng as therapy for achalasia disorders, whereas no Western authors have dealt with it up to date. The present study reports our preliminary experience in 7 patients with achalasia treated with a temporary stent. Partially covered self-expanding metallic stents (Micro-Tech, Nanjin, China) 80 mm long and 30 mm wide were placed under fluoroscopic control and removed after 6 days. Clinical follow-up was scheduled to check endoscopic success, symptoms release, and complications. The placement and the removal of the stents were obtained in all patients without complications. Mean clinical follow-up was 19 months. Five out of 7 patients referred total symptoms release and 2 experienced significant improvement of dysphagia. The procedure was not time consuming and was safe; no mild or severe complications were registered. In conclusion, our results may suggest a possible safe and effective endoscopic alternative treatment in patients with achalasia; however, further larger studies are necessary to confirm these promising, but very preliminary, data.

Anatomic structural study of cerebellopontine angle via endoscope

Institute of Scientific and Technical Information of China (English)

XIA Yin; LI Xi-ping; HAN De-min; ZHENG Jun; LONG Hai-shan; SHI Jin-feng

2007-01-01

Background Minimally invasive surgery in skull base relying on searching for possible anatomic basis for endoscopic technology is controversial. The objective of this study was to observe the spatial relationships between main blood vessels and nerves in the cerebellopontine angle area and provide anatomic basis for lateral and posterior skull base minimally invasive surgery via endoscopic retrosigmoid keyhole approach.Methods This study was conducted on thirty dried adult skulls to measure the spatial relationships among the surface bony marks of posterior cranial fossa, and to locate the most appropriate drilling area for retrosigmoid keyhole approach.In addition, we used 10 formaldehyde-fixed adult cadaver specimens for simulating endoscopic retrosigmoid approach to determine the visible scope.Results The midpoint between the mastoid tip and the asterion was the best drilling point for retrosigmoid approach. A hole centered on this point with the 2.0 cm in diameter was suitable for exposing the related structures in the cerebellopontine angle. Retrosigmoid keyhole approach can decrease the pressure on the cerebellum and expose the related structures effectively which include facial nerve, vestibulocochlear nerve, trigeminal nerve, glossopharyngeal nerve, vagus nerve, accessory nerve, hypoglossal nerve, anterior inferior cerebellar artery, posterior inferior cerebellar artery and labyrinthine artery, etc.Conclusions Exact location on endoscope retrosigmoid approach can avoid dragging cerebellum during the minimally invasive surgery. The application of retrosigmoid keyhole approach will extend the application of endoscopic technology.

Rescue endoscopic bleeding control for nonvariceal upper gastrointestinal hemorrhage using clipping and detachable snaring.

Science.gov (United States)

Lee, J H; Kim, B K; Seol, D C; Byun, S J; Park, K H; Sung, I K; Park, H S; Shim, C S

2013-06-01

Nonvariceal upper gastrointestinal (UGI) bleeding recurs after appropriate endoscopic therapy in 10 % - 15 % of cases. The mortality rate can be as high as 25 % when bleeding recurs, but there is no consensus about the best modality for endoscopic re-treatment. The aim of this study was to evaluate clipping and detachable snaring (CDS) for rescue endoscopic control of nonvariceal UGI hemorrhage. We report a case series of seven patients from a Korean tertiary center who underwent endoscopic hemostasis using the combined method of detachable snares with hemoclips. The success rate of endoscopic hemostasis with CDS was 86 %: six of the seven patients who had experienced primary endoscopic treatment failure or recurrent bleeding after endoscopic hemostasis were treated successfully. In conclusion, rescue endoscopic bleeding control by means of CDS is an option for controlling nonvariceal UGI bleeding when no other method of endoscopic treatment for recurrent bleeding and primary hemostatic failure is possible. © Georg Thieme Verlag KG Stuttgart · New York.

Lift, drag, and guidance forces on alternating polarity magnets, using loop guideways

International Nuclear Information System (INIS)

Lindenbaum, S.D.; Lee, M.S.

1975-01-01

Exact solutions of track current, lift force, and drag force, together with their velocity dependence, have been computed for a vehicle carrying a finite number of fixed current alternating polarity superconducting magnets, suspended at various heights over structured track guideways of the single- and double-loop (''null'') types. Results for the double-loop case are compared with those of a previously reported approximate analysis. The analytical method is then applied to a study of a low-drag guidance loop guideway which is integrable with lift loop guideways utilizing a common set of vehicle magnets. Solutions are obtained for guidance track restoring forces, lateral destabilization forces, and lift force degradation as functions of lateral displacement from symmetry. The dependence of lift, drag, and lift-to-drag on track loop parameters is studied and the linear dependence of lift-to-drag on loop time constant confirmed. The contribution to the forces made by successive addition of alternating polarity magnets is calculated and the marked reduction in lift force pulsation noted

Computational Analysis of Powered Lift Augmentation for the LEAPTech Distributed Electric Propulsion Wing

Science.gov (United States)

Deere, Karen A.; Viken, Sally A.; Carter, Melissa B.; Viken, Jeffrey K.; Wiese, Michael R.; Farr, Norma L.

2017-01-01

A computational study of a distributed electric propulsion wing with a 40deg flap deflection has been completed using FUN3D. Two lift-augmentation power conditions were compared with the power-off configuration on the high-lift wing (40deg flap) at a 73 mph freestream flow and for a range of angles of attack from -5 degrees to 14 degrees. The computational study also included investigating the benefit of corotating versus counter-rotating propeller spin direction to powered-lift performance. The results indicate a large benefit in lift coefficient, over the entire range of angle of attack studied, by using corotating propellers that all spin counter to the wingtip vortex. For the landing condition, 73 mph, the unpowered 40deg flap configuration achieved a maximum lift coefficient of 2.3. With high-lift blowing the maximum lift coefficient increased to 5.61. Therefore, the lift augmentation is a factor of 2.4. Taking advantage of the fullspan lift augmentation at similar performance means that a wing powered with the distributed electric propulsion system requires only 42 percent of the wing area of the unpowered wing. This technology will allow wings to be 'cruise optimized', meaning that they will be able to fly closer to maximum lift over drag conditions at the design cruise speed of the aircraft.

Crack detection with an eddy-current probe integrated into an endoscope

International Nuclear Information System (INIS)

Elfinger, F.X.

1982-01-01

Objective and quantitive crack detection in inaccessible machine internals is possible without dismantling the equipment through the combination of endoscopic and eddy-current techniques, whereby the endoscope is used both as an optical and a mechanical manipulator. Thus the availability of machinery can be increased and the overhaul costs lowered. The integrated endoscope/eddy-current probe should be utilised whenever normal endoscopic inspection indicates a possible crack location which cannot be assessed definitively through visual observation alone. Its use is also advantageous in monitoring crack propagation within a component. (orig.) [de

Optimal management of Barrett's esophagus: pharmacologic, endoscopic, and surgical interventions

Directory of Open Access Journals (Sweden)

Konda VJA

2011-11-01

Full Text Available Vani JA Konda1, Kunal Dalal21Section of Gastroenterology, Department of Medicine, 2Department of Internal Medicine, University of Chicago Medical Center, Chicago, Illinois, USAAbstract: Esophageal adenocarcinoma and its precursor, Barrett's esophagus, are rapidly rising in incidence. This review serves to highlight the role of pharmacologic, endoscopic, and surgical intervention in the management of Barrett's esophagus, which requires acid suppression and endoscopic assessment. Treatment with a proton pump inhibitor may decrease acid exposure and delay the progression to dysplasia. Patients who require aspirin for cardioprotection or other indications may also benefit in terms of a protective effect against the development of esophageal cancer. However, without other indications, aspirin is not indicated solely to prevent cancer. A careful endoscopic examination should include assessment of any visible lesions in a Barrett's segment. An expert gastrointestinal pathologist should confirm neoplasia in the setting of Barrett's esophagus. For those patients with high-grade dysplasia or intramucosal carcinoma, careful consideration of endoscopic therapy or surgical therapy must be given. All visible lesions in the setting of dysplasia should be targeted with focal endoscopic mucosal resection for both accurate histopathologic diagnosis and treatment. The remainder of the Barrett's epithelium should be eradicated to address all synchronous and metachronous lesions. This may be done by tissue acquiring or nontissue acquiring means. Radiofrequency ablation has a positive benefit-risk profile for flat Barrett's esophagus. At this time, endoscopic therapy is not indicated for nondysplastic Barrett's esophagus. Esophagectomy is still reserved for selected cases with evidence of lymph node metastasis, unsuccessful endoscopic therapy, or with high-risk features of high-grade dysplasia or intramucosal carcinoma.Keywords: Barrett's esophagus, high

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

Institute of Scientific and Technical Information of China (English)

Kazuto Kishimoto; Akira Hokama; Tetsuo Hirata; Yasushi Ihama; Manabu Nakamoto; Nagisa Kinjo; Fukunori Kinjo; Jiro Fujita

2008-01-01

AIM: To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis (5. stercoralis) hyperinfection.METHODS: Over a period of 23 years (1984-2006), we investigated 25 patients with 5. stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis. The clinical and endoscopic findings were analyzed retrospectively.RESULTS: Twenty-four (96%) of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1 (HTLV-1) infection. The abnormal endoscopic findings, mainly edematous mucosa, white villi and erythematous mucosa, were observed in 23 (92%) patients. The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy. The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative (Endoscopic severity score: 4.86 ± 2.47 vs 2.71 ± 1.38, P ＜ 0.05).CONCLUSION: Our study clearly demonstrates that, in addition to stool analysis, endoscopic observation and biopsies are very important. We also emphasize that 5. stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.

75 FR 27662 - Special Conditions: Boeing 747-468, Installation of a Medical Lift

Science.gov (United States)

2010-05-18

... electrical motors, mounted to the rear wall, between the struts. A lifting gear-drive with shafts and gear... OPERATE LIFT DURING TAXI, TAKEOFF, LANDING, OR TURBULENCE. c. AN APPROVED MEDICAL STRETCHER OR WHEELCHAIR... operation. b. Operate the lift. c. Stow the lift for non-operation such as during TTL and turbulence. d...

Transport of timber by rope-and-pulley lift in steep seams

Energy Technology Data Exchange (ETDEWEB)

Spaniol, J

1980-11-01

This paper describes the rope-and-pulley lift used to transport timber and small items of equipment, which has been installed in tubbing in the return air drop-hole. Gives details of how the lift works and the equipment involved (winch, rope, slings, pulleys, safety and signalling arrangements). Looks at the future prospects of installing these lifts. (In French)

Endoscopic treatment of early colorectal cancer – just a competition with surgery?

Directory of Open Access Journals (Sweden)

Ebigbo Alanna

2017-11-01

Full Text Available The endoscopic treatment of cancerous and precancerous lesions in the gastrointestinal (GI tract has experienced major breakthroughs in the past years. Endoscopic mucosal resection (EMR is a simple and efficient method for the treatment of most benign lesions in the GI tract. However, with the introduction of endoscopic submucosal dissection (ESD and endoscopic full-thickness resection (EFTR, the scope of lesions eligible for endoscopic treatment has been widened significantly even in the colon. These methods are now being used routinely not just for the treatment of benign lesions but also in the curative en bloc resection of early colorectal cancers. The quick, efficient, and noninvasive character of these endoscopic procedures make them not just an alternative to surgery but, in many cases, the methods of choice for the treatment of most early colon cancers and some rectal cancers.

Transsphenoidal surgery for pituitary tumors from microsurgery to the endoscopic surgery. Single surgeon's experience

International Nuclear Information System (INIS)

Iwai, Yoshiyasu; Yoshimura, Masaki; Terada, Aiko; Yamanaka, Kazuhiro; Koshimo, Naomi

2011-01-01

We reviewed results of the surgical outcome of pituitary tumors treated via the transsphenoidal approach between January, 1994 and January, 2010 at our institution. This data included 100 patients (124 procedures) treated through the sublabial transsphenoidal approach and 45 patients (54 procedures) treated through the endoscopic endonasal (bilateral nostrils) transsphenoidal approach performed by a single surgeon. The extent of tumor removal was significantly improved with endoscopic surgery; adjuvant gamma knife radiosurgery was needed for 65% of patients undergoing microsurgery vs. 30% for patients who had endoscopic surgery (p<0.0001). Patients who underwent endoscopic surgery had less intraoperative blood loss (mean volume: 100 mL for microsurgery patients vs. 30 mL for endoscopic surgery patients, p<0.0001), less pain, and less need for postoperative hormone replacement therapy (19% for microsurgery patients vs. 6% for endoscopic surgery patients; p<0.05). Cerebrospinal fluid (CSF) leakage and meningitis were experienced in one microsurgery patient (1%) and one endoscopic surgery patient (2.2%). Endoscopic surgery is a reasonable alternative to microsurgery and our experience supports the concept that an otolaryngologist/neurosurgeon team skilled in endoscopic techniques and pituitary surgery can safely make the transition from microsurgery to endoscopic surgery. (author)

The Efficacy of Endoscopic Palliation of Obstructive Jaundice in Hepatocellular Carcinoma

Science.gov (United States)

Park, Semi; Park, Jeong Youp; Chung, Moon Jae; Chung, Jae Bock; Park, Seung Woo; Han, Kwang-Hyub; Song, Si Young

2014-01-01

Purpose Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. Materials and Methods From 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks. Results Clinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1±5.3 mg/dL vs. 23.1±10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p≤0.001). Conclusion Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC. PMID:25048484

Percutaneous transgastric irrigation drainage in combination with endoscopic necrosectomy in necrotizing pancreatitis (with videos).

Science.gov (United States)

Raczynski, Susanne; Teich, Niels; Borte, Gudrun; Wittenburg, Henning; Mössner, Joachim; Caca, Karel

2006-09-01

Endoscopic drainage of pancreatic acute and chronic pseudocysts and pancreatic necrosectomy have been shown to be beneficial for critically ill patients, with complete endoscopic resolution rates of around 80%. Our purpose was to describe an improved endoscopic technique used to treat pancreatic necrosis. Case report. University hospital. Two patients with large retroperitoneal necroses were treated with percutaneous transgastric retroperitoneal flushing tubes and a percutaneous transgastric jejunal feeding tube by standard percutaneous endoscopic gastrostomy access in addition to endoscopic necrosectomy. Intensive percutaneous transgastric flushing in combination with percutaneous normocaloric enteral nutrition and repeated endoscopic necrosectomy led to excellent outcomes in both patients. Small number of patients. The "double percutaneous endoscopic gastrostomy" approach for simultaneous transgastric drainage and normocaloric enteral nutrition in severe cases of pancreatic necroses is safe and effective. It could be a promising improvement to endoscopic transgastric treatment options in necrotizing pancreatitis.

Endoscopic and minimally-invasive ear surgery: A path to better outcomes

Directory of Open Access Journals (Sweden)

Natasha Pollak

2017-09-01

Full Text Available The development of endoscopic ear surgery techniques promises to change the way we approach ear surgery. In this review paper, we explore the current evidence, seek to determine the advantages of endoscopic ear surgery, and see if these advantages are both measureable and meaningful. The wide field of view of the endoscope allows the surgeon to better visualize the various recesses of the middle ear cleft. Endoscopes make it possible to address the target pathology transcanal, while minimizing dissection or normal tissue done purely for exposure, leading to the evolution of minimally-invasive ear surgery and reducing morbidity. When used in chronic ear surgery, endoscopy appears to have the potential to significantly reduce cholesteatoma recidivism rates. Using endoscopes as an adjunct can increase the surgeon's confidence in total cholesteatoma removal. By doing so, endoscopes reduce the need to reopen the mastoid during second-look surgery, help preserve the canal wall, or even change post-cholesteatoma follow-up protocols by channeling more patients away from a planned second-look.

Anatomy of Forehead, Glabellar, Nasal and Orbital Muscles, and Their Correlation with Distinctive Patterns of Skin Lines on the Upper Third of the Face: Reviewing Concepts.

Science.gov (United States)

Abramo, Antonio Carlos; Do Amaral, Thiago Paoliello Alves; Lessio, Bruno Pierotti; De Lima, Germano Andrighetto

2016-12-01

The purpose of this study is to establish a relationship between the skin lines on the upper third of the face in cadavers, which represent the muscle activity in life and the skin lines achieved by voluntary contraction of the forehead, glabellar, and orbital muscles in patients. Anatomical dissection of fresh cadavers was performed in 20 fresh cadavers, 11 females and 9 males, with ages ranging from 53 to 77 years. Subcutaneous dissection identified the muscle shape and the continuity of the fibers of the eyebrow elevator and depress muscles. Subgaleal dissection identified the cutaneous insertions of the muscles. They were correlated with skin lines on the upper third of the face of the cadavers that represent the muscle activity in life. Voluntary contraction was performed by 20 voluntary patients, 13 females and 7 males, with ages ranging from 35 to 62 years. Distinct patterns of skin lines on the forehead, glabellar and orbital areas, and eyebrow displacement were identified. The frontalis exhibited four anatomical shapes with four different patterns of horizontal parallel lines on the forehead skin. The corrugator supercilii showed three shapes of muscles creating six patterns of vertical glabellar lines, three symmetrical and three asymmetrical. The orbicularis oculi and procerus had single patterns. The skin lines exhibited in voluntary contraction of the upper third of the face in patients showed the same patterns of the skin lines achieved in cadavers. Skin lines in cadavers, which are the expression of the muscle activity in life, were similar to those achieved in the voluntary contraction of patients, allowing us to assert that the muscle patterns of patients were similar to those identified in cadavers. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies

Abrasion behavior of graphite pebble in lifting pipe of pebble-bed HTR

Energy Technology Data Exchange (ETDEWEB)

Shen, Ke; Su, Jiageng [Institute of Nuclear and New Energy Technology, Advanced Nuclear Energy Technology Cooperation Innovation Center, The Key Laboratory of Advanced Nuclear Engineering and Safety, Ministry of Education, Beijing 10084 (China); Zhou, Hongbo [Institute of Nuclear and New Energy Technology, Advanced Nuclear Energy Technology Cooperation Innovation Center, The Key Laboratory of Advanced Nuclear Engineering and Safety, Ministry of Education, Beijing 10084 (China); Chinergy Co., LTD., Beijing 100193 (China); Peng, Wei; Liu, Bing [Institute of Nuclear and New Energy Technology, Advanced Nuclear Energy Technology Cooperation Innovation Center, The Key Laboratory of Advanced Nuclear Engineering and Safety, Ministry of Education, Beijing 10084 (China); Yu, Suyun, E-mail: suyuan@tsinghua.edu.cn [Center for Combustion Energy, The Key Laboratory for Thermal Science and Power Engineering, Ministry of Educations, Tsinghua University, Beijing 10084 (China)

2015-11-15

Highlights: • Quantitative determination of abrasion rate of graphite pebbles in different lifting velocities. • Abrasion behavior of graphite pebble in helium, air and nitrogen. • In helium, intensive collisions caused by oscillatory motion result in more graphite dust production. - Abstract: A pebble-bed high-temperature gas-cooled reactor (pebble-bed HTR) uses a helium coolant, graphite core structure, and spherical fuel elements. The pebble-bed design enables on-line refueling, avoiding refueling shutdowns. During circulation process, the pebbles are lifted pneumatically via a stainless steel lifting pipe and reinserted into the reactor. Inevitably, the movement of the fuel elements as they recirculate in the reactor produces graphite dust. Mechanical wear is the primary source of graphite dust production. Specifically, the sources are mechanisms of pebble–pebble contact, pebble–wall (structural graphite) contact, and fuel handling (pebble–metal abrasion). The key contribution to graphite dust production is from the fuel handling system, particularly from the lifting pipe. During pneumatic lift, graphite pebbles undergo multiple collisions with the stainless steel lifting pipe, thereby causing abrasion of the graphite pebbles and producing graphite dust. The present work explored the abrasion behavior of graphite pebble in the lifting pipe by measuring the abrasion rate at different lifting velocities. The abrasion rate of the graphite pebble in helium was found much higher than those in air and nitrogen. This gas environment effect could be explained by either tribology behavior or dynamic behavior. Friction testing excluded the possibility of tribology reason. The dynamic behavior of the graphite pebble was captured by analysis of the audio waveforms during pneumatic lift. The analysis results revealed unique dynamic behavior of the graphite pebble in helium. Oscillation and consequently intensive collisions occur during pneumatic lift, causing

Creating drag and lift curves from soccer trajectories

Science.gov (United States)

Goff, John Eric; Kelley, John; Hobson, Chad M.; Seo, Kazuya; Asai, Takeshi; Choppin, S. B.

2017-07-01

Trajectory analysis is an alternative to using wind tunnels to measure a soccer ball’s aerodynamic properties. It has advantages over wind tunnel testing such as being more representative of game play. However, previous work has not presented a method that produces complete, speed-dependent drag and lift coefficients. Four high-speed cameras in stereo-calibrated pairs were used to measure the spatial co-ordinates for 29 separate soccer trajectories. Those trajectories span a range of launch speeds from 9.3 to 29.9 m s-1. That range encompasses low-speed laminar flow of air over a soccer ball, through the drag crises where air flow is both laminar and turbulent, and up to high-speed turbulent air flow. Results from trajectory analysis were combined to give speed-dependent drag and lift coefficient curves for the entire range of speeds found in the 29 trajectories. The average root mean square error between the measured and modelled trajectory was 0.028 m horizontally and 0.034 m vertically. The drag and lift crises can be observed in the plots of drag and lift coefficients respectively.

Modeling and Design of Hybrid PEM Fuel Cell Systems for Lift Trucks

DEFF Research Database (Denmark)

Hosseinzadeh, Elham

driven lift trucks are being used more and more in different companies to reduce their emissions. However, battery driven lift trucks need a long time to recharge and thus may be out of work for a long time. Fuel cell driven lift trucks diminish this problem and are therefore getting more attention...... in a fork-lift truck. In order for the ejector to operate in the largest possible range of load, different approaches (with fixed nozzle and variable nozzle ejectors) have been investigated. Different geometries have been studied in order to optimize the ejector. The optimization is carried out not only...... a virtual fork-lift system. This investigation examines important performance metrics, such as hydrogen consumption and battery SOC as a function of the fuel cell and battery size, control strategy, drive cycle, and load variation for a fork-lift truck system. This study can be used as a benchmark...

Leading-edge vortex lifts swifts.

Science.gov (United States)

Videler, J J; Stamhuis, E J; Povel, G D E

2004-12-10

The current understanding of how birds fly must be revised, because birds use their hand-wings in an unconventional way to generate lift and drag. Physical models of a common swift wing in gliding posture with a 60 degrees sweep of the sharp hand-wing leading edge were tested in a water tunnel. Interactions with the flow were measured quantitatively with digital particle image velocimetry at Reynolds numbers realistic for the gliding flight of a swift between 3750 and 37,500. The results show that gliding swifts can generate stable leading-edge vortices at small (5 degrees to 10 degrees) angles of attack. We suggest that the flow around the arm-wings of most birds can remain conventionally attached, whereas the swept-back hand-wings generate lift with leading-edge vortices.

Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly.

Science.gov (United States)

Kim, Jung Hee; Hur, Kyu Yeon; Lee, Jung Hyun; Lee, Ji Hyun; Se, Young-Bem; Kim, Hey In; Lee, Seung Hoon; Nam, Do-Hyun; Kim, Seong Yeon; Kim, Kwang-Won; Kong, Doo-Sik; Kim, Yong Hwy

2017-08-01

Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 referral centers in Korea. We enrolled 134 patients with acromegaly (microadenomas, n = 15; macroadenomas, n = 119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n = 74) and Samsung Medical Center (n = 60) between January 2009 and March 2016. Remission was defined as having a normal insulin-like growth factor-1 and a suppressed growth hormone (GH) surgery, normal pituitary function was maintained in 34 patients (25.4%). Sixty-four patients (47.7%) presented complete (n = 59, 44.0%) or incomplete (n = 5, 3.7%) recovery of pituitary function. Hypopituitarism persisted in 20 patients (14.9%) and worsened in 16 patients (11.9%). Postoperatively, transient diabetes insipidus was reported in 52 patients (38.8%) but only persisted in 2 patients (1.5%). Other postoperative complications were epistaxis (n = 2), cerebral fluid leakage (n = 4), infection (n = 1), and intracerebral hemorrhage (n = 1). Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Occupational lifting, fetal death and preterm birth

DEFF Research Database (Denmark)

Mocevic, Emina; Svendsen, Susanne Wulff; Jørgensen, Kristian Tore

2014-01-01

OBJECTIVE: We examined the association between occupational lifting during pregnancy and risk of fetal death and preterm birth using a job exposure matrix (JEM). METHODS: For 68,086 occupationally active women in the Danish National Birth Cohort, interview information on occupational lifting...... the JEM. We used Cox regression models with gestational age as underlying time variable and adjustment for covariates. RESULTS: We observed 2,717 fetal deaths and 3,128 preterm births within the study cohort. No exposure-response relation was observed for fetal death, but for women with a prior fetal...... death, we found a hazard ratio (HR) of 2.87 (95% CI 1.37, 6.01) for stillbirth (fetal death ≥22 completed gestational weeks) among those who lifted >200 kg/day. For preterm birth, we found an exposure-response relation for primigravid women, reaching a HR of 1.43 (95% CI 1.13, 1.80) for total loads >200...

Lift 2013⎜February 6 to 8

CERN Multimedia

2013-01-01

The Lift Conference returns to the Centre International de Conférence de Genève, with speakers ranging from a science fiction author to a cognitive neuroscience researcher. As one of the foremost talk events of Europe, Lift 2013 seeks to discover new trends and turn them into opportunities.   The three-day conference is designed to engage and arouse intellectual curiosity by exploring the business and social implications of technological innovation. This year’s schedule also includes discussion of the political implications of technology and the impact of the online market on the future of economy. Alongside talks, workshops will be held on a wide range of topics, including the relationship between entrepreneur and investor, designs that influence social behaviour, and how ordinary people are changing the urban space. Lift 2013 also seeks to promote new business ventures and will award prizes to the start-up company that succeeds in convincing the audience an...

[Diagnostic utility of endoscopic ultrasonography elastography and contrast-enhanced harmonic endoscopic ultrasonography in a patient with type 2 autoimmune pancreatitis].

Science.gov (United States)

Yokode, Masataka; Shiomi, Hideyuki; Itai, Ryosuke; Mikami, Sakae; Yamashita, Yukimasa; Nakano, Ryota; Ezaki, Takeshi; Masuda, Atsuhiro; Zen, Yoh

2018-01-01

A referring hospital diagnosed a 57-year-old man with a pancreatic head mass. The initial endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) was inconclusive because of the small sample size. Endoscopic ultrasonography elastography (EUS-EG) and contrast-enhanced harmonic endoscopic ultrasonography (CE-EUS), conducted at our institute, raised the possibility of mass-forming pancreatitis or autoimmune pancreatitis (AIP). A repeat EUS-FNA revealed inflammatory changes, including a neutrophilic duct injury suggestive of type 2 AIP. The pancreatic lesion responded well to the steroid therapy. The present case suggests that EUS-EG and CE-EUS may be useful for diagnostic exclusion of pancreatic cancers, and the combined use of EUS-EG and CE-EUS, with EUS-FNA, may help characterize inflammatory pancreatic lesions.

FUNCTIONAL RESULTS OF ENDOSCOPIC EXTRAPERITONEAL RADICAL INTRAFASCIAL PROSTATECTOMY

Directory of Open Access Journals (Sweden)

D. V. Perlin

2014-01-01

Full Text Available Introduction. Endoscopic radical prostatectomy is a highly effective treatment for localized prostate cancer. Intrafascial prostate dissection ensures early recovery of urine continence function and erectile function. This article sums up our own experience of performing intrafascial endoscopic prostatectomy.Materials and methods. 25 patients have undergone this procedure. 12 months after surgery 88.2 % of the patients were fully continent, 11.7 % had symptoms of minimal stress urinary incontinence. We encountered no cases of positive surgical margins and one case of bio-chemical recurrence of the disease.Conclusion. Oncologically, intrafascial endoscopic radical prostatectomy is as effective as other modifications of radical prostatectomy and has the benefits of early recovery of urine continence function and erectile function. 

[Endoscopic assistance in surgery of cerebellopontine angle tumors].

Science.gov (United States)

Poshataev, V K; Shimansky, V N; Tanyashin, S V; Karnaukhov, V V

2014-01-01

During the period of 2010-2012, 33 patients with cerebellopontine angle tumors were operated on at the Burdenko Neurosurgical Institute (Moscow, Russia) using different types of endoscopic assistance. All patients were operated on via the retrosigmoid suboccipital approach in semi-sitting and prone positions. 30° and 70° endoscopes were used during the surgery. Endoscopic assistance allowed us to increase the completeness of tumor removal and to reduce the risk of postoperative complications by retaining the anatomic integrity of cranial nerves and vascular structures in the base of the posterior cranial fossa. These benefits made it possible to maintain and improve quality of life in patients with CPA tumors in the postoperative period.

Non-Exposure, Device-Assisted Endoscopic Full-thickness Resection.

Science.gov (United States)

Bauder, Markus; Schmidt, Arthur; Caca, Karel

2016-04-01

Recent developments have expanded the frontier of interventional endoscopy toward more extended resections following surgical principles. This article presents two new device-assisted techniques for endoscopic full-thickness resection in the upper and lower gastrointestinal tract. Both methods are nonexposure techniques avoiding exposure of gastrointestinal contents to the peritoneal cavity by a "close first-cut later" principle. The full-thickness resection device is a novel over-the-scope device designed for clip-assisted full-thickness resection of colorectal lesions. Endoscopic full-thickness resection of gastric subepithelial tumors can be performed after placing transmural sutures underneath the tumor with a suturing device originally designed for endoscopic antireflux therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Group Lifting Structures For Multirate Filter Banks, II: Linear Phase Filter Banks

Energy Technology Data Exchange (ETDEWEB)

Brislawn, Christopher M [Los Alamos National Laboratory

2008-01-01

The theory of group lifting structures is applied to linear phase lifting factorizations for the two nontrivial classes of two-channel linear phase perfect reconstruction filter banks, the whole-and half-sample symmetric classes. Group lifting structures defined for the reversible and irreversible classes of whole-and half-sample symmetric filter banks are shown to satisfy the hypotheses of the uniqueness theorem for group lifting structures. It follows that linear phase lifting factorizations of whole-and half-sample symmetric filter banks are therefore independent of the factorization methods used to compute them. These results cover the specification of user-defined whole-sample symmetric filter banks in Part 2 of the ISO JPEG 2000 standard.

Endoscopic facial skeletal surgery using a neuronavigator.

Science.gov (United States)

Sakai, Y; Kobayashi, S; Watanabe, E; Sekiya, S; Ohmori, K

1996-09-01

In the reconstruction of asymmetrical deformities of the facial skeleton, both an endoscope and a neuronavigator have been used. The endoscope allows the surgeon a wide view of the object on a television monitor, reduces the scarring, minimizes the undermined field, and reduces the need to work blind. The neuronavigator is a frameless computed tomographic stereotactic device that has been mainly used in neurosurgery. The device is easy to use and can offer the surgeon three-dimensional coordinates of the status during the operation. We have used this new technique in three clinical cases, two involving augmentation of the zygomatic bone on one side and one involving reduction of the frontal bone on one side. The surgical techniques we used and the versatility of both the endoscope and the neuronavigator are discussed herein based on our own experience.

Lifting devices with minimum effort for testing, maintenance and repair at the example of a lifting rig for core internals

Energy Technology Data Exchange (ETDEWEB)

Pache, Martin [Westinghouse Electric Germany GmbH (Germany); Wiesendanger, Robert [Kernkraftwerk Beznau, NOK (Switzerland)

2008-07-01

Beznau is a Westinghouse built nuclear power plant in the Aargau area Switzerland. It consists of two PWR units, each providing 365 MWe net capacity. The units were set into operation in 1969 and 1972, respectively, and hold an unlimited license for operation, provided they continue to fulfill current legal and security requirements. Beznau's previous lifting rigs for core internals required a high effort in testing and maintenance. Moreover, a damage to one of the rigs nearly resulted in the inoperability of the rig. However, no element of the load chain was affected, so there was no danger of a crash, but it could have caused an extended outage. Hence, it was decided to replace the lifting rigs with a state-of-the-art functional design that reflects modern requirements on maintenance and testing. Although the plant was built to ASME standards and codes, the new lifting rigs have been designed to German KTA code for lifting devices (KTA 3902 / 3903 for equipment with increased requirements, as per section 4.3 of KTA 3902). Given KTA's demands on periodic testing, one main requirement on the new design was to minimize the testing effort for the new rigs. (orig.)

Does team lifting increase the variability in peak lumbar compression in ironworkers?

NARCIS (Netherlands)

Faber, Gert; Visser, Steven; van der Molen, Henk F.; Kuijer, P. Paul F. M.; Hoozemans, Marco J. M.; van Dieën, Jaap H.; Frings-Dresen, Monique H. W.

2012-01-01

Ironworkers frequently perform heavy lifting tasks in teams of two or four workers. Team lifting could potentially lead to a higher variation in peak lumbar compression forces than lifts performed by one worker, resulting in higher maximal peak lumbar compression forces. This study compared

Development of Advanced High Lift Leading Edge Technology for Laminar Flow Wings

Science.gov (United States)

Bright, Michelle M.; Korntheuer, Andrea; Komadina, Steve; Lin, John C.

2013-01-01

This paper describes the Advanced High Lift Leading Edge (AHLLE) task performed by Northrop Grumman Systems Corporation, Aerospace Systems (NGAS) for the NASA Subsonic Fixed Wing project in an effort to develop enabling high-lift technology for laminar flow wings. Based on a known laminar cruise airfoil that incorporated an NGAS-developed integrated slot design, this effort involved using Computational Fluid Dynamics (CFD) analysis and quality function deployment (QFD) analysis on several leading edge concepts, and subsequently down-selected to two blown leading-edge concepts for testing. A 7-foot-span AHLLE airfoil model was designed and fabricated at NGAS and then tested at the NGAS 7 x 10 Low Speed Wind Tunnel in Hawthorne, CA. The model configurations tested included: baseline, deflected trailing edge, blown deflected trailing edge, blown leading edge, morphed leading edge, and blown/morphed leading edge. A successful demonstration of high lift leading edge technology was achieved, and the target goals for improved lift were exceeded by 30% with a maximum section lift coefficient (Cl) of 5.2. Maximum incremental section lift coefficients ( Cl) of 3.5 and 3.1 were achieved for a blown drooped (morphed) leading edge concept and a non-drooped leading edge blowing concept, respectively. The most effective AHLLE design yielded an estimated 94% lift improvement over the conventional high lift Krueger flap configurations while providing laminar flow capability on the cruise configuration.

CH-53K Heavy Lift Replacement Helicopter (CH-53K)

Science.gov (United States)

2015-12-01

Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-390 CH-53K Heavy Lift Replacement Helicopter (CH-53K) As of FY 2017 President’s Budget...December 2015 SAR March 4, 2016 10:04:18 UNCLASSIFIED 4 Col Henry Vanderborght PMA-261 Heavy Lift Helicopters Program Executive Office - Air, Anti...757-5780 Fax: 301-757-5109 DSN Phone: 757-5780 DSN Fax: 757-5109 Date Assigned: May 29, 2014 Program Information Program Name CH-53K Heavy Lift

Managing cultural diversity in healthcare partnerships: the case of LIFT.

Science.gov (United States)

Mannion, Russell; Brown, Sally; Beck, Matthias; Lunt, Neil

2011-01-01

The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care

Long-term results after endoscopic drainage and necrosectomy of symptomatic pancreatic fluid collections.

Science.gov (United States)

Seewald, Stefan; Ang, Tiing Leong; Richter, Hugo; Teng, Karl Yu Kim; Zhong, Yan; Groth, Stefan; Omar, Salem; Soehendra, Nib

2012-01-01

To determine the immediate and long-term results of endoscopic drainage and necrosectomy for symptomatic pancreatic fluid collections. The data of 80 patients with symptomatic pancreatic fluid collections (mean diameter: 11.7 cm, range 3-20; pseudocysts: 24/80, abscess: 20/80, infected walled-off necrosis: 36/80) referred for endoscopic management from October 1997 to March 2008 were analyzed retrospectively. Endoscopic drainage techniques included endoscopic ultrasound (EUS)-guided aspiration (2/80), EUS-guided transenteric drainage (70/80) and non-EUS-guided drainage across a spontaneous transenteric fistula (8/80). Endoscopic necrosectomy was carried out in 49/80 (abscesses: 14/20; infected necrosis: 35/36). Procedural complications were bleeding (12/80), perforation (7/80), portal air embolism (1/80) and Ogilvie Syndrome (1/80). Initial technical success was achieved in 78/80 (97.5%) and clinical resolution of the collections was achieved endoscopically in 67/80 (83.8%), with surgery required in 13/80 (perforation: four; endoscopically inaccessible areas: two; inadequate drainage: seven). Within 6 months five patients required surgery due to recurrent fluid collections; over a mean follow up of 31 months, surgery was required in four more patients due to recurrent collections as a consequence of underlying pancreatic duct abnormalities that could not be treated endoscopically. The long-term success of endoscopic treatment was 58/80 (72.5%). Endoscopic drainage of symptomatic pancreatic fluid collections is safe and effective, with excellent immediate and long-term results. Endoscopic necrosectomy has a risk of serious complications. The underlying pancreatic duct abnormalities must be addressed to prevent recurrence of fluid collections. © 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.

Cleft-lift operation for pilonidal sinuses under tumescent local anesthesia

DEFF Research Database (Denmark)

Bertelsen, Claus Anders

2011-01-01

The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before.......The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before....

Endoscopic lesions in Crohn's disease early after ileocecal resection

NARCIS (Netherlands)

Tytgat, G. N.; Mulder, C. J.; Brummelkamp, W. H.

1988-01-01

Fifty patients with Crohn's disease were studied endoscopically 6 weeks to 6 months (median 9 weeks) after ileocecal or ileocolonic resection for evidence of non-resected abnormality. Only 8 of the 50 patients were endoscopically free of abnormalities. Microscopic examination of the surgical

Transaxillary Endoscopic Breast Augmentation

Directory of Open Access Journals (Sweden)

Hyung-Bo Sim

2014-09-01

Full Text Available The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.

[GERD: endoscopic antireflux therapies].

Science.gov (United States)

Caca, K

2006-08-02

A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.

Laser-induced forward transfer (LIFT) of congruent voxels

Energy Technology Data Exchange (ETDEWEB)

Piqué, Alberto, E-mail: pique@nrl.navy.mil [Materials Science and Technology Division, Code 6364, Naval Research Laboratory, Washington, DC 20375 (United States); Kim, Heungsoo; Auyeung, Raymond C.Y.; Beniam, Iyoel [Materials Science and Technology Division, Code 6364, Naval Research Laboratory, Washington, DC 20375 (United States); Breckenfeld, Eric [National Research Council Fellow at the Naval Research Laboratory, Washington, DC 20375 (United States)

2016-06-30

Highlights: • Laser-induced forward transfer (LIFT) is demonstrated with high viscosity Ag nanopaste. • Under the right conditions (viscosity and fluence) the transfer of congruent voxels was achieved. • For viscosities under 100 Pa s, congruent voxel transfer of silver nano-suspensions is only possible under a very narrow range of conditions. • For viscosities over 100 Pa s, congruent voxel transfer of silver nano-pastes works over a wider range of fluences, donor substrate thickness, gap distances and voxel areas. • The laser transfer of congruent voxels can be used for printing electronic patterns in particular interconnects. - Abstract: Laser-induced forward transfer (LIFT) of functional materials offers unique advantages and capabilities for the rapid prototyping of electronic, optical and sensor elements. The use of LIFT for printing high viscosity metallic nano-inks and nano-pastes can be optimized for the transfer of voxels congruent with the shape of the laser pulse, forming thin film-like structures non-lithographically. These processes are capable of printing patterns with excellent lateral resolution and thickness uniformity typically found in 3-dimensional stacked assemblies, MEMS-like structures and free-standing interconnects. However, in order to achieve congruent voxel transfer with LIFT, the particle size and viscosity of the ink or paste suspensions must be adjusted to minimize variations due to wetting and drying effects. When LIFT is carried out with high-viscosity nano-suspensions, the printed voxel size and shape become controllable parameters, allowing the printing of thin-film like structures whose shape is determined by the spatial distribution of the laser pulse. The result is a new level of parallelization beyond current serial direct-write processes whereby the geometry of each printed voxel can be optimized according to the pattern design. This work shows how LIFT of congruent voxels can be applied to the fabrication of 2D

Laser-induced forward transfer (LIFT) of congruent voxels

International Nuclear Information System (INIS)

Piqué, Alberto; Kim, Heungsoo; Auyeung, Raymond C.Y.; Beniam, Iyoel; Breckenfeld, Eric

2016-01-01

Highlights: • Laser-induced forward transfer (LIFT) is demonstrated with high viscosity Ag nanopaste. • Under the right conditions (viscosity and fluence) the transfer of congruent voxels was achieved. • For viscosities under 100 Pa s, congruent voxel transfer of silver nano-suspensions is only possible under a very narrow range of conditions. • For viscosities over 100 Pa s, congruent voxel transfer of silver nano-pastes works over a wider range of fluences, donor substrate thickness, gap distances and voxel areas. • The laser transfer of congruent voxels can be used for printing electronic patterns in particular interconnects. - Abstract: Laser-induced forward transfer (LIFT) of functional materials offers unique advantages and capabilities for the rapid prototyping of electronic, optical and sensor elements. The use of LIFT for printing high viscosity metallic nano-inks and nano-pastes can be optimized for the transfer of voxels congruent with the shape of the laser pulse, forming thin film-like structures non-lithographically. These processes are capable of printing patterns with excellent lateral resolution and thickness uniformity typically found in 3-dimensional stacked assemblies, MEMS-like structures and free-standing interconnects. However, in order to achieve congruent voxel transfer with LIFT, the particle size and viscosity of the ink or paste suspensions must be adjusted to minimize variations due to wetting and drying effects. When LIFT is carried out with high-viscosity nano-suspensions, the printed voxel size and shape become controllable parameters, allowing the printing of thin-film like structures whose shape is determined by the spatial distribution of the laser pulse. The result is a new level of parallelization beyond current serial direct-write processes whereby the geometry of each printed voxel can be optimized according to the pattern design. This work shows how LIFT of congruent voxels can be applied to the fabrication of 2D

An unusual experience with endoscopic retrograde cholangiopancreatography

Directory of Open Access Journals (Sweden)

Mallikarjun Patil

2013-01-01

Full Text Available The endoscopic retrograde cholangiopancreatography (ERCP is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.

Importance of radiographic monitoring of endoscopic sphincterotomy

International Nuclear Information System (INIS)

Greenberg, H.M.; Goldberg, H.I.; Shapiro, H.A.

1981-01-01

The radiographic features of endoscopic sphincterotomies performed in 44 patients were evaluated. Radiographic landmarks aided in proper sphincterotome placement and also disclosed conditions and anatomic variations that made catheter placement difficult. Fluoroscopic and radiographic monitoring not only assisted the performance of endoscopic sphincterotomy, but also confirmed successful results and revealed reasons for failure. Radiographic changes in the biliary tract after sphincterotomy, as well as potential complications of sphincterotomy, are discussed and illustrated

Analysis of the Effects of Streamwise Lift Distribution on Sonic Boom Signature

Science.gov (United States)

Yoo, Paul

2013-01-01

Investigation of sonic boom has been one of the major areas of study in aeronautics due to the benefits a low-boom aircraft has in both civilian and military applications. This work conducts a numerical analysis of the effects of streamwise lift distribution on the shock coalescence characteristics. A simple wing-canard-stabilator body model is used in the numerical simulation. The streamwise lift distribution is varied by fixing the canard at a deflection angle while trimming the aircraft with the wing and the stabilator at the desired lift coefficient. The lift and the pitching moment coefficients are computed using the Missile DATCOM v. 707. The flow field around the wing-canard- stabilator body model is resolved using the OVERFLOW-2 flow solver. Overset/ chimera grid topology is used to simplify the grid generation of various configurations representing different streamwise lift distributions. The numerical simulations are performed without viscosity unless it is required for numerical stability. All configurations are simulated at Mach 1.4, angle-of-attack of 1.50, lift coefficient of 0.05, and pitching moment coefficient of approximately 0. Four streamwise lift distribution configurations were tested.

A Quasi-Steady Lifting Line Theory for Insect-Like Hovering Flight.

Directory of Open Access Journals (Sweden)

Mostafa R A Nabawy

Full Text Available A novel lifting line formulation is presented for the quasi-steady aerodynamic evaluation of insect-like wings in hovering flight. The approach allows accurate estimation of aerodynamic forces from geometry and kinematic information alone and provides for the first time quantitative information on the relative contribution of induced and profile drag associated with lift production for insect-like wings in hover. The main adaptation to the existing lifting line theory is the use of an equivalent angle of attack, which enables capture of the steady non-linear aerodynamics at high angles of attack. A simple methodology to include non-ideal induced effects due to wake periodicity and effective actuator disc area within the lifting line theory is included in the model. Low Reynolds number effects as well as the edge velocity correction required to account for different wing planform shapes are incorporated through appropriate modification of the wing section lift curve slope. The model has been successfully validated against measurements from revolving wing experiments and high order computational fluid dynamics simulations. Model predicted mean lift to weight ratio results have an average error of 4% compared to values from computational fluid dynamics for eight different insect cases. Application of an unmodified linear lifting line approach leads on average to a 60% overestimation in the mean lift force required for weight support, with most of the discrepancy due to use of linear aerodynamics. It is shown that on average for the eight insects considered, the induced drag contributes 22% of the total drag based on the mean cycle values and 29% of the total drag based on the mid half-stroke values.

Lifting simulation of an offshore supply vessel considering various operating conditions

Directory of Open Access Journals (Sweden)

Dong-Hoon Jeong

2016-06-01

Full Text Available Recently, an offshore support vessel is being widely used to install an offshore structure such as a subsea equipment which is laid on its deck. The lifting operation which is one of the installation operations includes lifting off, lifting in the air, splash zone crossing, deep submerging, and finally landing of the structure with an offshore support vessel crane. There are some major considerations during this operation. Especially, when lifting off the structure, if operating conditions such as ocean environmental loads and hoisting (or lowering speed are bad, the excess of tension of wire ropes of the crane and the collision between the offshore support vessel and the structure can be occurred due to the relative motion between them. To solve this problem, this study performs the lifting simulation while the offshore support vessel installs the structure. The simulation includes the calculation of dynamic responses of the offshore support vessel and the equipment, including the wire tension and the collision detection. To check the applicability of the simulation, it is applied to some lifting steps by varying operating conditions. As a result, it is confirmed that the conditions affect the operability of those steps.

Canadian East Coast offshore petroleum industry safe lifting practices respecting offshore pedestal cranes, offshore containers, loose gear, other lifting devices, and operational best practices : standard practices

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-11-15

This document was developed by a working group with representatives from the petroleum industry, the Offshore Petroleum Boards and Certifying Authorities. It outlines industry best practices for operators responsible for the management, planning and execution of offshore lifting operations. Its purpose is to assist in the interpretation of applicable legislation and standards. Considered within the practice are safe design requirements, manufacture, certification, testing, maintenance and inspection requirements for pedestal cranes, offshore containers, loose gear and lifting devices. Operational best practices for lifting operations are also included along with a section that identifies additional requirements for personnel lifting operations, including personnel transfers by crane and man-riding operations. 82 refs., 2 tabs., 4 figs., 3 appendices.

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

DEFF Research Database (Denmark)

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

1989-01-01

In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic cholangi......In patients with obstructive jaundice caused by malignant stricture of the extrahepatic bile duct we compared survival time, complication rates, hospitalisation requirements, and quality of life after palliation by endoscopic endoprosthesis or bypass surgery. During diagnostic endoscopic...... in survival between treatment groups or randomisation groups. No differences were found when other variables were compared. We conclude, that palliation of obstructive jaundice in malignant bile duct obstruction with endoscopically introduced endoprosthesis is as effective as operative bypass....

Heavy Lift Launch Capability with a New Hydrocarbon Engine

Science.gov (United States)

Threet, Grady E., Jr.; Holt, James B.; Philips, Alan D.; Garcia, Jessica A.

2011-01-01

The Advanced Concepts Office at NASA's George C. Marshall Space Flight Center was tasked to define the thrust requirement of a new liquid oxygen rich staged combustion cycle hydrocarbon engine that could be utilized in a launch vehicle to meet NASA s future heavy lift needs. Launch vehicle concepts were sized using this engine for different heavy lift payload classes. Engine out capabilities for one of the heavy lift configurations were also analyzed for increased reliability that may be desired for high value payloads or crewed missions. The applicability for this engine in vehicle concepts to meet military and commercial class payloads comparable to current ELV capability was also evaluated.

Vortex lift augmentation by suction on a 60 deg swept Gothic wing

Science.gov (United States)

Taylor, A. H.; Jackson, L. R.; Huffman, J. K.

1982-01-01

An experimental investigation was conducted in the Langley high-speed 7- by 10-foot wind tunnel to determine the aerodynamic performance of suction applied near the wing tips above the trailing edge of a 60 deg swept Gothic wing. Moveable suction inlets were symmetrically mounted in the proximity of the trailing edge, and the amount of suction was varied to maximize wing lift. Tests were conducted at Mach 0.15, 0.30, and 0.45, and the angle of attack was varied from -4 to 50 deg. The suction augmentation increases the lift coefficient over the entire range of angle of attack. The lift improvement exceeds the unaugmented wing lift by over 20%. Moreover, the augmented lift exceeds the lift predicted by vortex lattice theory to 30 deg angle of attack. Suction augmentation is postulated to strengthen the vortex system by increasing its velocity and making it more concentrated. This causes the vortex breakdown to be delayed to a higher angle of attack

Fatigue-related changes in the coordination of lifting and their effect of low back load

NARCIS (Netherlands)

Van Dieën, Jaap H.; Toussaint, Huub M.; Maurice, Cora; Mientjes, Martine

1996-01-01

In this study, changes in movement coordination caused by fatigue that developed during repetitive lifting were examined. Five men performed 6 times a 5-min bout of lifting an 8-kg barbell at 15 lifts/min, using two lifting techniques; one minimized trunk rotation (squat lift), and the other

Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy.

Science.gov (United States)

Lee, Doh Young; Baek, Seung-Kuk; Jung, Kwang-Yoon

2017-01-01

This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.

[Risk management for endoscopic surgery].

Science.gov (United States)

Kimura, Taizo

2010-05-01

The number of medical accidents in endoscopic surgery has recently increased. Surgical complications caused by inadequate preparation or immature technique or those resulting in serious adverse outcomes may be referred to as medical accidents. The Nationwide Survey of Endoscopic Surgery showed that bile duct injury and uncontrollable bleeding were seen in 0.68% and in 0.58%, respectively, of cholecystectomy patients; interoperative and postoperative complications in 0.84% and in 3.8%, respectively, of gastric cancer surgery patients; and operative complications in 6.74% of bowel surgery patients. Some required open repair, and 49 patients died. The characteristic causes of complications in endoscopic surgery are a misunderstanding of anatomy, handling of organs outside the visual field, burn by electrocautery, and injuries caused by forceps. Bleeding that requires a laparotomy for hemostasis is also a complication. Furthermore, since the surgery is usually videorecorded, immature techniques resulting in complications are easily discovered. To decrease the frequency of accidents, education through textbooks and seminars, training using training boxes, simulators, or animals, proper selection of the surgeon depending on the difficulty of the procedure, a low threshold for conversion to laparotomy, and use of the best optical equipment and surgical instruments are important. To avoid malpractice lawsuits, informed consent obtained before surgery and proper communication after accidents are necessary.

Endoscopic management of posterior epistaxis.

Science.gov (United States)

Paul, J; Kanotra, Sohit Paul; Kanotra, Sonika

2011-04-01

The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of the bleeding vessel. Of these, in four cases unsuspected diagnosis was made. Of the remaining 19, in three patients, the bleeding point could not be localized accurately and these patients were managed by anteroposterior packing. The rest of the 16 patients were managed by endoscopic cauterization. In four patients, there was recurrence of bleeding within 24 h. In one of these, cauterization controlled the bleeding while in the rest nasal packing had to be resorted to. Thus, of the 23 patients of posterior epistaxis subjected to nasal endoscopy, we could avoid nasal packing in 17 (74%). To conclude, endoscopic nasal cauterization is recommended as the first line to treatment in all cases of posterior epistaxis. This will not only prevent the uncomfortable and potentially dangerous nasal packing but also help in finding the underlying pathology.

The clinical and endoscopic spectrum of the watermelon stomach

NARCIS (Netherlands)

Gostout, C. J.; Viggiano, T. R.; Ahlquist, D. A.; Wang, K. K.; Larson, M. V.; Balm, R.

1992-01-01

The watermelon stomach is an uncommon but treatable cause of chronic gastrointestinal bleeding. We report our experience with the clinical and endoscopic features of 45 consecutive patients treated by endoscopic Nd:YAG laser coagulation. The prototypic patient was a woman (71%) with an average age

[Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess].

Science.gov (United States)

Yu, Huanxin; Liu, Gang

2014-01-01

To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess. Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded. All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach. Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

Endoscopic Submucosal Dissection: Indications and Application in Western Endoscopy Practice.

Science.gov (United States)

Bourke, Michael J; Neuhaus, Horst; Bergman, Jacques J

2018-05-01

Endoscopic submucosal dissection was developed in Japan, early in this century, to provide a minimally invasive yet curative treatment for the large numbers of patients with early gastric cancer identified by the national screening program. Previously, the majority of these patients were treated surgically at substantial cost and with significant risk of short- and long-term morbidity. En-bloc excision of these early cancers, most with a limited risk of nodal metastasis, allowed complete staging of the tumor, stratification of the subsequent therapeutic approach, and potential cure. This transformative innovation changed the nature of endoscopic treatment for superficial mucosal neoplasia and, ultimately, for the first time allowed endoscopists to assert that the early cancer had been definitively cured. Subsequently, Western endoscopists have increasingly embraced the therapeutic possibilities offered by endoscopic submucosal dissection, but with some justifiable scientific caution. Here we provide an evidence-based critical appraisal of the role of endoscopic submucosal dissection in advanced endoscopic tissue resection. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

Directory of Open Access Journals (Sweden)

Turan Calhan

2015-01-01

Full Text Available Duodenal intramural hematoma (DIH usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders.

Endoscopic burr hole evacuation of an acute subdural hematoma.

Science.gov (United States)

Codd, Patrick J; Venteicher, Andrew S; Agarwalla, Pankaj K; Kahle, Kristopher T; Jho, David H

2013-12-01

Acute subdural hematoma evacuations frequently necessitate large craniotomies with extended operative times and high relative blood loss, which can lead to additional morbidity for the patient. While endoscopic minimally invasive approaches to chronic subdural collections have been successfully demonstrated, this technique has not previously been applied to acute subdural hematomas. The authors report their experience with an 87-year-old patient presenting with a large acute right-sided subdural hematoma successfully evacuated via an endoscopic minimally invasive technique. The operative approach is outlined, and the literature on endoscopic subdural collection evacuation reviewed. Copyright © 2013. Published by Elsevier Ltd.

Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis.

Science.gov (United States)

Gong, Eun Jeong; Kim, Do Hoon; Chun, Joo Hyun; Ahn, Ji Yong; Choi, Kwi-Sook; Jung, Kee Wook; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon-Yong; Kim, Jin Ho; Song, In Hye; Kim, Yong-Gil

2016-07-15

Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low.

Software design to calculate and simulate the mechanical response of electromechanical lifts

Science.gov (United States)

Herrera, I.; Romero, E.

2016-05-01

Lift engineers and lift companies which are involved in the design process of new products or in the research and development of improved components demand a predictive tool of the lift slender system response before testing expensive prototypes. A method for solving the movement of any specified lift system by means of a computer program is presented. The mechanical response of the lift operating in a user defined installation and configuration, for a given excitation and other configuration parameters of real electric motors and its control system, is derived. A mechanical model with 6 degrees of freedom is used. The governing equations are integrated step by step through the Meden-Kutta algorithm in the MATLAB platform. Input data consists on the set point speed for a standard trip and the control parameters of a number of controllers and lift drive machines. The computer program computes and plots very accurately the vertical displacement, velocity, instantaneous acceleration and jerk time histories of the car, counterweight, frame, passengers/loads and lift drive in a standard trip between any two floors of the desired installation. The resulting torque, rope tension and deviation of the velocity plot with respect to the setpoint speed are shown. The software design is implemented in a demo release of the computer program called ElevaCAD. Further on, the program offers the possibility to select the configuration of the lift system and the performance parameters of each component. In addition to the overall system response, detailed information of transients, vibrations of the lift components, ride quality levels, modal analysis and frequency spectrum (FFT) are plotted.

Engineering aspects of a fully mirrored endoscope

International Nuclear Information System (INIS)

Terra, A.; Huber, A.; Schweer, B.; Mertens, Ph.; Arnoux, G.; Balshaw, N.; Brezinsek, S.; Egner, S.; Hartl, M.; Kampf, D.; Klammer, J.; Lambertz, H.T.; Morlock, C.; Murari, A.; Reindl, M.; Sanders, S.; Sergienko, G.; Spencer, G.

2013-01-01

Highlights: ► Replacement of JET diagnostics to match the new ITER-like Wall. ► The endoscope test ITER-like design with only mirror based optics. ► Withstanding and diagnostic capability during Plasma operation and disruptions. ► Engineering process from design to installation and procurement. -- Abstract: The development of optical diagnostics, like endoscopes, compatible with the ITER environment (metallic plasma facing components, neutron proof optics, etc.) is a challenge, but current tokamaks such as JET provide opportunities to test fully working concepts. This paper describes the engineering aspects of a fully mirrored endoscope that has recently been designed, procured and installed on JET. The system must operate in a very strict environment with high temperature, high magnetic fields up to B = 4 T and rapid field variations (∂B/∂t ∼ 100 T/s) that induce high stresses due to eddy currents in the front mirror assembly. It must be designed to withstand high mechanical loads especially during disruptions, which lead to acceleration of about 7 g at 14 Hz. For the JET endoscope, when the plasma thermal loading, direct and indirect, was added to the assumed disruption loads, the reserve factor, defined as a ratio of yield strength over summed up von Mises stresses, was close to 1 for the mirror components. To ensure reliable operation, several analyses were performed to evaluate the thermo-mechanical performance of the endoscope and a final validation was obtained from mechanical and thermal tests, before the system's final installation in May 2011. During the tests, stability of the field of view angle variation was kept below 1° despite the high thermal gradient on endoscope head (∂T/∂x ∼ 500 K/m). In parallel, to ensure long time operation and to prevent undesirable performance degradation, a shutter system was also implemented in order to reduce impurity deposition on in-vessel mirrors but also to allow in situ transmission calibration

Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma.

Science.gov (United States)

Kawakubo, Kazumichi; Kawakami, Hiroshi; Kuwatani, Masaki; Haba, Shin; Kudo, Taiki; Taya, Yoko A; Kawahata, Shuhei; Kubota, Yoshimasa; Kubo, Kimitoshi; Eto, Kazunori; Ehira, Nobuyuki; Yamato, Hiroaki; Onodera, Manabu; Sakamoto, Naoya

2016-05-10

To identify the most effective endoscopic biliary drainage technique for patients with hilar cholangiocarcinoma. In total, 118 patients with hilar cholangiocarcinoma underwent endoscopic management [endoscopic nasobiliary drainage (ENBD) or endoscopic biliary stenting] as a temporary drainage in our institution between 2009 and 2014. We retrospectively evaluated all complications from initial endoscopic drainage to surgery or palliative treatment. The risk factors for biliary reintervention, post-endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis, and percutaneous transhepatic biliary drainage (PTBD) were also analyzed using patient- and procedure-related characteristics. The risk factors for bilateral drainage were examined in a subgroup analysis of patients who underwent initial unilateral drainage. In total, 137 complications were observed in 92 (78%) patients. Biliary reintervention was required in 83 (70%) patients. ENBD was significantly associated with a low risk of biliary reintervention [odds ratio (OR) = 0.26, 95%CI: 0.08-0.76, P = 0.012]. Post-ERCP pancreatitis was observed in 19 (16%) patients. An absence of endoscopic sphincterotomy was significantly associated with post-ERCP pancreatitis (OR = 3.46, 95%CI: 1.19-10.87, P = 0.023). PTBD was required in 16 (14%) patients, and Bismuth type III or IV cholangiocarcinoma was a significant risk factor (OR = 7.88, 95%CI: 1.33-155.0, P = 0.010). Of 102 patients with initial unilateral drainage, 49 (48%) required bilateral drainage. Endoscopic sphincterotomy (OR = 3.24, 95%CI: 1.27-8.78, P = 0.004) and Bismuth II, III, or IV cholangiocarcinoma (OR = 34.69, 95%CI: 4.88-736.7, P hilar cholangiocarcinoma is challenging. ENBD should be selected as a temporary drainage method because of its low risk of complications.

Autoignited lifted flames of dimethyl ether in heated coflow air

KAUST Repository

Al-Noman, Saeed M.

2018-05-16

Autoignited lifted flames of dimethyl ether (DME) in laminar nonpremixed jets with high-temperature coflow air have been studied experimentally. When the initial temperature was elevated to over 860 K, an autoignition occurred without requiring an external ignition source. A planar laser-induced fluorescence (PLIF) technique for formaldehyde (CH2O) visualized qualitatively the zone of low temperature kinetics in a premixed flame. Two flame configurations were investigated; (1) autoignited lifted flames with tribrachial edge having three distinct branches of a lean and a rich premixed flame wings with a trailing diffusion flame and (2) autoignited lifted flames with mild combustion when the fuel was highly diluted. For the autoignited tribrachial edge flames at critical autoignition conditions, exhibiting repetitive extinction and re-ignition phenomena near a blowout condition, the characteristic flow time (liftoff height scaled with jet velocity) was correlated with the square of the ignition delay time of the stoichiometric mixture. The liftoff heights were also correlated as a function of jet velocity times the square of ignition delay time. Formaldehydes were observed between the fuel nozzle and the lifted flame edge, emphasizing a low-temperature kinetics for autoignited lifted flames, while for a non-autoignited lifted flame, formaldehydes were observed near a thin luminous flame zone.For the autoignited lifted flames with mild combustion, especially at a high temperature, a unique non-monotonic liftoff height behavior was observed; decreasing and then increasing liftoff height with jet velocity. This behavior was similar to the binary mixture fuels of CH4/H2 and CO/H2 observed previously. A transient homogeneous autoignition analysis suggested that such decreasing behavior with jet velocity can be attributed to partial oxidation characteristics of DME in producing appreciable amounts of CH4/CO/H2 ahead of the edge flame region.

Heavy Lift Launch Capability with a New Hydrocarbon Engine (NHE)

Science.gov (United States)

Threet, Grady E., Jr.; Holt, James B.; Philips, Alan D.; Garcia, Jessica A.

2011-01-01

The Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center has analyzed over 2000 Ares V and other heavy lift concepts in the last 3 years. These concepts were analyzed for Lunar Exploration Missions, heavy lift capability to Low Earth Orbit (LEO) as well as exploratory missions to other near earth objects in our solar system. With the pending retirement of the Shuttle fleet, our nation will be without a civil heavy lift launch capability, so the future development of a new heavy lift capability is imperative for the exploration and large science missions our Agency has been tasked to deliver. The majority of the heavy lift concepts analyzed by ACO during the last 3 years have been based on liquid oxygen / liquid hydrogen (LOX/LH2) core stage and solids booster stage propulsion technologies (Ares V / Shuttle Derived and their variants). These concepts were driven by the decisions made from the results of the Exploration Systems Architecture Study (ESAS), which in turn, led to the Ares V launch vehicle that has been baselined in the Constellation Program. Now that the decision has been made at the Agency level to cancel Constellation, other propulsion options such as liquid hydrocarbon fuels are back in the exploration trade space. NASA is still planning exploration missions with the eventual destination of Mars and a new heavy lift launch vehicle is still required and will serve as the centerpiece of our nation s next exploration architecture s infrastructure. With an extensive launch vehicle database already developed on LOX/LH2 based heavy lift launch vehicles, ACO initiated a study to look at using a new high thrust (> 1.0 Mlb vacuum thrust) hydrocarbon engine as the primary main stage propulsion in such a launch vehicle.

Autoignited lifted flames of dimethyl ether in heated coflow air

KAUST Repository

Al-Noman, Saeed M.; Choi, Byung Chul; Chung, Suk-Ho

2018-01-01

Autoignited lifted flames of dimethyl ether (DME) in laminar nonpremixed jets with high-temperature coflow air have been studied experimentally. When the initial temperature was elevated to over 860 K, an autoignition occurred without requiring an external ignition source. A planar laser-induced fluorescence (PLIF) technique for formaldehyde (CH2O) visualized qualitatively the zone of low temperature kinetics in a premixed flame. Two flame configurations were investigated; (1) autoignited lifted flames with tribrachial edge having three distinct branches of a lean and a rich premixed flame wings with a trailing diffusion flame and (2) autoignited lifted flames with mild combustion when the fuel was highly diluted. For the autoignited tribrachial edge flames at critical autoignition conditions, exhibiting repetitive extinction and re-ignition phenomena near a blowout condition, the characteristic flow time (liftoff height scaled with jet velocity) was correlated with the square of the ignition delay time of the stoichiometric mixture. The liftoff heights were also correlated as a function of jet velocity times the square of ignition delay time. Formaldehydes were observed between the fuel nozzle and the lifted flame edge, emphasizing a low-temperature kinetics for autoignited lifted flames, while for a non-autoignited lifted flame, formaldehydes were observed near a thin luminous flame zone.For the autoignited lifted flames with mild combustion, especially at a high temperature, a unique non-monotonic liftoff height behavior was observed; decreasing and then increasing liftoff height with jet velocity. This behavior was similar to the binary mixture fuels of CH4/H2 and CO/H2 observed previously. A transient homogeneous autoignition analysis suggested that such decreasing behavior with jet velocity can be attributed to partial oxidation characteristics of DME in producing appreciable amounts of CH4/CO/H2 ahead of the edge flame region.

Diagnosis and treatment with endoscopic retrograde cholangiopancreatography

International Nuclear Information System (INIS)

Soendenaa, K.; Horn, A.; Viste, A.

1994-01-01

Endoscopic retrograde cholangiopancreatography (ERCP) was carried out for the first time in 1968. Five years later endoscopic sphincterotomy was performed. Since then both modalities have become established as necessary adjuncts in the diagnosis and treatment of patients with pathology in the bile duct or pancreas. The main indication is common bile duct stone, and as a consequence of this treatment fewer patients are now treated surgically. Patients with malignant bile duct obstruction can be given reasonable palliation of both jaundice and pruritus and therefore improved quality of life. Some reports indicate that endoscopic drainage may be useful for pancreatic stenosis. Complications are few, but vigilance and prompt treatment is necessary to keep morbidity at a minimum. Follow-up after several years shows that sphincterotomy is successful also in the long term. The authors discuss the present diagnostic and therapeutic situation. 31 refs., 2 tabs

Soccer ball lift coefficients via trajectory analysis

International Nuclear Information System (INIS)

Goff, John Eric; Carre, Matt J

2010-01-01

We performed experiments in which a soccer ball was launched from a machine while two high-speed cameras recorded portions of the trajectory. Using the trajectory data and published drag coefficients, we extracted lift coefficients for a soccer ball. We determined lift coefficients for a wide range of spin parameters, including several spin parameters that have not been obtained by today's wind tunnels. Our trajectory analysis technique is not only a valuable tool for professional sports scientists, it is also accessible to students with a background in undergraduate-level classical mechanics.

Soccer ball lift coefficients via trajectory analysis

Energy Technology Data Exchange (ETDEWEB)

Goff, John Eric [Department of Physics, Lynchburg College, Lynchburg, VA 24501 (United States); Carre, Matt J, E-mail: goff@lynchburg.ed [Department of Mechanical Engineering, University of Sheffield, Sheffield S1 3JD (United Kingdom)

2010-07-15

We performed experiments in which a soccer ball was launched from a machine while two high-speed cameras recorded portions of the trajectory. Using the trajectory data and published drag coefficients, we extracted lift coefficients for a soccer ball. We determined lift coefficients for a wide range of spin parameters, including several spin parameters that have not been obtained by today's wind tunnels. Our trajectory analysis technique is not only a valuable tool for professional sports scientists, it is also accessible to students with a background in undergraduate-level classical mechanics.

Asymmetric Gepner models II. Heterotic weight lifting

International Nuclear Information System (INIS)

Gato-Rivera, B.; Schellekens, A.N.

2011-01-01

A systematic study of 'lifted' Gepner models is presented. Lifted Gepner models are obtained from standard Gepner models by replacing one of the N=2 building blocks and the E 8 factor by a modular isomorphic N=0 model on the bosonic side of the heterotic string. The main result is that after this change three family models occur abundantly, in sharp contrast to ordinary Gepner models. In particular, more than 250 new and unrelated moduli spaces of three family models are identified. We discuss the occurrence of fractionally charged particles in these spectra.

Endoscopic Camera Control by Head Movements for Thoracic Surgery

NARCIS (Netherlands)

Reilink, Rob; de Bruin, Gart; Franken, M.C.J.; Mariani, Massimo A.; Misra, Sarthak; Stramigioli, Stefano

2010-01-01

In current video-assisted thoracic surgery, the endoscopic camera is operated by an assistant of the surgeon, which has several disadvantages. This paper describes a system which enables the surgeon to control the endoscopic camera without the help of an assistant. The system is controlled using

Bilateral endoscopic endonasal marsupialization of nasopalatine duct cyst

Directory of Open Access Journals (Sweden)

Yohei Honkura

2015-02-01

Full Text Available Nasopalatine duct cysts are the most common non-odontogenic cysts in the maxilla, and are conventionally treated through a sublabial or palatine approach. Recently, the endoscopic approach has been used, but experience is extremely limited. We treated a 29-year-old male with nasopalatine duct cyst by endoscopic marsupialization, but paresthesia of the incisor region occurred after surgery. This paresthesia gradually remitted within 6 months. The nasopalatine nerve, which innervates the upper incisor region, enters two lateral canals separately at the nasal floor and exits the central main canal at the palate. Damage to the bilateral nasopalatine nerves might lead to paresthesia, so we recommend careful examination for nerve fibers during endoscopic surgery, especially if fenestration is performed on both sides.

Cracked lifting lug welds on ten-ton UF{sub 6} cylinders

Energy Technology Data Exchange (ETDEWEB)

Dorning, R.E. [Martin Marietta Energy Systems, Inc., Piketon, OH (United States)

1991-12-31

Ten-ton, Type 48X, UF{sub 6} cylinders are used at the Portsmouth Gaseous Diffusion Plant to withdraw enriched uranium hexafluoride from the cascade, transfer enriched uranium hexafluoride to customer cylinders, and feed enriched product to the cascade. To accomplish these activities, the cylinders are lifted by cranes and straddle carriers which engage the cylinder lifting lugs. In August of 1988, weld cracks on two lifting lugs were discovered during preparation to lift a cylinder. The cylinder was rejected and tagged out, and an investigating committee formed to determine the cause of cracking and recommend remedial actions. Further investigation revealed the problem may be general to this class of cylinder in this use cycle. This paper discusses the actions taken at the Portsmouth site to deal with the cracked lifting lug weld problem. The actions include inspection activities, interim corrective actions, metallurgical evaluation of cracked welds, weld repairs, and current monitoring/inspection program.

Sunspots and the physics of magnetic flux tubes. III - Aerodynamic lift

Science.gov (United States)

Parker, E. N.

1979-01-01

The aerodynamic lift exerted on a magnetic flux tube by the asymmetric flow around the two sides of the tube is calculated as part of an investigation of the physics of solar flux tubes. The general hydrodynamic forces on a rigid circular cylinder in a nonuniform flow of an ideal fluid are derived from the first derivatives of the velocity field. Aerodynamic lift in a radial nonuniform flow is found to act in the direction of the flow, toward the region of increased flow velocity, while in a shear flow, lift is perpendicular to the free stream and directed toward increasing flow velocity. For a general, three dimensional, large-scale stationary incompressible equilibrium flow, an expression is also derived relating the lift per unit length to the dynamical pressure, cylinder radius and the gradient of the free-stream velocity. Evidence from an asymmetric airfoil in a uniform flow indicates that lift is enhanced in a real fluid in the presence of turbulence.

Radiological findings after endoscopic incision of ureterocele

International Nuclear Information System (INIS)

Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang; Cheon, Jung Eun; Seok, Eul Hye; Cha, Joo Hee; Choi, Guk Myung

2001-01-01

Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required

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.

A comparison of microdebrider assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for nasal polypi.

Science.gov (United States)

Singh, Rohit; Hazarika, Produl; Nayak, Dipak Ranjan; Balakrishnan, R; Gangwar, Navneeta; Hazarika, Manali

2013-07-01

Nasal polyposis is often encountered in rhinology practice. Those who fail conservative management, a definitive surgery is essential to achieve sufficient ventilation and drainage of the affected sinuses by using either microdebrider or conventional instruments for functional endoscopic sinus surgery (FESS). A prospective study was conducted on 40 cases of nasal polypi in a tertiary care hospital. 20 cases were operated by conventional endoscopic instruments and 20 using the microdebrider. The study aimed at comparing the intra operative (blood loss, duration of surgery) and post operative results (crusting, scarring, discharge, symptoms, recurrence) between the two groups using Lund-Mackay scoring system and the data was statistically analysed. There was no statistically significant difference in surgical outcome for patients when either conventional endoscopic instruments or microdebrider was used. However, there was a significant symptomatic improvement in cases undergoing microdebrider FESS. Microdebrider assisted polypectomy is precise, relatively bloodless surgery though the precision depends on the surgeon's anatomical knowledge and operative skills. Study substantiates that these instruments are helpful but not a prerequisite for successful outcomes in FESS. The study re-emphasises the utility of the microdebrider to young learning FESS surgeons.

Simulation of temperature-pressure profiles and wax deposition in gas-lift wells

Directory of Open Access Journals (Sweden)

Sevic Snezana

2017-01-01

Full Text Available Gas-lift is an artificial lift method in which gas is injected down the tubing- -casing annulus and enters the production tubing through the gas-lift valves to reduce the hydrostatic pressure of the formation fluid column. The gas changes pressure, temperature and fluid composition profiles throughout the production tubing string. Temperature and pressure drop along with the fluid composition changes throughout the tubing string can lead to wax, asphaltenes and inorganic salts deposition, increased emulsion stability and hydrate formation. This paper presents a new model that can sucesfully simulate temperature and pressure profiles and fluid composition changes in oil well that operates by means of gas-lift. This new model includes a pipe-in-pipe segment (production tubing inside production casing, countercurrent flow of gas-lift gas and producing fluid, heat exchange between gas-lift gas and the surrounding ambient – ground; and gas-lift gas with the fluid in the tubing. The model enables a better understanding of the multiphase fluid flow up the production tubing. Model was used to get insight into severity and locations of wax deposition. The obtained information on wax deposition can be used to plan the frequency and depth of wax removing operations. Model was developed using Aspen HYSYS software.

Comparative cost-efficiency of the EVOTECH endoscope cleaner and reprocessor versus manual cleaning plus automated endoscope reprocessing in a real-world Canadian hospital endoscopy setting

Directory of Open Access Journals (Sweden)

Shum Cynthia

2011-10-01

Full Text Available Abstract Background Reprocessing of endoscopes generally requires labour-intensive manual cleaning followed by high-level disinfection in an automated endoscope reprocessor (AER. EVOTECH Endoscope Cleaner and Reprocessor (ECR is approved for fully automated cleaning and disinfection whereas AERs require manual cleaning prior to the high-level disinfection procedure. The purpose of this economic evaluation was to determine the cost-efficiency of the ECR versus AER methods of endoscopy reprocessing in an actual practice setting. Methods A time and motion study was conducted at a Canadian hospital to collect data on the personnel resources and consumable supplies costs associated with the use of EVOTECH ECR versus manual cleaning followed by AER with Medivators DSD-201. Reprocessing of all endoscopes was observed and timed for both reprocessor types over three days. Laboratory staff members were interviewed regarding the consumption and cost of all disposable supplies and equipment. Exact Wilcoxon rank sum test was used for assessing differences in total cycle reprocessing time. Results Endoscope reprocessing was significantly shorter with the ECR than with manual cleaning followed by AER. The differences in median time were 12.46 minutes per colonoscope (p Conclusions The EVOTECH ECR was more efficient and less costly to use for the reprocessing of endoscopes than manual cleaning followed by AER disinfection. Although the cost of consumable supplies required to reprocess endoscopes with EVOTECH ECR was slightly higher, the value of the labour time saved with EVOTECH ECR more than offset the additional consumables cost. The increased efficiency with EVOTECH ECR could lead to even further cost-savings by shifting endoscopy laboratory personnel responsibilities but further study is required.

Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.

Science.gov (United States)

Larson, R N; Ginn, J A; Bell, C M; Davis, M J; Foy, D S

2012-01-01

The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported. To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity. 51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies. Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated. Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%. Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Molecular Endoscopic Ultrasound for Diagnosis of Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Bournet, Barbara [Department of Gastroenterology, University Hospital Center Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9 (France); INSERM U1037, University Hospital Center Rangueil, Toulouse (France); Pointreau, Adeline; Delpu, Yannick; Selves, Janick; Torrisani, Jerome [INSERM U1037, University Hospital Center Rangueil, Toulouse (France); Buscail, Louis, E-mail: buscail.l@chu-toulouse.fr [Department of Gastroenterology, University Hospital Center Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9 (France); INSERM U1037, University Hospital Center Rangueil, Toulouse (France); Cordelier, Pierre [INSERM U1037, University Hospital Center Rangueil, Toulouse (France)

2011-02-24

Endoscopic ultrasound-guided fine needle aspiration-biopsy is a safe and effective technique in diagnosing and staging of pancreatic ductal adenocarcinoma. However its predictive negative value does not exceed 50% to 60%. Unfortunately, the majority of pancreatic cancer patients have a metastatic and/or a locally advanced disease (i.e., not eligible for curative resection) which explains the limited access to pancreatic tissue specimens. Endoscopic ultrasound-guided fine needle aspiration-biopsy is the most widely used approach for cytological and histological material sampling in these situations used in up to two thirds of patients with pancreatic cancer. Based on this unique material, we and others developed strategies to improve the differential diagnosis between carcinoma and inflammatory pancreatic lesions by analysis of KRAS oncogene mutation, microRNA expression and methylation, as well as mRNA expression using both qRT-PCR and Low Density Array Taqman analysis. Indeed, differentiating pancreatic cancer from pseudotumoral chronic pancreatitis remains very difficult in current clinical practice, and endoscopic ultrasound-guided fine needle aspiration-biopsy analysis proved to be very helpful. In this review, we will compile the clinical and molecular advantages of using endoscopic ultrasound-guided fine needle aspiration-biopsy in managing pancreatic cancer.

Molecular Endoscopic Ultrasound for Diagnosis of Pancreatic Cancer

International Nuclear Information System (INIS)

Bournet, Barbara; Pointreau, Adeline; Delpu, Yannick; Selves, Janick; Torrisani, Jerome; Buscail, Louis; Cordelier, Pierre

2011-01-01

Endoscopic ultrasound-guided fine needle aspiration-biopsy is a safe and effective technique in diagnosing and staging of pancreatic ductal adenocarcinoma. However its predictive negative value does not exceed 50% to 60%. Unfortunately, the majority of pancreatic cancer patients have a metastatic and/or a locally advanced disease (i.e., not eligible for curative resection) which explains the limited access to pancreatic tissue specimens. Endoscopic ultrasound-guided fine needle aspiration-biopsy is the most widely used approach for cytological and histological material sampling in these situations used in up to two thirds of patients with pancreatic cancer. Based on this unique material, we and others developed strategies to improve the differential diagnosis between carcinoma and inflammatory pancreatic lesions by analysis of KRAS oncogene mutation, microRNA expression and methylation, as well as mRNA expression using both qRT-PCR and Low Density Array Taqman analysis. Indeed, differentiating pancreatic cancer from pseudotumoral chronic pancreatitis remains very difficult in current clinical practice, and endoscopic ultrasound-guided fine needle aspiration-biopsy analysis proved to be very helpful. In this review, we will compile the clinical and molecular advantages of using endoscopic ultrasound-guided fine needle aspiration-biopsy in managing pancreatic cancer

The hybrid assistive limb (HAL) for Care Support successfully reduced lumbar load in repetitive lifting movements.

Science.gov (United States)

Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

2018-05-03

Work-related low back pain is a serious socioeconomic problem. This study examined whether HAL for Care Support, which is a newly developed wearable robot, would decrease lumbar fatigue and improve lifting performance during repetitive lifting movements. Eighteen healthy volunteers (11 men, 7 women) performed repetitive stoop lifting movements of a cardboard box weighing 12 kg as many times as possible. The first lifting trial was executed without HAL for Care Support, and the second was with it. We evaluated the VAS of lumbar fatigue as the lumbar load and the number of lifts and the lifting time as lifting performance. Without HAL for Care Support, the mean VAS of lumbar fatigue, the number of lifts and lifting time were 68 mm, 60 and 230 s; with HAL for Care Support, they were 51 mm, 87 and 332 s, respectively. Both lifting performance measures were significantly improved by using HAL for Care Support (Fig. 2). A power analysis showed that there was sufficient statistical power for the VAS of lumbar fatigue (0.99), the number of lifts (0.92), and lifting time (0.93). All participants performed their repetitive lifting trials safely. There were no adverse events caused by using HAL for Care Support. In conclusion, the HAL for Care Support can decrease lumbar load and improve the lifting performance during repetitive stoop lifting movements in healthy adults. Copyright © 2018. Published by Elsevier Ltd.

A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy

NARCIS (Netherlands)

Bergman, J. J.; van Berkel, A. M.; Bruno, M. J.; Fockens, P.; Rauws, E. A.; Tijssen, J. G.; Tytgat, G. N.; Huibregtse, K.

2001-01-01

BACKGROUND: A prior Billroth II gastrectomy renders endoscopic sphincterotomy (EST) more difficult in patients with bile duct stones. Endoscopic balloon dilation (EBD) is a relatively easy procedure that potentially reduces the risk of bleeding and perforation. METHODS: Thirty-four patients with

Fuel Cell-Powered Lift Truck Fleet Deployment Projects Final Technical Report May 2014

Energy Technology Data Exchange (ETDEWEB)

Klingler, James J [GENCO Infrastructure Solutions, Inc.

2014-05-06

The overall objectives of this project were to evaluate the performance, operability and safety of fork lift trucks powered by fuel cells in large distribution centers. This was accomplished by replacing the batteries in over 350 lift trucks with fuel cells at five distribution centers operated by GENCO. The annual cost savings of lift trucks powered by fuel cell power units was between $2,400 and $5,300 per truck compared to battery powered lift trucks, excluding DOE contributions. The greatest savings were in fueling labor costs where a fuel cell powered lift truck could be fueled in a few minutes per day compared to over an hour for battery powered lift trucks which required removal and replacement of batteries. Lift truck operators where generally very satisfied with the performance of the fuel cell power units, primarily because there was no reduction in power over the duration of a shift as experienced with battery powered lift trucks. The operators also appreciated the fast and easy fueling compared to the effort and potential risk of injury associated with switching heavy batteries in and out of lift trucks. There were no safety issues with the fueling or operation of the fuel cells. Although maintenance costs for the fuel cells were higher than for batteries, these costs are expected to decrease significantly in the next generation of fuel cells, making them even more cost effective.

NASA safety standard for lifting devices and equipment

Science.gov (United States)

1990-09-01

NASA's minimum safety requirements are established for the design, testing, inspection, maintenance, certification, and use of overhead and gantry cranes (including top running monorail, underhung, and jib cranes), mobile cranes, derrick hoists, and special hoist supported personnel lifting devices (these do not include elevators, ground supported personnel lifts, or powered platforms). Minimum requirements are also addressed for the testing, inspection, and use of Hydra-sets, hooks, and slings. Safety standards are thoroughly detailed.

Dynamic response of Hovercraft lift fans

Science.gov (United States)

Moran, D. D.

1981-08-01

Hovercraft lift fans are subjected to varying back pressure due to wave action and craft motions when these vehicles are operating in a seaway. The oscillatory back pressure causes the fans to perform dynamically, exhibiting a hysteresis type of response and a corresponding degradation in mean performance. Since Hovercraft motions are influenced by variations in lift fan pressure and discharge, it is important to understand completely the nature of the dynamic performance of lift fans in order to completely solve the Hovercraft seakeeping problem. The present study was performed to determine and classify the instabilities encountered in a centrifugal fan operating against time-varying back pressure. A model-scale experiment was developed in which the fan discharge was directed into a flow-measuring device, terminating in a rotating valve which produced an oscillatory back pressure superimposed upon a mean aerodynamic resistance. Pressure and local velocity were measured as functions of time at several locations in the fan volute. The measurements permitted the identification of rotating (or propagating) stall in the impeller. One cell and two cell configurations were classified and the transient condition connecting these two configurations was observed. The mechanisms which lead to rotating stall in a centrifugal compressor are presented and discussed with specific reference to Hovercraft applications.

Advances in endoscopic retrograde cholangiopancreatography

Directory of Open Access Journals (Sweden)

WANG Xiangping

2018-03-01

Full Text Available Endoscopic retrograde cholangiopancreatography (ERCP is a well-established advanced endoscopic technique for the diagnosis and treatment of pancreatobiliary diseases. New advances have been made in the treatment concept and techniques of ERCP in recent years. This article elaborates on the recent advances in ERCP, including the application of pancreatic duct stent, non-steroidal anti-inflammatory drugs, and aggressive hydration to prevent postoperative pancreatitis, covered metal stent for the treatment of benign bile duct stenosis, intraluminal radiofrequency ablation for malignant bile duct stenosis, extracorporeal shockwave lithotripsy and covered metal stent for the treatment of chronic pancreatitis, peroral choledochoscopy for qualitative diagnosis of bile duct stenosis and huge refractory stones, definition of difficult intubation, timing of pre-cut technique, and ERCP after gastrointestinal reconstruction.

Occupational lifting during pregnancy and child's birth size in a large cohort study

DEFF Research Database (Denmark)

Juhl, Mette; Larsen, Pernille Stemann; Andersen, Per Kragh

2014-01-01

OBJECTIVES: It has been suggested that the handling of heavy loads during pregnancy is associated with impaired fetal growth. We examined the association between quantity and frequency of maternal occupational lifting and the child's size at birth, measured by weight, length, ponderal index, small......-for-gestational-age (SGA), abdominal circumference, head circumference, and placental weight. METHODS: We analyzed birth size from the Danish Medical Birth Registry of 66 693 live-born children in the Danish National Birth Cohort according to the mother's self-reported information on occupational lifting from telephone...... women with occupational lifting versus women with no lifting, but the differences were very small, and there was a statistically significant trend only for placental weight showing lighter weight with increasing number of kilos lifted per day. In jobs likely to include person-lifting, we found increased...

Lifting as You Climb

Science.gov (United States)

Sullivan, Debra R.

2009-01-01

This article addresses leadership themes and answers leadership questions presented to "Exchange" by the Panel members who attended the "Exchange" Panel of 300 Reception in Dallas, Texas, last November. There is an old proverb that encourages people to lift as they climb: "While you climb a mountain, you must not forget others along the way." With…

Endoscopic full-thickness resection of gastric subepithelial tumors: a single-center series.

Science.gov (United States)

Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; von Renteln, Daniel; Muehleisen, Helmut; Caca, Karel

2015-02-01

Endoscopic full-thickness resection of gastric subepithelial tumors with a full-thickness suturing device has been described as feasible in two small case series. The aim of this study was to evaluate the efficacy, safety, and clinical outcome of this resection technique. After 31 patients underwent endoscopic full-thickness resection, the data were analyzed retrospectively. Before snare resection, 1 to 3 full-thickness sutures were placed underneath each tumor with a device originally designed for endoscopic anti-reflux therapy. All tumors were resected successfully. Bleeding occurred in 12 patients (38.7 %); endoscopic hemostasis could be achieved in all cases. Perforation occurred in 3 patients (9.6 %), and all perforations could be managed endoscopically. Complete resection was histologically confirmed in 28 of 31 patients (90.3 %). Mean follow-up was 213 days (range, 1 - 1737), and no tumor recurrences were observed. Endoscopic full-thickness resection of gastric subepithelial tumors with the suturing technique described above is feasible and effective. After the resection of gastrointestinal stromal tumors (GISTs), we did not observe any recurrences during follow-up, indicating that endoscopic full-thickness resection may be an alternative to surgical resection for selected patients. © Georg Thieme Verlag KG Stuttgart · New York.

Flexible endoscope-assisted evacuation of chronic subdural hematomas.

Science.gov (United States)

Májovský, Martin; Masopust, Václav; Netuka, David; Beneš, Vladimír

2016-10-01

Chronic subdural hematoma (CSDH) is a common neurosurgical condition with an increasing incidence. Standard treatment of CSDHs is surgical evacuation. The objective of this study is to present a modification of standard burr-hole hematoma evacuation using a flexible endoscope and to assess the advantages and risks. Prospectively, 34 consecutive patients diagnosed with CSDH were included in the study. Epidemiological, clinical and radiographical data were collected and reviewed. All patients underwent a burr-hole evacuation of CSDH. A flexible endoscope was inserted and subdural space inspected during surgery. The surgeon was looking specifically for the presence of septations, draining catheter position and acute bleeding. Thirty-four patients underwent 37 endoscope-assisted surgeries. Presenting symptoms were hemiparesis (79%), decreased level of consciousness (18%), gait disturbances (15%), headache (12%), aphasia (6%), cognitive disturbances (6%) and epileptic seizure (3%). Average operative time was 43 min, and the average increase in operative time due to the use of the endoscope was 6 min. Recurrence rate was 8.8%, and clinical outcome was favorable (defined as mRS ≤ 2) in 97% of the cases. To our knowledge, the present cohort of 34 patients is the largest group of patients with CSDH treated using an endoscope. This technique allows decent visualization of the hematoma cavity while retaining the advantages of a minimally invasive approach under a local anesthesia. The main advantages are correct positioning of the catheter under visual control, identification of septations and early detection of cortex or vessel injury during surgery.

Experimental transapical endoscopic ventricular visualization and mitral repair.

Science.gov (United States)

Ruttkay, Tamas; Czesla, Markus; Nagy, Henrietta; Götte, Julia; Baksa, Gabor; Patonay, Lajos; Doll, Nicolas; Galajda, Zoltan

2015-04-01

An increasing number of experimental beating heart animal studies describe simple transapical mitral valve repairs based on the direct endoscopic visualization of the left ventricle. The aim of our human cadaveric study was to develop a method for more complex transapical endoscopic procedures by on-pump heart operations. After preparation of 20 human fresh cadavers, a standard left anterolateral minithoracotomy was performed in the fifth intercostal space and the pericardium was entered. A rigid 0 degree endoscope and the instruments were introduced through a silicon apical port. To restore the natural form of the left heart, CO2 was insufflated. To test the mitral valve competence, the left ventricle was pressure-injected with saline after each step. After transecting the chords of the A2 segment of the anterior mitral leaflet before the experimental mitral valve repair, the tendinous chord was replaced using an especially designed clip chord. The second part of the experiment consisted of a segmental excision of the P2 segment of the posterior mitral leaflet followed by a standard valvuloplasty and suture annuloplasty. With the help of the described transapical endoscopic mitral valve repair technique, we gained direct visual information of the coaptation line of the mitral leaflets as well as the anatomy and function of the subvalvular apparatus. Using intracardiac imaging, we could perform successful transapical complex mitral repair in each case. The minimally invasive transapical endoscopic method has the potential to offer advantages for on-pump mitral valve repair procedures even in complex mitral valve repair cases. Georg Thieme Verlag KG Stuttgart · New York.

Endoscopic management of pancreatic pseudocysts at atypical locations.

Science.gov (United States)

Bhasin, Deepak Kumar; Rana, Surinder Singh; Nanda, Mohit; Chandail, Vijant Singh; Masoodi, Ibrahim; Kang, Mandeep; Kalra, Navin; Sinha, Saroj Kant; Nagi, Birinder; Singh, Kartar

2010-05-01

There is paucity of data on endoscopic management of pseudocysts at atypical locations. We evaluated the efficacy of endoscopic transpapillary nasopancreatic drain (NPD) placement in the management of pseudocysts of pancreas at atypical locations. Eleven patients with pseudocysts at atypical locations were treated with attempted endoscopic transpapillary nasopancreatic drainage. On endoscopic retrograde pancreatography (ERP), a 5-F NPD was placed across/near the site of duct disruption. Three patients each had mediastinal, intrahepatic, and intra/perisplenic pseudocysts and one patient each had renal and pelvic pseudocyst. Nine patients had chronic pancreatitis whereas two patients had acute pancreatitis. The size of the pseudocysts ranged from 2 to 15 cm. On ERP, the site of ductal disruption was in the body of pancreas in five patients (45.4%), and tail of pancreas in six patients (54.6%). All the patients had partial disruption of pancreatic duct. The NPD was successfully placed across the disruption in 10 of the 11 patients (90.9%) and pseudocysts resolved in 4-8 weeks. One of the patients developed fever, 5 days after the procedure, which was successfully treated by intravenous antibiotics. In another patient, NPD became blocked 12 days after the procedure and was successfully opened by aspiration. The NPD slipped out in one of the patient with splenic pseudocyst and was replaced with a stent. There was no recurrence of symptoms or pseudocysts during follow-up of 3-70 months. Pancreatic pseudocysts at atypical locations with ductal communication and partial ductal disruption that is bridged by NPD can also be effectively treated with endoscopic transpapillary NPD placement.

Advanced virtual endoscopy for endoscopic transsphenoidal pituitary surgery.