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Sample records for external ventricular drains

  1. App-assisted external ventricular drain insertion.

    Science.gov (United States)

    Eftekhar, Behzad

    2016-09-01

    The freehand technique for insertion of an external ventricular drain (EVD) is based on fixed anatomical landmarks and does not take individual variations into consideration. A patient-tailored approach based on augmented-reality techniques using devices such as smartphones can address this shortcoming. The Sina neurosurgical assist (Sina) is an Android mobile device application (app) that was designed and developed to be used as a simple intraoperative neurosurgical planning aid. It overlaps the patient's images from previously performed CT or MRI studies on the image seen through the device camera. The device is held by an assistant who aligns the images and provides information about the relative position of the target and EVD to the surgeon who is performing EVD insertion. This app can be used to provide guidance and continuous monitoring during EVD placement. The author describes the technique of Sina-assisted EVD insertion into the frontal horn of the lateral ventricle and reports on its clinical application in 5 cases as well as the results of ex vivo studies of ease of use and precision. The technique has potential for further development and use with other augmented-reality devices.

  2. Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience

    Directory of Open Access Journals (Sweden)

    O A Ojo

    2015-01-01

    Full Text Available Background: The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP shunt due to its high protein content. In centers where standard external ventricular drain (EVD sets are not available, improvised feeding tube can be used. Aim: The main focus of this study is to encourage the use of improvised feeding tube catheters for EVD when standard sets are not available to improve patients′ survival. Methodology: This was a prospective study. Consecutive patients with hydrocephalus that cannot be shunted immediately for high chances of shunt failure or signs of increasing intracranial pressure were recruited into the study. Other inclusion criteria were preoperative brain tumor with possibility of blocked CSF pathway and massive intraventricular hemorrhage necessitating ventricular drainage as a salvage procedure. Standard EVD set is not readily available and too expensive for most of the parents to afford. Improvised feeding tube is used to drain/divert CSF using the standard documented procedure for EVD insertion. Outcome is measured and recorded. Results: A total of 28 patients were recruited into the study over a time frame of 2 years. There were 19 (67.9% male and 9 (32.1% females with a ratio of about 2:1. Age ranges varied from as low as 7 days to 66 years. The median age of the study sample was 6.5 months while the mean was 173.8 months. Duration of EVD varied from 2 days to 11 days with a median of 7 while the average was 6 days. Eventual outcome following the procedure of EVD showed that 19 (67.9% survived and were discharged either to go home or to have VP shunt afterwards while 8 (28.6% of the patients died. Conclusions: External ventricular drain can and should be done when it is necessary. Potential mortalities could be reduced by the improvised drainage using a

  3. Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience.

    Science.gov (United States)

    Ojo, O A; Asha, M A; Bankole, O B; Kanu, O O

    2015-01-01

    The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF) however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP) shunt due to its high protein content. In centers where standard external ventricular drain (EVD) sets are not available, improvised feeding tube can be used. The main focus of this study is to encourage the use of improvised feeding tube catheters for EVD when standard sets are not available to improve patients' survival. This was a prospective study. Consecutive patients with hydrocephalus that cannot be shunted immediately for high chances of shunt failure or signs of increasing intracranial pressure were recruited into the study. Other inclusion criteria were preoperative brain tumor with possibility of blocked CSF pathway and massive intraventricular hemorrhage necessitating ventricular drainage as a salvage procedure. Standard EVD set is not readily available and too expensive for most of the parents to afford. Improvised feeding tube is used to drain/divert CSF using the standard documented procedure for EVD insertion. Outcome is measured and recorded. A total of 28 patients were recruited into the study over a time frame of 2 years. There were 19 (67.9%) male and 9 (32.1%) females with a ratio of about 2:1. Age ranges varied from as low as 7 days to 66 years. The median age of the study sample was 6.5 months while the mean was 173.8 months. Duration of EVD varied from 2 days to 11 days with a median of 7 while the average was 6 days. Eventual outcome following the procedure of EVD showed that 19 (67.9%) survived and were discharged either to go home or to have VP shunt afterwards while 8 (28.6%) of the patients died. External ventricular drain can and should be done when it is necessary. Potential mortalities could be reduced by the improvised drainage using a standard feeding tube as described.

  4. Improvised external ventricular drain in neurosurgery: A Nigerian tertiary hospital experience

    Science.gov (United States)

    Ojo, O. A.; Asha, M. A.; Bankole, O. B.; Kanu, O. O.

    2015-01-01

    Background: The most common type of hydrocephalus in developing countries is post infective hydrocephalus. Infected cerebrospinal fluid (CSF) however cannot be shunted for the reason that it will block the chamber of the ventriculo-peritoneal (VP) shunt due to its high protein content. In centers where standard external ventricular drain (EVD) sets are not available, improvised feeding tube can be used. Aim: The main focus of this study is to encourage the use of improvised feeding tube catheters for EVD when standard sets are not available to improve patients’ survival. Methodology: This was a prospective study. Consecutive patients with hydrocephalus that cannot be shunted immediately for high chances of shunt failure or signs of increasing intracranial pressure were recruited into the study. Other inclusion criteria were preoperative brain tumor with possibility of blocked CSF pathway and massive intraventricular hemorrhage necessitating ventricular drainage as a salvage procedure. Standard EVD set is not readily available and too expensive for most of the parents to afford. Improvised feeding tube is used to drain/divert CSF using the standard documented procedure for EVD insertion. Outcome is measured and recorded. Results: A total of 28 patients were recruited into the study over a time frame of 2 years. There were 19 (67.9%) male and 9 (32.1%) females with a ratio of about 2:1. Age ranges varied from as low as 7 days to 66 years. The median age of the study sample was 6.5 months while the mean was 173.8 months. Duration of EVD varied from 2 days to 11 days with a median of 7 while the average was 6 days. Eventual outcome following the procedure of EVD showed that 19 (67.9%) survived and were discharged either to go home or to have VP shunt afterwards while 8 (28.6%) of the patients died. Conclusions: External ventricular drain can and should be done when it is necessary. Potential mortalities could be reduced by the improvised drainage using a standard

  5. Culture and sensitivity pattern in patients with external ventricular drain infection

    International Nuclear Information System (INIS)

    Rafiq, M.F.A.; Ali, S.

    2011-01-01

    Background: External ventricular (EVD) is a life saving procedure and involves insertion of a catheter in ventricular space to drain cerebrospinal fluid (CSF). Our objective of this study was to determine the culture and sensitivity (C/S) pattern in patients with EVD infection. Methods: This cross sectional study was conducted in Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from December 1, 2008 to January 31, 2010. All admitted patients who had acute hydrocephalus, underwent EVD insertion after excluding meningitis and ventriculitis by physical examination and per operative CSF sampling. The EVD was done at right Kocher's point. Prophylactic third generation antibiotic (Ceftriaxone) was started and continued till EVD was in place. C/S was sent to PIMS laboratory on first documented fever and or change of CSF color or when plan was to replace EVD with Ventriculo-peritoneal shunt (VP). Once infection was there CSF was sent for C/S initially and routine examination (R/E) daily. Antibiotics were changed according to C/S report and continued till they were needed. Infection rate was also estimated. Results: Among 76 patients 41 (53.9%) were male and 35 (46.1%) were females. Most were adults and were between 31 to 40 years of age. Mean duration of EVD was 11.41 days. Overall infection rate was 11.8%. Among causative organisms Staphylococcus Aureus (44.4%) was most common followed by Acenitobacter and Enterobacter and commonly used prophylactic antibiotic (Ceftriaxone) had considerable resistance. Conclusion: EVD is a simple and life saving procedure. Most common organisms causing infection are Staphylococcus Aureus followed by Acenitobacter. Conventional used antibiotic Ceftriaxone has considerable resistance. (author)

  6. Development and Validation of a Mobile Device-based External Ventricular Drain Simulator.

    Science.gov (United States)

    Morone, Peter J; Bekelis, Kimon; Root, Brandon K; Singer, Robert J

    2017-10-01

    Multiple external ventricular drain (EVD) simulators have been created, yet their cost, bulky size, and nonreusable components limit their accessibility to residency programs. To create and validate an animated EVD simulator that is accessible on a mobile device. We developed a mobile-based EVD simulator that is compatible with iOS (Apple Inc., Cupertino, California) and Android-based devices (Google, Mountain View, California) and can be downloaded from the Apple App and Google Play Store. Our simulator consists of a learn mode, which teaches users the procedure, and a test mode, which assesses users' procedural knowledge. Twenty-eight participants, who were divided into expert and novice categories, completed the simulator in test mode and answered a postmodule survey. This was graded using a 5-point Likert scale, with 5 representing the highest score. Using the survey results, we assessed the module's face and content validity, whereas construct validity was evaluated by comparing the expert and novice test scores. Participants rated individual survey questions pertaining to face and content validity a median score of 4 out of 5. When comparing test scores, generated by the participants completing the test mode, the experts scored higher than the novices (mean, 71.5; 95% confidence interval, 69.2 to 73.8 vs mean, 48; 95% confidence interval, 44.2 to 51.6; P mobile-based EVD simulator that is inexpensive, reusable, and accessible. Our results demonstrate that this simulator is face, content, and construct valid. Copyright © 2017 by the Congress of Neurological Surgeons

  7. From the Skin to the Brain: Pathophysiology of Colonization and Infection of External Ventricular Drain, a Prospective Observational Study.

    Directory of Open Access Journals (Sweden)

    Roman Mounier

    Full Text Available Ventriculostomy-related infection (VRI is a serious complication of external ventricular drain (EVD but its natural history is poorly studied. We prospectively tracked the bacteria pathways from skin towards ventricles to identify the infectious process resulting in ventriculostomy-related colonization (VRC, and VRI. We systematically sampled cerebrospinal fluid (CSF on a daily basis and collected swabs from both the skin and stopcock every 3.0 days for microbiological analysis including in 101 neurosurgical patient. Risk factors for positive event defined as either VRC or VRI were recorded and related to our microbiological findings. A total of 1261 CSF samples, 473 skin swabs, and 450 stopcock swabs were collected. Skin site was more frequently colonized than stopcock (70 (60% vs 34 (29%, p = 0.023, and earlier (14 ±1.4 vs 24 ±1.5 days, p<0.0001. Sixty-one (52% and 32 (27% skin and stopcock sites were colonized with commensal bacteria, 1 (1% and 1 (1% with pathogens, 8 (7% and 1 (1% with combined pathogens and commensal bacteria, respectively. Sixteen positive events were diagnosed; a cutaneous origin was identified in 69% of cases. The presence of a pathogen at skin site (6/16 vs 4/85, OR: 11.8, [2.5-56.8], p = 0.002 and CSF leakage (7/16 vs 6/85, OR 10 [2.4-41.2], p = 0.001 were the two independent significant risk factors statistically linked to positive events occurrence. Our results suggest that VRC and VRI mainly results from an extra-luminal progression of pathogens initially colonizing the skin site where CSF leaks.

  8. Acute cerebellitis successfully managed with temporary cerebrospinal fluid diversion using a long tunnel external ventricular drain: a long-term radiological follow-up of two cases

    Science.gov (United States)

    Waqas, Muhammad; Hadi, Yousaf Bashir; Sheikh, Sadaf; Shamim, Shahzad M

    2016-01-01

    Acute cerebellitis (AC) is a rare inflammatory childhood disorder. Although there is no consensus on standard treatment for cerebellitis, its outcome is usually favourable. We report two cases of AC in the paediatric age group, successfully managed with long tunnel external ventricular drain (EVD). The first patient was an 8-year-old boy with a history of fever and headache. Sequential MRI showed diffuse cerebellar swelling with tonsillar herniation and resulting hydrocephalus. The second patient was a 6-month-old boy who presented with high-grade fever associated with chills. CT scan of the head showed triventricular hydrocephalus with obliteration of cerebrospinal fluid spaces and cisterns. Both patients underwent immediate emergency right-sided long tunnel EVD insertion. The EVD was removed on the 9th day in the first patient and the 10th day in the second patient; the patients showed no neurological deficits at a follow-up of 2 years and 1 year, respectively. PMID:27166004

  9. Bundle of measures for external cerebral ventricular drainage-associated ventriculitis.

    Science.gov (United States)

    Chatzi, Maria; Karvouniaris, Marios; Makris, Demosthenes; Tsimitrea, Eleni; Gatos, Charalampos; Tasiou, Anastasia; Mantzarlis, Kostas; Fountas, Kostas N; Zakynthinos, Epaminondas

    2014-01-01

    To assess the prevalence and outcome of external cerebral ventricular drainage-associated ventriculitis in neurocritical patients before and after the implementation of a bundle of external cerebral ventricular drainage-associated ventriculitis control measures. Clinical prospective case series. University Hospital of Larissa, Greece. Consecutive patients were recruited from the ICU of the hospital. Patient inclusion criteria included presence of external ventricular drainage and ICU stay more than 48 hours. The bundle of external cerebral ventricular drainage-associated ventriculitis control measures included 1) reeducation of ICU personnel on issues of infection control related to external cerebral ventricular drainage, 2) meticulous intraventricular catheter handling, 3) cerebrospinal fluid sampling only when clinically necessary, and 4) routine replacement of the drainage catheter on the seventh drainage day if the catheter was still necessary. The bundle was applied after an initial period (preintervention) where standard policy for external cerebral ventricular drainage-associated ventriculitis was established. External cerebral ventricular drainage-associated ventriculitis prevalence, external cerebral ventricular drainage-associated ventriculitis events per 1,000 drainage days (drain-associated infection rate), length of ICU stay, Glasgow Outcome Scale at 6 months, and risk factors for external cerebral ventricular drainage-associated ventriculitis. Eighty-two patients entered the study in the preintervention period and 57 patients during the intervention period. During the preintervention and intervention period, external cerebral ventricular drainage-associated ventriculitis prevalence was 28% and 10.5% (p = 0.02) and drain-associated infection rate was 18 and 7.1, respectively (p = 0.0001); mean (95% CI) length of ICU stay in patients who presented external cerebral ventricular drainage-associated ventriculitis was 44.4 days (36.4-52.4 d), whereas mean

  10. Hollow mandrin facilitates external ventricular drainage placement.

    Science.gov (United States)

    Heese, O; Regelsberger, J; Kehler, U; Westphal, M

    2005-07-01

    Placement of ventricular catheters is a routine procedure in neurosurgery. Ventricle puncture is done using a flexible ventricular catheter stabilised by a solid steel mandrin in order to improve stability during brain penetration. A correct catheter placement is confirmed after removing the solid steel mandrin by observation of cerebrospinal fluid (CSF) flow out of the flexible catheter. Incorrect placement makes further punctures necessary. The newly developed device allows CSF flow observation during the puncture procedure and in addition precise intracranial pressure (ICP) measurement. The developed mandrin is hollow with a blunt tip. On one side 4-5 small holes with a diameter of 0.8 mm are drilled corresponding exactly with the holes in the ventricular catheter, allowing CSF to pass into the hollow mandrin as soon as the ventricle is reached. By connecting a small translucent tube at the distal portion of the hollow mandrin ICP can be measured without loss of CSF. The system has been used in 15 patients with subarachnoid haemorrhage (SAH) or intraventricular haemeorrhage (IVH) and subsequent hydrocephalus. The new system improved the external ventricular drainage implantation procedure. In all 15 patients catheter placement was correct. ICP measurement was easy to perform immediately at ventricle puncture. In 4 patients at puncture no spontaneous CSF flow was observed, therefore by connecting a syringe and gentle aspiration of CSF correct placement was confirmed in this unexpected low pressure hydrocephalus. Otherwise by using the conventional technique further punctures would have been necessary. Advantages of the new technique are less puncture procedures with a lower risk of damage to neural structures and reduced risk of intracranial haemorrhages. Implantation of the ventricular catheter to far into the brain can be monitored and this complication can be overcome. Using the connected pressure monitoring tube an exact measurement of the opening

  11. External Suction and Fluid Output in Chest Drains After Lobectomy

    DEFF Research Database (Denmark)

    Lijkendijk, Marike; Neckelmann, Kirsten; Licht, Peter B

    2018-01-01

    influences the amount of fluid. METHODS: We randomly assigned (1:1) 106 patients who underwent lobectomy to either low (-5 cm H2O) or high (-20 cm H2O) external suction using an electronic chest drainage system. Only one chest drain was allowed, and we used strict algorithms for chest drain removal, which...... was delegated to staff nurses: air leakage less than 20 mL/min for 6 hours regardless of fluid output, provided it was serous. The primary end point was fluid output after 24 and 48 hours. RESULTS: Mean fluid output was significantly higher with high suction after both 24 (338 ± 265 mL versus 523 ± 215 m...

  12. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria.

    Science.gov (United States)

    Muñoz-Gómez, Sigridh; Wirkowski, Elizabeth; Cunha, Burke A

    2015-01-01

    Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four CSF criteria combined are useful in diagnosing EVD-AM in adults. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Fewer complications with bolt-connected than tunneled external ventricular drainage

    DEFF Research Database (Denmark)

    Jensen, Torben Slott; Carlsen, Jakob Gram; Poulsen, Frantz Rom

    2016-01-01

    BACKGROUND: Ventriculostomy/external ventricular drain (EVD) is a common neurosurgical procedure. Various techniques are used to fixate the drain and the objective of this study was, in a retrospective setting, to compare the incidence of complications when using bolt-connected EVD (BC-EVD) versus...... tunneled EVD (T-EVD). METHODS: All patients subjected to an EVD performed through a new burr hole from 2009 through 2010 at two Depts. of Neurosurgery in Denmark (Odense and Aarhus) were retrospectively identified. Patient files were evaluated for EVD fixation technique (tunneled or bolt-connected EVD...... %), compared to the bolt-connected EVD group (6.5 %). There was no significant difference in infection rates. CONCLUSIONS: Tunneled EVD has a relatively high frequency of complications leading to reinsertion. The use of Bolt-connected EVD technique can lower this frequency significantly. The number needed...

  14. The role of external drains and peritoneal conduits in the treatment of recurrent chronic subdural hematoma.

    Science.gov (United States)

    Santarius, Thomas; Qureshi, Hammad U; Sivakumaran, Ram; Kirkpatrick, Peter J; Kirollos, Ramez W; Hutchinson, Peter J

    2010-06-01

    A considerable body of evidence supporting the use of external drainage after evacuation of primary chronic subdural hematoma (CSDH) exists in the literature. However, no systematic study of the value of postoperative drainage in the treatment of recurrent CSDH has been published. The aim of the study was to investigate external drains and subdural-to-peritoneal conduit in the treatment of recurrent CSDH. A retrospective review of cases of CSDH treated in our institution between October 2002 and October 2006 was conducted. During the study period, 408 patients had burr hole evacuation. Sixty-four patients (15.9%) had treatment for recurrence. One patient had craniotomy, and the remaining 63 had another burr hole evacuation: 36 without placement of a drain (BHO), 14 with external drainage (SED), and 13 with placement of subdural-peritoneal catheter (SPC). Fifteen patients (24%) developed a secondary recurrence requiring a third drainage procedure. Postoperative drainage (SED or SPC) was associated with a significantly lower secondary recurrence rate when compared to BHO: 3/27 (11%) versus 12/36 (33%) (χ(2), P=.040). There was no significant difference in recurrence rates between SED and SPC. Postoperative complications included acute subdural hematoma (2), subdural empyema (2), brain edema (2), pneumonia (3), and in-hospital death (2). None of the complications was associated with the use of a specific technique. The results indicate that, as in the treatment of primary CSDHs, the use of drain (SED or SPC) with burr hole evacuation is safe and is associated with lower recurrence rate. Further investigation is needed to clarify the indications of currently available surgical techniques in the treatment of recurrent CSDH. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Experiments of draining and filling processes in a collapsible tube at high external pressure

    Science.gov (United States)

    Flaud, P.; Guesdon, P.; Fullana, J.-M.

    2012-02-01

    The venous circulation in the lower limb is mainly controlled by the muscular action of the calf. To study the mechanisms governing the venous draining and filling process in such a situation, an experimental setup, composed by a collapsible tube under external pressure, has been built. A valve preventing back flows is inserted at the bottom of the tube and allows to model two different configurations: physiological when the fluid flow is uni-directional and pathological when the fluid flows in both directions. Pressure and flow rate measurements are carried out at the inlet and outlet of the tube and an original optical device with three cameras is proposed to measure the instantaneous cross-sectional area. The experimental results (draining and filling with physiological or pathological valves) are confronted to a simple one-dimensional numerical model which completes the physical interpretation. One major observation is that the muscular contraction induces a fast emptying phase followed by a slow one controlled by viscous effects, and that a defect of the valve decreases, as expected, the ejected volume.

  16. Preliminary Results of Emergency Computed Tomography-Guided Ventricular Drain Placement-Precision for the Most Difficult Cases.

    Science.gov (United States)

    Nowacki, Andreas; Wagner, Franca; Söll, Nicole; Hakim, Arsany; Beck, Jürgen; Raabe, Andreas; Z'Graggen, Werner J

    2018-04-05

    External ventricular drainage (EVD) catheter placement is one of the most commonly performed neurosurgical procedures. The study's objective was to compare a computed tomography (CT) bolt scan-guided approach for the placement of EVDs with conventional landmark-based insertion. In this retrospective case-control study, we analyzed patients undergoing bolt-kit EVD catheter placement, either CT-guided or landmark-based, between 2013 and 2016. The CT bolt scan-guided approach was based on a dose-reduced CT scan after bolt fixation with immediate image reconstruction along the axis of the bolt to evaluate the putative insertion axis. If needed, angulation of the bolt was corrected and the procedure repeated before the catheter was inserted. Primary endpoint was the accuracy of insertion. Secondary endpoints were the overall number of attempts, duration of intervention, complication rates, and cumulative radiation dose. In total, 34 patients were included in the final analysis. In the group undergoing CT-guided placement, the average ventricle width was significantly smaller (P = 0.04) and average midline shift significantly more pronounced (P = 0.01). CT-guided placement resulted in correct positioning of the catheter in the ipsilateral frontal horn in all 100% of the cases compared with landmark-guided insertion (63%; P = 0.01). Application of the CT-guided approach increased the number of total CT scans (3.6 ± 1.9) and the overall radiation dose (3.34 ± 1.61 mSv) compared with the freehand insertion group (1.84 ± 2.0 mSv and 1.55 ± 1.66 mSv). No differences were found for the other secondary outcome parameters. CT-guided bolt-kit EVD catheter placement is feasible and accurate in the most difficult cases. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants.

    Science.gov (United States)

    Zucchelli, Mino; Lefosse, Mariella; Corvaglia, Luigi; Martini, Silvia; Sandri, Fabrizio; Soffritti, Silvia; Ancora, Gina; Mammoliti, Palma; Gargano, Giancarlo; Galassi, Ercole

    2016-07-01

    OBJECTIVE Hydrocephalus treatment in extremely low-birth-weight (ELBW) infants still represents a challenge for the pediatric neurosurgeon, particularly when the patient weighs far less than 1000 g. In such cases, the benefits in terms of neurological outcome following early treatment do not always outweigh the surgical risks, especially considering the great difference in the surgical risk before patient weight increases. To assess the efficacy and reliability of a percutaneous-tunneled, transfontanellar external ventricular drain (PTTEVD) in ELBW infants, the authors started a new protocol for the early surgical treatment of hydrocephalus. METHODS Ten cases of posthemorrhagic hydrocephalus (PHH) in ELBW infants (5 cases CSF leakage (due to insufficient CSF removal). In another patient Enterococcus in the CSF sample was detected the day after abdominal surgery with ileostomy (infection resolved with intrathecal vancomycin). One patient died of Streptococcus sepsis, a systemic infection existing prior to drain placement that never resolved. One patient had Pseudomonas aeruginosa sepsis prior to drain insertion; a PTTEVD was implanted, the infection resolved, and the hydrocephalus was treated in the same way as with a traditional EVD, while the advantages of a quick, minimally invasive, bedside procedure were maintained. Once a patient reached 1 kg in weight, when necessary, a ventriculoperitoneal shunt was implanted and the PTTEVD was removed. CONCLUSIONS The introduction of PTTEVD placement in our standard protocol for the management of PHH has proved to be a wise option for small patients.

  18. Outflow monitoring of a pneumatic ventricular assist device using external pressure sensors.

    Science.gov (United States)

    Kang, Seong Min; Her, Keun; Choi, Seong Wook

    2016-08-25

    In this study, a new algorithm was developed for estimating the pump outflow of a pneumatic ventricular assist device (p-VAD). The pump outflow estimation algorithm was derived from the ideal gas equation and determined the change in blood-sac volume of a p-VAD using two external pressure sensors. Based on in vitro experiments, the algorithm was revised to consider the effects of structural compliance caused by volume changes in an implanted unit, an air driveline, and the pressure difference between the sensors and the implanted unit. In animal experiments, p-VADs were connected to the left ventricles and the descending aorta of three calves (70-100 kg). Their outflows were estimated using the new algorithm and compared to the results obtained using an ultrasonic blood flow meter (UBF) (TS-410, Transonic Systems Inc., Ithaca, NY, USA). The estimated and measured values had a Pearson's correlation coefficient of 0.864. The pressure sensors were installed at the external controller and connected to the air driveline on the same side as the external actuator, which made the sensors easy to manage.

  19. Cerebrospinal Fluid Leak at Percutaneous Exit of Ventricular Catheter as a Crucial Risk Factor for External Ventricular Drainage-Related Infection in Adult Neurosurgical Patients.

    Science.gov (United States)

    Park, Jaechan; Choi, Yeon-Ju; Ohk, Boram; Chang, Hyun-Ha

    2018-01-01

    The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected. Four of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit. A prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak. Copyright © 2017 Elsevier Inc. All rights reserved.

  20.   Antibiotica Impregnated Shunts effectively reduces positive cultures from External Ventricular Drainage

    DEFF Research Database (Denmark)

    Sørensen, Preben; Gulisano, Helga Angela; Ejlertsen, Tove

    -samples were collected every day. Samples was obtained from the line away from the patient and cultered on agar plates for six days in both aerobic and aerobic environment. VAI was defined as positive cultures in CSF.   Results A total of 485 patients were included. No significant differences in gender, age....... The frequency of VAI differs in the literature between x and 21.1 % depending mainly on methods of diagnosis.     Methods A prospective study with historical controls. From 1.1.2001 to 31.9.2007 patients was treated with standard EVD, and from 1.10.2007 -to 31.9.2008 AIS (Bactiseal, Codman ) was used. CSF...... or diagnosis.   Standard drain: 417 patients. 97 patients had positive CFS-cultures (23.3 %). 10 patients had more than one infection. Most frequent findings was Propionibacterium Acnes, Coagulasenegative Staffyllococci and Staffylococcus Epidermidis accounting for 70,1 % of species.   AIS-drain: 68 patients...

  1. Preventing ventriculostomy-related infections with antibiotic-impregnated drains in hospitals : a two-centre Dutch study

    NARCIS (Netherlands)

    Verberk, J. D M; Berkelbach vd Sprenkel, J. W; Arts, M. P.; Dennesen, P. J W; Bonten, M. J M; van Mourik, M. S M

    2016-01-01

    This observational cohort study assessed the effect of the introduction of antibiotic-impregnated external ventricular drains (AI-EVDs), as opposed to plain silicone EVDs, on the occurrence of ventriculostomy-related infections (VRIs) in two Dutch hospitals, with no other changes to their clinical

  2. INFECTION RELATED TO THE EXTERNAL VENTRICULAR SHUNT IN A NEUROSURGERY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Elizandra Silva Oliveira

    2013-04-01

    Full Text Available OBJETIVO:Identificar os fatores co-responsáveis de infecção relacionada à derivação ventricular externa.MÉTODO: estudo retrospectivo com análise quantitativa dos dados; desenvolvido no Serviço de Arquivo Médico de um hospital público referencia em neurocirurgia em Pernambuco. Amostra constituída de 140 pacientes submetidos a inserção de Derivação Ventricular Externa. Os dados foram coletados por questionário semi-estruturado; analisados através do programa software SPSS 13.0. RESULTADOS: Predominância do sexo masculino 39,7%; idade entre 20 e 39 anos 52%;tempo de internamento acima de 60 dias 72,7%; Múltiplas DVE instaladas 100%;tempo de uso da DVE acima de 30 dias 96,2%. CONLUSÃO: significância estatística para os fatores: tempo de internamento prolongado, número de DVE instaladas, tempo de uso da DVE e o desenvolvimento de infecção. Ações de enfermagem são emergentes visando garantir a segurança do paciente no ambiente hospitalar.

  3. Evaluation of ECG-gated [(11)C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency.

    Science.gov (United States)

    Hansson, Nils Henrik; Tolbod, Lars; Harms, Johannes; Wiggers, Henrik; Kim, Won Yong; Hansen, Esben; Zaremba, Tomas; Frøkiær, Jørgen; Jakobsen, Steen; Sørensen, Jens

    2016-08-01

    Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [(11)C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [(11)C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [(11)C]acetate PET. Thirty-five subjects with aortic valve stenosis underwent ECG-gated [(11)C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE. LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P PET (P PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P PET-based MEE bias was strongly associated with LV wall thickness. Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [(11)C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.

  4. Physiological Effects of Early Incremental Mobilization of a Patient with Acute Intracerebral and Intraventricular Hemorrhage Requiring Dual External Ventricular Drainage.

    Science.gov (United States)

    Kumble, Sowmya; Zink, Elizabeth K; Burch, Mackenzie; Deluzio, Sandra; Stevens, Robert D; Bahouth, Mona N

    2017-08-01

    Recent trials have challenged the notion that very early mobility benefits patients with acute stroke. It is unclear how cerebral autoregulatory impairments, prevalent in this population, could be affected by mobilization. The safety of mobilizing patients who have external ventricular drainage (EVD) devices for cerebrospinal fluid diversion and intracranial pressure (ICP) monitoring is another concern due to risk of device dislodgment and potential elevation in ICP. We report hemodynamic and ICP responses during progressive, device-assisted mobility interventions performed in a critically ill patient with intracerebral hemorrhage (ICH) requiring two EVDs. A 55-year-old man was admitted to the Neuroscience Critical Care Unit with an acute thalamic ICH and complex intraventricular hemorrhage requiring placement of two EVDs. Progressive mobilization was achieved using mobility technology devices. Range of motion exercises were performed initially, progressing to supine cycle ergometry followed by incremental verticalization using a tilt table. Physiological parameters were recorded before and after the interventions. All mobility interventions were completed without any adverse event or clinically detectable change in the patient's neurological state. Physiological parameters including hemodynamic variables and ICP remained within prescribed goals throughout. Progressive, device-assisted early mobilization was feasible and safe in this critically ill patient with hemorrhagic stroke when titrated by an interdisciplinary team of skilled healthcare professionals. Studies are needed to gain insight into the hemodynamic and neurophysiological responses associated with early mobility in acute stroke to identify subsets of patients who are most likely to benefit from this intervention.

  5. Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series.

    Science.gov (United States)

    Zhang, Wei; Wei, Lin; Li, Gang; Sun, Jinlong; Jin, Peng; Yang, Jun; Wang, Daokui; Bai, Yunan; Li, Xingang; Fei, Chang; Wang, Chengwei; Wang, Baoan; Pan, Shumao; Du, Jihai; Xie, Bo; Xu, Dongfang; Xin, Changming; Wang, Jihua; Zhang, Qinglin

    2015-06-01

    This study aimed to describe the technique details of rapid pore cranial drilling with external ventricular drainage and document its clinical outcomes by highlighting the advantages over the traditional and modified cranial drilling technique. Intraventricular hemorrhage is one of the most severe subtypes of hemorrhagic stroke with high mortality. The amount of blood in the ventricles is associated with severity of outcomes, and fast removal of the blood clot is the key to a good prognosis. Between 1977 and 2013, 3773 patients admitted for intraventricular hemorrhage underwent rapid pore cranial drilling drainage. The therapeutic effects and clinical outcomes were retrospectively analyzed. Of these patients, 1049 (27.8%) experienced complete remission, 1788 (47.4%) had improved condition, and 936 (24.8%) died. A total of 3229 (85.6%) patients gained immediate remission. One typical case was illustrated to demonstrate the efficacy of the rapid pore drilling technique. Rapid pore cranial drilling drainage in patients with intraventricular hemorrhage is fast, effective, and provides immediate relief in patients with severe conditions. It could be a better alternative to the conventional drilling approach for treatment of intraventricular hemorrhage. A randomized controlled trial for direct comparison between the rapid pore cranial drilling drainage and conventional drilling technique is in urgent need.

  6. Transmural recording of shock potential gradient fields, early postshock activations, and refibrillation episodes associated with external defibrillation of long-duration ventricular fibrillation in swine.

    Science.gov (United States)

    Allred, James D; Killingsworth, Cheryl R; Allison, J Scott; Dosdall, Derek J; Melnick, Sharon B; Smith, William M; Ideker, Raymond E; Walcott, Gregory P

    2008-11-01

    Knowledge of the shock potential gradient (nablaV) and postshock activation is limited to internal defibrillation of short-duration ventricular fibrillation (SDVF). The purpose of this study was to determine these variables after external defibrillation of long-duration VF (LDVF). In six pigs, 115-20 plunge needles with three to six electrodes each were inserted to record throughout both ventricles. After the chest was closed, the biphasic defibrillation threshold (DFT) was determined after 20 seconds of SDVF with external defibrillation pads. After 7 minutes of LDVF, defibrillation shocks that were less than or equal to the SDVF DFT strength were given. For DFT shocks (1632 +/- 429 V), the maximum minus minimum ventricular voltage (160 +/- 100 V) was 9.8% of the shock voltage. Maximum cardiac nablaV (28.7 +/- 17 V/cm) was 4.7 +/- 2.0 times the minimum nablaV (6.2 +/- 3.5 V/cm). Although LDVF did not increase the DFT in five of the six pigs, it significantly lengthened the time to earliest postshock activation following defibrillation (1.6 +/- 2.2 seconds for SDVF and 4.9 +/- 4.3 seconds for LDVF). After LDVF, 1.3 +/- 0.8 episodes of spontaneous refibrillation occurred per animal, but there was no refibrillation after SDVF. Compared with previous studies of internal defibrillation, during external defibrillation much less of the shock voltage appears across the heart and the shock field is much more even; however, the minimum nablaV is similar. Compared with external defibrillation of SDVF, the biphasic external DFT for LDVF is not increased; however, time to earliest postshock activation triples. Refibrillation is common after LDVF but not after SDVF in these normal hearts, indicating that LDVF by itself can cause refibrillation without requiring preexisting heart disease.

  7. Technique of stepwise intracranial decompression combined with external ventricular drainage catheters improve the prognosis of acute post-traumatic hemispheric brain swelling patients

    Directory of Open Access Journals (Sweden)

    Lei eShi

    2015-09-01

    Full Text Available Background: Acute post-traumatic cerebral hemispheric brain swelling (ACHS is a serious disorder that occurs after traumatic brain injury (TBI, and it often requires immediate treatment. The aim of our clinical study was to assess the effects of stepwise intracranial decompression combined with external ventricular drainage catheters on the prognosis of ACHS patients.Methods: A retrospective study was performed on 172 cases of severe craniocerebral trauma patients with acute cerebral hemispheric swelling. The patients were divided into two groups: unilateral stepwise standard large trauma craniectomy (S-SLTC combined with external ventricular drainage (EVD catheter implants (n = 86 and unilateral routine frontal temporal parietal SLTC (control group, n = 86.Result: No significant differences in age, sex, or preoperative Glasgow Coma Scale score were observed between groups (P < 0.05. There were no significant differences in the ipsilateral subdural effusion incidence rates between the S-SLTC+EVD treatment group and the routine SLTC group. However, the incidence rates of intraoperative acute encephalocele and contralateral epidural and subdural hematoma in the S-SLTC+EVD group were significantly lower than those in the SLTC group (17.4% and 3.5% vs. 37.2% and 23.3%, respectively. The mean intracranial pressure (ICP values of patients in the S-SLTC+EVD group were also lower than those in the SLTC group at days 1 through7 (P<0.05. A positive neurological outcome (GOS score 4 to 5, 50.0% and decreased mortality (15.1% was observed in the S-SLTC+EVD group compared to the neurological outcome (GOS score 4 to 5, 33.8%; 36.0% in the SLTC group (P<0.05.Conclusions: Our data suggest that S-SLTC+EVD is more effective for controlling ICP, improving neurological outcome, and decreasing mortality rate compared with routine SLTC.

  8. Survival After Ventricular Fibrillation Cardiac Arrest in the Sao Paulo Metropolitan Subway System: First Successful Targeted Automated External Defibrillator (AED) Program in Latin America.

    Science.gov (United States)

    Gianotto-Oliveira, Renan; Gonzalez, Maria Margarita; Vianna, Caio Brito; Monteiro Alves, Maurício; Timerman, Sergio; Kalil Filho, Roberto; Kern, Karl B

    2015-10-09

    Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Containment vessel drain system

    Science.gov (United States)

    Harris, Scott G.

    2018-01-30

    A system for draining a containment vessel may include a drain inlet located in a lower portion of the containment vessel. The containment vessel may be at least partially filled with a liquid, and the drain inlet may be located below a surface of the liquid. The system may further comprise an inlet located in an upper portion of the containment vessel. The inlet may be configured to insert pressurized gas into the containment vessel to form a pressurized region above the surface of the liquid, and the pressurized region may operate to apply a surface pressure that forces the liquid into the drain inlet. Additionally, a fluid separation device may be operatively connected to the drain inlet. The fluid separation device may be configured to separate the liquid from the pressurized gas that enters the drain inlet after the surface of the liquid falls below the drain inlet.

  10. Ventriculostomy Simulation Using Patient-Specific Ventricular Anatomy, 3D Printing, and Hydrogel Casting.

    Science.gov (United States)

    Ryan, Justin R; Chen, Tsinsue; Nakaji, Peter; Frakes, David H; Gonzalez, L Fernando

    2015-11-01

    Educational simulators provide a means for students and experts to learn and refine surgical skills. Educators can leverage the strengths of medical simulators to effectively teach complex and high-risk surgical procedures, such as placement of an external ventricular drain. Our objective was to develop a cost-effective, patient-derived medical simulacrum for cerebral lateral ventriculostomy. A cost-effective, patient-derived medical simulacrum was developed for placement of an external lateral ventriculostomy. Elastomeric and gel casting techniques were used to achieve realistic brain geometry and material properties. 3D printing technology was leveraged to develop accurate cranial properties and dimensions. An economical, gravity-driven pump was developed to provide normal and abnormal ventricular pressures. A small pilot study was performed to gauge simulation efficacy using a technology acceptance model. An accurate geometric representation of the brain was developed with independent lateral cerebral ventricular chambers. A gravity-driven pump pressurized the ventricular cavities to physiologic values. A qualitative study illustrated that the simulation has potential as an educational tool to train medical professionals in the ventriculostomy procedure. The ventricular simulacrum can improve learning in a medical education environment. Rapid prototyping and multi-material casting techniques can produce patient-derived models for cost-effective and realistic surgical training scenarios. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Left ventricular outflow obstruction as a result of external cardiac compression by a mediastinal tumor; Zwezenie drogi odplywu lewej komory wywolane uciskiem przeez guz srodpiersia

    Energy Technology Data Exchange (ETDEWEB)

    Rydlewska-Sadowska, W.; Kowalski, M.; Borowiecka, E.; Polkowski, J.; Szaroszyk, W. [Klinika Szybkiej Diagnostyki, Zaklad Radiologii, Instytut Kardiologii, Warsaw (Poland)

    1993-12-31

    A case of left ventricular outflow tract stenosis resulted from compression of the heart is presented. This symptomatic cardiovascular lesion was produced by extensive growth of mediastinal tumour. Numerous noninvasive methods were necessary to establish this difficult diagnosis. The patient underwent surgery that disclosed a benign process (of neurofibroma). After tumour`s resection marked hemodynamic signs subsided. (author) 12 refs, 6 figs

  12. Thailand and brain drain

    Directory of Open Access Journals (Sweden)

    Terry Commins

    2009-01-01

    Full Text Available Brain drain has been the subject of research since the 1960s. This research has been hampered by a lack of accurate data from both source and receiving countries on migration and on the losses and gains to developing economies of skilled migration. However, despite these handicaps, research has been able to clearly show that trends are changing and the effect this is having is usually quite different for individual source countries.Thailand, as a developing economy, could be regarded as a source country. Fortunately, Thailand has never ranked highly in terms of brain drain when compared to other states in Asia and while it may not be a significant problem it nonetheless needs to be monitored. Thailand is also somewhat unique in that the migration that has occurred has been almost equally split between secondary and tertiary educated Thais. Thailand also ranks low in terms of tertiary educated population who have migrated when compared to other countries in the region. Globalisation is having a profound effect on the migration of skilled workers. As trade becomes increasingly free, barriers to the movement of services or people are also freed. As the better educated are encouraged to think globally, so too will they be inclined to move globally into the world community.This paper examines Thailand’s position with respect to brain drain, some of the lessons we have learned and some of the steps that are being taken to minimise the impact of the loss of skilled workers, with a particular focus on science and technology. The conclusion is that brain drain should not be viewed as an entirely negative development and that the positive outcomes should be recognised, encouraged and incorporated into policy.

  13. Globalization, Brain Drain, and Development

    OpenAIRE

    Docquier, Frédéric; Rapoport, Hillel

    2012-01-01

    This paper reviews four decades of economics research on the brain drain, with a focus on recent contributions and on development issues. We first assess the magnitude, intensity, and determinants of the brain drain, showing that brain drain (or high-skill) migration is becoming a dominant pattern of international migration and a major aspect of globalization. We then use a stylized growth model to analyze the various channels through which a brain drain affects the sending countries and revi...

  14. Thailand and brain drain

    OpenAIRE

    Terry Commins

    2009-01-01

    Brain drain has been the subject of research since the 1960s. This research has been hampered by a lack of accurate data from both source and receiving countries on migration and on the losses and gains to developing economies of skilled migration. However, despite these handicaps, research has been able to clearly show that trends are changing and the effect this is having is usually quite different for individual source countries.Thailand, as a developing economy, could be regarded as a sou...

  15. The health workforce crisis: the brain drain scourge.

    Science.gov (United States)

    Ike, Samuel O

    2007-01-01

    The magnitude of the health workforce crisis engendered by brain drain particularly in Africa, and nay more especially Nigeria, has been assuming increasingly alarming proportions in the past three decades. The challenge it poses in meeting the manpower needs in the healthcare sector as well as in the larger economy of the sending countries is enormous. This paper thus sets out to highlight the scope of this brain drain, its effects and the reasons sustaining it, as well as makes concrete suggestions to help stern the tide. A review of the literature on brain drain with particular emphasis on the health workforce sector was done, with focus on Africa, and specifically Nigeria. Literature search was done using mainly the Medline, as well as local journals. The historical perspectives, with the scope of external and internal brain drain are explored. The glaring effects of brain drain both in the global workforce terrain and specifically in the health sectors are portrayed. The countries affected most and the reasons for brain drain are outlined. Strategic steps to redress the brain drain crisis are proffered in this paper. The health workforce crisis resulting from brain drain must be brought to the front-burner of strategic policy decisions leading to paradigm shift in political, social and economic conditions that would serve as incentives to curb the scourge.

  16. Drains and Drainage Capabilities: Quantitative Analysis of Drain Efficiencies

    Directory of Open Access Journals (Sweden)

    Andaç Aykan

    2016-03-01

    Full Text Available Objective: In this study, it was aimed to compare the efficiency of the same type of but different-sized silicone drains at different surgical procedures. Material and Methods: Twenty-four patients, who had different diagnoses and were operated between 2011 and 2013, were included. In all patients, 7- and 10-mm silicone-ended, Jackson–Pratt drains were used. Drains that were under 30 cc/day removed. The connection tube and perforated silicone end were examined due to the clot content. All drain efficiencies were calculated, and the results were statistically analyzed. Results: Seven of the 24 patients (29.2% were males and 17 (70.8% were females; the mean age was 39.0±11.4 years. Totally, 49 drains were used, of which 25 (51% were 7 mm and 24 (49% were 10 mm in size. Median removal time was the 5th day (2–12 for the 7-mm drains and the 6th day (3–14 for the 10-mm drains. There was no statistically significant difference between the groups for drain removal time (p=0.268. Further, there was no difference at the connection tube and silicone end for clot content between the 7- and 10-mm drains (p=0.58. For the drainage volume and efficiency, no difference was observed between the groups (p=0.146. Conclusion: In this study it was observed that there is no difference in the drainage volume and efficiency between different-sized Jackson–Pratt drains.

  17. Plumbing the brain drain.

    Science.gov (United States)

    Saravia, Nancy Gore; Miranda, Juan Francisco

    2004-08-01

    Opportunity is the driving force of migration. Unsatisfied demands for higher education and skills, which have been created by the knowledge-based global economy, have generated unprecedented opportunities in knowledge-intensive service industries. These multi-trillion dollar industries include information, communication, finance, business, education and health. The leading industrialized nations are also the focal points of knowledge-intensive service industries and as such constitute centres of research and development activity that proactively draw in talented individuals worldwide through selective immigration policies, employment opportunities and targeted recruitment. Higher education is another major conduit of talent from less-developed countries to the centres of the knowledge-based global economy. Together career and educational opportunities drive "brain drain and recirculation". The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the asymmetric movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies to: provide world-class educational opportunities, construct knowledge-based research and development industries, and sustainably finance the required investment for these strategies. Brazil, China and India have moved in this direction, offering world-class education in areas crucial to national development, such as biotechnology and information technology, paralleled by investments in research and development. As a result, only a small proportion of the most highly educated individuals migrate from these countries, and research and development opportunities employ national talent and even attract immigrants.

  18. Xpand chest drain: assessing equivalence to current standard ...

    African Journals Online (AJOL)

    The Xpand chest drain is an external medical device made of plastic that incorporates a fluid reservoir, a one-way valve and an air-leak detection system ... conect ed to a 2 000 ml drainage bag) prevents exposure of body fluids to nursing staff.

  19. An elusive persistent left superior vena cava draining into left atrium

    NARCIS (Netherlands)

    A. Soward; F.J. ten Cate (Folkert); P.M. Fioretti (Paolo); P.W.J.C. Serruys (Patrick); J.R.T.C. Roelandt (Jos)

    1986-01-01

    textabstractA case report of a persistent left superior vena cava draining into left atrium with a fibromuscular left ventricular outflow tract obstruction and a small atrial septal defect. The anomalous vessel escaped detection during two right and left heart catheterizations from the right arm and

  20. Bleeding and infection with external ventricular drainage: a systematic review in comparison with adjudicated adverse events in the ongoing Clot Lysis Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR-III IHV) trial.

    Science.gov (United States)

    Dey, Mahua; Stadnik, Agnieszka; Riad, Fady; Zhang, Lingjiao; McBee, Nichol; Kase, Carlos; Carhuapoma, J Ricardo; Ram, Malathi; Lane, Karen; Ostapkovich, Noeleen; Aldrich, Francois; Aldrich, Charlene; Jallo, Jack; Butcher, Ken; Snider, Ryan; Hanley, Daniel; Ziai, Wendy; Awad, Issam A

    2015-03-01

    Retrospective series report varied rates of bleeding and infection with external ventricular drainage (EVD). There have been no prospective studies of these risks with systematic surveillance, threshold definitions, or independent adjudication. To analyze the rate of complications in the ongoing Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR III) trial, providing a comparison with a systematic review of complications of EVD in the literature. Patients were prospectively enrolled in the CLEAR III trial after placement of an EVD for obstructive intraventricular hemorrhage and randomized to receive recombinant tissue-type plasminogen activator or placebo. We counted any detected new hemorrhage (catheter tract hemorrhage or any other distant hemorrhage) on computed tomography scan within 30 days from the randomization. Meta-analysis of published series of EVD placement was compiled with STATA software. Growing or unstable hemorrhage was reported as a cause of exclusion from the trial in 74 of 5707 cases (1.3%) screened for CLEAR III. The first 250 patients enrolled have completed adjudication of adverse events. Forty-two subjects (16.8%) experienced ≥1 new bleeds or expansions, and 6 of 250 subjects (2.4%) suffered symptomatic hemorrhages. Eleven cases (4.4%) had culture-proven bacterial meningitis or ventriculitis. Risks of bleeding and infection in the ongoing CLEAR III trial are comparable to those previously reported in EVD case series. In the present study, rates of new bleeds and bacterial meningitis/ventriculitis are very low despite multiple daily injections, blood in the ventricles, the use of thrombolysis in half the cases, and generalization to >60 trial sites.

  1. Ventricular Fibrillation

    Science.gov (United States)

    ... to the heart with a device called an automated external defibrillator (AED). Treatments to prevent sudden cardiac ... number of places, such as in airplanes, police cars and shopping malls. They can even be purchased ...

  2. Intraoperative precautionary insertion of external ventricular ...

    African Journals Online (AJOL)

    Hosam A.M. Habib

    2013-12-05

    Dec 5, 2013 ... 4.5%.39 The development of this de novo hydrocephalus seems to result from ... toma, the EVD system was left open until the CSF becomes clear of any .... 32. Vloeberghs M. Decision making in paediatric brain tumours: a.

  3. Closed suction drain with bulb

    Science.gov (United States)

    ... of gloves. Put a new bandage around the drain tube site. Use surgical tape to hold it down ... small amount of redness is normal). There is drainage from the skin around the tube site. There is more tenderness and swelling at ...

  4. Influence of the hole geometry on the flow distribution in ventricular catheters for hydrocephalus.

    Science.gov (United States)

    Giménez, Ángel; Galarza, Marcelo; Pellicer, Olga; Valero, José; Amigó, José M

    2016-07-15

    Hydrocephalus is a medical condition consisting of an abnormal accumulation of cerebrospinal fluid within the brain. A catheter is inserted in one of the brain ventricles and then connected to an external valve to drain the excess of cerebrospinal fluid. The main drawback of this technique is that, over time, the ventricular catheter ends up getting blocked by the cells and macromolecules present in the cerebrospinal fluid. A crucial factor influencing this obstruction is a non-uniform flow pattern through the catheter, since it facilitates adhesion of suspended particles to the walls. In this paper we focus on the effects that tilted holes as well as conical holes have on the flow distribution and shear stress. We have carried out 3D computational simulations to study the effect of the hole geometry on the cerebrospinal fluid flow through ventricular catheters. All the simulations were done with the OpenFOAM® toolbox. In particular, three different groups of models were investigated by varying (i) the tilt angles of the holes, (ii) the inner and outer diameters of the holes, and (iii) the distances between the so-called hole segments. The replacement of cylindrical holes by conical holes was found to have a strong influence on the flow distribution and to lower slightly the shear stress. Tilted holes did not involve flow distribution changes when the hole segments are sufficiently separated, but the mean shear stress was certainly reduced. The authors present new results about the behavior of the fluid flow through ventricular catheters. These results complete earlier work on this topic by adding the influence of the hole geometry. The overall objective pursued by this research is to provide guidelines to improve existing commercially available ventricular catheters.

  5. Method of processing laundry drain

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, Y; Oda, A; Yusa, H; Kitamura, M; Horiuchi, S

    1979-09-28

    Purpose: To subject the laundry drain to flocculation precipitation treatment in the prior stage of an inverse osmotic treatment, and subject only the supernatant to the inverse osmotic treatment and the precipitate directly to the condensation treatment, thereby decreasing the frequency of exchange of the inverse osmotic membranes, and reducing the quantity of purifying water. Method: The laundry drain is supplied to a flocculation precipitation tank, and added and mixed with a flocculant and a neutralizing agent, thus being subjected to a flocculation precipitation treatment. The supernatant is transported to a circulation tank through a transportation pipe, and is subjected to an inverse osmotic treatment in inverse osmotic module through the circulation tank, a filter and a high tension pump, and then returned to the circulation tank. The supernatant is thus concentrated to a predetermined concentration by repeating such operations. On the other hand, the precipitate at the bottom part of the flocculation precipitation tank is supplied through the transportation pipe to an evaporator supply tank together with the concentrate from the drain circulation tank, and evaporated and concentrated in the evaporator.

  6. Americium/curium bushing melter drain tests

    International Nuclear Information System (INIS)

    Smith, M.E.; Hardy, B.J.; Smith, M.E.

    1997-01-01

    Americium and curium were produced in the past at the Savannah River Site (SRS) for research, medical, and radiological applications. They have been stored in a nitric acid solution in an SRS reprocessing facility for a number of years. Vitrification of the americium/curium (Am/Cm) solution will allow the material to be safely stored or transported to the DOE Oak Ridge Reservation. Oak Ridge is responsible for marketing radionuclides for research and medical applications. The bushing melter technology being used in the Am/Cm vitrification research work is also under consideration for the stabilization of other actinides such as neptunium and plutonium. A series of melter drain tests were conducted at the Savannah River Technology Center to determine the relationship between the drain tube assembly operating variables and the resulting pour initiation times, glass flowrates, drain tube temperatures, and stop pour times. Performance criteria such as ability to start and stop pours in a controlled manner were also evaluated. The tests were also intended to provide support of oil modeling of drain tube performance predictions and thermal modeling of the drain tube and drain tube heater assembly. These drain tests were instrumental in the design of subsequent melter drain tube and drain tube heaters for the Am/Cm bushing melter, and therefore in the success of the Am/Cm vitrification and plutonium immobilization programs

  7. Lone ventricular cardiomyopathy,

    African Journals Online (AJOL)

    ... (I) cardiac catheterisation, including coronary arteriography and pulmonary ... described existence of lone ventricular idiopathic ... spectrum of classic idiopathic dilated cardiomyopathy. ... endomyocardial fibrosis, and from discussions at an.

  8. Development of rationalized system treating floor drain

    International Nuclear Information System (INIS)

    Nakamura, Yasuyuki; Serizawa, Kenichi; Komatsu, Akihiro; Shimizu, Takayuki

    1998-01-01

    Radioactive liquid wastes generated at BWR plants are collected and treated as required. These days, however, generation of floor drain has deceased and HFF (Hollow Fiber Filter) has experienced a wide applicability to several kinds of liquid wastes. We should consider that the floor drain can be mixed and diluted with equipment drain and be purified by HFF. That enables some of the sumps and long priming pipes to be combined. From this point of view, we have developed a highly rationalized waste liquid system. We have evaluated the applicability of this system after an investigation into the generation and properties of floor drain and equipment drain at the latest BWR'S and an on-site test at a typical BWR. (author)

  9. Regional Externalities

    NARCIS (Netherlands)

    Heijman, W.J.M.

    2007-01-01

    The book offers practical and theoretical insights in regional externalities. Regional externalities are a specific subset of externalities that can be defined as externalities where space plays a dominant role. This class of externalities can be divided into three categories: (1) externalities

  10. 216-Z-8 French drain characterization study

    International Nuclear Information System (INIS)

    Marratt, M.C.; Kasper, R.B.; Van Luik, A.E.

    1984-09-01

    The 216-Z-8 French drain study is one of a series of studies examining historical transuranic waste facilities no longer in use at the Hanford Site. The 216-Z-8 French drain underground disposal system consisted of a large settling tank that overflowed into a French drain. The French drain consisted of two large-diameter, gravel filled, vitrified clay pipes placed on end, end-to-end, over a gravel-filled excavation. The top of the drain was sealed with concrete to prevent the upward flow of waste solution. The waste solution discharged to the 216-Z-8 waste disposal system was a neutralized, transuranic recovery process, filter cake, backflush slurry. The primary objective of this study was to determine the distribution of plutonium and americium beneath the French drain. Transuranic activity under the French drain did not exceed 5 nCi/g in the soil samples obtained from a well within 1 m of the drain structure. Conservative estimates indicated that 4 to 5 m 3 of radioactive contaminated sediments, 10 nCi/g may lie directly under the 216-Z-8 French drain. The secondary objective of the study was to evaluate the possibility of a leak in the settling tank. Results from the analysis of soil samples from wells drilled around the settling tank indicated the presence of low-level transuranic contamination (on the order of 0.001 nci/g) in the soil surrounding the tank. However, the distribution of the contamination does not support a leak as a plausible mechanism to account for the observed activity surrounding the tank. The bulk of the plutonium was confirmed to be in the sludge that remained in the tank; thus, no significant environmental impact would be expected even if there has been a leak

  11. QUALIFIED VERSION OF MIGRATION: BRAIN DRAIN

    Directory of Open Access Journals (Sweden)

    Ayhan GENCLER

    2009-07-01

    Full Text Available Though globalization suggests an international exchange of people besides goods and capital, developed countries often tended to put forward some restrictions on the migration of workers from developed countries. However, there has been an increase in skilled international migration especially during the last two decades. Skilled international migration or brain drain points out the emigration of educated and highly skilled workers. It seems that, in general, developing or underdeveloped countries experience the negative consequences of the brain drain and suffer from the decreases in their human capital. The paper explains the phenomenon of skilled international migration, or brain drain, and summarizes the main global trends in this area.

  12. Drain Back, Low Flow Solar Combi Systems

    DEFF Research Database (Denmark)

    Perers, Bengt; Furbo, Simon; Fan, Jianhua

    2014-01-01

    Drain Back systems with ETC collectors are tested and analyzed in a Danish - Chinese cooperation project. Experiences from early work at DTU, with drain back, low flow systems, was used to design two systems: 1) One laboratory system at DTU and 2) One demonstration system in a single family house...... in Sorö Denmark. Detailed monitoring and modelling of the system in the DTU lab is done to be able to generalize the results, to other climates and loads and to make design optimizations. The advantage with drain back, low flow systems, is that the system can be made more simple with less components...... and that the performance can be enhanced. A combination of the drain back- and system expansion vessel was tested successfully. Small initial problems with installation and proposals for design improvements to avoid these in practice are described in the paper. Installer education and training is an important step to have...

  13. Prefabricated vertical drains, vol. I : engineering guidelines.

    Science.gov (United States)

    1986-09-01

    This volume presents procedures and guidelines applicable to the design and instal : tion of prefabricated vertical drains to accelerate consolidation of soils. The : contents represent the Consultant's interpretation of the state-of-the-art as of : ...

  14. Penrose Drain Migration After Laparoscopic Surgery

    Directory of Open Access Journals (Sweden)

    Pazouki AbdolReza

    2009-05-01

    Full Text Available Laparoscopy has made a revolution in surgical procedures and treatment of various diseases but its complications are still under investigation. Intra-abdominal visceral and vessel injuries, trocar site hernia, and leaving foreign bodies into the peritoneal cavity are among some laparoscopic surgery complications. This is a rare report of Penrose drain migration following incomplete laparoscopic Fundoplication surgery. The patient was a 47- year- old woman, who was a candidate for Touplet Fundoplication via laparoscopic approach due to refractory gastro-esophageal reflux disease (GERD. While wrapping a Penrose drain around the esophagus, the patient had a cardiorespiratory arrest. Attempts to remove the Penrose drain were unsuccessful and the surgical procedure was terminated due to patient's condition. Four months later, after a long period of dysphagia and abdominal pain, the Penrose drain was defecated via rectum.

  15. Brain drain of China and India

    OpenAIRE

    Li, Yuan

    2012-01-01

    Abstract Under the background of globalization, brain drain is a common phenomenon in many countries. Talents flow from developing countries to developed countries, and this phenomenon unavoidably exerts various and profound influences to both the source countries and the receiving countries. This thesis deals with the phenomenon of brain drain with the aim to investigate the phenomenon further and carry out two case studies of China and India. The research method is main...

  16. Necessity of suction drains in gynecomastia surgery.

    Science.gov (United States)

    Keskin, Mustafa; Sutcu, Mustafa; Cigsar, Bulent; Karacaoglan, Naci

    2014-05-01

    The aim of gynecomastia surgery is to restore a normal chest contour with minimal signs of breast surgery. The authors examine the rate of complications in gynecomastia surgery when no closed-suction drains are placed. One hundred thirty-eight consecutive male patients who underwent gynecomastia surgery without drains were retrospectively analyzed to determine whether the absence of drains adversely affected patient outcomes. Patients were managed by ultrasonic-assisted liposuction both with and without the pull-through technique. The mean age of the patients was 29 years, and the mean volume of breast tissue aspirated was 350 mL per beast. Pull-through was needed in 23 cases. There was only 1 postoperative hematoma. These results are comparable with previously published data for gynecomastia surgery in which drains were placed, suggesting that the absence of drains does not adversely affect postoperative recovery. Routine closed-suction drainage after gynecomastia surgery is unnecessary, and it may be appropriate to omit drains after gynecomastia surgery.

  17. How to remove a chest drain.

    Science.gov (United States)

    Allibone, Elizabeth

    2015-10-07

    RATIONALE AND KEY POINTS: This article aims to help nurses to undertake the removal of a chest drain in a safe, effective and patient-centred manner. This procedure requires two practitioners. The chest drain will have been inserted aseptically to remove air, blood, fluid or pus from the pleural cavity. ▶ Chest drains may be small or wide bore depending on the underlying condition and clinical setting. They may be secured with a mattress suture and/or an anchor suture. ▶ Chest drains are usually removed under medical instructions when the patient's lung has inflated, the underlying condition has resolved, there is no evidence of respiratory compromise or failure, and their anticoagulation status has been assessed as satisfactory. ▶ Chest drains secured with a mattress suture should be removed by two practitioners. One practitioner is required to remove the tube and the other to tie the mattress suture (if present) and secure the site. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. How this article could be used to educate patients with chest drains. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

  18. Ventricular Septal Defect (VSD)

    Science.gov (United States)

    ... Call your doctor if your baby or child: Tires easily when eating or playing Is not gaining ... heart procedures. Risk factors Ventricular septal defects may run in families and sometimes may occur with other ...

  19. Catheters, wires, tubes and drains on postoperative radiographs of pediatric cardiac patients: the whys and wherefores

    Energy Technology Data Exchange (ETDEWEB)

    Teele, Sarah A.; Thiagarajan, Ravi R. [Children' s Hospital Boston, Department of Cardiology, Boston, MA (United States); Harvard Medical School, Department of Pediatrics, Boston, MA (United States); Emani, Sitaram M. [Children' s Hospital Boston, Department of Cardiac Surgery, Boston, MA (United States); Harvard Medical School, Department of Surgery, Boston, MA (United States); Teele, Rita L. [Harvard Medical School, Department of Radiology, Boston, MA (United States); Starship Children' s Hospital, Department of Radiology, Grafton (New Zealand)

    2008-10-15

    Surgical treatment of congenital heart disease has advanced dramatically since the first intracardiac repairs in the mid-20th century. Previously inoperable lesions have become the focus of routine surgery and patients are managed successfully in intensive care units around the world. As a result, increasing numbers of postoperative images are processed by departments of radiology in children's hospitals. It is important that the radiologist accurately documents and describes the catheters, wires, tubes and drains that are present on the chest radiograph. This article reviews the reasons for the placement and positioning of perioperative equipment in children who have surgical repair of atrial septal defect, ventricular septal defect or transposition of the great arteries. Also included are a brief synopsis of each cardiac anomaly, the surgical procedure for its correction, and an in-depth discussion of the postoperative chest radiograph including illustrations of catheters, wires, tubes and drains. (orig.)

  20. Catheters, wires, tubes and drains on postoperative radiographs of pediatric cardiac patients: the whys and wherefores

    International Nuclear Information System (INIS)

    Teele, Sarah A.; Thiagarajan, Ravi R.; Emani, Sitaram M.; Teele, Rita L.

    2008-01-01

    Surgical treatment of congenital heart disease has advanced dramatically since the first intracardiac repairs in the mid-20th century. Previously inoperable lesions have become the focus of routine surgery and patients are managed successfully in intensive care units around the world. As a result, increasing numbers of postoperative images are processed by departments of radiology in children's hospitals. It is important that the radiologist accurately documents and describes the catheters, wires, tubes and drains that are present on the chest radiograph. This article reviews the reasons for the placement and positioning of perioperative equipment in children who have surgical repair of atrial septal defect, ventricular septal defect or transposition of the great arteries. Also included are a brief synopsis of each cardiac anomaly, the surgical procedure for its correction, and an in-depth discussion of the postoperative chest radiograph including illustrations of catheters, wires, tubes and drains. (orig.)

  1. Laparoscopic radical prostatectomy: omitting a pelvic drain

    Directory of Open Access Journals (Sweden)

    David Canes

    2008-03-01

    Full Text Available PURPOSE: Our goal was to assess outcomes of a selective drain placement strategy during laparoscopic radical prostatectomy (LRP with a running urethrovesical anastomosis (RUVA using cystographic imaging in all patients. Materials and Methods: A retrospective chart review was performed for all patients undergoing LRP between January 2003 and December 2004. The anastomosis was performed using a modified van Velthoven technique. A drain was placed at the discretion of the senior surgeon when a urinary leak was demonstrated with bladder irrigation, clinical suspicion for a urinary leak was high, or a complex bladder neck reconstruction was performed. Routine postoperative cystograms were obtained. RESULTS: 208 patients underwent LRP with a RUVA. Data including cystogram was available for 206 patients. The overall rate of cystographic urine leak was 5.8%. A drain was placed in 51 patients. Of these, 8 (15.6% had a postoperative leak on cystogram. Of the 157 undrained patients, urine leak was radiographically visible in 4 (2.5%. The higher leak rate in the drained vs. undrained cohort was statistically significant (p = 0.002. Twenty-four patients underwent pelvic lymph node dissection (8 drained, 16 undrained. Three undrained patients developed lymphoceles, which presented clinically on average 3 weeks postoperatively. There were no urinomas or hematomas in either group. CONCLUSIONS: Routine placement of a pelvic drain after LRP with a RUVA is not necessary, unless the anastomotic integrity is suboptimal intraoperatively. Experienced clinical judgment is essential and accurate in identifying patients at risk for postoperative leakage. When suspicion is low, omitting a drain does not increase morbidity.

  2. CT changes in children with drained hydrocephalus and intermittently raised intracranial pressure

    International Nuclear Information System (INIS)

    Schmidt, H.; Korinthenberg, R.; Erlemann, R.; Lengerke, H.J. von; Muenster Univ.

    1987-01-01

    Seven children with drained hydrocephalus are described who showed increasingly severe and frequent episodes of intermittently raised intracranial pressure. CT examinations during symptom-free intervals, or after conservative treatment, showed collapsed slit-like ventricles. Examination during attacks of raised pressure showed relative dilatation of the ventricles as compared with earlier examinations. Children with ventricular shunts of long duration may develop a shunt-dependent syndrome; CT may show normal or narrow ventricles and this does not exclude the possibility of a rise of intracranial pressure. These findings may help in making the diagnosis by means of CT without any further invasive procedure. (orig.) [de

  3. Systolic ventricular filling.

    Science.gov (United States)

    Torrent-Guasp, Francisco; Kocica, Mladen J; Corno, Antonio; Komeda, Masashi; Cox, James; Flotats, A; Ballester-Rodes, Manel; Carreras-Costa, Francesc

    2004-03-01

    The evidence of the ventricular myocardial band (VMB) has revealed unavoidable coherence and mutual coupling of form and function in the ventricular myocardium, making it possible to understand the principles governing electrical, mechanical and energetical events within the human heart. From the earliest Erasistratus' observations, principal mechanisms responsible for the ventricular filling have still remained obscured. Contemporary experimental and clinical investigations unequivocally support the attitude that only powerful suction force, developed by the normal ventricles, would be able to produce an efficient filling of the ventricular cavities. The true origin and the precise time frame for generating such force are still controversial. Elastic recoil and muscular contraction were the most commonly mentioned, but yet, still not clearly explained mechanisms involved in the ventricular suction. Classical concepts about timing of successive mechanical events during the cardiac cycle, also do not offer understandable insight into the mechanism of the ventricular filling. The net result is the current state of insufficient knowledge of systolic and particularly diastolic function of normal and diseased heart. Here we summarize experimental evidence and theoretical backgrounds, which could be useful in understanding the phenomenon of the ventricular filling. Anatomy of the VMB, and recent proofs for its segmental electrical and mechanical activation, undoubtedly indicates that ventricular filling is the consequence of an active muscular contraction. Contraction of the ascendent segment of the VMB, with simultaneous shortening and rectifying of its fibers, produces the paradoxical increase of the ventricular volume and lengthening of its long axis. Specific spatial arrangement of the ascendent segment fibers, their interaction with adjacent descendent segment fibers, elastic elements and intra-cavitary blood volume (hemoskeleton), explain the physical principles

  4. Left ventricular function in right ventricular overload

    International Nuclear Information System (INIS)

    Iwanaga, Shiro; Handa, Shunnosuke; Abe, Sumihisa; Onishi, Shohei; Nakamura, Yoshiro; Kunieda, Etsuo; Ogawa, Koichi; Kubo, Atsushi

    1989-01-01

    This study clarified regional and global functions of the distorted left ventricle due to right ventricular overload by gated radionuclide ventriculography (RNV). Cardiac catheterization and RNV were performed in 13 cases of atrial septal defect (ASD), 13 of pure mitral stenosis (MS), 10 of primary pulmonary hypertension (PPH), and 10 of normal subjects (NL). Right ventricular systolic pressure (RVSP) was 32.9±13.9, 45.0±12.2, 88.3±17.1, and 21.2±4.5 mmHg, respectively. The end-systolic LAO view of the left ventricle was halved into septal and free-wall sides. The end-diastolic halves were determined in the same plane. Ejection fractions of the global left ventricle (LVEF), global right ventricle (RVEF), the septal half of the left ventricle (SEPEF), and the free-wall half of the left ventricle (FWEF) were obtained. LVEF was 56.8±9.8% in NL, 52.8±10.5% in ASD, and 49.5±12.9% in PPH. In MS, LVEF (47.0±13.0%) was smaller than those in the other groups. RVEF was 37.0±5.2% in NL, 43.7±15.5% in ASD, and 32.8±11.5% in MS. In PPH, RVEF (25.0±10.6%) was smaller than those in the other groups. SEPEF was smaller in ASD (42.5±13.2%), MS (40.4±13.1%), PPH (40.5±12.5%) than in NL (53.5±8.5%). Systolic function of the septal half of the left ventricle was disturbed by right ventricular overload. RVEF (r=-0.35, p<0.05) and SEPEF (r=-0.51, p<0.01) had negative correlations with RVSP. As RVSP rose, systolic function of the septal half of the left ventricle was more severely disturbed. FWEF was the same among the four groups; NL (57.0±12.6%), ASD (48.6±15.2%), MS (50.5±12.0%), and PPH (51.1±12.3%). There was a good correlation between SEPEF and LVEF in NL (r=0.81), although in PPH this correlation was poor (r=0.64). These data showed that the distorted left ventricular due to right ventricular overload maintains its global function with preserved function of the free-wall side. (J.P.N.)

  5. Mechanical decontamination techniques for floor drain systems

    International Nuclear Information System (INIS)

    Palau, G.L.

    1987-01-01

    The unprecedented nature of cleanup activities at Three Mile Island Unit 2 (TMI-2) following the 1979 accident has necessitated the development of new techniques to deal with radiation and contamination in the plant. One of these problems was decontamination of floor drain systems, which had become highly contaminated with various forms of dirt and sludge containing high levels of fission products and fuel from the damaged reactor core. The bulk of this contamination is loosely adherent to the drain pipe walls; however, significant amounts of contamination have become incorporated into pipe wall oxide and corrosion layers and embedded in microscopic pits and fissures in the pipe wall material. The need to remove this contamination was recognized early in the TMI-2 cleanup effort. A program consisting of development and laboratory testing of floor drain decontamination techniques was undertaken early in the cleanup with support from the Electric Power Research Institute (EPRI). Based on this initial research, two techniques were judged to show promise for use at TMI-2: a rotating brush hone system and a high-pressure water mole nozzle system. Actual use of these devices to clean floor drains at TMI-2 has yielded mixed decontamination results. The decontamination effectiveness that has been obtained is highly dependent on the nature of the contamination in the drain pipe and the combination of decontamination techniques used

  6. 21 CFR 868.5995 - Tee drain (water trap).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tee drain (water trap). 868.5995 Section 868.5995...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5995 Tee drain (water trap). (a) Identification. A tee drain (water trap) is a device intended to trap and drain water that collects in ventilator...

  7. Brain drain and health workforce distortions in Mozambique.

    Science.gov (United States)

    Sherr, Kenneth; Mussa, Antonio; Chilundo, Baltazar; Gimbel, Sarah; Pfeiffer, James; Hagopian, Amy; Gloyd, Stephen

    2012-01-01

    Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs), and the private sector. An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980-2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties. Of 723 qualifying physicians between 1980-2006, 95.9% (693) were working full-time, including 71.1% (493) as clinicians, 20.5% (142) as health system managers, and 6.9% (48) as researchers/professors. 25.5% (181) of the sample had left the public sector, of which 62.4% (113) continued working in-country and 37.6% (68) emigrated from Mozambique. Of those cases of internal migration, 66.4% (75) worked for NGOs, 21.2% (24) for donor agencies, and 12.4% (14) in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113) of internal migration cases had previously held senior-level management positions in the public sector. Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring practices may undermine the very systems they seek

  8. Brain drain and health workforce distortions in Mozambique.

    Directory of Open Access Journals (Sweden)

    Kenneth Sherr

    Full Text Available Trained human resources are fundamental for well-functioning health systems, and the lack of health workers undermines public sector capacity to meet population health needs. While external brain drain from low and middle-income countries is well described, there is little understanding of the degree of internal brain drain, and how increases in health sector funding through global health initiatives may contribute to the outflow of health workers from the public sector to donor agencies, non-governmental organisations (NGOs, and the private sector.An observational study was conducted to estimate the degree of internal and external brain drain among Mozambican nationals qualifying from domestic and foreign medical schools between 1980-2006. Data were collected 26-months apart in 2008 and 2010, and included current employment status, employer, geographic location of employment, and main work duties.Of 723 qualifying physicians between 1980-2006, 95.9% (693 were working full-time, including 71.1% (493 as clinicians, 20.5% (142 as health system managers, and 6.9% (48 as researchers/professors. 25.5% (181 of the sample had left the public sector, of which 62.4% (113 continued working in-country and 37.6% (68 emigrated from Mozambique. Of those cases of internal migration, 66.4% (75 worked for NGOs, 21.2% (24 for donor agencies, and 12.4% (14 in the private sector. Annual incidence of physician migration was estimated to be 3.7%, predominately to work in the growing NGO sector. An estimated 36.3% (41/113 of internal migration cases had previously held senior-level management positions in the public sector.Internal migration is an important contributor to capital flight from the public sector, accounting for more cases of physician loss than external migration in Mozambique. Given the urgent need to strengthen public sector health systems, frank reflection by donors and NGOs is needed to assess how hiring practices may undermine the very systems they

  9. Using Smoke Injection in Drains to Identify Potential Preferential Pathways in a Drained Arable Field

    Science.gov (United States)

    Nielsen, M. H.; Petersen, C. T.; Hansen, S.

    2014-12-01

    Macropores forming a continuous pathway between the soil surface and subsurface drains favour the transport of many contaminants from agricultural fields to surface waters. The smoke injection method presented by Shipitalo and Gibbs (2000) used for demonstrating and quantifying such pathways has been further developed and used on a drained Danish sandy loam. In order to identify the preferential pathways to drains, smoke was injected in three 1.15 m deep tile drains (total drain length 93 m), and smoke emitting macropores (SEMP) at the soil surface were counted and characterized as producing either strong or weak plumes compared to reference plumes from 3 and 6 mm wide tubes. In the two situations investigated in the present study - an early spring and an autumn situation, smoke only penetrated the soil surface layer via earthworm burrows located in a 1.0 m wide belt directly above the drain lines. However, it is known from previous studies that desiccation fractures in a dry summer situation also can contribute to the smoke pattern. The distance between SEMP measured along the drain lines was on average 0.46 m whereas the average spacing between SEMP with strong plumes was 2.3 m. Ponded water was applied in 6 cm wide rings placed above 52 burrows including 17 reference burrows which did not emit smoke. Thirteen pathways in the soil were examined using dye tracer and profile excavation. SEMP with strong plumes marked the entrance of highly efficient transport pathways conducting surface applied water and dye tracer into the drain. However, no single burrow was traced all the way from the surface into the drain, the dye patterns branched off in a network of other macropores. Water infiltration rates were significantly higher (P drains and surface waters, pathways being associated primarily with unevenly distributed SEMP producing strong smoke plumes.

  10. FROM BRAIN DRAIN TO BRAIN NETWORKING

    Directory of Open Access Journals (Sweden)

    Irina BONCEA

    2015-06-01

    Full Text Available Scientific networking is the most accessible way a country can turn the brain drain into brain gain. Diaspora’s members offer valuable information, advice or financial support from the destination country, without being necessary to return. This article aims to investigate Romania’s potential of turning brain drain into brain networking, using evidence from the medical sector. The main factors influencing the collaboration with the country of origin are investigated. The conclusions suggest that Romania could benefit from the diaspora option, through an active implication at institutional level and the implementation of a strategy in this area.

  11. Arrhythmogenic right ventricular dysplasia

    International Nuclear Information System (INIS)

    Vignolo Puglia, W.; Freire Colla, D.; Rivara Urrutia, D.; Lujambio Grene, M.; Arbiza Bruno, T.; Oliveira, G.; Cobas Rodriguez, J.

    1997-01-01

    The arrhythmogenic right ventricular dysplasia is a condition predominantly well defined with arrhythmic events. We analyze three cases diagnosed by the group. These cases were presented as ventricular tachycardia with a morphology of left bundle branch block, presenting one of them aborted sudden death in evolution. The baseline electrocardiogram and signal averaging were abnormal in two of the three cases, like the echocardiogram. The electrophysiological study was able to induce in the three patients with sustained monomorphic ventricular tachycardia morphology of left bundle branch block. The definitive diagnosis was made by right ventriculography in two cases and magnetic resonance imaging in the other. Treatment included antiarrhythmic drugs in the three cases and the placement of an automatic defibrillator which survived a sudden death (Author)

  12. QUALIFIED VERSION OF MIGRATION: BRAIN DRAIN

    OpenAIRE

    Ayhan GENCLER

    2009-01-01

    Though globalization suggests an international exchange of people besides goods and capital, developed countries often tended to put forward some restrictions on the migration of workers from developed countries. However, there has been an increase in skilled international migration especially during the last two decades. Skilled international migration or brain drain points out the emigration of educated and highly skilled workers. It seems tha...

  13. The European Politics of Brain Drain

    DEFF Research Database (Denmark)

    Hasselbalch, Jacob

    This qualitative multi-method studymaps the politics of brain drain at the level of the European Union and follows the evolution of the issue over the last four parliamentary periods. By utilizing a novel combination of interviews with a content and network analysis of parliamentary questions...

  14. A Rare Complication of Abdominal Drain: Fallopian Tube Herniation Through the Drain Site

    Directory of Open Access Journals (Sweden)

    Dilek Uygur

    2016-05-01

    Full Text Available Prophylactic drainage of the peritoneal cavity after obstetrical and gynecological surgery is widely practiced. The idea of “when in doubt, drain” is accepted and applied clinically by many surgeons. However, surgically placed drains are not without risk. The present case describes herniation of fallopian tube during the removal of a surgical drain placed after a cesarean section.

  15. A Rare Complication of Abdominal Drain: Fallopian Tube Herniation Through the Drain Site

    OpenAIRE

    Dilek Uygur; Seval Erdinç; Hülya Dede; Ümit Taşdemir; Oktay Kaymak; Nuri Danışman

    2016-01-01

    Prophylactic drainage of the peritoneal cavity after obstetrical and gynecological surgery is widely practiced. The idea of “when in doubt, drain” is accepted and applied clinically by many surgeons. However, surgically placed drains are not without risk. The present case describes herniation of fallopian tube during the removal of a surgical drain placed after a cesarean section.

  16. Drain Current Modulation of a Single Drain MOSFET by Lorentz Force for Magnetic Sensing Application.

    Science.gov (United States)

    Chatterjee, Prasenjit; Chow, Hwang-Cherng; Feng, Wu-Shiung

    2016-08-30

    This paper reports a detailed analysis of the drain current modulation of a single-drain normal-gate n channel metal-oxide semiconductor field effect transistor (n-MOSFET) under an on-chip magnetic field. A single-drain n-MOSFET has been fabricated and placed in the center of a square-shaped metal loop which generates the on-chip magnetic field. The proposed device designed is much smaller in size with respect to the metal loop, which ensures that the generated magnetic field is approximately uniform. The change of drain current and change of bulk current per micron device width has been measured. The result shows that the difference drain current is about 145 µA for the maximum applied magnetic field. Such changes occur from the applied Lorentz force to push out the carriers from the channel. Based on the drain current difference, the change in effective mobility has been detected up to 4.227%. Furthermore, a detailed investigation reveals that the device behavior is quite different in subthreshold and saturation region. A change of 50.24 µA bulk current has also been measured. Finally, the device has been verified for use as a magnetic sensor with sensitivity 4.084% (29.6 T(-1)), which is very effective as compared to other previously reported works for a single device.

  17. Carbon accumulation in pristine and drained mires

    Energy Technology Data Exchange (ETDEWEB)

    Maekilae, M.

    2011-07-01

    The carbon accumulation of 73 peat columns from 48 pristine and drained mires was investigated using a total of 367 dates and age-depth models derived from bulk density measurements. Peat columns were collected from mires of varying depth, age, degree of natural state and nutrient conditions in aapa mire and raised bog regions and coastal mires from southern and central Finland and Russian Karelia. Particular attention was paid to the accumulation of carbon over the last 300 years, as this period encompasses the best estimates of the oxic layer (acrotelm) age across the range of sites investigated. In general, drained mires are initially more nutrient-rich than pristine mires. Organic matter decomposes more rapidly at drained sites than at pristine sites, resulting in thinner peat layers and carbon accumulation but a higher dry bulk density and carbon content. The average carbon accumulation was calculated as 24.0 g m-2 yr-1 at pristine sites and 19.4 g m-2 yr-1 at drained sites, while for peat layers younger than 300 years the respective figures were 45.3 and 34.5 g m-2 yr-1 at pristine and drained sites. For the <300-year-old peat layers studied here, the average thickness was 19 cm less and the carbon accumulation rate 10.8 g m-2 yr-1 lower in drained areas than in pristine areas. The amount carbon accumulation of surface peat layers depends upon the mire site type, vegetation and natural state; variations reflect differences in plant communities as well as factors that affect biomass production and decay rates. The highest accumulation rates and thus carbon binding for layers younger than 300 years were measured in the ombrotrophic mire site types (Sphagnum fuscum bog and Sphagnum fuscum pine bog), and the second highest rates in wet, treeless oligotrophic and minerotrophic mire site types. The lowest values of carbon accumulation over the last 300 years were obtained for the most transformed, sparsely forested and forested mire site types, where the water

  18. Climate mitigation scenarios of drained peat soils

    Science.gov (United States)

    Kasimir Klemedtsson, Åsa; Coria, Jessica; He, Hongxing; Liu, Xiangping; Nordén, Anna

    2014-05-01

    The national inventory reports (NIR) submitted to the UNFCCC show Sweden - which as many other countries has wetlands where parts have been drained for agriculture and forestry purposes, - to annually emit 12 million tonnes carbon dioxide equivalents, which is more GHG'es than industrial energy use release in Sweden. Similar conditions can be found in other northern countries, having cool and wet conditions, naturally promoting peat accumulation, and where land use management over the last centuries have promoted draining activities. These drained peatland, though covering only 2% of the land area, have emissions corresponding to 20% of the total reported NIR emissions. This substantial emission contribution, however, is hidden within the Land Use Land Use Change and Forestry sector (LULUCF) where the forest Carbon uptake is even larger, which causes the peat soil emissions become invisible. The only drained soil emission accounted in the Swedish Kyoto reporting is the N2O emission from agricultural drained organic soils of the size 0.5 million tonnes CO2e yr-1. This lack of visibility has made incentives for land use change and management neither implemented nor suggested, however with large potential. Rewetting has the potential to decrease soil mineralization, why CO2 and N2O emissions are mitigated. However if the soil becomes very wet CH4 emission will increase together with hampered plant growth. By ecological modeling, using the CoupModel the climate change mitigation potential have been estimated for four different land use scenarios; 1, Drained peat soil with Spruce (business as usual scenario), 2, raised ground water level to 20 cm depth and Willow plantation, 3, raised ground water level to 10 cm depth and Reed Canary Grass, and 4, rewetting to an average water level in the soil surface with recolonizing wetland plants and mosses. We calculate the volume of biomass production per year, peat decomposition, N2O emission together with nitrate and DOC

  19. Processing method of radioactive cleaning drain

    International Nuclear Information System (INIS)

    Otsuka, Shigemitsu; Murakami, Tadashi; Kitao, Hideo

    1998-01-01

    Upon processing of radioactive cleaning drains, contained Co-60 is removed by a selectively adsorbing adsorbent. In addition, after removing suspended materials by a filtering device, Co-60 as predominant nuclides in the drain is selectively adsorbed. The concentration of objective Co-60 is in the order of 0.1 Bq/cc, and non-radioactive metal ions such as Na + ions are present in the order of ppm in addition to Co-60. A granular adsorbent for selectively adsorbing Co-60 is oxine-added activated carbon, and has a grain size of from 20 to 48 mesh. The granular adsorbent is used while being filled in an adsorbing tower. Since a relatively simple device comprising the filtering device and the adsorbing tower in combination is provided, the reduction of the construction cost can be expected. In addition, since no filtering aid is used in the filtering device, the amount of secondary wastes is small. (N.H.)

  20. Percutaneous Retrieval of a Retained Jackson-Pratt Drain Fragment

    International Nuclear Information System (INIS)

    Namyslowski, Jan; Halin, Neil J.; Greenfield, Alan J.

    1996-01-01

    A retained intraabdominal Jackson-Pratt drain fragment was percutaneously retrieved using an inflated angioplasty balloon that had been maneuvered inside of the drain lumen over a hydrophilic-coated steerable guidewire

  1. Device for discharging drain in a control rod driving apparatus

    International Nuclear Information System (INIS)

    Ikeda, Tadasu; Ikuta, Takuzo; Yoshida, Tomiji; Tsukahara, Katsumi.

    1975-01-01

    Object: To efficiently and safely collect and discharge drain by a simple construction in which a drain cover and a drain tank in a control rod driving apparatus are integrally formed, and an overhauling wrench of said apparatus and a drain hose are mounted on the drain tank. Structure: When a mounting bolt is untightened by a torque wrench so as to be removed from a flange surface of the control rod driving apparatus in a nuclear reactor, axial movement of said apparatus is absorbed by a spring so that drain containing a radioactive material is discharged into a drain tank through the flange surface of said apparatus and is then guided into a collecting tank through a drain hose. (Kamimura, M.)

  2. Water Table Recession in Subsurface Drained Soils

    OpenAIRE

    Moustafa, Mahmoud Mohamed; Yomota, Atsushi

    1999-01-01

    Theoretical drainage equations are intensively tested in many parts of humid and arid regions and are commonly used in drainage design. However, this is still a great concern in Japan as the drainage design is exclusively based on local experiences and empirical basis. There is a need therefore to evaluate the theoretical drainage equations under Japanese field conditions to recommend equations for design of subsurface drainage systems. This was the main motivation for this study. While drain...

  3. Drained Triaxial Tests on Eastern Scheldt Sand

    DEFF Research Database (Denmark)

    Praastrup, U.; Jakobsen, Kim Parsberg

    In the process of understanding and developing models for geomaterials, the stress-strain behaviour is commonly studied by performing triaxial tests. In the present study static triaxial tests have been performed to gain knowledge of the stress-strain behaviour of frictional materials during...... monotonic loading. The tests reported herein are all drained tests, starting from different initial states of stress and following various stress paths. AIl the tests are performed on reconstituted medium dense specimens of Eastern Scheldt Sand....

  4. QUALIFIED VERSION OF MIGRATION: BRAIN DRAIN

    OpenAIRE

    Gencler, Ayhan

    2009-01-01

    Though globalization suggests an international exchange of people besides goods and capital, developed countries often tended to put forward some restrictions on the migration of workers from developed countries. However, there has been an increase in skilled international migration especially during the last two decades. Skilled international migration or brain drain points out the emigration of educated and highly skilled workers. It seems that, in general, developing or underdeveloped...

  5. Brain drain: Propulsive factors and consequences

    Directory of Open Access Journals (Sweden)

    Dragan ILIC

    2018-01-01

    Full Text Available When speaking about the total number of highly educated individuals’ migration, it is easy to spot that it is rapidly increasing. The brain drain issues should be taken very seriously especially in under developed and in the developing countries, knowing that the human capital is globally mobile and that highly educated individuals can without any issues market their knowledge around the globe. Dealing with it requires a carefully tailored strategy for these countries, which are suffering from severe human capital losses on annual basis. Since the labor markets of today are highly competitive, it is necessary for these countries to secure good advancement and doing business opportunities. The purpose of this research is to provide an insight into the key propulsive factors and potential consequences caused by the brain drain. The method used in order to conduct the research was a carefully designed questionnaire taken by the date subject enrolled at the third and fourth years of state governed and privately owned universities. This research shows that one of the key reasons for brain drain in underdeveloped and in the developing countries is shortage of further educational advancement opportunities.

  6. Fallopian Tube Herniation: An Unusual Complication of Surgical Drain

    OpenAIRE

    Sharma, Lipi; Singh, Alpana; Bhaskaran, Sruthi; Radhika, A. G.; Radhakrishnan, Gita

    2012-01-01

    Background. Surgical drains have been used since time immemorial, but their use is not without complications. By presenting this case we aim to describe an uncommon complication of herniation of fallopian tube following the simple procedure of surgical drain removal. Case Presentation. This case describes a 23-year G2P1L1 who underwent an emergency cesarean section for obstructed labor with intraperitoneal drain insertion. The patient had an uneventful postoperative period, drain was removed ...

  7. Fallopian Tube Herniation through Left Sided Abdominal Drain Site.

    Science.gov (United States)

    Hussain, Khalid; Masood, Jovaria

    2016-06-01

    Intra-abdominal drains have been used since long to prevent intra-abdominal collection, and detect any anastomotic leaks. We report a case of left sided fallopian tube herniation from a left lower abdominal drain site in a 27-year female who underwent caesarian section for breach presentation. Several complications related to drain usage has been described but left sided fallopian tube prolapse through drain site has not been reported in literature.

  8. 46 CFR 45.157 - Scuppers and gravity drains.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Scuppers and gravity drains. 45.157 Section 45.157 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) LOAD LINES GREAT LAKES LOAD LINES Conditions of Assignment § 45.157 Scuppers and gravity drains. Scuppers and gravity deck drains from spaces...

  9. MEDICAL BRAIN DRAIN - A THEORETICAL APPROACH

    Directory of Open Access Journals (Sweden)

    Boncea Irina

    2013-07-01

    Full Text Available Medical brain drain is defined as the migration of health personnel from developing countries to developed countries and between industrialized nations in search for better opportunities. This phenomenon became a global growing concern due to its impact on both the donor and the destination countries. This article aims to present the main theoretical contributions starting from 1950 until today and the historical evolution, in the attempt of correlating the particular case of medical brain drain with the theory and evolution of the brain drain in general. This article raises questions and offers answers, identifies the main issues and looks for possible solutions in order to reduce the emigration of medical doctors. Factors of influence include push (low level of income, poor working conditions, the absence of job openings and social recognition, oppressive political climate and pull (better remuneration and working conditions, prospects for career development, job satisfaction, security factors. Developing countries are confronting with the loss of their most valuable intellectuals and the investment in their education, at the benefit of developed nations. An ethical debate arises as the disparities between countries increases, industrialized nations filling in the gaps in health systems with professionals from countries already facing shortages. However, recent literature emphasizes the possibility of a “beneficial brain drain” through education incentives offered by the emigration prospects. Other sources of “brain gain” for donor country are the remittances, the scientific networks and return migration. Measures to stem the medical brain drain involve the common effort and collaboration between developing and developed countries and international organizations. Measures adopted by donor countries include higher salaries, better working conditions, security, career opportunities, incentives to stimulate return migration. Destination

  10. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  11. A prospective randomized study of use of drain versus no drain after burr-hole evacuation of chronic subdural hematoma.

    Science.gov (United States)

    Singh, Amit Kumar; Suryanarayanan, Bhaskar; Choudhary, Ajay; Prasad, Akhila; Singh, Sachin; Gupta, Laxmi Narayan

    2014-01-01

    Chronic subdural hematoma (CSDH) recurs after surgical evacuation in 5-30% of patients. Inserting subdural drain might reduce the recurrence rate, but is not commonly practiced. There are few prospective studies to evaluate the effect of subdural drains. A prospective randomized study to investigate the effect of subdural drains in the on recurrence rates and clinical outcome following burr-hole drainage (BHD) of CSDH was undertaken. During the study period, 246 patients with CSDH were assessed for eligibility. Among 200 patients fulfilling the eligibility criteria, 100 each were assigned to "drain group" (drain inserted into the subdural space following BHD) and "without drain group" (subdural drain was not inserted following BHD) using random allocation software. The primary end point was recurrence needing re-drainage up to a period of 6 months from surgery. Recurrence occurred in 9 of 100 patients with a drain, and 26 of 100 patients in without drain group (P = 0.002). The mortality was 5% in patients with drain and 4% in patients without drain group (P = 0.744). The medical and surgical complications were comparable between the two study groups. Use of a subdural drain after burr-hole evacuation of a CSDH reduces the recurrence rate and is not associated with increased complications.

  12. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

  13. Thermal-fluid analysis of the fill and drain operations of a cryrogenic fuel tank

    Science.gov (United States)

    Stephens, Craig A.; Hanna, Gregory J.; Gong, Leslie

    1993-01-01

    The Generic Research Cryogenic Tank was designed to establish techniques for testing and analyzing the behavior of reusable fuel tank structures subjected to cryogenic fuels and aerodynamic heating. The Generic Research Cryogenic Tank tests will consist of filling a pressure vessel to a prescribed fill level, waiting for steady-state conditions, then draining the liquid while heating the external surface to simulate the thermal environment associated with hypersonic flight. Initial tests of the Generic Research Cryogenic Tank will use liquid nitrogen with future tests requiring liquid hydrogen. Two-dimensional finite-difference thermal-fluid models were developed for analyzing the behavior of the Generic Research Cryogenic Tank during fill and drain operations. The development and results of the two-dimensional fill and drain models, using liquid nitrogen, are provided, along with results and discussion on extrapolating the model results to the operation of the full-size Generic Research Cryogenic Tank. These numerical models provided a means to predict the behavior of the Generic Research Cryogenic Tank during testing and to define the requirements for the Generic Research Cryogenic Tank support systems such as vent, drain, pressurization, and instrumentation systems. In addition, the fill model provided insight into the unexpected role of circumferential conduction in cooling the Generic Research Cryogenic Tank pressure vessel during fill operations.

  14. Cryogenic Fuel Tank Draining Analysis Model

    Science.gov (United States)

    Greer, Donald

    1999-01-01

    One of the technological challenges in designing advanced hypersonic aircraft and the next generation of spacecraft is developing reusable flight-weight cryogenic fuel tanks. As an aid in the design and analysis of these cryogenic tanks, a computational fluid dynamics (CFD) model has been developed specifically for the analysis of flow in a cryogenic fuel tank. This model employs the full set of Navier-Stokes equations, except that viscous dissipation is neglected in the energy equation. An explicit finite difference technique in two-dimensional generalized coordinates, approximated to second-order accuracy in both space and time is used. The stiffness resulting from the low Mach number is resolved by using artificial compressibility. The model simulates the transient, two-dimensional draining of a fuel tank cross section. To calculate the slosh wave dynamics the interface between the ullage gas and liquid fuel is modeled as a free surface. Then, experimental data for free convection inside a horizontal cylinder are compared with model results. Finally, cryogenic tank draining calculations are performed with three different wall heat fluxes to demonstrate the effect of wall heat flux on the internal tank flow field.

  15. Roundtable. Strategies to discourage brain drain.

    Science.gov (United States)

    Kupfer, Linda; Hofman, Karen; Jarawan, Raya; McDermott, Jeanne; Bridbord, Ken

    2004-08-01

    Building health research expertise in developing countries often requires personnel to receive training beyond national borders. For research funding agencies that sponsor this type of training, a major goal is to ensure that trainees return to their country of origin: attaining this objective requires the use of proactive strategies. The strategies described were developed under the extramural acquired immunodeficiency syndrome (AIDS) International Training and Research Program (AITRP) funded by the Fogarty International Center (FIC) at the National Institutes of Health, United States. This programme supports universities in the United States that provide research training to scientists from developing countries to enable them to address the global epidemic of human immunodeficiency virus (HIV)/AIDS and the related tuberculosis (TB) epidemic. This paper describes the strategies employed to discourage brain drain by the principle investigators (PIs) of five of the longest-funded AITRPs (funded for 15 years). Long-term trainees in these programmes spent from 11 to 96 months (an average of 26 months) studying. Using scientific, political and economic strategies that address brain drain issues, PIs working in AITRPs have attained an average rate of return home for their trainees of 80%.

  16. Genetics Home Reference: arrhythmogenic right ventricular cardiomyopathy

    Science.gov (United States)

    ... cardiomyopathy Merck Manual Consumer Version: Cardiomyopathy Merck Manual Consumer Version: Overview of Abnormal Heart Rhythms Orphanet: Arrhythmogenic right ventricular cardiomyopathy Orphanet: Familial isolated arrhythmogenic right ventricular ...

  17. Fine root production at drained peatland sites

    Energy Technology Data Exchange (ETDEWEB)

    Finer, L [Finnish Forest Research Inst. (Finland). Joensuu Research Station; Laine, J [Helsinki Univ. (Finland). Dept. of Forest Ecology

    1997-12-31

    The preliminary results of the Finnish project `Carbon balance of peatlands and climate change` show that fine roots play an important role in carbon cycling on peat soils. After drainage the roots of mire species are gradually replaced by the roots of trees and other forest species. Pine fine root biomass reaches a maximum level by the time of crown closure, some 20 years after drainage on pine mire. The aim of this study is to compare the results of the sequential coring method and the ingrowth bag method used for estimating fine root production on three drained peatland sites of different fertility. The results are preliminary and continuation to the work done in the study Pine root production on drained peatlands, which is part of the Finnish project `Carbon cycling on peatlands and climate change`. In this study the fine root biomass was greater on the poor site than on the rich sites. Pine fine root production increased with the decrease in fertility. Root turnover and the production of field layer species were greater on the rich sites than on the poor site. The results suggested that the in growth bag method measured more root activity than the magnitude of production. More than two growing seasons would have been needed to balance the root dynamics in the in growth bags with the surrounding soil. That time would probably have been longer on the poor site than on the rich ones and longer for pine and field layer consisting of dwarf shrubs than for field layer consisting of sedge like species and birch. (11 refs.)

  18. Fine root production at drained peatland sites

    Energy Technology Data Exchange (ETDEWEB)

    Finer, L. [Finnish Forest Research Inst. (Finland). Joensuu Research Station; Laine, J. [Helsinki Univ. (Finland). Dept. of Forest Ecology

    1996-12-31

    The preliminary results of the Finnish project `Carbon balance of peatlands and climate change` show that fine roots play an important role in carbon cycling on peat soils. After drainage the roots of mire species are gradually replaced by the roots of trees and other forest species. Pine fine root biomass reaches a maximum level by the time of crown closure, some 20 years after drainage on pine mire. The aim of this study is to compare the results of the sequential coring method and the ingrowth bag method used for estimating fine root production on three drained peatland sites of different fertility. The results are preliminary and continuation to the work done in the study Pine root production on drained peatlands, which is part of the Finnish project `Carbon cycling on peatlands and climate change`. In this study the fine root biomass was greater on the poor site than on the rich sites. Pine fine root production increased with the decrease in fertility. Root turnover and the production of field layer species were greater on the rich sites than on the poor site. The results suggested that the in growth bag method measured more root activity than the magnitude of production. More than two growing seasons would have been needed to balance the root dynamics in the in growth bags with the surrounding soil. That time would probably have been longer on the poor site than on the rich ones and longer for pine and field layer consisting of dwarf shrubs than for field layer consisting of sedge like species and birch. (11 refs.)

  19. Peso dos ventrículos cardíacos determinado em necropsia de indivíduos saudáveis mortos por causas externas Cardiac ventricular weights recorded at the autopsy of healthy subjects who died of external causes

    Directory of Open Access Journals (Sweden)

    Sérgio Lamêgo Rodrigues

    2007-11-01

    Full Text Available OBJETIVO: Determinar o peso dos ventrículos cardíacos em necropsia de indivíduos sadios vítimas de morte acidental, visando determinar padrões de normalidade em nossa população. MÉTODOS: Foram examinados 94 corações no Instituto Médico Legal de Vitória. Após remoção do coração e ressecção dos átrios e gordura epicárdica, os ventrículos direito (VD e esquerdo (VE, incluindo o septo, foram separados e pesados e a massa indexada pela altura. O teste de Kolmogorov-Smirnov foi usado para testar normalidade da distribuição. Os dados são apresentados como média ± desvio padrão. RESULTADOS: Após 12 exclusões (doença cardiovascular possível detectada após a morte foram analisados 82 corações (52 homens e 30 mulheres, 16-68 anos, média 31±12 anos. O peso do VE foi de 181±25 g e 125±15 g, do VD foi de 54±7 g e 38±6 g e a massa de VE indexada pela altura foi de 105±14 g/m e 78±8 g/m para homens e mulheres, respectivamente. O P95 do peso do VE foi de 218 g e 128 g/m em homens e 148 g e 88 g/m em mulheres. Não detectamos correlação significante entre a massa ventricular e idade. CONCLUSÃO: O peso do ventrículo esquerdo do coração dos homens da nossa amostra foi superior aos relatados na literatura contemporânea. Nossos resultados sugerem que a presença de hipertrofia de VE pode ser inferida em presença de massa de VE superior a 218 g ou 128 g/m nos homens e 148 g ou 88 g/m nas mulheres.OBJECTIVE:To establish cardiac ventricular weights recorded during the autopsy of healthy individuals who died of external causes, aiming at determining normality patterns in our population. METHODS:A total of 94 hearts were evaluated at the Forensics Department of the city of Vitória, Espírito Santo. After the heart removal and resection of the atria and epicardial fat, the right ventricle (RV and the left ventricle (LV, including the septum, were separated and weighed and the mass was indexed by the height. The Kolmogorov

  20. Brain drain from developing countries: how can brain drain be converted into wisdom gain?

    OpenAIRE

    Dodani, Sunita; LaPorte, Ronald E

    2005-01-01

    Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their count...

  1. Generation of airborne Listeria innocua from model floor drains.

    Science.gov (United States)

    Berrang, Mark E; Frank, Joseph F

    2012-07-01

    Listeria monocytogenes can colonize floor drains in poultry processing and further processing facilities, remaining present even after cleaning and disinfection. Therefore, during wash down, workers exercise caution to avoid spraying hoses directly into drains in an effort to prevent the escape and transfer of drain microflora to food contact surfaces. The objective of this study was to examine the extent to which an inadvertent water spray into a colonized floor drain can cause the spread of airborne Listeria. Listeria innocua was used to inoculate a polyvinyl chloride model floor drain, resulting in approximately 10(8) cells per ml of phosphate-buffered saline and 10(4) attached cells per square centimeter of inner surface. Each model drain was subjected to a 2-s spray of tap water at 68.9 kPa from a distance of 1 m. Drains were sprayed while filled and again after emptying. Airborne cells were collected by using sedimentation plates containing Listeria selective agar which were placed on the floor and walls of a contained room at incremental horizontal and vertical distances of 0.6, 1.2, 2.4, or 4.0 m from the drain. Sedimentation plates were exposed for 10 min. A mechanical sampler was used to also collect air by impaction on the surface of Listeria selective agar to determine the number of cells per liter of air. The experiment was conducted in triplicate rooms for each of four replications. L. innocua was detected on sedimentation plates on the floor as far as 4.0 m from the drain and on walls as high as 2.4 m above the floor and 4 m from the drain. A 2-s spray with a water hose into a contaminated drain can cause airborne spread of Listeria, resulting in the potential for cross-contamination of food contact surfaces, equipment, and exposed product.

  2. 241-AY-102 Leak Detection Pit Drain Line Inspection Report

    International Nuclear Information System (INIS)

    Boomer, Kayle D.; Engeman, Jason K.; Gunter, Jason R.; Joslyn, Cameron C.; Vazquez, Brandon J.; Venetz, Theodore J.; Garfield, John S.

    2014-01-01

    This document provides a description of the design components, operational approach, and results from the Tank AY-102 leak detection pit drain piping visual inspection. To perform this inspection a custom robotic crawler with a deployment device was designed, built, and operated by IHI Southwest Technologies, Inc. for WRPS to inspect the 6-inch leak detection pit drain line

  3. Horner's syndrome caused by an intercostal chest drain.

    OpenAIRE

    Campbell, P; Neil, T; Wake, P N

    1989-01-01

    Horner's syndrome occurred in a young woman as a complication of the treatment of a traumatic pneumothorax with an intercostal drain. The nerve damage probably occurred when the lung had fully re-expanded, pressing the tip of the intercostal drain, lying at the apex of the pleural cavity, on to the sympathetic chain.

  4. Rethinking "Brain Drain" in the Era of Globalisation

    Science.gov (United States)

    Rizvi, Fazal

    2005-01-01

    This paper discusses a range of issues concerning the idea of "brain drain" within the context of recent thinking on transnational mobility. It argues that the traditional analyses of brain drain are not sufficient, and that we can usefully approach the topic from a postcolonial perspective concerned with issues of identity, national…

  5. A new specifically designed forceps for chest drain insertion.

    LENUS (Irish Health Repository)

    Andrews, Emmet

    2012-02-03

    Insertion of a chest drain can be associated with serious complications. It is recommended that the drain is inserted with blunt dissection through the chest wall but there is no specific instrument to aid this task. We describe a new reusable forceps that has been designed specifically to facilitate the insertion of chest drains.A feasibility study of its use in patients who required a chest drain as part of elective cardiothoracic operations was undertaken. The primary end-point was successful and accurate placement of the drain. The operators also completed a questionnaire rating defined aspects of the procedure. The new instrument was used to insert the chest drain in 30 patients (19 male, 11 female; median age 61.5 years (range 16-81 years)). The drain was inserted successfully without the trocar in all cases and there were no complications. Use of the instrument rated as significantly easier relative to experience of previous techniques in all specified aspects. The new device can be used to insert intercostal chest drains safely and efficiently without using the trocar or any other instrument.

  6. Measurement of ventricular function using Doppler ultrasound

    International Nuclear Information System (INIS)

    Teague, S.M.

    1986-01-01

    Doppler has wide application in the evaluation of valvular heart disease. The need to know ventricular function is a much more common reason for an echocardiographic evaluation. Interestingly, Doppler examinations can assess ventricular function from many perspectives. Description of ventricular function entails measurement of the timing, rate and volume of ventricular filling and ejection. Doppler ultrasound examination reveals all of these aspects of ventricular function noninvasively, simply, and without great expense or radiation exposure, as described in this chapter

  7. Idiopathic ventricular tachycardia and fibrillation.

    Science.gov (United States)

    Belhassen, B; Viskin, S

    1993-06-01

    Important data have recently been added to our understanding of sustained ventricular tachyarrhythmias occurring in the absence of demonstrable heart disease. Idiopathic ventricular tachycardia (VT) is usually of monomorphic configuration and can be classified according to its site of origin as either right monomorphic (70% of all idiopathic VTs) or left monomorphic VT. Several physiopathological types of monomorphic VT can be presently individualized, according to their mode of presentation, their relationship to adrenergic stress, or their response to various drugs. The long-term prognosis is usually good. Idiopathic polymorphic VT is a much rarer type of arrhythmia with a less favorable prognosis. Idiopathic ventricular fibrillation may represent an underestimated cause of sudden cardiac death in ostensibly healty patients. A high incidence of inducibility of sustained polymorphic VT with programmed ventricular stimulation has been found by our group, but not by others. Long-term prognosis on Class IA antiarrhythmic medications that are highly effective at electrophysiologic study appears excellent.

  8. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  9. Ventricular arrhythmias in Chagas disease

    Directory of Open Access Journals (Sweden)

    Marco Paulo Tomaz Barbosa

    2015-02-01

    Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

  10. The overloaded right heart and ventricular interdependence.

    Science.gov (United States)

    Naeije, Robert; Badagliacca, Roberto

    2017-10-01

    The right and the left ventricle are interdependent as both structures are nested within the pericardium, have the septum in common and are encircled with common myocardial fibres. Therefore, right ventricular volume or pressure overloading affects left ventricular function, and this in turn may affect the right ventricle. In normal subjects at rest, right ventricular function has negligible interaction with left ventricular function. However, the right ventricle contributes significantly to the normal cardiac output response to exercise. In patients with right ventricular volume overload without pulmonary hypertension, left ventricular diastolic compliance is decreased and ejection fraction depressed but without intrinsic alteration in contractility. In patients with right ventricular pressure overload, left ventricular compliance is decreased with initial preservation of left ventricular ejection fraction, but with eventual left ventricular atrophic remodelling and altered systolic function. Breathing affects ventricular interdependence, in healthy subjects during exercise and in patients with lung diseases and altered respiratory system mechanics. Inspiration increases right ventricular volumes and decreases left ventricular volumes. Expiration decreases both right and left ventricular volumes. The presence of an intact pericardium enhances ventricular diastolic interdependence but has negligible effect on ventricular systolic interdependence. On the other hand, systolic interdependence is enhanced by a stiff right ventricular free wall, and decreased by a stiff septum. Recent imaging studies have shown that both diastolic and systolic ventricular interactions are negatively affected by right ventricular regional inhomogeneity and prolongation of contraction, which occur along with an increase in pulmonary artery pressure. The clinical relevance of these observations is being explored. Published on behalf of the European Society of Cardiology. All rights

  11. Miniinvasive paracentetic drain surgical interventions under ultrasonic control concerning liquid formations of abdominal cavity

    Directory of Open Access Journals (Sweden)

    G.I. Ohrimenko

    2013-08-01

    concerning the pseudocyst of pancreas complicated by the arrosive bleeding, were exposed to an open method before operations, related to the internal or external drain of cystic formations. Subsequently pain relapsed in their epigastric area, and the plural cysts of pancreas and retroperitoneum were found out at ultrasonic reexamination and computer tomography. In most patients analysis of liver abscess content showed E.Coli most sensible to carbapenems and cephalosporins of IV generation. Conclusions. The miniinvasive percutaneous paracentetic drain surgical interventions under ultrasonic control are effective enough in treatment of liver abscess and pseudocysts of pancreas, and accompanied by the few complications. Multicamerate liver abscesses are the relative contraindications for these operations. It is not recommended to apply paracentetic drain surgical interventions for patients who had ineffective operations of internal or external drain of pancreatic pseudocyst, in case of plural cysts . These patients have a high risk of the arrosive bleeding. Empiric antibacterial therapy in case of liver abscess before the result of bacterial analysis, must be based on the use of wide spectrum antibiotics, mainly carbapenems and cephalosporin of IV generation.

  12. Decommissioning of fast reactors after sodium draining

    International Nuclear Information System (INIS)

    2009-11-01

    Acknowledging the importance of passing on knowledge and experience, as well mentoring the next generation of scientists and engineers, and in response to expressed needs by Member States, the IAEA has undertaken concrete steps towards the implementation of a fast reactor data retrieval and knowledge preservation initiative. Decommissioning of fast reactors and other sodium bearing facilities is a domain in which considerable experience has been accumulated. Within the framework and drawing on the wide expertise of the Technical Working Group on Fast Reactors (TWG-FR), the IAEA has initiated activities aiming at preserving the feedback (lessons learned) from this experience and condensing those to technical recommendations on fast reactor design features that would ease their decommissioning. Following a recommendation by the TWG-FR, the IAEA had convened a topical Technical Meeting (TM) on 'Operational and Decommissioning Experience with Fast Reactors', hosted by CEA, Centre d'Etudes de Cadarache, France, from 11 to 15 March 2002 (IAEA-TECDOC- 1405). The participants in that TM exchanged detailed technical information on fast reactor operation and decommissioning experience with various sodium cooled fast reactors, and, in particular, reviewed the status of the various decommissioning programmes. The TM concluded that the decommissioning of fast reactors to reach safe enclosure presented no major difficulties, and that this had been accomplished mainly through judicious adaptation of processes and procedures implemented during the reactor operation phase, and the development of safe sodium waste treatment processes. However, the TM also concluded that, on the path to achieving total dismantling, challenges remain with regard to the decommissioning of components after sodium draining, and suggested that a follow-on TM be convened, that would provide a forum for in-depth scientific and technical exchange on this topic. This publication constitutes the Proceedings of

  13. Advances in chest drain management in thoracic disease

    Science.gov (United States)

    George, Robert S.

    2016-01-01

    An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

  14. Shearon Harris steam generator channel head drain line leakage

    International Nuclear Information System (INIS)

    Bauer, P.A.

    1992-01-01

    All three Shearon Harris steam generators were equipped with Inconel 600 drain penetrations inserted into clearance holes on the bottom center line of the plenums, roll expanded into the plenum shell, and seal welded to the stainless steel cladding. Eddy current inspections showed axial cracks in the drain lines of B and C generators, but not on the leaking A generator. The drain lines of the three generators were repaired by cutting off the pipe under the plenum, applying Inconel 600 cladding to the underside of the plenum by a temper bead process, spot facing the overlay cladding and welding a new Inconel 600 pipe coupling to the clad surface. 3 figs

  15. Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Alberto Cipriani

    2017-11-01

    Full Text Available Arrhythmogenic right ventricular cardiomyopathy (ARVC is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT. These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes.

  16. Vernakalant selectively prolongs atrial refractoriness with no effect on ventricular refractoriness or defibrillation threshold in pigs.

    Science.gov (United States)

    Bechard, Jeff; Gibson, John Ken; Killingsworth, Cheryl R; Wheeler, Jeffery J; Schneidkraut, Marlowe J; Huang, Jian; Ideker, Raymond E; McAfee, Donald A

    2011-03-01

    Vernakalant is a novel antiarrhythmic agent that has demonstrated clinical efficacy for the treatment of atrial fibrillation. Vernakalant blocks, to various degrees, cardiac sodium and potassium channels with a pattern that suggests atrial selectivity. We hypothesized, therefore, that vernakalant would affect atrial more than ventricular effective refractory period (ERP) and have little or no effect on ventricular defibrillation threshold (DFT). Atrial and ventricular ERP and ventricular DFT were determined before and after treatment with vernakalant or vehicle in 23 anesthetized male mixed-breed pigs. Vernakalant was infused at a rate designed to achieve stable plasma levels similar to those in human clinical trials. Atrial and ventricular ERP were determined by endocardial extrastimuli delivered to the right atria or right ventricle. Defibrillation was achieved using external biphasic shocks delivered through adhesive defibrillation patches placed on the thorax after 10 seconds of electrically induced ventricular fibrillation. The DFT was estimated using the Dixon "up-and-down" method. Vernakalant significantly increased atrial ERP compared with vehicle controls (34 ± 8 versus 9 ± 7 msec, respectively) without significantly affecting ventricular ERP or DFT. This is consistent with atrial selective actions and supports the conclusion that vernakalant does not alter the efficacy of electrical defibrillation.

  17. Predicting artificailly drained areas by means of selective model ensemble

    DEFF Research Database (Denmark)

    Møller, Anders Bjørn; Beucher, Amélie; Iversen, Bo Vangsø

    . The approaches employed include decision trees, discriminant analysis, regression models, neural networks and support vector machines amongst others. Several models are trained with each method, using variously the original soil covariates and principal components of the covariates. With a large ensemble...... out since the mid-19th century, and it has been estimated that half of the cultivated area is artificially drained (Olesen, 2009). A number of machine learning approaches can be used to predict artificially drained areas in geographic space. However, instead of choosing the most accurate model....... The study aims firstly to train a large number of models to predict the extent of artificially drained areas using various machine learning approaches. Secondly, the study will develop a method for selecting the models, which give a good prediction of artificially drained areas, when used in conjunction...

  18. Development of Charge Drain Coatings: Final CRADA Report

    Energy Technology Data Exchange (ETDEWEB)

    Elam, Jeffrey W. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-01-17

    The primary goal of this CRADA project was to develop and optimize tunable resistive coatings prepared by atomic layer deposition (ALD) for use as charge-drain coatings on the KLA-Tencor digital pattern generators (DPGs).

  19. The stable stiffness triangle - drained sand during deformation cycles

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    2017-01-01

    Cyclic, drained sand stiffness was observed using the Danish triaxial appa- ratus. New, deformation dependant soil property (the stable stiffness triangle) was detected. Using the the stable stiffness triangle, secant stiffness of drained sand was plausible to predict (and control) even during ir...... findings can find application in off-shore, seismic and other engi- neering practice, or inspire new branches of research and modelling wherever dynamic, cyclic or transient loaded sand is encountered....

  20. Drain Back Systems in Laboratory and in Practice

    DEFF Research Database (Denmark)

    Perers, Bengt; Furbo, Simon; Fan, Jianhua

    2015-01-01

    in the collector loop to have a safe reliable operation. The components should also be designed and marked so that only one correct mounting option is possible, like forward and return pipes to/from the collector of slightly different sizes or color. Adapted installer education and training is a very important...... step to have success with drain back systems. Practices used in glycol systems may give serious failures. Key-words: Drain Back, Low Flow, Solar Combi System, ETC collectors....

  1. Cold Vacuum Drying facility effluent drain system design description

    International Nuclear Information System (INIS)

    PITKOFF, C.C.

    1999-01-01

    This document describes the Cold Vacuum Drying Facility (CVDF) effluent drain system (EFS). The primary function of the EFS is to collect and transport fire suppression water discharged into a CVDF process bay to a retention basin located outside the facility. The EFS also provides confinement of spills that occur inside a process bay and allows non-contaminated water that drains to the process bay sumps to be collected until sampling and analysis are complete

  2. Steam generator fitted with a dynamic draining device

    International Nuclear Information System (INIS)

    Chaix, J.E.

    1982-01-01

    This generator has, at its upper part, at least one drying structure for holding the water carried with the steam and communicating at its lower part with at least one discharge pipe for draining off the water, each pipe communicating with a dynamic draining device capable of creating a depression in order to suck up the water contained in the drying structure. Application is for pressurized water nuclear reactors [fr

  3. Right Ventricular Pseudoaneurysm Following Endomyocardial Biopsy.

    Science.gov (United States)

    Pita; Santos; Manteiga; Rodriguez; Beiras

    1996-03-01

    Ventricular perforation is an unusual complication after endomyocardial biopsy in heart transplanted patients. We report a case of asymptomatic right ventricular perforation and pseudoaneurysm formation, secondary to endomyocardial biopsy, diagnosed by angiography. The spontaneous obliteration of the pseudoaneurysm was observed.

  4. Circuital model for the spherical geodesic waveguide perfect drain

    Science.gov (United States)

    González, Juan C.; Grabovičkić, Dejan; Benítez, Pablo; Miñano, Juan C.

    2012-08-01

    The perfect drain for the Maxwell fish eye (MFE) is a non-magnetic dissipative region placed in the focal point to absorb all the incident radiation without reflection or scattering. The perfect drain was recently designed as a material with complex permittivity that depends on frequency. However, this material is only a theoretical material, so it cannot be used in practical devices. The perfect drain has been claimed as necessary for achieving super-resolution (Leonhardt 2009 New J. Phys. 11 093040), which has increased the interest in practical perfect drains suitable for manufacturing. Here, we present a practical perfect drain that is designed using a simple circuit (made of a resistance and a capacitor) connected to the coaxial line. Moreover, we analyze the super-resolution properties of a device equivalent to the MFE, known as a spherical geodesic waveguide, loaded with this perfect drain. The super-resolution analysis for this device is carried out using COMSOL Multiphysics. The results of simulations predict a super-resolution of up to λ/3000.

  5. Circuital model for the spherical geodesic waveguide perfect drain

    International Nuclear Information System (INIS)

    González, Juan C; Grabovičkić, Dejan; Benítez, Pablo; Miñano, Juan C

    2012-01-01

    The perfect drain for the Maxwell fish eye (MFE) is a non-magnetic dissipative region placed in the focal point to absorb all the incident radiation without reflection or scattering. The perfect drain was recently designed as a material with complex permittivity that depends on frequency. However, this material is only a theoretical material, so it cannot be used in practical devices. The perfect drain has been claimed as necessary for achieving super-resolution (Leonhardt 2009 New J. Phys. 11 093040), which has increased the interest in practical perfect drains suitable for manufacturing. Here, we present a practical perfect drain that is designed using a simple circuit (made of a resistance and a capacitor) connected to the coaxial line. Moreover, we analyze the super-resolution properties of a device equivalent to the MFE, known as a spherical geodesic waveguide, loaded with this perfect drain. The super-resolution analysis for this device is carried out using COMSOL Multiphysics. The results of simulations predict a super-resolution of up to λ/3000. (paper)

  6. Brain drain from developing countries: how can brain drain be converted into wisdom gain?

    Science.gov (United States)

    Dodani, Sunita; LaPorte, Ronald E

    2005-01-01

    Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their countries and go abroad? What are the consequences of such migrations especially on the educational sector? What policies can be adopted to stem such movements from developing countries to developed countries? This article seeks to raise questions, identify key issues and provide solutions which would enable immigrant health professionals to share their knowledge, skills and innovative capacities and thereby enhancing the economic development of their countries. PMID:16260795

  7. Post-traumatic Left Ventricular Aneurysm with Massive Hemopericardium in a Child Presenting 3 Years After a Fall

    Directory of Open Access Journals (Sweden)

    Wei-Ting Lai

    2013-12-01

    Full Text Available A 7-year-old boy developed a left ventricular aneurysm with massive hemopericardium 3 years ago due to a fall from a fourth-floor window. He had mild neurological sequelae including cranial nerve III palsy and abnormal electroencephalography findings at that time. He had no chest pain until recently when he presented with chest tightness and abdominal pain for 2 days prior to admission. Chest X-ray showed marked cardiomegaly. Echocardiography revealed massive pericardial effusion and a large left ventricular aneurysm. The massive hemopericardium was surgically drained, and the aneurysm was resected under cardiopulmonary bypass. He was discharged uneventfully 1 week after operation. Because symptoms and signs can vary in patients with ventricular aneurysm, we strongly suggest a close clinical follow-up, preferably with chest X-ray or echocardiography, for patients experiencing a blunt chest trauma.

  8. Study of the patency of different peritoneal drains used prophylactically in bariatric surgery.

    Science.gov (United States)

    Salgado Júnior, Wilson; Macedo Neto, Marcelo Martins; dos Santos, José Sebastião; Sakarankutty, Ajith Kumar; Ceneviva, Reginaldo; de Castro e Silva, Orlando

    2009-05-21

    To compare the performance of different types of abdominal drains used in bariatric surgery. A vertical banded Roux-en-Y gastric bypass was performed in 33 morbidly obese patients. Drainage of the peritoneal cavity was performed in each case using three different types of drain selected in a randomized manner: a latex tubular drain, a Watterman tubulolaminar drain, and a silicone channeled drain. Drain permeability, contamination of the drained fluid, ease of handling, and patient discomfort were evaluated postoperatively over a period of 7 d. The patients with the silicone channeled drain had larger volumes of drainage compared to patients with tubular and tubulolaminar drains between the third and seventh postoperative days. In addition, a lower incidence of discomfort and of contamination with bacteria of a more pathogenic profile was observed in the patients with the silicone channeled drain. The silicone channeled drain was more comfortable and had less chance of occlusion, which is important in the detection of delayed dehiscence.

  9. Signal analysis of ventricular fibrillation

    NARCIS (Netherlands)

    Herbschleb, J.N.; Heethaar, R.M.; Tweel, L.H. van der; Zimmerman, A.N.E.; Meijler, F.L.

    Signal analysis of electro(cardio)grams during ventricular fibrillation (VF) in dogs and human patients indicates more organization and regularity than the official WHO definition suggests. The majority of the signal is characterized by a power spectrum with narrow, equidistant peaks. In a further

  10. Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Merve Tarhan

    2016-12-01

    Full Text Available Objective: The physician is responsible for inserting one or more chest tubes into the pleural space or the mediastinal space and connecting them to an appropriate drainage system. When the general principles about care of patients with chest drains were implemented correctly and effectively by nurses, nurse will contribute to accelerate the healing process of patients. In this context, the aim of this study was to determine the nurses’ level of knowledge regarding the care of patients with chest drains. Methods: The study was conducted with 153 nurses who worked in a chest diseases and thoracic surgery hospital in July 2014. Questionnaire form of 35 questions prepared by investigators was used to collect data. For the analysis of results, frequency tests, independent sample t-test and oneway ANOVA test were used. Results: 69.3% of nurses stated that they had obtained information from colleguages. 35.3% considered their knowledge about chest drain management to be inadequate. 55.6% scored 13 points and above from knowledge questionnaire about chest drain management. There were statistically significant difference between knowledge level and educational background, clinic work type, working unit, years of professional experience and institutional experience, frequency of contact patients with chest drain and perception of knowledge level (p<0.05. Conclusion: Results of this study indicate that lack of evidence-based nursing care and insufficient training has resulted in uncertainty and knowledge deficit in important aspects of chest drain care. It can be concluded that nurses receive training needs and training protocols are about chest drain management.

  11. Alternative right ventricular pacing sites.

    Science.gov (United States)

    Łuciuk, Dariusz; Łuciuk, Marek; Gajek, Jacek

    2015-01-01

    The main adverse effect of chronic stimulation is stimulation-induced heart failure in case of ventricular contraction dyssynchrony. Because of this fact, new techniques of stimulation should be considered to optimize electrotherapy. One of these methods is pacing from alternative right ventricular sites. The purpose of this article is to review currently accumulated data about alternative sites of cardiac pacing. Medline and PubMed bases were used to search English and Polish reports published recently. Recent studies report a deleterious effect of long term apical pacing. It is suggested that permanent apical stimulation, by omitting physiological conduction pattern with His-Purkinie network, may lead to electrical and mechanical dyssynchrony of heart muscle contraction. In the long term this pathological situation can lead to severe heart failure and death. Because of this, scientists began to search for some alternative sites of cardiac pacing to reduce the deleterious effect of stimulation. Based on current accumulated data, it is suggested that the right ventricular outflow tract, right ventricular septum, direct His-bundle or biventricular pacing are better alternatives due to more physiological electrical impulse propagation within the heart and the reduction of the dyssynchrony effect. These methods should preserve a better left ventricular function and prevent the development of heart failure in permanent paced patients. As there is still not enough, long-term, randomized, prospective, cross-over and multicenter studies, further research is required to validate the benefits of using this kind of therapy. The article should pay attention to new sites of cardiac stimulation as a better and safer method of treatment.

  12. Four cases of right ventricular dysplasia

    International Nuclear Information System (INIS)

    Takamura, Ichiro; Ando, Joji; Miyamoto, Atsushi; Kobayashi, Takeshi; Sakamoto, Sanya; Yasuda, Hisakazu

    1985-01-01

    Finding of 81 Kr right ventriculography and 201 Tl myocardial perfusion imaging in 4 patients with right ventricular dysplasia (RVD) were compared with those in 28 patients with dilated cardiomyopathy. Remarkably dilated right ventricle was detected on 201 Tl myocardial perfusion imaging in the RVD group. In a patient with RVD who died suddenly, perfusion defect of the left ventricular myocardium, a decreased right ventricular ejection fraction, and an increased right ventricular end diastolic volume were seen. Perfusion defect of the left ventricular myocardium was seen in 10 of the 28 patients with dilated cardiomyopathy, 4 of whom died suddenly. In these 4 patients, a decreased left ventricular ejection fraction and an increased right ventricular end diastolic volume were seen. These findings obtained by the radionuclide techniques suggested that there are differences in cardiac dysfunction of the both ventricles between the groups with RVD and dilated cardiomyopathy. (Namekawa, K.)

  13. Leaching of dissolved phosphorus from tile-drained agricultural areas.

    Science.gov (United States)

    Andersen, H E; Windolf, J; Kronvang, B

    2016-01-01

    We investigated leaching of dissolved phosphorus (P) from 45 tile-drains representing animal husbandry farms in all regions of Denmark. Leaching of P via tile-drains exhibits a high degree of spatial heterogeneity with a low concentration in the majority of tile-drains and few tile-drains (15% in our investigation) having high to very high concentration of dissolved P. The share of dissolved organic P (DOP) was high (up to 96%). Leaching of DOP has hitherto been a somewhat overlooked P loss pathway in Danish soils and the mechanisms of mobilization and transport of DOP needs more investigation. We found a high correlation between Olsen-P and water extractable P. Water extractable P is regarded as an indicator of risk of loss of dissolved P. Our findings indicate that Olsen-P, which is measured routinely in Danish agricultural soils, may be a useful proxy for the P leaching potential of soils. However, we found no straight-forward correlation between leaching potential of the top soil layer (expressed as either degree of P saturation, Olsen-P or water extractable P) and the measured concentration of dissolved P in the tile-drain. This underlines that not only the source of P but also the P loss pathway must be taken into account when evaluating the risk of P loss.

  14. Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.

    Science.gov (United States)

    Sugrue, Conor M; McInerney, Niall; Joyce, Cormac W; Jones, Deidre; Hussey, Alan J; Kelly, Jack L; Kerin, Michael J; Regan, Padraic J

    2015-01-01

    Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs. An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test. Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07). Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.

  15. The right ventricular response to ventricular hypofunction in anteroseptal infarction

    International Nuclear Information System (INIS)

    Kanayama, Sugako

    1992-01-01

    Thirty-seven patients with acute anteroseptal infarction but not significant right coronary artery stenosis were examined by using thallium-201 (Tl-201) myocardial perfusion SPECT to determine how the right ventricular (RV) free wall responded to a severely impaired ventricular septum. The patients were divided into the group in which RV free wall was visualized on Tl-201 myocardial SPECT (n=19, RV(+) Group) and the group in which it was not visualized (n=18, RV(-) Group). The relationship between visualization of RV free wall and both RV and left ventricular (LV) function was evaluated. RV(+) Group had larger extent of anteroseptal necrosis and severer impairment of RV free wall, as compared with RV(-) Group. LV ejection fraction (LVEF) was significantly lower in RV(+) Group than RV(-) Group in both acute and chronic phases. Although RV ejection fraction (RVEF) in acute phase was significantly lower in RV(+) Group than RV(-) Group, it did not differ in chronic phase between the two groups. In RV(+) Group, RV stroke work index (RVSWI), pulmonary artery end diastolic pressure (PAEDP), and mean pulmonary artery pressure (MPA) in chronic phase showed a statistically significant increase compared with those in acute phase; these hemodynamic variables in chronic phase were also significantly higher than those in RV(-) Group. RV/LV ratio inversely correlated with LVEF, and both necrotic extent and impairment severity positively correlated with both PAEDP and MPA. RV free wall could be visualized more clearly, corresponding to extremely decreased LV function. These findings suggest that RV free wall may play an important role in maintaining LV and RV function when ventricular septum is severely impaired by anteroseptal infarction. (N.K.)

  16. A study of the complications of small bore 'Seldinger' intercostal chest drains.

    Science.gov (United States)

    Davies, Helen E; Merchant, Shairoz; McGown, Anne

    2008-06-01

    Use of small bore chest drains (drainage over a 12-month period. One hundred consecutive small bore Seldinger (12F) chest drain insertions were evaluated. Few serious complications occurred. However, 21% of the chest drains were displaced ('fell out') and 9% of the drains became blocked. This contributed to high morbidity rates, with 13% of patients requiring repeat pleural procedures. The frequency of drain blockage in pleural effusion was reduced by administration of regular normal saline drain flushes (odds ratio for blockage in flushed drains compared with non-flushed drains 0.04, 95% CI: 0.01-0.37, P < 0.001). Regular chest drain flushes are advocated in order to reduce rates of drain blockage, and further studies are needed to determine optimal fixation strategies that may reduce associated patient morbidity.

  17. Frequency dependence and passive drains in fish-eye lenses

    Science.gov (United States)

    Quevedo-Teruel, O.; Mitchell-Thomas, R. C.; Hao, Y.

    2012-11-01

    The Maxwell fish eye lens has previously been reported as being capable of the much sought after phenomenon of subwavelength imaging. The inclusion of a drain in this system is considered crucial to the imaging ability, although its role is the topic of much debate. This paper provides a numerical investigation into a practical implementation of a drain in such systems, and analyzes the strong frequency dependence of both the Maxwell fish eye lens and an alternative, the Miñano lens. The imaging capability of these types of lens is questioned, and it is supported by simulations involving various configurations of drain arrays. Finally, a discussion of the near-field and evanescent wave contribution is given.

  18. The effect of drains on the alkalinity of agricultural soils

    International Nuclear Information System (INIS)

    Iqbal, M.A.; Butt, T.; Anwar-ul-Haque; Haroon, M.; Haq, I.U.

    2009-01-01

    The purpose of the study was to observe the effect of industrial and domestic drains on the nearby agricultural areas which are either irrigated or not by the waste water but are close to drains. For this purpose 48 soil samples were collected from the selected areas of Faisalabad and were analyzed for alkali metals like Na/sup +/, K/sup +/, Li/sup +/ and some alkaline earth metals like Ba/sup 2+/> Mg/sup 3+/> Na/sup +/> K/sup +/> Li/sup +/ the levels of Ba/sup +2/ and K/sup +/ were found higher than permissible levels in almost all the soil samples. It was also concluded that the agricultural areas near the industrial drain which are either irrigated or not by the industrial waste water are found highly contaminated with mobile alkali metals (K, Na etc.) and higher values of percentage salinity. (author)

  19. Fibredrain method. Environmentally friendly vertical drain; Fiberdrain koho. Kankyo ni yasashii vertical drain koho

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y.; Inoue, T. [Fukken Co. Ltd., Hiroshima (Japan); Miura, N. [Saga University, Saga (Japan). Faculty of Science and Engineering; Yoshida, Y.; Hamada, K. [Hiroshima Prefectural Government Office, Hiroshima (Japan); Aboshi, H. [Hiroshima University, Hiroshima (Japan)

    1997-11-01

    Ground improvement using fibredrain (FD) material has not been used in Japan. For its practical use in Japan, laboratory experiment was made on such technological characteristics of FD material as tensile strength and permeability, and field test was also made to verify its improvement effect. A plane FD specimen of nearly 90mm wide and 9mm thick is composed of a folded double jute fabrics band and 4 twisted coir ropes arranged between the jute fabrics at even intervals, and the band is sewn up along center lines between the ropes. A mean permeability coefficient is estimated to be {kappa} = 1.0times10{sup -1}cm/s and {kappa} = 1.0times10{sup -2}cm/s at {sigma}{sup 3} = 0.5kgf/cm{sup 2} and {sigma}{sup 3} = 2.0kgf/cm{sup 2} in lateral pressure, respectively, showing sufficient permeabilities for vertical drain material. The tensile strength of fresh FD material is estimated to be a little stronger than 900kg/material width which is far stronger than that of conventional FD materials. The field test result showed that the FD material achieved the target for ground improvement, and has sufficient functions as a substitute for SD material. 6 refs., 10 figs.

  20. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior ventricular fibrillation or sustained ventricular tachycardia.

    LENUS (Irish Health Repository)

    Corrado, Domenico

    2010-09-21

    The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.

  1. Replacement of the drain system of secondary circuit at Monju

    International Nuclear Information System (INIS)

    Itoh, Kenji; Onuki, Koji; Tomobe, Katsuma; Taniyama, Sadami

    2003-01-01

    Monju is as a Japan's prototype fast breeder reactor cooled by liquid sodium. In the course of power buildup tests, the sodium leakage accident broke out on 8th December 1995. Though Monju has been already equipped with countermeasure systems against the sodium leakage accident, some additional improvements will be taken in order to reduce the damage by the leaked sodium when another leakage accident should recur. The most characteristic work is the drain system modification that leads to shorten the drain time and to reduce the quantity of leaked sodium in the event of sodium leakage. (author)

  2. Optimization design for drain to nuclear power condenser

    International Nuclear Information System (INIS)

    Ding Jiapeng; Jiang Chengren

    2010-01-01

    Characters and varieties of drain to nuclear power condenser are discussed in this paper. Take the main steam system of a nuclear power as an example, normal and detailed optimization design are introduced, related expatiate are used as a reference for the drain of other systems. According to the characters of nuclear power instant operation, the influence and needed actions related with the optimization design are also analyzed. Based on the above research, the scheme has been carried out in a nuclear power station and safety for the condenser operation of the nuclear power has been improved largely. (authors)

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

    Directory of Open Access Journals (Sweden)

    Seung Eun Lee

    2016-01-01

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

  4. [ILCOR recommendation on signage of automated external defibrillators (AEDs)].

    Science.gov (United States)

    Truhlár, A

    2010-05-01

    Early defibrillation is a determinant of survival in both out-of-hospital and in-hospital cardiac arrests from ventricular fibrillation and pulseless ventricular tachycardia. The review summarizes importance of early defibrillation with automated external defibrillators (AED) and presents the International Liaison Committee on Resuscitation (ILCOR) recommendation for universal AED sign. The aim of the recommendation is to unify the AED signs worldwide and to spread the knowledge of this. The public in general, but healthcare professionals particularly, should be able to recognize AED location and use the device immediately in case of cardiac arrest.

  5. An Equal-Strain Analytical Solution for the Radial Consolidation of Unsaturated Soils by Vertical Drains considering Drain Resistance

    Directory of Open Access Journals (Sweden)

    Feng Zhou

    2018-01-01

    Full Text Available Developing an analytical solution for the consolidation of unsaturated soils remains a challenging task due to the complexity of coupled governing equations for air and water phases. This paper presents an equal-strain model for the radial consolidation of unsaturated soils by vertical drains, and the effect of drain resistance is also considered. Simplified governing equations are established, and an analytical solution to calculate the excess pore-air and pore-water pressures is derived by using the methods of matrix analysis and eigenfunction expansion. The average degrees of consolidation for air and water phases and the ground surface settlement are also given. The solutions of the equal-strain model are verified by comparing the proposed free-strain model with the equal-strain model, and reasonably good agreement is obtained. Moreover, parametric studies regarding the drain resistance effect are graphically presented.

  6. Does the suction drain diameter matter? Bleeding analysis after total knee replacement comparing different suction drain gauges

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    Full Text Available ABSTRACT OBJECTIVES: To evaluate bleeding and the estimated blood loss in patients who underwent total knee replacement (TKR with different closed suction drains (3.2-mm and 4.8-mm gauge. METHODS: This was a randomized controlled trial with 22 patients who underwent TKR and were divided into two groups: Group I, with 11 patients in whom the 3.2-mm suction drain was used, and Group II, with 11 patients in whom the 4.8-mm suction drain was used. The hematocrit was measured after 24, 48 and 72 h after surgery in order to calculate the estimated blood loss. The drained volume was measured 3, 6, 12, 24, and 48 h after TKR, and thereafter both groups were compared. RESULTS: Regarding the hematocrit, there were no differences between groups in measured periods (24, 48, and 72 h after surgery. The total bleeding measured at the suction drains within 48 h was higher in Group II, with a statistically significant difference (p = 0.005; in the first 24 h, there was major bleeding in Group II (mean 893 mL, with a significant difference (p = 0.004. Between 24 and 48 h, there was no statistically significant difference in both groups (p = 0.710. The total estimated bleeding was higher in Group I, with mean of 463 mL, versus 409 mL in Group II, with no statistical significance (p = 0.394. CONCLUSIONS: Bleeding was higher in the group that used the 4.8 mm gauge suction drain, with no differences in hematocrit and estimated blood loss.

  7. Right ventricular function in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Araki, Haruo; Hisano, Ryuichi; Nagata, Yoshiyuki; Caglar, N.; Nakamura, Motoomi

    1985-01-01

    Thirty-five patients with ischemic heart disease (IHD) and 10 normal subjects were studied. Right and left ventricular ejecction fractions (EF) were determined using equilibrium radionuclide ventriculography with technetium-99m. Furthermore, abnormal motion of the right ventricular septal wall was obtained by cardiac cathetelization, and its relation to the right ventricular EF was examined. In IHD patients with anterior myocardial infarction, left ventricular EF decreased, but right ventricular EF was normal. This suggested that left ventricular dysfunction does not always have an effect on right ventricular function. Right ventricular EF was normal even when akinesis or dyskinesis was present in the ventricular septul, suggesting that abnormal motion of the ventricular septal wall has no significantly stimulant effect on right ventricular function. A decreased right ventricular EF was likely to occur only when the right ventricular free wall became ischemic or necrotic simultaneously with occurrence of posterior myocardial infarction. (Namekawa, K.)

  8. Arrhythmogenic Right Ventricular Cardiomyopathy in an Endurance Athlete Presenting with Ventricular Tachycardia and Normal Right Ventricular Function.

    Science.gov (United States)

    Hedley, Jeffrey S; Al Mheid, Ibhar; Alikhani, Zoubin; Pernetz, Maria A; Kim, Jonathan H

    2017-08-01

    Arrhythmogenic right ventricular cardiomyopathy, a genetically inherited disease that results in fibrofatty replacement of normal cardiac myocytes, has been associated with sudden cardiac death in athletes. Long-term participation in endurance exercise hastens the development of both the arrhythmic and structural arrhythmogenic right ventricular cardiomyopathy phenotypes. We describe the unusual case of a 34-year-old, symptomatic, female endurance athlete who had arrhythmogenic right ventricular cardiomyopathy in the presence of a structurally normal right ventricle. Clinicians should be aware of this infrequent presentation when evaluating athletic patients who have ventricular arrhythmias and normal findings on cardiac imaging studies.

  9. The management of vacuum neck drains in head and neck surgery and the comparison of two different practice protocols for drain removal.

    Science.gov (United States)

    Kasbekar, A V; Davies, F; Upile, N; Ho, M W; Roland, N J

    2016-01-01

    Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at Measuring drainage volumes three times daily allows for more accurate assessment of wound drainage, and this can lead to earlier removal of neck drains and safe discharge.

  10. Surgical ablation of ventricular tachycardia secondary to congenital ventricular septal aneurysm.

    Science.gov (United States)

    Graffigna, A; Minzioni, G; Ressia, L; Vigano, M

    1994-04-01

    Three patients underwent surgical ablation for ventricular tachycardia resulting from an aneurysm of the membranous portion of the ventricular septum. Two patients had a definite history of cardiac murmur during infancy, and one of them was found at the time of operation to have a left-to-right shunt through the apex of the aneurysm. The earliest ventricular activation sites were located around the neck of the aneurysm and were ablated in 1 patient by encircling the endocardial ventriculotomy and by cryoablation in the remaining 2. After focus resection had been completed, aneurysm resection and ventricular septal reconstruction were performed. All patients were alive and free of ventricular tachycardia and did not need medication as of 61, 66, and 88 months postoperatively. Spontaneous closure of a ventricular septal defect may lead to the formation of an aneurysm in the ventricular septum that may sustain ventricular tachycardias. Such arrhythmias can be effectively treated using electrically guided surgical techniques.

  11. Brain drain or brain gain : The case of Suriname

    NARCIS (Netherlands)

    T.W. Dulam (Tina)

    2015-01-01

    markdownabstractAbstract Brain drain refers to the emigration of highly skilled individuals mostly from a less developed (home) to a developed country (destination) thereby reducing the capacity of the home country to generate welfare for its population. In the literature there is much written

  12. State waste discharge permit application, 200-E chemical drain field

    International Nuclear Information System (INIS)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations (Ecology et al. 1994), the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affect groundwater or have the potential to affect ground would be subject to permitting under the structure of Chapter 173-216 (or 173-218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. As a result of this decision, the Washington State Department of Ecology and the US Department of Energy, Richland Operations Office entered into Consent Order No. DE 91NM-177, (Ecology and DOE-RL 1991). The Consent Order No. DE 91NM-177 requires a series of permitting activities for liquid effluent discharges. This document presents the State Waste Discharge Permit (SWDP) application for the 200-E Chemical Drain Field. Waste water from the 272-E Building enters the process sewer line directly through a floor drain, while waste water from the 2703-E Building is collected in two floor drains, (north and south) that act as sumps and are discharged periodically. The 272-E and 2703-E Buildings constitute the only discharges to the process sewer line and the 200-E Chemical Drain Field

  13. Outcome in Chronic Subdural Hematoma After Subdural vs. Subgaleal Drain.

    Science.gov (United States)

    Ishfaq, Asim

    2017-07-01

    To compare the outcome after surgery for chronic subdural hematoma when the drain is placed in subdural space or subgaleal space. Quasi experimental study. Combined Military Hospital, Lahore, from July 2015 to June 2016. Patients with chronic subdural hematoma of both genders and age, ranging between 55 to 85 years, were included. Patients on antiplatelet/anticoagulant therapy and acute on chronic subdural hematoma were excluded. Patients were divided in two equal groups each depending on whether drain was placed in subgaleal space (Group 1), and subdual space (Group 2), (n=31 patients each). Patients were positioned flat in bed after surgery. Clinical and radiological parameters and clinical outcome were compared between the two groups. Statistical test with significance of p hematoma was 15 ±6.5 mm. Patients with subdural drain placement had more complications such as pneumocephalus 11 (35.4%) vs. 6 (19.3%), and intracerebral hemorrhage 4 (12.9%) vs. 2 (6.4%). Clinical outcome was good in both groups 27 (87%) in Group 1 and 28 (90%) in Group 2. Patients of both groups had good outcome after surgery. Complications like pneumocephalus and intracerebral hemorrhage were more common in subdural location of drain, though not reaching statistically significance level to favor one technique over another.

  14. On the use of drains in orthopedic and trauma

    African Journals Online (AJOL)

    2013-11-08

    Nov 8, 2013 ... Even major procedures like total knee and arthroplasties are being performed without drains. We set to find ... discourage wound healing while encouraging bacterial ... a period of two days or if drainage over the first twenty‑four hours was found ... Three of the twenty Kuntscher nailings for femoral fracture.

  15. Brain Drain: A Child's Brain on Poverty. Poverty Fact Sheet

    Science.gov (United States)

    Damron, Neil

    2015-01-01

    "Brain Drain: A Child's Brain on Poverty," released in March 2015 and prepared by intern Neil Damron, explores the brain's basic anatomy and recent research findings suggesting that poverty affects the brain development of infants and young children and the potential lifelong effects of the changes. The sheet draws from a variety of…

  16. State waste discharge permit application, 200-E chemical drain field

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations (Ecology et al. 1994), the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affect groundwater or have the potential to affect ground would be subject to permitting under the structure of Chapter 173-216 (or 173-218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. As a result of this decision, the Washington State Department of Ecology and the US Department of Energy, Richland Operations Office entered into Consent Order No. DE 91NM-177, (Ecology and DOE-RL 1991). The Consent Order No. DE 91NM-177 requires a series of permitting activities for liquid effluent discharges. This document presents the State Waste Discharge Permit (SWDP) application for the 200-E Chemical Drain Field. Waste water from the 272-E Building enters the process sewer line directly through a floor drain, while waste water from the 2703-E Building is collected in two floor drains, (north and south) that act as sumps and are discharged periodically. The 272-E and 2703-E Buildings constitute the only discharges to the process sewer line and the 200-E Chemical Drain Field.

  17. Moving Policy Forward: "Brain Drain" as a Wicked Problem

    Science.gov (United States)

    Logue, Danielle

    2009-01-01

    The mobility of scientists and the concerns surrounding "brain drain" are not new. Even in the Ptolemic dynasty, the first king set out to attract and influence the movements of scholars to shift the centre of learning from Athens to Alexandria. Yet after all this time, there is still much policy discourse and debate focused on attempting to…

  18. Xpand chest drain: assessing equivalence to current standard ...

    African Journals Online (AJOL)

    leakage from 'open to air' system or breakage of glass bottle (with associated risk to ... and an air-leak detection system. It is connected to a ... need to add water. Xpand chest drain: assessing equivalence to current standard therapy – a randomised controlled trial. CHARL COOPER, M.B. CH.B. TIMOTHY HARDCASTLE ...

  19. An Improvised Active Drain | Ogirima | Nigerian Journal of Surgical ...

    African Journals Online (AJOL)

    An improvised active drain is designed from intravenous infusion set and recycled RedivacR or Haemovac® bottle. Outcome of the use of this system on 100 patients is presented. This suction drainage system had been used in major orthopaedic and common minor surgical procedures and no significant complication was ...

  20. Case Report: Supernumerary right renal vein draining inferior to the ...

    African Journals Online (AJOL)

    With recent increase in renal transplantations, renovascular reconstructions and imaging advances, meticulous knowledge of the normal and variant anatomy of the renal vasculature is important to avoid potential pitfalls. We report a case of an accessory renal vein arising from the right kidney, and draining into the inferior ...

  1. English and the Brain Drain : An Uncertain Relationship

    NARCIS (Netherlands)

    Houtkamp, C.

    2016-01-01

    In his book Linguistic Justice for Europe and the World, Van Parijs analyses in one of his chapters the brain drain from non-Anglophone to Anglophone countries, which hurts the economic development of the nonAnglophone states. Van Parijs deems it clear that English is a very important factor to

  2. Organic loss in drained wetland: managing the carbon footprint

    NARCIS (Netherlands)

    Durham, B.; van de Noort, R.; Martens, V.V.; Vorenhout, M.

    2012-01-01

    The recent installation of land drains at Star Carr, Yorkshire, UK, has been linked with loss of preservation quality in this important Mesolithic buried landscape, challenging the PARIS principle. Historically captured organic carbon, including organic artefacts, is being converted to soluble

  3. Brain Drain in Higher Education: Lost Hope or Opportunity?

    Science.gov (United States)

    Odhiambo, George

    2012-01-01

    The flight of human capital is a phenomenon that has been of concern to academics and development practitioners for decades but unfortunately, there is no systematic record of the number of skilled professionals that many African countries have continued to lose to the developed world. Termed the "brain drain", it represents the loss of…

  4. Draining Collars and Lenses in Liquid-Lined Vertical Tubes.

    Science.gov (United States)

    Jensen

    2000-01-01

    The speed at which an annular liquid collar drains under gravity g in a vertical tube of radius a, when the tube has an otherwise thin viscous liquid lining on its interior, is determined by a balance between the collar's weight and viscous shear stresses confined to narrow regions in the neighborhood of the collar's effective contact lines. Whether a collar grows or shrinks in volume as it drains depends on the modified Bond number B=rho g a(2)/(sigmaepsilon), where rho is the fluid density, sigma is its surface tension, and epsilona is the thickness of the thin film immediately ahead of the collar. Asymptotic methods are used here to determine the following nonlinear stability criteria for an individual collar, valid in the limit of small epsilon. For 0draining collars grow in volume and, in sufficiently long tubes, ultimately "snap off" to form stable lenses. For 0.5960drain, so that any lens ultimately ruptures, unless stabilizing intermolecular forces allow the formation of a lamella supported by a macroscopic Plateau border. If surfactant immobilizes the liquid's free surface, these critical values of B are reduced by a factor of 2 but the distance a collar must travel before it snaps off is unchanged. Gravitationally driven snap off is therefore most likely to occur in long tubes with radii substantially less than the capillary lengthscale sigma/rhog)(1/2). Copyright 2000 Academic Press.

  5. Phosphorus modeling in tile drained agricultural systems using APEX

    Science.gov (United States)

    Phosphorus losses through tile drained systems in agricultural landscapes may be causing the persistent eutrophication problems observed in surface water. The purpose of this paper is to evaluate the state of the science in the Agricultural Policy/Environmental eXtender (APEX) model related to surf...

  6. Drains after Thyroidectomy for Benign Thyroid Disorders; Are ...

    African Journals Online (AJOL)

    Prophylactic drainage after thyroidectomy has been a regular practice at Kenyatta National Hospital( KNH). This has been ... stay and post-operative pain. Introduction. Prophylactic drains are still regularly used in ..... Total versus subtotal thyroidectomy for the management of benign multinodular goiter in an endemic region.

  7. Influence of Hudiara Drain Water Irrigation on Trace Elements Load ...

    African Journals Online (AJOL)

    ... Drain Water Irrigation on Trace Elements Load In Soil And Uptake By Vegetables. ... This polluted water not only contains organic matter and crop nutrients but also ... Plant samples were collected at maturity from all the monitoring points. ... (DO), Chemical Oxygen Demand (COD) and Biological Oxygen Demand (BOD) ...

  8. Anomie and the "Brain Drain": A Sociological Explanation.

    Science.gov (United States)

    Karadima, Oscar

    The concept of anomie is proposed as one sociological variable that may explain the "brain drain" phenomenon (i.e., the movement of highly qualified personnel from their country of origin to another, most often a more developed, technologically advanced country). It is hypothesized that the higher the level of anomie found among…

  9. Timing of Re-Transfusion Drain Removal Following Total Knee Replacement

    Science.gov (United States)

    Leeman, MF; Costa, ML; Costello, E; Edwards, D

    2006-01-01

    INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible. PMID:16551400

  10. Arrhythmogenic right ventricular dysplasia: MRI findings

    International Nuclear Information System (INIS)

    Wall, E.E. van der; Bootsma, M.M.; Schalij, M.J.; Kayser, H.W.M.; Roos, A. de

    2000-01-01

    Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disorder of unknown cause that is characterized pathologically by fibrofatty replacement of the right ventricular myocardium. Clinical manifestations include structural and functional malformations of the right ventricle, electrocardiographic abnormalities, and presentation with ventricular tachycardias with left bundle branch pattern or sudden death. The disease is often familial with an autosomal inheritance. In addition to right ventricular dilatation, right ventricular aneurysms are typical deformities of ARVD and they are distributed in the so-called ''triangle of dysplasia'', i. e., right ventricular outflow tract, apex, and infundibulum. Ventricular aneurysms at these sites can be considered pathognomonic of ARVD. Another typical hallmark of ARVD is fibrofatty infiltration of the right ventricular free wall. These functional and morphologic characteristics are relevant to clinical imaging investigations such as contrast angiography, echocardiography, radionuclide angiography, ultrafast computed tomography, and magnetic resonance imaging (MRI). Among these techniques, MRI allows the clearest visualization of the heart, in particular because the right ventricle is involved, which is usually more difficult to explore with the other imaging modalities. Furthermore, MRI offers the specific advantage of visualizing adipose infiltration as a bright signal of the right ventricular myocardium. MRI provides the most important anatomic, functional, and morphologic criteria for diagnosis of ARVD within one single study. As a result, MRI appears to be the optimal imaging technique for detecting and following patients with clinical suspicion of ARVD. (orig.) [de

  11. Improved simulation of poorly drained forests using Biome-BGC.

    Science.gov (United States)

    Bond-Lamberty, Ben; Gower, Stith T; Ahl, Douglas E

    2007-05-01

    Forested wetlands and peatlands are important in boreal and terrestrial biogeochemical cycling, but most general-purpose forest process models are designed and parameterized for upland systems. We describe changes made to Biome-BGC, an ecophysiological process model, that improve its ability to simulate poorly drained forests. Model changes allowed for: (1) lateral water inflow from a surrounding watershed, and variable surface and subsurface drainage; (2) adverse effects of anoxic soil on decomposition and nutrient mineralization; (3) closure of leaf stomata in flooded soils; and (4) growth of nonvascular plants (i.e., bryophytes). Bryophytes were treated as ectohydric broadleaf evergreen plants with zero stomatal conductance, whose cuticular conductance to CO(2) was dependent on plant water content. Individual model changes were parameterized with published data, and ecosystem-level model performance was assessed by comparing simulated output to field data from the northern BOREAS site in Manitoba, Canada. The simulation of the poorly drained forest model exhibited reduced decomposition and vascular plant growth (-90%) compared with that of the well-drained forest model; the integrated bryophyte photosynthetic response accorded well with published data. Simulated net primary production, biomass and soil carbon accumulation broadly agreed with field measurements, although simulated net primary production was higher than observed data in well-drained stands. Simulated net primary production in the poorly drained forest was most sensitive to oxygen restriction on soil processes, and secondarily to stomatal closure in flooded conditions. The modified Biome-BGC remains unable to simulate true wetlands that are subject to prolonged flooding, because it does not track organic soil formation, water table changes, soil redox potential or anaerobic processes.

  12. Origin of the water drained by the tunnel Graton

    International Nuclear Information System (INIS)

    Plata B, A.

    1992-12-01

    The research of the origin of the water drained by the Graton tunnel was attempted using isotope techniques. During the period of studies (April 1989-October 1992), four field work was executed to sample waters for chemistry, stable isotope and Tritium analysis, an to inject tracers and verify the possible infiltration from the Rimac and Blanco rivers to the tunnel. The results of the stable isotope analysis show that the water drained by the Graton tunnel comes from a basin around 300 meters above the average altitude of the basin where the Graton is located. The Tritium analysis show that the water is relatively modern. Using the model of total mixing, the residence times of the water drained at the km 0.5 and 2.5 are in the order to 45 years. The conductivities of the water of the tunnel is higher than the Rimac river ones because the influence of mine water. The chemical analysis of the water sampled at the downstream end of the tunnel, show that the conservative ions of the water kept almost constant during more than two years. The results of the work with artificial tracer show that there is no significant leakage from the Rimac and Blanco rivers to the Graton tunnel. So far, it can be concluded as a preliminary approach that the Graton tunnel drains relatively modern water originated in another basin. The hydrodynamics of the area of study seems to include a large storage on underground water in the system. The topography, geology and isotopic composition of the water samples, points to the upper Mantaro river basin as the possible source of part of the water drained by the Graton tunnel. (authors). 20 p. 2 figs., 7 ills., 4 tabs

  13. Perioperative lumbar drain utilization in transsphenoidal pituitary resection.

    Science.gov (United States)

    Alharbi, Shatha; Harsh, Griffith; Ajlan, Abdulrazag

    2018-01-01

    To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay. We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors. Patients were divided into 2 groups: group 1 received a preoperative drain, while LD was not preoperatively inserted in group 2. In cases of tumors with suprasellar extension with anticipation of high-flow leak, LD was inserted after the patient was intubated and in a lateral position. Lumbar drain was used for 48 hours, and the drain was removed if no leak was observed postoperatively. In documented postoperative CSF leak patients with no preoperative drain, the leak was treated by LD trial prior to surgical reconstruction. Cases in which leak occurred 6 months postoperatively were excluded. Our study population consisted of 186 patients, 99 women (53%) and 87 men (47%), with a mean age of 50.3+/-16.1 years. Complications occurred in 7 patients (13.7%) in group 1 versus 21 (15.5%) in group 2 (p=0.72). Postoperative CSF leak was observed in 1 patient (1.9%) in group 1 and 7 (5%) in group 2 (Fisher exact test=0.3). Length of hospital stay was a mean of 4.7+/-1.9 days in group 1 and a mean of 2.7+/-2.4 days in group 2 (pLD insertion is generally considered safe with a low risk of complications, it increases the length of hospitalization. Minor complications include headaches and patient discomfort.

  14. Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

    Directory of Open Access Journals (Sweden)

    Bortolo Martini

    2015-01-01

    Full Text Available A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT. ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

  15. Electrical Signs predictors of malignant ventricular arrhythmias

    International Nuclear Information System (INIS)

    Aleman Fernandez, Ailema Amelia; Dorantes Sanchez, Margarita

    2012-01-01

    Recurrence of malignant ventricular arrhythmia is frequent in cardioverter-defibrillators related patients. The risk stratification is difficult, there are numerous electrocardiographic predictors but his sensibility and specificity are not absolute. The limit between normal and pathological is not defined, besides the complexity of ventricular arrhythmias. We expose different electrocardiographic predictors that can help to better individual risk stratification

  16. Bidirectional ventricular tachycardia of unusual etiology

    Directory of Open Access Journals (Sweden)

    Praloy Chakraborty

    2015-11-01

    Full Text Available Bidirectional ventricular tachycardia (BDVT is a rare form of ventricular arrhythmia, characterized by changing QRS axis of 180 degrees. Digitalis toxicity is considered as commonest cause of BDVT; other causes include aconite toxicity, myocarditis, myocardial infarction, metastatic cardiac tumour and cardiac channelopathies. We describe a case of BDVT in a patient with Anderson-Tawil syndrome.

  17. Detection of premature ventricular contractions on a ventricular electrocardiogram for patients with left ventricular assist devices.

    Science.gov (United States)

    Park, Sung Min; Lee, Jin Hong; Choi, Seong Wook

    2014-12-01

    The ventricular electrocardiogram (v-ECG) was developed for long-term monitoring of heartbeats in patients with a left ventricular assist device (LVAD) and does not normally have the functionality necessary to detect additional heart irregularities that can progress to critical arrhythmias. Although the v-ECG has the benefits of physiological optimization and counterpulsation control, when abnormal heartbeats occur, the v-ECG does not show the distinct abnormal waveform that enables easy detection of an abnormal heartbeat among normal heartbeats on the conventional ECG. In this study, the v-ECGs of normal and abnormal heartbeats are compared with each other with respect to peak-to-peak voltage, area, and maximal slopes, and a new method to detect abnormal heartbeats is suggested. In a series of animal experiments with three porcine models (Yorkshire pigs weighing 30-40 kg), a v-ECG and conventional ECG were taken simultaneously during LVAD perfusion. Clinical experts found 104 abnormal heartbeats from the saved conventional ECG data and confirmed that the other 3159 heartbeats were normal. Almost all of the abnormal heartbeats were premature ventricular contractions (PVCs), and there was short-term tachycardia for 3 s. A personal computer was used to automatically detect abnormal heartbeats with the v-ECG according to the new method, and its results were compared with the clinicians' results. The new method found abnormal heartbeats with 90% accuracy, and less than 15% of the total PVCs were missed. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  18. Predictors of the left ventricular dysfunction induced by ventricular arrhythmia

    Directory of Open Access Journals (Sweden)

    А. І. Vytryhovskiy

    2016-08-01

    Full Text Available The most powerful predictor of life-threatening arrhythmia risk is a combination of low heart rate variability with low ejection fraction (EF of the left ventricle. Aim. To identify predictors of left ventricle dysfunction which is induced by ventricular arrhythmia. Materials and methods. To diagnose structural changes of left ventricular functional capacity and reserves in patients with previous myocardial infarction and patients with high and very high cardiovascular risk by SCORE scale and for establishment the relationship between morphological heart changes and pathological phenomenon of heart turbulence echocardiography and study of heart rate turbulence variability were performed. 603 patients were selected for the research. All patients were divided into groups: group 1 – patients with coronary heart disease, but without associated risk factors, such as smoking, obesity, metabolic syndrome; group 2 – patients who smoke tobacco more than 2 years (very high cardiovascular risk by scale SCORE; group 3 – patients with metabolic syndrome without coronary heart disease or arterial hypertension (very high cardiovascular risk by scale SCORE. The control group consisted of 149 persons. Results. The feature of structural changes in patients with myocardial infarction and in patients with a high cardiovascular risk by SCORE with heart rate turbulence compared with cases without НRT is considerably thickening of the left interventricular septum in systole. Based on this, it can be argued that the emergence of ventricular arrhythmia and accordingly phenomenon of heart rate turbulence in patients with existing cardiovascular diseases and risk factors has both morphological and functional character. Significant difference of echocardioscopy parameters in patients with postinfarction cardiosclerosis and risk factors by the SCORE system was established by index of intraventricular septum thickness in systole, and in persons with high risk – in

  19. An experimental study about efficacy of the drain catheters

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Bum Gyu; Nho, Joon Young; Woo, Hyo Cheol; Hwang, Woo Cheol; Park, Choong Ki; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Although percutaneous abscess drainage has become and accepted alternative from of therapy for selected patients with abscess, it is well known that there are several factors in the failure of adequate drainage such as pre- and post-procedural management, technique itself, various features of abscess, and selection and application of catheters. Among these factors, we made an experiment about drainage efficacy of commonly used various catheters with different viscosities of water-glycerin solution under the two different pressure gradients. The experimental values of flow rate were very lower than the calculated values. An efficacy of experimental value was 4-14%. Because the inner diameter of fittings and stopcocks was usually smaller than the inner diameter of catheters, these factors also affected the drain efficacy. Finally, we thought that it will be very helpful to the treatment of patient as well as to study about the catheter drainage, if the drain efficacy of individual catheters has been notified.

  20. 'Brain drain' from Serbia: One face of globalization of education?

    Directory of Open Access Journals (Sweden)

    Avramović Zoran

    2012-01-01

    Full Text Available In this paper we point out the role of the practice and ideology of globalization in brain drain process from Serbia. The listed data are based on the large-scale departure of highly educated persons from Serbia to the counties of West Europe and the USA. The dynamics, proportions and tendencies are analysed the role of the educational system in the process of departure of highly educated people and the reasons and consequences of the departure of scientist and engineering experts. In this article, education policy as state financial support are critical analysed. For Serbia, as the relatively undeveloped country in the middle of the modernization processes, this process has far-reaching effects on the social development. So, here we implied the possible solutions for the problem of brain drain.

  1. Reduction in wick drain effectiveness with spacing for Utah silts and clays.

    Science.gov (United States)

    2012-04-01

    Although decreasing the spacing of vertical drains usually decreases the time for consolidation, previous field tests have shown that there is a critical drain spacing for which tighter spacing does not decrease the time for consolidation. This...

  2. Inhibition of Rac1 reduces store overload-induced calcium release and protects against ventricular arrhythmia.

    Science.gov (United States)

    Zhang, Lili; Lu, Xiangru; Gui, Le; Wu, Yan; Sims, Stephen M; Wang, Guoping; Feng, Qingping

    2016-08-01

    Rac1 is a small GTPase and plays key roles in multiple cellular processes including the production of reactive oxygen species (ROS). However, whether Rac1 activation during myocardial ischaemia and reperfusion (I/R) contributes to arrhythmogenesis is not fully understood. We aimed to study the effects of Rac1 inhibition on store overload-induced Ca(2+) release (SOICR) and ventricular arrhythmia during myocardial I/R. Adult Rac1(f/f) and cardiac-specific Rac1 knockdown (Rac1(ckd) ) mice were subjected to myocardial I/R and their electrocardiograms (ECGs) were monitored for ventricular arrhythmia. Myocardial Rac1 activity was increased and ventricular arrhythmia was induced during I/R in Rac1(f/f) mice. Remarkably, I/R-induced ventricular arrhythmia was significantly decreased in Rac1(ckd) compared to Rac1(f/f) mice. Furthermore, treatment with Rac1 inhibitor NSC23766 decreased I/R-induced ventricular arrhythmia. Ca(2+) imaging analysis showed that in response to a 6 mM external Ca(2+) concentration challenge, SOICR was induced with characteristic spontaneous intracellular Ca(2+) waves in Rac1(f/f) cardiomyocytes. Notably, SOICR was diminished by pharmacological and genetic inhibition of Rac1 in adult cardiomyocytes. Moreover, I/R-induced ROS production and ryanodine receptor 2 (RyR2) oxidation were significantly inhibited in the myocardium of Rac1(ckd) mice. We conclude that Rac1 activation induces ventricular arrhythmia during myocardial I/R. Inhibition of Rac1 suppresses SOICR and protects against ventricular arrhythmia. Blockade of Rac1 activation may represent a new paradigm for the treatment of cardiac arrhythmia in ischaemic heart disease. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  3. Brain drain: a challenge to global mental health

    OpenAIRE

    Oladeji, Bibilola D.; Gureje, Oye

    2016-01-01

    The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries t...

  4. Outcome in Chronic Subdural Hematoma After Subdural vs. Subgaleal Drain

    International Nuclear Information System (INIS)

    Ishfaq, A.

    2017-01-01

    Objective: To compare the outcome after surgery for chronic subdural hematoma when the drain is placed in subdural space or subgaleal space. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Lahore, from July 2015 to June 2016. Methodology: Patients with chronic subdural hematoma of both genders and age, ranging between 55 to 85 years, were included. Patients on antiplatelet/anticoagulant therapy and acute on chronic subdural hematoma were excluded. Patients were divided in two equal groups each depending on whether drain was placed in subgaleal space (Group 1), and subdual space (Group 2), (n=31 patients each). Patients were positioned flat in bed after surgery. Clinical and radiological parameters and clinical outcome were compared between the two groups. Statistical test with significance of p <0.05 was utilized using Statistical Package of Social Sciences (SPSS version 17). Results: Median age of the 62 patients was 72 +-12.5 years. Headache was the most common symptom reported in both groups, (n=47,75.8%) patients. Median thickness of hematoma was 15 +-6.5 mm. Patients with subdural drain placement had more complications such as pneumocephalus 11 (35.4%) vs. 6 (19.3%), and intracerebral hemorrhage 4 (12.9%) vs. 2 (6.4%). Clinical outcome was good in both groups 27 (87%) in Group 1 and 28 (90%) in Group 2. Conclusion: Patients of both groups had good outcome after surgery. Complications like pneumocephalus and intracerebral hemorrhage were more common in subdural location of drain, though not reaching statistically significance level to favor one technique over another. (author)

  5. Consolidation by Prefabricated Vertical Drains with a Threshold Gradient

    OpenAIRE

    Xiao Guo; Kang-He Xie; Yue-Bao Deng

    2014-01-01

    This paper shows the development of an approximate analytical solution of radial consolidation by prefabricated vertical drains with a threshold gradient. To understand the effect of the threshold gradient on consolidation, a parametric analysis was performed using the present solution. The applicability of the present solution was demonstrated in two cases, wherein the comparisons with Hansbo’s results and observed data were conducted. It was found that (1) the flow with the threshold gradie...

  6. Globalization and migration: A "unified brain drain" model

    OpenAIRE

    Brezis, Elise S.; Soueri, Ariel

    2012-01-01

    Globalization has led to a vast flow of migration of workers but also of students. The purpose of this paper is to analyze the migration of individuals encompassing decisions already at the level of education. We develop a unified brain drain model that incorporates the decisions of an individual vis - à - vis both education and migration. In the empirical part, this paper addresses international flows of migration within the EU and presents strong evidence of concentration of students in cou...

  7. Theoretical computation background for transformation of foundations using pile drains

    Directory of Open Access Journals (Sweden)

    Ter-Martirosyan Zaven

    2017-01-01

    Full Text Available In the design of foundations for buildings and structures of various purposes, including improved risk, weak water-saturated clay soils with low mechanical characteristics are often found on a construction site. One of the possible ways of using them as a foundation is to seal them in various ways, including using pile drains of sand or rock stone material that are capable of both absorbing the load at the base and accelerating the process of filtration consolidation. This paper describes an analytical solution to the problem of interaction between the pile and the mattress with the surrounding soil of the foundation, taking into account the possibility of expanding the pile shaft. Solutions are obtained for determining the stresses in the shaft of the pile drain and in the soil under the mattress. The solution takes into account the influence of the pre-stressed state of the foundation after compaction on the formation of a stress-strain state during the erection and operation of structures. The solutions are relevant for consolidating pile drains made of rubble or for jet grouting piles, the rigidity of which is comparable to the rigidity of the surrounding soil. The paper describes the technique for determining the characteristics of the strength and deformability of the converted foundation and the results of large-scale tests at the experimental site for the construction of a large energy facility in Russia.

  8. Powerful Software to Simulate Soil Consolidation Problems with Prefabricated Vertical Drains

    OpenAIRE

    Gonzalo García-Ros; Iván Alhama; Manuel Cánovas

    2018-01-01

    The present work describes the program Simulation of Consolidation with Vertical Drains (SICOMED_2018), a tool for the solution of consolidation processes in heterogeneous soils, with totally or partially penetrating prefabricated vertical drains (PVD) and considering both the effects of the smear zone, generated when introducing the drain into the ground, and the limitation in the discharge capacity of the drain. In order to provide a completely free program, the code Next-Generation Simulat...

  9. Drain site evisceration of fallopian tube, another reason to discourage abdominal drain: report of a case and brief review of literature.

    Science.gov (United States)

    Saini, Pradeep; Faridi, M S; Agarwal, Nitin; Gupta, Arun; Kaur, Navneet

    2012-04-01

    Placement of a drain following abdominal surgery is common despite a lack of convincing evidence in the current literature to support this practice. The use of intra-abdominal drain is associated with many potential and serious complications. We report a drain site evisceration of the right fallopian tube after the removal of an intra-abdominal drain. The drain was placed in the right iliac fossa in a patient who underwent a lower segment Caesarean section (LSCS) for meconium liquor with fetal distress. The Pfannenstiel incision made for LSCS was reopened and the protruding inflamed fimbrial end of the right fallopian tube was excised. The patient made an uneventful recovery. Routine intra-abdominal prophylactic drain following an abdominal surgery including LSCS should be discouraged.

  10. The Simple Urine Bag as Wound Drain Post-Craniotomy in a Low ...

    African Journals Online (AJOL)

    Methods: A 4-year prospective cohort study of the effectiveness, outcome with use and complications of the Uribag as post craniotomy wound drain in a consecutive cohort of neurosurgical patients. Data analyzed include the patients' brief demographics; the types of cranial surgery in which drain was used; the drain ...

  11. 76 FR 62605 - Virginia Graeme Baker Pool and Spa Safety Act; Interpretation of Unblockable Drain

    Science.gov (United States)

    2011-10-11

    ... the VGB Act defines an ``unblockable drain'' as ``a drain of any size and shape that a human body... intentions. They claim that for this reason, backup systems are necessary, and a swimming pool or spa with a... of an ``unblockable drain,'' at 16 CFR 1450.2(b) and believe it was in error. Regardless of the size...

  12. Draining after breast reduction: a randomised controlled inter-patient study

    NARCIS (Netherlands)

    Corion, Leonard U. M.; Smeulders, Mark J. C.; van Zuijlen, Paul P. M.; van der Horst, Chantal M. A. M.

    2009-01-01

    One hundred and seven bilateral breast reductions were prospectively randomised during surgery to receive or not receive wound drains. Fifty-five patients were randomised to have a drain and 52 to not have a drain. There was no statistical difference in the number of complications between the

  13. Regulating multiple externalities

    DEFF Research Database (Denmark)

    Waldo, Staffan; Jensen, Frank; Nielsen, Max

    2016-01-01

    Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory instrume......Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory...

  14. An economic perspective on Malawi's medical "brain drain"

    Directory of Open Access Journals (Sweden)

    Mohiddin Abdu

    2006-12-01

    Full Text Available Abstract Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production" of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a

  15. An economic perspective on Malawi's medical "brain drain"

    Science.gov (United States)

    Record, Richard; Mohiddin, Abdu

    2006-01-01

    Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence

  16. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K; Maelkki, H; Wihersaari, M; Pirilae, P [VTT Energy, Espoo (Finland); Hongisto, M [Imatran Voima Oy, Vantaa (Finland); Siitonen, S [Ekono Energy Ltd, Espoo (Finland); Johansson, M [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  17. ExternE National Implementation Finland

    International Nuclear Information System (INIS)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P.; Hongisto, M.; Siitonen, S.; Johansson, M.

    1999-01-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  18. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  19. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... otitis. Fungal external otitis (otomycosis), typically caused by Aspergillus niger or Candida albicans, is less common. Boils are ... in the ear. Fungal external otitis caused by Aspergillus niger usually causes grayish black or yellow dots (called ...

  20. ExternE: Externalities of energy Vol. 2. Methodology

    International Nuclear Information System (INIS)

    Berry, J.; Holland, M.; Watkiss, P.

    1995-01-01

    This report describes the methodology used by the ExternE Project of the European Commission (DGXII) JOULE Programme for assessment of the external costs of energy. It is one of a series of reports describing analysis of nuclear, fossil and renewable fuel cycles for assessment of the externalities associated with electricity generation. Part I of the report deals with analysis of impacts, and Part II with the economic valuation of those impacts. Analysis is conducted on a marginal basis, to allow the effect of an incremental investment in a given technology to be quantified. Attention has been paid to the specificity of results with respect to the location of fuel cycle activities, the precise technologies used, and the type and source of fuel. The main advantages of this detailed approach are as follows: It takes full and proper account of the variability of impacts that might result from different power projects; It is more transparent than analysis based on hypothetically 'representative' cases for each of the different fuel cycles; It provides a framework for consistent comparison between fuel cycles. A wide variety of impacts have been considered. These include the effects of air pollution on the natural and human environment, consequences of accidents in the workplace, impacts of noise and visual intrusion on amenity, and the effects of climate change arising from the release of greenhouse gases. Wherever possible we have used the 'impact pathway' or 'damage function' approach to follow the analysis from identification of burdens (e.g. emissions) through to impact assessment and then valuation in monetary terms. This has required a detailed knowledge of the technologies involved, pollutant dispersion, analysis of effects on human and environmental health, and economics. In view of this the project brought together a multi-disciplinary team with experts from many European countries and the USA. The spatial and temporal ranges considered in the analysis are

  1. β1-Adrenoceptor blocker aggravated ventricular arrhythmia.

    Science.gov (United States)

    Wang, Yan; Patel, Dimpi; Wang, Dao Wu; Yan, Jiang Tao; Hsia, Henry H; Liu, Hao; Zhao, Chun Xia; Zuo, Hou Juan; Wang, Dao Wen

    2013-11-01

    To assess the impact of β1 -adrenoceptor blockers (β1 -blocker) and isoprenaline on the incidence of idiopathic repetitive ventricular arrhythmia that apparently decreases with preprocedural anxiety. From January 2010 to July 2012, six patients were identified who had idiopathic ventricular arrhythmias that apparently decreased (by greater than 90%) with preprocedural anxiety. The number of ectopic ventricular beats per hour (VPH) was calculated from Holter or telemetry monitoring to assess the ectopic burden. The mean VPH of 24 hours from Holter before admission (VPH-m) was used as baseline (100%) for normalization. β1 -Blockers, isoprenaline, and/or aminophylline were administrated successively on the ward and catheter lab to evaluate their effects on the ventricular arrhythmias. Among 97 consecutive patients with idiopathic ventricular arrhythmias, six had reduction in normalized VPHs in the hour before the scheduled procedure time from (104.6 ± 4.6%) to (2.8 ± 1.6%) possibly due to preprocedural anxiety (P < 0.05), then increased to (97.9 ± 9.7%) during β1 -blocker administration (P < 0.05), then quickly reduced to (1.6 ± 1.0%) during subsequent isoprenaline infusion. Repeated β1 -blocker quickly counteracted the inhibitory effect of isoprenaline, and VPHs increased to (120.9 ± 2.4%) from (1.6 ± 1.0%; P < 0.05). Isoprenaline and β1 -blocker showed similar effects on the arrhythmias in catheter lab. In some patients with structurally normal heart and ventricular arrhythmias there is a marked reduction of arrhythmias associated with preprocedural anxiety. These patients exhibit a reproducible sequence of β1 -blocker aggravation and catecholamine inhibition of ventricular arrhythmias, including both repetitive ventricular premature beats and monomorphic ventricular tachycardia. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  2. ASH External Web Portal (External Portal) -

    Data.gov (United States)

    Department of Transportation — The ASH External Web Portal is a web-based portal that provides single sign-on functionality, making the web portal a single location from which to be authenticated...

  3. Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

    OpenAIRE

    Kim, Dongmin; Lim, Seong-Hoon; Seo, Pil Won

    2013-01-01

    Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining ...

  4. Remodelado ventricular y cirugía

    Directory of Open Access Journals (Sweden)

    Ignacio Moriones

    2008-01-01

    Se han diseñado anillos mitrales como el de Carpentier- McCarthy-Adams (IMR ETlogix™ para pacientes isquémicos, o el Edwards-Geoform™ en miocardiopatías. La asistencia ventricular puede conseguir en determinados casos recuperación permanente del volumen de la cavidad y función ventricular, particularmente en miocarditis y determinadas miocardiopatías. Paralelamente, se han iniciado experiencias con el sistema de contención CorCap o el sistema Myosplint. Finalmente, la actuación sobre las valvulopatías y la revascularización favorecen la restauración ventricular.

  5. [The reasonable use of right ventricular protection strategy in right ventricular outflow tract reconstruction].

    Science.gov (United States)

    Zhang, Y; Yuan, H Y; Liu, X B; Wen, S S; Xu, G; Cui, H J; Zhuang, J; Chen, J M

    2018-06-01

    As a result of right ventricular outflow tract reconstruction, which is the important and basic step of complex cardiac surgery, the blood flow of right ventricular outflow tract is unobstructed, while pulmonary valve regurgitation and right heart dysfunction could be happened. These problems are often ignored in early days, more and more cases of right heart dysfunction need clinical intervention, which is quite difficult and less effective. How to protect effectively the right ventricular function is the focus. At present main methods to protect the right ventricular function include trying to avoid or reduce length of right ventricular incision, reserving or rebuilding the function of the pulmonary valve, using growth potential material for surgery. The protection of the right ventricular function is a systemic project, it involves many aspects, single measures is difficult to provide complete protection, only the comprehensive use of various protection strategy, can help to improve the long-term prognosis.

  6. A retrospective study of the use of active suction wound drains in dogs and cats.

    Science.gov (United States)

    Bristow, P C; Halfacree, Z J; Baines, S J

    2015-05-01

    To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases. Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®. Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species. Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management. © 2015 British Small Animal Veterinary Association.

  7. Comparison of a large and small-calibre tube drain for managing spontaneous pneumothoraces.

    Science.gov (United States)

    Benton, Ian J; Benfield, Grant F A

    2009-10-01

    To compare treatment success of large- and small-bore chest drains in the treatment of spontaneous pneumothoraces the case-notes were reviewed of those admitted to our hospital with a total of 73 pneumothoraces and who were treated by trainee doctors of varying experience. Both a large- and a small-bore intercostal tube drain system were in use during the two-year period reviewed. Similar pneumothorax profile and numbers treated with both drains were recorded, resulting in a similar drain time and numbers of successful and failed re-expansion of pneumothoraces. Successful pneumothorax resolution was the same for both drain types and the negligible tube drain complications observed with the small-bore drain reflected previously reported experiences. However the large-bore drain was associated with a high complication rate (32%) with more infectious complications (24%). The small-bore drain was prone to displacement (21%). There was generally no evidence of an increased failure and morbidity, reflecting poorer expertise, in the non-specialist trainees managing the pneumothoraces. A practical finding however was that in those large pneumothoraces where re-expansion failed, the tip of the drain had not been sited at the apex of the pleural cavity irrespective of the drain type inserted.

  8. Evisceration of Appendix through the Drain Site: A Rare Case Report.

    Science.gov (United States)

    Ravishankaran, Praveen; Rajamani, A

    2013-06-01

    Placing a drain after surgery is a usual procedure in any emergency abdominal operation. The drain is removed as soon as its purpose of draining the intraabdominal collection in served. Evisceration of intraabdominal organs through the drain site is a rare occurance. This case report is about an 12 year old girl who was admitted with blunt trauma abdomen. After completion of emergency laparotomy a drain was placed in the right lower quadrant. When the drain was removed on the 6th post operative day, the appendix eviscerated out of the drain site. The wound was extended a little and an appendectomy was done. This case is presented for its rarity as only two similar instances have been reported in literature so far.

  9. Perioperative management of calves undergoing implantation of a left ventricular assist device.

    Science.gov (United States)

    Wilson, D V; Kantrowitz, A; Pacholewicz, J; Salat, O; Paules, B R; Zhou, Y; Dawe, E J

    2000-01-01

    To describe perioperative management of calves that underwent left lateral thoracotomy, aortic cross-clamping, partial left heart bypass and implantation of a left ventricular assist device. A total of 43 healthy castrated male calves, weighing 121 +/- 24 kg. Diazepam (mean +/- SD, 0.26 +/- 0.07 mg/kg), ketamine (5.9 +/- 2.17 mg/kg) and isoflurane were used in the anesthetic management of calves undergoing implantation of a left ventricular assist device in the descending thoracic aorta. Other adjunctive agents administered were fentanyl (11 +/- 5.4 microg/kg), lidocaine (4.9 +/- 3.19 mg/kg), bupivacaine (0.75%) and butorphanol (0.49 +/- 0.13 mg/kg). None of the calves regurgitated at induction or during intubation. A tube was used to drain the rumen and prevent bloat during the procedure. Partial left heart bypass was used to perfuse the caudal half of the body during the period of aortic cross clamp and device implantation. Initial mean systemic blood pressure was 96 +/- 25 mm Hg, and pressures measured in the auricular artery increased during aortic cross-clamping and bypass. Vasoconstrictor therapy was required to treat caudal arterial hypotension during the procedure in 9 calves. Mean systemic arterial pressures returned to baseline values by the end of the anesthetic period. Initial mean pulmonary arterial pressures (PAP) were 22 +/- 3 mm Hg. A significant but transient increase in pulmonary arterial pressure occurred after both heparin and protamine administration. The described anesthetic protocol was effective for thoracotomy and implantation of an intra-aortic left ventricular assist device in normal calves. Partial left ventricular bypass was a useful adjunct during the period of aortic cross clamp. The doses of heparin and protamine administered were effective. Responsibility to monitor oxygenation of the cranial half of the animal continues during the bypass period as hypoxemia due to pulmonary dysfunction will not be detected by the perfusionist.

  10. India: 'brain drain' or the migration of talent?

    Science.gov (United States)

    Oommen, T K

    1989-09-01

    2 views on "brain drain" exist: 1) LDCs lose their enormous investments on higher education when skilled people migrate to other countries and 2) LDCs are exaggerating the problem and only a few skilled people migrate at 1 time. India does not completely lose its investment in education when professionals migrate, since the migrants still contribute to knowledge and also send remittances to relatives in India. Unemployed educated people would cause a greater drain on India's resources than educated migrants. The author prefers the phrase migration of talent to brain drain, since the former indicates a 2-way movement. Most migrants from LDCs are students. About 11,000 university graduates leave India every year for advanced study and/or work. A conservative estimate is that 2500 will remain abroad permanently. Most professionals who migrate go to the US and Canada. Factors promoting migration include 1) unemployment, 2) immigration rules, 3) colonial links, 4) financial incentives and material benefits, 5) pursuit of higher education, 6) improvement of working conditions and facilities, 7) avoidance of excessive bureaucratic procedures, and 8) compensation for the mismatch between Indian education and employment. Reasons for returning to India include 1) deference to wives who were unable to adjust to a foreign way of life, 2) contributing to Indian development, and 3) racial discrimination. It will probably not be possible to lure back migrants who left for material reasons. Attractive job offers could entice back those who left for advanced training. To encourage the return of those who left to pursue high quality research, India must 1) increase expenditure on research and development, possibly through the private industrial sector, 2) promote travel to other countries for professional enrichment, and 3) improve conditions of research work. The article concludes with an analysis of migration of talent from 3 perspectives: 1) the individual, 2) the nation

  11. Surgery for ventricular tachycardia in patients undergoing surgical ventricular restoration: the Karolinska approach.

    Science.gov (United States)

    Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan

    2007-09-01

    This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.

  12. Right Ventricular Endomyocardial Fibrosis Presenting With Ventricular Tachycardia And Apical Thrombus - An Interesting Presentation

    Directory of Open Access Journals (Sweden)

    Amitesh Aggarwal

    2009-11-01

    Full Text Available Endomyocardial fibrosis is a progressive disease of unknown origin affecting children and young adults. It involves inflow portion of right and/or left ventricle and apex. It may be associated with thrombus. Literature regarding right ventricular endomyocardial fibrosis with thrombus is scarce. Here we report a rare case of right ventricular endomyocardial fibrosis presenting as ventricular tachycardia and echocardiographic evidence of apical thrombus. Interestingly there was no pulmonary involvement or evidence of deep venous thrombosis. This case also underscores the importance of urgent echocardiography in diagnosis of obscure cases of ventricular tachycardia.

  13. Left ventricular function in patients with ventricular arrhythmias and aortic valve disease

    International Nuclear Information System (INIS)

    Santinga, J.T.; Kirsh, M.M.; Brady, T.J.; Thrall, J.; Pitt, B.

    1983-01-01

    Forty patients having aortic valve replacement were evaluated preoperatively for ventricular arrhythmia and left ventricular ejection fraction. Arrhythmias were classified as complex or simple using the Lown criteria on the 24-hour ambulatory electrocardiogram; ejection fractions were determined by radionuclide gated blood pool analysis and contrast angiography. The ejection fractions determined by radionuclide angiography were 59.1 +/- 13.1% for 26 patients with simple or no ventricular arrhythmias, and 43.9 +/- 20.3% for 14 patients with complex ventricular arrhythmias (p less than 0.01). Ejection fractions determined by angiography, available for 31 patients, were also lower in patients with complex ventricular arrhythmias (61.1 +/- 16.3% versus 51.4 +/- 13.4%; p less than 0.05). Seven of 9 patients showing conduction abnormalities on the electrocardiogram had complex ventricular arrhythmias. Eight of 20 patients with aortic stenosis had complex ventricular arrhythmias, while 2 of 13 patients with aortic insufficiency had such arrhythmias. It is concluded that decreased left ventricular ejection fraction, intraventricular conduction abnormalities, and aortic stenosis are associated with an increased frequency of complex ventricular arrhythmias in patients with aortic valve disease

  14. Rest and exercise ventricular function in adults with congenital ventricular septal defects

    International Nuclear Information System (INIS)

    Jablonsky, G.; Hilton, J.D.; Liu, P.P.; Morch, J.E.; Druck, M.N.; Bar-Shlomo, B.Z.; McLaughlin, P.R.

    1983-01-01

    Rest and exercise right and left ventricular function were compared using equilibrium gated radionuclide angiography in 19 normal sedentary control subjects and 34 patients with hemodynamically documented congenital ventricular septal defect (VSD). Gated radionuclide angiography was performed at rest and during each level of graded supine bicycle exercise to fatigue. Heart rate, blood pressure, maximal work load achieved, and right and left ventricular ejection fractions were assessed. The control subjects demonstrated an increase in both the left and right ventricular ejection fractions with exercise. All study groups failed to demonstrate an increase in ejection fraction in either ventricle with exercise. Furthermore, resting left ventricular ejection fraction in Groups 2 and 3 was lower than that in the control subjects and resting right ventricular ejection fraction was lower in Group 3 versus control subjects. Thus left and right ventricular function on exercise were abnormal in patients with residual VSD as compared with control subjects; rest and exercise left ventricular ejection fractions remained abnormal despite surgical closure of VSD in the remote past; resting left and right ventricular function was abnormal in patients with Eisenmenger's complex; lifelong volume overload may be detrimental to myocardial function

  15. Processing method for drained water containing ethanol amine

    International Nuclear Information System (INIS)

    Wakuta, Kuniharu; Ogawa, Naoki; Sagawa, Hiroshi; Kamiyoshi, Hideki; Fukunaga, Kazuo; Iwamoto, Ken; Miki, Tsuyoshi; Hirata, Toshio

    1998-01-01

    Drained water containing ethanol amine is processed with microorganisms such as hydrazine resistant denitrification bacteria in a biodegrading vessel (A) in the coexistence of nitrous ions and/or nitric ions under an anaerobic condition, and then it is processed with microorganisms such as nitrification bacteria in another biotic oxidation vessel (B) under an aerobic condition to generate the coexistent nitrate ion and/or nitric ion, and returned to the biodegrading vessel (A). Further, they are exposed to air or incorporated with an oxidant and optionally a copper compound such as copper sulfate as a catalyst is added in a step of removing hydrazine. (T.M.)

  16. Characterization Plan for Soils Around Drain Line PLA-100115

    Energy Technology Data Exchange (ETDEWEB)

    D. Shanklin

    2006-05-24

    This Characterization Plan supports the Hazardous Waste Management Act/Resource Conservation and Recovery Act (HWMA/RCRA) closure of soils that may have been contaminated by releases from drain line PLA-100115, located within the Idaho Nuclear Technology and Engineering Center at the Idaho National Laboratory Site. The requirements to address the closure of soils contaminated by a potential release from this line in a characterization plan was identified in the "HWMA/RCRA Less Than 90-day Generator Closure Report for the VES-SFE-126."

  17. Right superior vena cava draining into the left atrium

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); Batisse, Alain [Institut de Puericulture et de Perinatalogie, Paris (France); Vouhe, Pascal [University Rene Descartes-Paris 5, Department of Paediatric Cardiac Surgery, Hopital Necker-Enfants Malades, Paris (France); Ou, Phalla [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker-Enfants Malades, Paris (France)

    2008-08-15

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  18. Laparoscopic primary repair and isoperistaltic endoluminal drain for Boerhaave's Syndrome.

    Science.gov (United States)

    Prete, Francesco; Pezzolla, Angela; Nitti, Paolo; Prete, Fernando

    2015-01-01

    Spontaneous oesophageal rupture, also known as Boerhaave syndrome (BS), is a rare and potentially lethal pathological condition. BS recognition is difficult, while rapidity of diagnosis, along with extension of the lesion, affects type and outcome of treatment. BS was classically treated by thoracotomy, but laparoscopic (LS), thoracoscopic (TS) surgery, and nonsurgical procedures as endoscopic stent positioning or use of glues have been described. Still, there is no model treatment, and selection of the most appropriate therapeutic procedure is complex in the absence of standardised criteria. We successfully managed a patient affected with BS by LS approach and present our experience along with a review of treatment options so far described. Our treatment integrated positioning of an oesophageal isoperistaltic endoluminal drain (IED), that we routinely use in oesophageal sutures at risk of leakage, and of which there is no previous report in the setting of BS. A 68 year old man presented to our attention with true BS, suspected on chest-abdominal CT scan and confirmed by upper GI contrast swallow test, showing leakage of hydro-soluble contrast from the lower third of the oesophagus. Of note, pleural cavities appeared intact. We performed an urgent laparoscopy 12 hours after the onset of symptoms. Laparoscopic toilet of the inferior mediastinum and dual layer oesophageal repair with pedicled omental flap were complemented by positioning of IED, feeding jejunostomy and two tubular drains. The patient had a slow but consistent recovery where IED played as a means of oesophageal suture protection, until he could be discharged home. We think that, when integrity of the pleura is documented, LS should be priority choice to avoid contamination of the pleural cavities. We have to consider every type of oesophageal repair in BS at risk of failure, and every means of protection of the suture is opportune. In our patient the oesophageal suture, covered with a flap of omentum

  19. Consequences assessment for fuel channel failure with consequential moderator drain

    International Nuclear Information System (INIS)

    Wahba, N.N.; Bayoumi, M.H.

    2002-01-01

    This paper documents the consequences of spontaneous pressure tube/consequential calandria tube rupture followed by the ejection of end fittings (as a result of guillotine failure of pressure tube) leading to the drain of the moderator. The event is postulated to occur in conjunction with an independent failure of Emergency Coolant Injection System (ECIS). The results of the detailed consequence assessments are used to propose a course of action to mitigate the consequences of such an event. A methodology based on a lumped-parameter model was developed to assess the consequences of the postulated event. (author)

  20. Interior drains for open pit disposal of uranium mill tailings

    International Nuclear Information System (INIS)

    Staub, W.P.

    1978-01-01

    A conceptualized interior drainage system is presented for reducing the environmental impact on natural groundwater by disposal of uranium mill tailings in the mined-out open pit. The evaporation/seepage ratio can be increased through the use of interior drains, long-term monitoring of groundwater quality can be eliminated, and the open pit will not require an extensive liner. Other advantages not related to groundwater are: control of fugitive dust and radon emanation during mill operations and timely reclamation after the impoundment is filled with tailings

  1. Right superior vena cava draining into the left atrium

    International Nuclear Information System (INIS)

    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien; Batisse, Alain; Vouhe, Pascal; Ou, Phalla

    2008-01-01

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  2. Application of Prefabricated Vertical Drain in Soil Improvement

    Directory of Open Access Journals (Sweden)

    Tedjakusuma B.

    2012-01-01

    Full Text Available Although the use of Prefabricated Vertical Drain (PVD in soil improvement is not new, this paper is interesting since it gives the full spectrum from preliminary design stage; trial embankment and pilot test to final soil improvement. The final installation of the PVD was based on the soil investigation report and the results of instrumentation monitoring. Finally, using back analysis, vertical and horizontal coefficients of consolidation and compression index can be determined, which can be applied to predict a more accurate prediction of settlement.

  3. Arrhythmogenic right ventricular dysplasia: A case report

    Directory of Open Access Journals (Sweden)

    Tessa Negrín Valdés

    2015-10-01

    Full Text Available Arrhythmogenic right ventricular dysplasia is a heart muscle disease that predominantly affects the right ventricle, bringing about the replacement of normal myocardium with fatty or fibrofatty tissue and causing sudden death in young individuals. Ventricular tachycardia is an important clinical manifestation, although there are reports of right or global heart failure. The diagnosis is confirmed by echocardiography and magnetic resonance imaging. The case of a 65-year-old former smoker, with hypertension and ischemic heart disease, a history of effort syncope symptoms and proven non-sustained ventricular tachycardia, with morphology of left bundle branch block, is reported. Relevant diagnostic studies were performed, and echocardiographic elements which were compatible with arrhythmogenic right ventricular dysplasia were found. Therefore, an implantable cardioverter defibrillator was implanted, after which the patient has had a favorable outcome.

  4. Ventricular repolarization measures for arrhythmic risk stratification

    Institute of Scientific and Technical Information of China (English)

    Francesco Monitillo; Marta Leone; Caterina Rizzo; Andrea Passantino; Massimo Iacoviello

    2016-01-01

    Ventricular repolarization is a complex electrical phenomenon which represents a crucial stage in electrical cardiac activity. It is expressed on the surface electrocardiogram by the interval between the start of the QRS complex and the end of the T wave or U wave(QT). Several physiological, pathological and iatrogenic factors can influence ventricular repolarization. It has been demonstrated that small perturbations in this process can be a potential trigger of malignant arrhythmias, therefore the analysis of ventricular repolarization represents an interesting tool to implement risk stratification of arrhythmic events in different clinical settings. The aim of this review is to critically revise the traditional methods of static analysis of ventricular repolarization as well as those for dynamic evaluation, their prognostic significance and the possible application in daily clinical practice.

  5. Fibrilação ventricular durante atividade esportiva tratada com sucesso Fibrilación ventricular durante actividad deportiva tratada con êxito Ventricular fibrillation during sport activity successfully treated

    Directory of Open Access Journals (Sweden)

    Maria Margarita Gonzalez

    2009-08-01

    Full Text Available A sobrevida após parada cardio-respiratória extra-hospitalar é estimada em menos de 5%. Apresentamos um caso de fibrilação ventricular, durante atividade esportiva. Ressuscitação cardio-pulmonar foi iniciada precocemente por pessoa leiga, e desfibrilação foi realizada em menos de três minutos, com desfibrilador externo automático, com sucesso. O programa de acesso público à desfibrilação tem aumentado a sobrevida após fibrilação ventricular extra-hospitalar. Devemos estimular o treinamento de pessoas leigas com relação ao uso de desfibriladores externos automáticos e o programa Suporte Básico de Vida, incentivando a implementação deste em locais com grande afluxo de pessoas e locais com risco elevado de ocorrer morte súbita, a exemplo de centros esportivos.La sobrevida tras una parada cardiorrespiratoria extrahospitalaria se estima en menos del 5%. Presentamos un caso de fibrilación ventricular durante actividad deportiva La resucitación cardiopulmonar fue iniciada precozmente por personal no técnico, y la desfibrilación se realizó en menos de tres minutos, con desfibrilador externo automático, con éxito. El programa de acceso público a la desfibrilación aumentó la sobrevida después de la fibrilación ventricular extrahospitalaria. Debemos estimular la capacitación de personas no técnicas con relación al uso de desfibriladores externos automáticos y el programa Soporte Básico de Vida, incentivando la implementación del mismo en locales con gran afluencia de personas y locales con riesgo elevado de ocurrencia de muerte súbita, como es el caso de los centros deportivos.Survival after out-of-hospital cardiopulmonary arrest is estimated at less than 5%. We report a case of ventricular fibrillation during sports activity. Cardiopulmonary resuscitation was initiated early by a layperson, and defibrillation was successfully performed within less than three minutes, with an automated external defibrillator. The

  6. Salbutamol Abuse is Associated with Ventricular Fibrillation

    Directory of Open Access Journals (Sweden)

    Emin UYSAL

    2015-06-01

    Full Text Available SUMMARY: Salbutamol-induced cardiac complications are well-established. Herein, we describe a case of a 24-year female who was admitted to the emergency department because of a suicide attempt with salbutamol (76 mg. Salbutamol abuse induced the development of supraventricular tachycardia and ventricular fibrillation. Regular sinus rhythm was restored with defibrillation. The hypokalemic patient who stayed in the intensive care unit was discharged after 48 hours of hospitalization. Key words: Salbutamol, suicide, ventricular fibrillation

  7. Clustering Of Left Ventricular Wall Motion Patterns

    Science.gov (United States)

    Bjelogrlic, Z.; Jakopin, J.; Gyergyek, L.

    1982-11-01

    A method for detection of wall regions with similar motion was presented. A model based on local direction information was used to measure the left ventricular wall motion from cineangiographic sequence. Three time functions were used to define segmental motion patterns: distance of a ventricular contour segment from the mean contour, the velocity of a segment and its acceleration. Motion patterns were clustered by the UPGMA algorithm and by an algorithm based on K-nearest neighboor classification rule.

  8. Ventricular tachycardia induced by weight loss pills

    DEFF Research Database (Denmark)

    Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

    2013-01-01

    A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

  9. Resolving the True Ventricular Mural Architecture

    Directory of Open Access Journals (Sweden)

    Robert S. Stephenson

    2018-06-01

    Full Text Available The precise nature of packing together of the cardiomyocytes within the ventricular walls has still to be determined. The spiraling nature of the chains of interconnected cardiomyocytes has long been recognized. As long ago as the end of the nineteenth century, Pettigrew had emphasized that the ventricular cone was not arranged on the basis of skeletal muscle. Despite this guidance, subsequent anatomists described entities such as “bulbo-spiral muscles”, with this notion of subunits culminating in the suggestion that the ventricular cone could be unwrapped so as to produce a “ventricular myocardial band”. Others, in contrast, had suggested that the ventricular walls were arranged on the basis of “sheets”, or more recently “sheetlets”, with investigators seeking to establishing the angulation of these entities using techniques such as magnetic resonance imaging. Our own investigations, in contrast, have shown that the cardiomyocytes are aggregated together within the supporting fibrous matrix so as to produce a three-dimensional myocardial mesh. In this review, we summarize the previous accounts, and provide the anatomical evidence we have thus far accumulated to support the model of the myocardial mesh. We show how these anatomic findings underscore the concept of the myocardial mesh functioning in antagonistic fashion. They lend evidence to support the notion that the ventricular myocardium works as a muscular hydrostat.

  10. Use of Cardiac Computed Tomography for Ventricular Volumetry in Late Postoperative Patients with Tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Ho Jin Kim

    2017-04-01

    Full Text Available Background: Cardiac computed tomography (CT has emerged as an alternative to magnetic resonance imaging (MRI for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. Methods: Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI in 11 patients (median age, 19 years who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI and semiautomatic 3-dimensional region-growing method (CT were used to measure ventricular volumes. Results: All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI, which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI (r=0.88, p<0.001, the right ventricular end-systolic volume index (RV-ESVI (r=0.84, p=0.001, the left ventricular end-diastolic volume index (LV-EDVI (r=0.90, p=0.001, and the LV-ESVI (r=0.55, p=0.079. While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: 197 mL/m 2 vs. 175 mL/m 2 , p=0.008; median LV-EDVI: 94 mL/m 2 vs. 92 mL/m 2 , p=0.026, no significant differences were found for the RV-ESVI or LV-ESVI. Conclusion: The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.

  11. Use of Cardiac Computed Tomography for Ventricular Volumetry in Late Postoperative Patients with Tetralogy of Fallot.

    Science.gov (United States)

    Kim, Ho Jin; Mun, Da Na; Goo, Hyun Woo; Yun, Tae-Jin

    2017-04-01

    Cardiac computed tomography (CT) has emerged as an alternative to magnetic resonance imaging (MRI) for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI) in 11 patients (median age, 19 years) who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI) and semiautomatic 3-dimensional region-growing method (CT) were used to measure ventricular volumes. All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI), which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI) (r=0.88, p<0.001), the right ventricular end-systolic volume index (RV-ESVI) (r=0.84, p=0.001), the left ventricular end-diastolic volume index (LV-EDVI) (r=0.90, p=0.001), and the LV-ESVI (r=0.55, p=0.079). While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: 197 mL/m 2 vs. 175 mL/m 2 , p=0.008; median LV-EDVI: 94 mL/m 2 vs. 92 mL/m 2 , p=0.026), no significant differences were found for the RV-ESVI or LV-ESVI. The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.

  12. Large right ventricular sinusoids in an infant with aorta-left ventricular tunnel and proximal right coronary artery atresia.

    Science.gov (United States)

    Chen, Peter C; Spinner, Joseph A; Heinle, Jeffrey S

    2018-07-01

    We report a 1-month-old infant diagnosed with an aorta-left ventricular tunnel, ventricular septal defect, and right coronary atresia with right ventricular sinusoids. The patient's anatomy and physiology did not indicate right-ventricular-dependent coronary circulation, and therefore right ventricular decompression could be performed without compromising coronary perfusion during surgical correction. A detailed understanding of the coronary anatomy is critical in managing this defect when coronary anomalies are present.

  13. Consolidation by Prefabricated Vertical Drains with a Threshold Gradient

    Directory of Open Access Journals (Sweden)

    Xiao Guo

    2014-01-01

    Full Text Available This paper shows the development of an approximate analytical solution of radial consolidation by prefabricated vertical drains with a threshold gradient. To understand the effect of the threshold gradient on consolidation, a parametric analysis was performed using the present solution. The applicability of the present solution was demonstrated in two cases, wherein the comparisons with Hansbo’s results and observed data were conducted. It was found that (1 the flow with the threshold gradient would not occur instantaneously throughout the whole unit cell. Rather, it gradually occurs from the vertical drain to the outside; (2 the moving boundary would never reach the outer radius of influence if R+1

  14. Global estimates of high-level brain drain and deficit.

    Science.gov (United States)

    Ioannidis, John P A

    2004-06-01

    Brain drain, the international migration of scientists in search of better opportunities, has been a long-standing concern, but quantitative measurements are uncommon and limited to specific countries or disciplines. We need to understand brain drain at a global level and estimate the extent to which scientists born in countries with low opportunities never realize their potential. Data on 1523 of the most highly cited scientists for 1981-1999 are analyzed. Overall, 31.9% of these scientists did not reside in the country where they were born (range 18.1-54.6% across 21 different scientific fields). There was great variability across developed countries in the proportions of foreign-born resident scientists and emigrating scientists. Countries without a critical mass of native scientists lost most scientists to migration. This loss occurred in both developed and developing countries. Adjusting for population and using the U.S. as reference, the number of highly cited native-born scientists was at least 75% of the expected number in only 8 countries other than the U.S. It is estimated that approximately 94% of the expected top scientists worldwide have not been able to materialize themselves due to various adverse conditions. Scientific deficit is only likely to help perpetuate these adverse conditions.

  15. ExternE: Externalities of energy Vol. 1. Summary

    International Nuclear Information System (INIS)

    Holland, M.; Berry, J.

    1995-01-01

    There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase 1 was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes is underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

  16. Externalities of fuel cycles 'ExternE' project. Summary report

    International Nuclear Information System (INIS)

    Holland, M.; Berry, J.

    1994-01-01

    There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase I was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes are underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

  17. Drain Insertion in Chronic Subdural Hematoma: An International Survey of Practice.

    Science.gov (United States)

    Soleman, Jehuda; Kamenova, Maria; Lutz, Katharina; Guzman, Raphael; Fandino, Javier; Mariani, Luigi

    2017-08-01

    To investigate whether, after the publication of grade I evidence that it reduces recurrence rates, the practice of drain insertion after burr-hole drainage of chronic subdural hematoma has changed. Further, we aimed to document various practice modalities concerning the insertion of a drain adopted by neurosurgeons internationally. We administered a survey to neurosurgeons worldwide with questions relating to the surgical treatment of chronic subdural hematoma, with an emphasis on their practices concerning the use of a drain. The preferred surgical technique was burr-hole drainage (89%). Most surgeons prefer to place a drain (80%), whereas in 56% of the cases the reason for not placing a drain was brain expansion after evacuation. Subdural drains are placed by 50% and subperiosteal drains by 27% of the responders, whereas 23% place primarily a subdural drain if possible and otherwise a subperiosteal drain. Three quarters of the responders leave the drain for 48 hours and give prophylactic antibiotic treatment, mostly a single-shot dose intraoperatively (70%). Routine postoperative computed tomography is done by 59% mostly within 24-48 hours after surgery (94%). Adjunct treatment to surgery rarely is used (4%). The publication of grade I evidence in favor of drain use influenced positively this practice worldwide. Some surgeons are still reluctant to insert a drain, especially when the subdural space is narrow after drainage of the hematoma. The insertion of a subperiosteal drain could be a good alternative solution. However, its outcome and efficacy must be evaluated in larger studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Estimating drain flow from measured water table depth in layered soils under free and controlled drainage

    Science.gov (United States)

    Saadat, Samaneh; Bowling, Laura; Frankenberger, Jane; Kladivko, Eileen

    2018-01-01

    Long records of continuous drain flow are important for quantifying annual and seasonal changes in the subsurface drainage flow from drained agricultural land. Missing data due to equipment malfunction and other challenges have limited conclusions that can be made about annual flow and thus nutrient loads from field studies, including assessments of the effect of controlled drainage. Water table depth data may be available during gaps in flow data, providing a basis for filling missing drain flow data; therefore, the overall goal of this study was to examine the potential to estimate drain flow using water table observations. The objectives were to evaluate how the shape of the relationship between drain flow and water table height above drain varies depending on the soil hydraulic conductivity profile, to quantify how well the Hooghoudt equation represented the water table-drain flow relationship in five years of measured data at the Davis Purdue Agricultural Center (DPAC), and to determine the impact of controlled drainage on drain flow using the filled dataset. The shape of the drain flow-water table height relationship was found to depend on the selected hydraulic conductivity profile. Estimated drain flow using the Hooghoudt equation with measured water table height for both free draining and controlled periods compared well to observed flow with Nash-Sutcliffe Efficiency values above 0.7 and 0.8 for calibration and validation periods, respectively. Using this method, together with linear regression for the remaining gaps, a long-term drain flow record for a controlled drainage experiment at the DPAC was used to evaluate the impacts of controlled drainage on drain flow. In the controlled drainage sites, annual flow was 14-49% lower than free drainage.

  19. Probe code: a set of programs for processing and analysis of the left ventricular function - User's manual

    International Nuclear Information System (INIS)

    Piva, R.M.V.

    1987-01-01

    The User's Manual of the Probe Code is an addendum to the M.Sc. thesis entitled A Microcomputer System of Nuclear Probe to Check the Left Ventricular Function. The Probe Code is a software which was developed for processing and off-line analysis curves from the Left Ventricular Function, that were obtained in vivo. These curves are produced by means of an external scintigraph probe, which was collimated and put on the left ventricule, after a venous inoculation of Tc-99 m. (author)

  20. External radiation surveillance

    International Nuclear Information System (INIS)

    Antonio, E.J.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site

  1. External radiation surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  2. Stress induced right ventricular dysfunction: An indication of reversible right ventricular ischaemia

    International Nuclear Information System (INIS)

    Underwood, S.R.; Walton, S.; Emanuel, R.W.; Swanton, R.H.; Campos Costa, D.; Laming, P.J.; Ell, P.J.

    1987-01-01

    Stress induced changes in left ventricular ejection fraction are widely used in the detection and assessment of coronary artery disease. This study demonstrates that right ventricular dysfunction may also occur, and assesses its significance in terms of coronary artery anatomy. This study involved 14 normal subjects and 26 with coronary artery disease investigated by equilibrium radionuclide ventriculography, at rest and during maximal dynamic exercise. Mean normal resting right ventricular ejection fraction (RVEF) was 0.40 (SD 0.118), and all normal subjects increased RVEF with stress (mean ΔRVEF+0.13 SD 0.099). Mean ΔRVEF in the subjects with coronary artery disease was significantly lower at 0.00 (SD 0.080), but there was overlap between the two groups. The largest falls in RVEF were seen if the right coronary artery was occluded without retrograde filling. In this subgroup with the most severely compromised right ventricular perfusion (nine subjects), RVEF always fell with stress, and mean ΔRVEF was -0.08 (SD 0.050). There was no significant correlation between ΔLVEF and ΔRVEF, implying that the right ventricular dysfunction was due to right ventricular ischaemia, rather than secondary to left ventricular dysfunction. Stress induced right ventricular ischaemia can therefore be detected readily by radionuclide ventriculography. (orig.)

  3. Action potential conduction between a ventricular cell model and an isolated ventricular cell

    NARCIS (Netherlands)

    Wilders, R.; Kumar, R.; Joyner, R. W.; Jongsma, H. J.; Verheijck, E. E.; Golod, D.; van Ginneken, A. C.; Goolsby, W. N.

    1996-01-01

    We used the Luo and Rudy (LR) mathematical model of the guinea pig ventricular cell coupled to experimentally recorded guinea pig ventricular cells to investigate the effects of geometrical asymmetry on action potential propagation. The overall correspondence of the LR cell model with the recorded

  4. Right ventricular failure after implantation of a continuous-flow left ventricular assist device

    DEFF Research Database (Denmark)

    Cordtz, Johan Joakim; Nilsson, Jens C; Hansen, Peter B

    2014-01-01

    Right ventricular failure (RVF) is a significant complication after implantation of a left ventricular assist device. We aimed to identify haemodynamic changes in the early postoperative phase that predicted subsequent development of RVF in a cohort of HeartMate II (HMII) implanted patients....

  5. Exercise thallium testing in ventricular preexcitation

    Energy Technology Data Exchange (ETDEWEB)

    Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

    1987-05-01

    Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation.

  6. Exercise thallium testing in ventricular preexcitation

    International Nuclear Information System (INIS)

    Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

    1987-01-01

    Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation

  7. Greenhouse gases emission from the sewage draining rivers.

    Science.gov (United States)

    Hu, Beibei; Wang, Dongqi; Zhou, Jun; Meng, Weiqing; Li, Chongwei; Sun, Zongbin; Guo, Xin; Wang, Zhongliang

    2018-01-15

    Carbon dioxide (CO 2 ), methane (CH 4 ) and nitrous oxide (N 2 O) concentration, saturation and fluxes in rivers (Beitang drainage river, Dagu drainage rive, Duliujianhe river, Yongdingxinhe river and Nanyunhe river) of Tianjin city (Haihe watershed) were investigated during July and October in 2014, and January and April in 2015 by static headspace gas chromatography method and the two-layer model of diffusive gas exchange. The influence of environmental variables on greenhouse gases (GHGs) concentration under the disturbance of anthropogenic activities was discussed by Spearman correlative analysis and multiple stepwise regression analysis. The results showed that the concentration and fluxes of CO 2 , CH 4 and N 2 O were seasonally variable with >winter>fall>summer, spring>summer>winter>fall and summer>spring>winter>fall for concentrations and spring>summer>fall>winter, spring>summer>winter>fall and summer>spring>fall>winter for fluxes respectively. The GHGs concentration and saturation were higher in comprehensively polluted river sites and lower in lightly polluted river sites. The three GHGs emission fluxes in two sewage draining rivers of Tianjin were clearly higher than those of other rivers (natural rivers) and the spatial variation of CH 4 was more obvious than the others. CO 2 and N 2 O air-water interface emission fluxes of the sewage draining rivers in four seasons were about 1.20-2.41 times and 1.13-3.12 times of those in the natural rivers. The CH 4 emission fluxes of the sewage draining rivers were 3.09 times in fall to 10.87 times in spring of those in the natural rivers in different season. The wind speed, water temperature and air temperature were related to GHGs concentrations. Nitrate and nitrite (NO 3 - +NO 2 - -N) and ammonia (NH 4 + -N) were positively correlated with CO 2 concentration and CH 4 concentration; and dissolved oxygen (DO) concentration was negatively correlated with CH 4 concentration and N 2 O concentration. The effect of

  8. ExternE: Externalities of energy Vol. 5. Nuclear

    International Nuclear Information System (INIS)

    Dreicer, M.; Tort, V.; Manen, P.

    1995-01-01

    Since the early 1970s, there has been increased interest in the environmental impacts that are caused by the generation of electricity. The comparative risk assessment studies at that time used mainly deaths and injuries as impact indicators. By the end of the 1980s studies changed to the assessment of the costs imposed on society and the environment that were not included in the market price of the energy produced, the so-called external costs. The preliminary studies that were published set the conceptual basis, grounded in neo-classical economics, for the valuation of the health and environmental impacts that could be assessed. As a consequence of the many questions raised by the methodologies employed by these early studies, Directorate General XII (DG XII) of the Commission of the European Communities established a collaborative research programme with the United States Department of Energy to identify an appropriate methodology for this type of work. Following the completion of this collaboration, the DG XII programme has continued as the ExternE project. The main objective of the work carried out at CEPN was to develop an impact pathway methodology for the nuclear fuel cycle that would be consistent with the methodologies developed for other fuel cycles, without loosing the nuclear-specific techniques required for a proper evaluation. In this way, comparisons between the different fuel cycles would be possible. This report presents the methodology and demonstration of the results in the context of the French nuclear fuel cycle. The United States team at Oak Ridge National Laboratory has previously issued a draft report on the results of their assessment. The French fuel cycle was broken down into 8 separate stages. Reference sites and 1990s technology were chosen to represent the total nuclear fuel cycle, as it exists today. In addition, the transportation of material between the sites was considered. The facilities are assessed for routine operation, except

  9. A programmable point-of-care device for external CSF drainage and monitoring.

    Science.gov (United States)

    Simkins, Jeffrey R; Subbian, Vignesh; Beyette, Fred R

    2014-01-01

    This paper presents a prototype of a programmable cerebrospinal fluid (CSF) external drainage system that can accurately measure the dispensed fluid volume. It is based on using a miniature spectrophotometer to collect color data to inform drain rate and pressure monitoring. The prototype was machined with 1 μm dimensional accuracy. The current device can reliably monitor the total accumulated fluid volume, the drain rate, the programmed pressure, and the pressure read from the sensor. Device requirements, fabrication processes, and preliminary results with an experimental set-up are also presented.

  10. Dynamic Changes of QRS Morphology of Premature Ventricular Contractions During Ablation in the Right Ventricular Outflow Tract: A Case Report.

    Science.gov (United States)

    Yue-Chun, Li; Jia-Feng, Lin; Jia-Xuan, Lin

    2015-10-01

    Electrocardiographic characteristics can be useful in differentiating between right ventricular outflow tract (RVOT) and aortic sinus cusp (ASC) ventricular arrhythmias. Ventricular arrhythmias originating from ASC, however, show preferential conduction to RVOT that may render the algorithms of electrocardiographic characteristics less reliable. Even though there are few reports describing ventricular arrhythmias with ASC origins and endocardial breakout sites of RVOT, progressive dynamic changes in QRS morphology of the ventricular arrhythmias during ablation obtained were rare.This case report describes a patient with symptomatic premature ventricular contractions of left ASC origin presenting an electrocardiogram (ECG) characteristic of right ventricular outflow tract before ablation. Pacing at right ventricular outflow tract reproduced an excellent pace map. When radiofrequency catheter ablation was applied to the right ventricular outflow tract, the QRS morphology of premature ventricular contractions progressively changed from ECG characteristics of right ventricular outflow tract origin to ECG characteristics of left ASC origin.Successful radiofrequency catheter ablation was achieved at the site of the earliest ventricular activation in the left ASC. The distance between the successful ablation site of the left ASC and the site with an excellent pace map of the RVOT was 20 mm.The ndings could be strong evidence for a preferential conduction via the myocardial bers from the ASC origin to the breakout site in the right ventricular outflow tract. This case demonstrates that ventricular arrhythmias with a single origin and exit shift may exhibit QRS morphology changes.

  11. Effect of an intervention in storm drains to prevent Aedes aegypti reproduction in Salvador, Brazil.

    Science.gov (United States)

    Souza, Raquel Lima; Mugabe, Vánio André; Paploski, Igor Adolfo Dexheimer; Rodrigues, Moreno S; Moreira, Patrícia Sousa Dos Santos; Nascimento, Leile Camila Jacob; Roundy, Christopher Michael; Weaver, Scott C; Reis, Mitermayer Galvão; Kitron, Uriel; Ribeiro, Guilherme Sousa

    2017-07-11

    Aedes aegypti, the principal vector for dengue, chikungunya and Zika viruses, is a synanthropic species that uses stagnant water to complete its reproductive cycle. In urban settings, rainfall water draining structures, such as storm drains, may retain water and serve as a larval development site for Aedes spp. reproduction. Herein, we describe the effect of a community-based intervention on preventing standing water accumulation in storm drains and their consequent infestation by adult and immature Ae. aegypti and other mosquitoes. Between April and May of 2016, local residents association of Salvador, Brazil, after being informed of water accumulation and Ae. aegypti infestation in the storm drains in their area, performed an intervention on 52 storm drains. The intervention consisted of placing concrete at the bottom of the storm drains to elevate their base to the level of the outflow tube, avoiding water accumulation, and placement of a metal mesh covering the outflow tube to avoid its clogging with debris. To determine the impact of the intervention, we compared the frequency at which the 52 storm drains contained water, as well as adult and immature mosquitoes using data from two surveys performed before and two surveys performed after the intervention. During the pre-intervention period, water accumulated in 48 (92.3%) of the storm drains, and immature Ae. aegypti were found in 11 (21.2%) and adults in 10 (19.2%). After the intervention, water accumulated in 5 (9.6%) of the storm drains (P Aedes mosquitoes (mainly Culex spp.) in the storm drains also decreased after the intervention. This study exemplifies how a simple intervention targeting storm drains can result in a major reduction of water retention, and, consequently, impact Ae. aegypti larval populations. Larger and multi-center evaluations are needed to confirm the potential of citywide structural modifications of storm drains to reduce Aedes spp. infestation level.

  12. Pesticide transport to tile-drained fields in SWAT model – macropore flow and sediment

    DEFF Research Database (Denmark)

    Lu, Shenglan; Trolle, Dennis; Blicher-Mathiesen, Gitte

    2015-01-01

    Tool (SWAT) to simulate transport of both mobile (e.g. Bentazon) and strongly sorbed (e.g. Diuron) pesticides in tile drains. Macropore flow is initiated when soil water content exceeds a threshold and rainfall intensity exceeds infiltration capacity. The amount of macropore flow is calculated...... to macropore sediment transport. Simulated tile drain discharge, sediment and pesticide loads are calibrated against data from intensively monitored tile-drained fields and streams in Denmark....

  13. Brain drain in globalization A general equilibrium analysis from the sending countries’ perspective

    OpenAIRE

    Luca MARCHIORI; I-Ling SHEN; Frederic DOCQUIER

    2009-01-01

    The paper assesses the global effects of brain drain on developing economies and quantifies the relative sizes of various static and dynamic impacts. By constructing a unified generic framework characterized by overlapping generations dynamics and calibrated to real data, this study incorporates many direct impacts of brain drain whose interactions, along with other indirect effects, are endogenously and dynamically generated. Our findings suggest that the short-run impact of brain drain on r...

  14. Stress corrosion on austenitic stainless steels components after sodium draining

    International Nuclear Information System (INIS)

    Champeix, L.; Baque, P.; Chairat, C.

    1980-04-01

    The damage study performed on 316 pipes of a loop after two leakages allows to conclude that a stress corrosion process in sodium hydroxide environment has induced trans-crystaline cracks. The research of conditions inducing such a phenomenon is developed, including parametric tests under uniaxial load and some tests on pipe with welded joints. In aqueous sodium hydroxide, two corrosion processes have been revealed: a general oxidization increasing with environment aeration and a transcrystalline cracking appearing for stresses of the order of yield strength. Other conditions such a temperature (upper than 100 0 C) and time exposures (some tens of hours) are necessary. Cautions in order to limit introduction of wet air into drained loop and a choice of appropriate preheating conditions when restarting the installation must permit to avoid such a type of incident

  15. Brain drain: a challenge to global mental health.

    Science.gov (United States)

    Oladeji, Bibilola D; Gureje, Oye

    2016-08-01

    The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.

  16. Reducing resin use in floor drain processing system

    International Nuclear Information System (INIS)

    Flint, W.; Hobart, S.A.; Miller, A.D.

    1995-01-01

    The Kewaunee Nuclear Power Plant utilizes two mixed bed demineralizers for processing floor drain wastes. These demineralizers were originally designed for stream generator blowdown treatment, but were not needed for that purpose. Effluent from the resin beds is monitored for radioactivity and released for discharge. Plant radwaste inleakage volumes and resin disposal volumes were low in comparison with industry averages, but decontamination factors through the treatment system were less than desirable. Release criteria for discharges always had been met, but plant personnel wished to decrease their already low discharges of radioactive species, reduce their resin disposal costs, and provide a margin of safety in the unlikely event that fuel damage would be experienced during an operating cycle. This paper describes the study initiated to address those issues, the findings of the study, and results of implementing some of the study recommendations

  17. Nuclear power plant laundry drain treatment using membrane bio reactor

    International Nuclear Information System (INIS)

    Tsukamoto, Masaaki; Kohanawa, Osamu; Kinugasa, Atsushi; Ogawa, Naoki; Murogaki, Kenta

    2012-01-01

    In nuclear power plant, the radioactive effluent generated by washing the clothes worn in controlled area and the hand and shower water used at the controlled area are treated in laundry drain treatment system. Although various systems which treat such liquid waste preexist, the traditional treatment system has disadvantages such as high running cost and a large amount of secondary waste generation. To solve these matters, we have considered application of an activated sludge system, membrane bio reactor, which has been practically used in general industry. For nuclear power plant, the activated sludge system has been developed, tested in its adaptability and the adequacy has been proved. Some preexisting treatment systems have been replaced with this activated sludge system for the first time in a domestic nuclear power plant, and the renewal system is now in operation. The result is reported. (author)

  18. Centrifuge modelling of drained lateral pile - soil response

    DEFF Research Database (Denmark)

    Klinkvort, Rasmus Tofte

    of rigid piles. The tests have been performed in homogeneously dense dry or saturated Fontainebleau sand in order to mimic simplified drained offshore soil conditions. Approximately half of the tests have been carried out to investigate the centrifuge procedure in order to create a methodology of testing...... tests were used to investigate the pile - soil interaction to gain a better in-sight into the complex problem. A monotonic test series was carried out initially and then pile - soil interaction curves were deduced from these tests and compared with methodologies used today. The results indicate...... that the current methodologies can be improved and a modification to the methodology has been proposed. Secondly, a cyclic test series was carried out. The accumulation of displacement and the change in secant stiffness of the total response of these tests were evaluated. A simple mathematical model was proposed...

  19. Muscular anatomy of the human ventricular folds.

    Science.gov (United States)

    Moon, Jerald; Alipour, Fariborz

    2013-09-01

    Our purpose in this study was to better understand the muscular anatomy of the ventricular folds in order to help improve biomechanical modeling of phonation and to better understand the role of these muscles during phonatory and nonphonatory tasks. Four human larynges were decalcified, sectioned coronally from posterior to anterior by a CryoJane tape transfer system, and stained with Masson's trichrome. The total and relative areas of muscles observed in each section were calculated and used for characterizing the muscle distribution within the ventricular folds. The ventricular folds contained anteriorly coursing thyroarytenoid and ventricularis muscle fibers that were in the lower half of the ventricular fold posteriorly, and some ventricularis muscle was evident in the upper and lateral portions of the fold more anteriorly. Very little muscle tissue was observed in the medial half of the fold, and the anterior half of the ventricular fold was largely devoid of any muscle tissue. All 4 larynges contained muscle bundles that coursed superiorly and medially through the upper half of the fold, toward the lateral margin of the epiglottis. Although variability of expression was evident, a well-defined thyroarytenoid muscle was readily apparent lateral to the arytenoid cartilage in all specimens.

  20. CSER 94-011: Use of glovebags for demister draining operations

    International Nuclear Information System (INIS)

    Hess, A.L.

    1994-01-01

    A criticality safety review is presented for the use of plastic-sheet glovebags for the operations of draining demisters on the 26-inch vacuum system headers. A criticality drain is required because of the possibility for spilling liquid of sufficient volume and fissile content for criticality. It is recommended that the glovebag design include a rigid, 2ft x 2ft floor with a central drain feeding a geometrically favorable spill-catch vessel, plus a screen grid above the bottom for drain protection

  1. Method of draining water through a solid waste site without leaching

    Science.gov (United States)

    Treat, Russell L.; Gee, Glendon W.; Whyatt, Greg A.

    1993-01-01

    The present invention is a method of preventing water from leaching solid waste sites by preventing atmospheric precipitation from contacting waste as the water flows through a solid waste site. The method comprises placing at least one drain hole through the solid waste site. The drain hole is seated to prevent waste material from entering the drain hole, and the solid waste site cover material is layered and graded to direct water to flow toward the drain hole and to soil beneath the waste site.

  2. Estimation of local and regional components of drain - flow from an irrigated field

    International Nuclear Information System (INIS)

    Eching, S.O.; Hopmans, J.W.; Wallender, W.W.; Macyntyre, J.L.; Peters, D.

    1995-01-01

    The contribution of regional ground water and deep percolation from a furrow irrigated field to total drain flow was estimated using salt load analysis. It was found that 64% of the drain flow comes from regional ground water flow. The electrical conductivity of the drain water was highly correlated with the drain flow rate. From the field water balance with deep percolation as estimated from the salt load analysis, using yield function derived evapotranspiration, and measured changes in root zone water storage, it was shown that 14% of the crop evapotranspiration comes from ground water during the study period. 8 figs; 5 tabs; 15 refs ( Author )

  3. Ventricular and myocardial scintiscanning: Methodical fundamentals

    International Nuclear Information System (INIS)

    Standke, R.; Hoer, G.; Maul, F.D.

    1984-01-01

    Nuclear cardiology is concerned with non invasive procedures to quantitate global and regional left ventricular function (Radionuclide ventriculography), also the imaging of vitally perfused myocardium (Myocardial scintigraphy) is achieved. A gammacamera and a minicomputer are necessary. Radionuclide ventriculography enables the analysis of global and regional time dependent left ventricular volume curves and hence the evaluation of contraction and contractility of the heart muscle. The basis is a sequence of scans covering an average heartcycle. This sequence may be produced either by first pass or equilibrium technique. Myocardial scintigraphy at rest images vital myocardium, scans immediately after exercise represent the interference of myocardial perfusion and muscle mass. The regional difference (Redistribution) between normalized exercise- and rest scans provide quantitative parameters to detect impairment of exercise-induced myocardial perfusion anomalies. The procedures of sectorial analysis of left ventricular function and myocardial perfusion are presented. (orig.) [de

  4. Left ventricular hypertrophy: virtuous intentions, malign consequences.

    Science.gov (United States)

    Pokharel, Saraswati; Sharma, Umesh C; Pinto, Yigal M

    2003-06-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca(2+) homeostasis, there are structural changes in myofilaments, disorganization of the cytoskeletal framework and increased collagen synthesis. LVH is associated with progressive left ventricular remodeling that culminates to heart failure. The modern treatment of left ventricular hypertrophy is now largely based on the hypothesis that neuroendocrine activation is important in the progression of the disease and inhibition of neurohormones is likely to have long-term benefit with regard to morbidity and mortality. Drugs specifically designed to unload the left ventricle, such as diuretics and vasodilators, appears to be less effective in reducing LV mass and improving prognosis. Thus, the evolution of treatment for LVH itself has provided much enlightenment for our understanding of the fundamental biology of the disorder.

  5. [External cephalic version].

    Science.gov (United States)

    Navarro-Santana, B; Duarez-Coronado, M; Plaza-Arranz, J

    2016-08-01

    To analyze the rate of successful external cephalic versions in our center and caesarean sections that would be avoided with the use of external cephalic versions. From January 2012 to March 2016 external cephalic versions carried out at our center, which were a total of 52. We collected data about female age, gestational age at the time of the external cephalic version, maternal body mass index (BMI), fetal variety and situation, fetal weight, parity, location of the placenta, amniotic fluid index (ILA), tocolysis, analgesia, and newborn weight at birth, minor adverse effects (dizziness, hypotension and maternal pain) and major adverse effects (tachycardia, bradycardia, decelerations and emergency cesarean section). 45% of the versions were unsuccessful and 55% were successful. The percentage of successful vaginal delivery in versions was 84% (4% were instrumental) and 15% of caesarean sections. With respect to the variables studied, only significant differences in birth weight were found; suggesting that birth weight it is related to the outcome of external cephalic version. Probably we did not find significant differences due to the number of patients studied. For women with breech presentation, we recommend external cephalic version before the expectant management or performing a cesarean section. The external cephalic version increases the proportion of fetuses in cephalic presentation and also decreases the rate of caesarean sections.

  6. Piezosurgery in External Dacryocystorhinostomy.

    Science.gov (United States)

    Czyz, Craig N; Fowler, Amy M; Dutton, Jonathan J; Cahill, Kenneth V; Foster, Jill A; Hill, Robert H; Everman, Kelly R; Nabavi, Cameron B

    Dacryocystorhinostomy (DCR) can be performed via an external or endoscopic approach. The use of ultrasonic or piezosurgery has been well described for endoscopic DCRs but is lacking for external DCRs. This study presents a case series of external DCRs performed using piezosurgery evaluating results and complications. Prospective, consecutive case series of patients undergoing primary external DCR for lacrimal drainage insufficiency. A standard external DCR technique was used using 1 of 2 piezosurgery systems for all bone incision. All patients received silicone intubation to the lacrimal system. Surgical outcome was measured in terms of patient-reported epiphora as follows: 1) complete resolution, 2) improvement >50%, 3) improvement 50% improvement. There were 4 patients (7%) who had <50% improvement. There was 1 (2%) intraoperative complication and 2 (4%) postoperative complications recorded. Piezourgery is a viable modality for performing external DCRs. The lack of surgical complications shows a potential for decreased soft tissues damage. The surgical success rate based on patient-reported epiphora is similar to those published for mechanical external DCRs. This modality may benefit the novice surgeon in the reduction of soft and mucosal tissue damage.

  7. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2014-05-15

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

  8. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    International Nuclear Information System (INIS)

    Tassi, Eduardo Marinho; Continentino, Marcelo Abramoff; Nascimento, Emília Matos do; Pereira, Basílio de Bragança; Pedrosa, Roberto Coury

    2014-01-01

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups

  9. Left cardiac sympathetic denervation for catecholaminergic polymorphic ventricular tachycardia

    NARCIS (Netherlands)

    Wilde, Arthur A. M.; Bhuiyan, Zahurul A.; Crotti, Lia; Facchini, Mario; de Ferrari, Gaetano M.; Paul, Thomas; Ferrandi, Chiara; Koolbergen, Dave R.; Odero, Attilio; Schwartz, Peter J.

    2008-01-01

    Catecholaminergic polymorphic ventricular tachycardia is a potentially lethal disease characterized by adrenergically mediated ventricular arrhythmias manifested especially in children and teenagers. Beta-blockers are the cornerstone of therapy, but some patients do not have a complete response to

  10. Evaluation of right ventricular volumes measured by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Møgelvang, J; Stubgaard, M; Thomsen, C

    1988-01-01

    stroke volume was calculated as the difference between end-diastolic and end-systolic volume and compared to left ventricular stroke volume and to stroke volume determined simultaneously by a classical indicator dilution technique. There was good agreement between right ventricular stroke volume......Right ventricular volumes were determined in 12 patients with different levels of right and left ventricular function by magnetic resonance imaging (MRI) using an ECG gated multisection technique in planes perpendicular to the diastolic position of the interventricular septum. Right ventricular...... determined by MRI and by the indicator dilution method and between right and left ventricular stroke volume determined by MRI. Thus, MRI gives reliable values not only for left ventricular volumes, but also for right ventricular volumes. By MRI it is possible to obtain volumes from both ventricles...

  11. An Incidentally Detected Right Ventricular Pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Vamsi C. Gaddipati

    2017-01-01

    Full Text Available Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

  12. Left ventricular performance during psychological stress

    International Nuclear Information System (INIS)

    Young, D.Z.; Massachusetts General Hospital, Boston; Dimsdale, J.E.; Moore, R.H.; Barlai-Kovach, M.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Fifer, M.A.; Strauss, H.W.

    1989-01-01

    Left ventricular ejection fraction, systolic blood pressure and plasma norepinephrine were measured in six normotensive and six mildly hypertensive subjects during rest and psychological stress. Compared with rest, 8 of the 12 subjects developed significant changes in ejection fraction (increase in 6, decrease in 2); 10 of 12 subjects developed significant elevations of plasma norepinephrine; and all developed significant increases in systolic blood pressure. When the stress effects were examined for the total group, as opposed to within subjects, there were significant increases in plasma norepinephrine and systolic blood pressure but, interestingly, mean ejection fraction and stroke volume remained unchanged, implying stress led to increased left ventricular contractility. (orig.)

  13. Nuclear medical diagnostic with ventricular aneurysm

    International Nuclear Information System (INIS)

    Litter, H.

    1987-01-01

    In the diagnostic of ventricular aneurysms myocardial scintigraphy and above all radionuclide ventriculography (RNV) have special importance. Because of the non-invasive method and the as a result safe and easy use even with stress studies, RNV can provide a very valuable aid with aneurysm patients in early diagnosis, evaluation of the operability and as well as in the prognosis. It must be noted, however, that the differentiation of multivascular diseases and sometimes ventricular aneurysms can be difficult and the inclusion of an angiocardiograph as a radiological invasive examination procedure seems fitting. (orig./MG) [de

  14. Bidirectional ventricular tachycardia of unknown etiology

    International Nuclear Information System (INIS)

    Ali, M.; Khan, J.A.; Masood, T.; Shamsi, F.; Dero, M.H.; Khan, S.

    2013-01-01

    A 45 years old male presented to the emergency department with palpitations, headache and apprehension. His electrocardiogram revealed bidirectional ventricular tachycardia. He remained vitally stable and responded to intravenous beta-blocker. Initially digitalis toxicity was suspected but history was negative for digitalis intake. The cause remained unidentified in patient despite detailed investigations. During a short follow-up (of 6 months) he remained asymptomatic and no cause was further identified during this period. Some other unseen causes of bidirectional ventricular tachycardia need to be explored. (author)

  15. Catecholaminergic polymorphic ventricular tachycardia in 2012

    Directory of Open Access Journals (Sweden)

    Christian van der Werf

    2011-12-01

    Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a rare, potentially lethal inherited arrhythmia syndrome characterized by stress or emotion-induced ventricular arrhythmias. CPVT was first described in 1960, while the genetic basis underlying this syndrome was discovered in 2001. The past decade has seen substantial advances in understanding the pathophysiology of CPVT. In addition, significant advances have been made in elucidating clinical characteristics of CPVT patients and new treatment options have become available. Here, we review current literature on CPVT to present state-of-the-art knowledge on the subject of the genetic basis, pathophysiology, clinical presentation, diagnosis, treatment and prognosis.

  16. Isolated left ventricular non-compaction cardiomyopathy associated with polymorphous ventricular tachycardia mimicking torsades de pointes

    Directory of Open Access Journals (Sweden)

    Oana Dickinson

    2013-02-01

    Full Text Available Left ventricular non-compaction (LVNC cardiomyopathy is a rare congenital disorder, classified by the American Heart Association as a primary genetic cardiomyopathy and characterized by multiple trabeculations within the left ventricle. LVNC cardiomyopathy has been associated with 3 major clinical manifestations: heart failure, atrial and ventricular arrhythmias and thromboembolic events, including stroke. In this case report, we describe a female patient with apparently isolated LVNC in whom pause-dependent polymorphic ventricular tachycardia suggesting torsades de pointes occurred in the presence of a normal QT interval.

  17. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  18. Liquefaction under drained condition, from the lab to reality ?

    Science.gov (United States)

    Clément, Cécile; Aharonov, Einat; Stojanova, Menka; Toussaint, Renaud

    2015-04-01

    Liquefaction constitutes a significant natural hazard in relation to earthquakes and landslides. This effect can cause buildings to tilt or sink into the soil, mud-volcanoes, floatation of buried objects, long-runout landslides, etc. In this work we present a new understanding regarding the mechanism by which buildings sink and tilt during liquefaction caused by earthquakes. Conventional understanding of liquefaction explains most observed cases as occurring in an undrained, under-compacted, layer of sandy soil saturated with water [1]: According to that understanding, the under compacted sandy layer has the tendency to compact when a load is applied. In our case the load comes from ground shaking during an earthquake. When the soil compacts, the fluid pore pressure rises. Because in undrained conditions the fluid cannot flow out, the pore pressure builds up. The weight of buildings is in this case transferred from the grains of the soil to the pore water. The soil loses its rigidity and it flows like a liquid. From this model scientists made theoretical and empirical laws for geotechnical use and buildings construction. Despite the success of this conventional model in many cases, liquefied soils were also observed under drained conditions, and in previously compacted soils, which doesn't agree with the assumption of the model quoted above. One of the famous liquefaction events is the Kobe port destruction during the 1995 earthquake. A simple calculation of the Deborah number following Goren et al ([2][3]) shows that the undrained constraint was not met below the Kobe port during the 1995 earthquake. We propose another model, of liquefaction in drained granular media. According to our model the mere presence of water in granular media is enough to cause liquefaction during an earthquake, provided that the water reaches close to the surface. Our computations are based on the buoyancy force, and we take into account the static fluid pressure only. For small

  19. Automated External Defibrillator

    Science.gov (United States)

    ... leads to a 10 percent reduction in survival. Training To Use an Automated External Defibrillator Learning how to use an AED and taking a CPR (cardiopulmonary resuscitation) course are helpful. However, if trained ...

  20. Energy policy and externalities

    International Nuclear Information System (INIS)

    Bertel, E.; Fraser, P.

    2002-01-01

    External costs of energy have been assessed in a number of authoritative and reliable studies based upon widely accepted methodologies such as life cycle analysis (LCA). However, although those costs are recognised by most stakeholders and decision makers, results from analytical work on externalities and LCA studies are seldom used in policy making. The International Energy Agency (IEA) and the Nuclear Energy Agency (NEA) convened a joint workshop in November 2001 to offer experts and policy makers an opportunity to present state-of-the-art results from analytical work on externalities and debate issues related to the relevance of external costs and LCA for policy-making purposes. The findings from the workshop highlight the need for further work in the field and the potential rote of international organisations like the IEA and the NEA in this context. (authors)

  1. Externally Verifiable Oblivious RAM

    Directory of Open Access Journals (Sweden)

    Gancher Joshua

    2017-04-01

    Full Text Available We present the idea of externally verifiable oblivious RAM (ORAM. Our goal is to allow a client and server carrying out an ORAM protocol to have disputes adjudicated by a third party, allowing for the enforcement of penalties against an unreliable or malicious server. We give a security definition that guarantees protection not only against a malicious server but also against a client making false accusations. We then give modifications of the Path ORAM [15] and Ring ORAM [9] protocols that meet this security definition. These protocols both have the same asymptotic runtimes as the semi-honest original versions and require the external verifier to be involved only when the client or server deviates from the protocol. Finally, we implement externally verified ORAM, along with an automated cryptocurrency contract to use as the external verifier.

  2. follow-up of patients with arrhythmogenic right ventricular

    African Journals Online (AJOL)

    was sudden, 1 patient died due to left ventricular failure, and ... Arrhythmogenic right ventricular cardiomyopathy/ dysplasia .... hypertension and from atrial fibrillation that developed 2.4 .... of left ventricular function was global without regional ..... 99mTc he brain si before a acid (G minute his sem next 3 - his sem showed.

  3. Left Ventricular Geometry In Nigerians With Type II Diabetes Mellitus ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower ...

  4. Use of Ventricular Assist Device in Univentricular Physiology: The Role of Lumped Parameter Models.

    Science.gov (United States)

    Di Molfetta, Arianna; Ferrari, Gianfranco; Filippelli, Sergio; Fresiello, Libera; Iacobelli, Roberta; Gagliardi, Maria G; Amodeo, Antonio

    2016-05-01

    Failing single-ventricle (SV) patients might benefit from ventricular assist devices (VADs) as a bridge to heart transplantation. Considering the complex physiopathology of SV patients and the lack of established experience, the aim of this work was to realize and test a lumped parameter model of the cardiovascular system, able to simulate SV hemodynamics and VAD implantation effects. Data of 30 SV patients (10 Norwood, 10 Glenn, and 10 Fontan) were retrospectively collected and used to simulate patients' baseline. Then, the effects of VAD implantation were simulated. Additionally, both the effects of ventricular assistance and cavopulmonary assistance were simulated in different pathologic conditions on Fontan patients, including systolic dysfunction, diastolic dysfunction, and pulmonary vascular resistance increment. The model can reproduce patients' baseline well. Simulation results suggest that the implantation of VAD: (i) increases the cardiac output (CO) in all the three palliation conditions (Norwood 77.2%, Glenn 38.6%, and Fontan 17.2%); (ii) decreases the SV external work (SVEW) (Norwood 55%, Glenn 35.6%, and Fontan 41%); (iii) increases the mean pulmonary arterial pressure (Pap) (Norwood 39.7%, Glenn 12.1%, and Fontan 3%). In Fontan circulation, with systolic dysfunction, the left VAD (LVAD) increases CO (35%), while the right VAD (RVAD) determines a decrement of inferior vena cava pressure (Pvci) (39%) with 34% increment of CO. With diastolic dysfunction, the LVAD increases CO (42%) and the RVAD decreases the Pvci. With pulmonary vascular resistance increment, the RVAD allows the highest CO (50%) increment with the highest decrement of Pvci (53%). The single ventricular external work (SVEW) increases (decreases) increasing the VAD speed in cavopulmonary (ventricular) assistance. Numeric models could be helpful in this challenging and innovative field to support patients and VAD selection to optimize the clinical outcome and personalize the therapy

  5. Draining Water from Aircraft Fuel Using Nitrogen Enriched Air

    Directory of Open Access Journals (Sweden)

    Michael Frank

    2018-04-01

    Full Text Available This paper concerns a computational study of the process of removing water from an aircraft’s fuel tank by pumping nitrogen enriched air (NEA from the bottom of the tank. This is an important procedure for the smooth, efficient, and safe operation of the aircraft’s engine. Due to the low partial pressure of water in the pumped NEA, it absorbs water from the fuel. The water-laden bubbles enter the ullage, the empty space above the fuel, and escape into the environment. The effects of the number of NEA inlets and the NEA mass flow rate on the timescale of the NEA pumping were investigated using Computational Fluid Dynamics. The results reveal that the absorption of water by the NEA bubbles is low and is not affected by the number of the inlets used. Yet, the water content in the fuel decreases fast during the procedure, which is the desired outcome. We show that this is due to the relatively dry NEA entering the ullage and displacing the moist air, thus reducing the partial pressure of water at the fuel/ullage interface. This shift from equilibrium conditions forces water to evaporate from the fuel’s entire surface. Furthermore, the amount of water migrating from the fuel directly into the ullage is significantly greater than that absorbed by the rising bubbles. In turn, the rate of decrease of the water content in the ullage is determined by the total NEA mass flow rate and this is the dominant contributor to the draining time, with the number of NEA nozzles playing a minor role. We confirmed this by pumping NEA directly into the ullage, where we observe a significant decrease of water even when the NEA is not pumped through the fuel. We also show that doubling the mass flow rate halves the draining time. When considering the capability of most modern aircraft to pump NEA through the fuel as part of their inerting system, the proposed method for removing water is particularly attractive, requiring very little (if at all design modification.

  6. Filling, storing and draining. Three key aspects of landslide hydrology

    Science.gov (United States)

    Bogaard, Thom; Greco, Roberto

    2016-04-01

    Rainfall-triggered landslides are among the most widespread hazards in the world. The hydrology in and around a landslide area is key to pore pressure build-up in the soil skeleton which reduces shear strength due to the buoyancy force exerted by water in a saturated soil and to soil suction in an unsaturated soil. Extraordinary precipitation events trigger most of the landslides, but, at the same time, the vast majority of slopes do not fail. The intriguing question is: 'When and where exactly can a slope become triggered to slide and flow downwards?' The objective of this article is to present and discuss landslide hydrology at three scales - pore, hillslope, and catchment - which, taken together, give an overview of this interdisciplinary science. In fact, for rainfall-triggered landslides to occur, an unfavourable hydrological interplay should exist between fast and/or prolonged infiltration, and a relatively 'slow' drainage. The competition of water storage, pressure build-up and the subsequently induced drainage contains the importance of the timing, which is indisputably one of the more delicate but relevant aspects of landslide modelling, the overlay of hydrological processes with different time scales. As slopes generally remain stable, we can argue that effective drainage mechanisms spontaneously develop, as the best for a slope to stay stable is getting rid of the overload of water (above field capacity), either vertically or laterally. So, landslide hydrology could be framed as 'Filling-Storing-Draining'. Obviously, 'Storing' is added to stress the importance of dynamic pressure build-up for slope stability. 'Draining' includes all removal of water from the system (vertical and lateral flow, evaporation and transpiration) and thus pore water pressure release. Furthermore, by addressing landslide hydrology from both earth sciences and soil mechanics perspectives, we aim to manifest the hydrological processes in hillslopes and their influence on behaviour

  7. Management of Chest Drains: A National Survey on Surgeons‑in ...

    African Journals Online (AJOL)

    triangle of safety [Figure 1]. Just above a quarter of respondents (27.2%) always utilized different sizes of tubes for different pathologies and the same proportion of respondents always positioned the tip of the tube apically to drain pneumothorax and basally to drain pleural effusion. In contrast, 9.9% and 6.2% of respondents.

  8. Controlling the ambipolarity and improvement of RF performance using Gaussian Drain Doped TFET

    Science.gov (United States)

    Nigam, Kaushal; Gupta, Sarthak; Pandey, Sunil; Kondekar, P. N.; Sharma, Dheeraj

    2018-05-01

    Ambipolar conduction in tunnel field-effect transistors (TFETs) has been occurred as an inherent issue due to drain-channel tunneling. It makes TFET less efficient and restricts its application in complementary digital circuits. Therefore, this manuscript reports the application of Gaussian doping profile on nanometer regime silicon channel TFETs to completely eliminate the ambipolarity. For this, Gaussian doping is used in the drain region of conventional gate-drain overlap TFET to control the tunneling of electrons from the valence band of channel to the conduction band of drain. As a result, barrier width at the drain/channel junction increases significantly leading to the suppression of an ambipolar current even when higher doping concentration (1 ? 10 ? cm ?) is considered in the drain region. However, significant improvement in terms of RF figure-of-merits such as cut-off frequency (f ?), gain bandwidth product (GBW), and gate-to-drain capacitance (C ?) is achieved with Gaussian doped gate on drain overlap TFET as compared to its counterpart TFET.

  9. 77 FR 30886 - Virginia Graeme Baker Pool and Spa Safety Act; Interpretation of Unblockable Drain

    Science.gov (United States)

    2012-05-24

    ... interpretation and installed unblockable drain covers and now would have to go back and ``re-do'' their work... compliance and whether the pool operator is seeking a plan review and not just limited advice about how to... secondary anti-entrapment system to come into compliance, unless the pool uses a gravity drain system or the...

  10. Laparoscopic elective cholecystectomy with and without drain: A controlled randomised trial

    Directory of Open Access Journals (Sweden)

    Gouda El-labban

    2012-01-01

    Full Text Available Background : Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Routine drainage after laparoscopic cholecystectomy is an issue of considerable debate. Therefore, a controlled randomised trial was designed to assess the value of drains in elective laparoscopic cholecystectomy. Materials and Methods: During a two-year period (From April 2008 to January 2010, 80 patients were simply randomised to have a drain placed (group A, an 8-mm pentose tube drain was retained below the liver bed, whereas 80 patients were randomised not to have a drain (group B placed in the subhepatic space. End points of this trial were to detect any differences in morbidity, postoperative pain, wound infection and hospital stay between the two groups. Results : There was no mortality in either group and no statistically significant difference in postoperative pain, nausea and vomiting, wound infection or abdominal collection between the two groups. However, hospital stay was longer in the drain group than in group without drain and it is appearing that the use of drain delays hospital discharge. Conclusion : The routine use of a drain in non-complicated laparoscopic cholecystectomy has nothing to offer; in contrast, it is associated with longer hospital stay.

  11. Drain Tube-Induced Jejunal Penetration Masquerading as Bile Leak following Whipple's Operation.

    Science.gov (United States)

    Bae, Sang Ho; Lee, Tae Hoon; Lee, Sae Hwan; Lee, Suck-Ho; Park, Sang-Heum; Kim, Sun-Joo; Kim, Chang Ho

    2011-05-01

    A 70-year-old man had undergone pancreaticoduodenectomy due to a distal common bile duct malignancy. After the operation, serous fluid discharge decreased from two drain tubes in the retroperitoneum. Over four weeks, the appearance of the serous fluid changed to a greenish bile color and the patient persistently drained over 300 ml/day. Viewed as bile leak at the choledochojejunostomy, treatment called for endoscopic diagnosis and therapy. Cap-fitted forward-viewing endoscopy demonstrated that the distal tip of a pancreatic drain catheter inserted at the pancreaticojejunostomy site had penetrated the opposite jejunum wall. One of the drain tubes primarily placed in the retroperitoneum had also penetrated the jejunum wall, with the distal tip positioned near the choledochojejunostomy site. No leak of contrast appeared beyond the jejunum or anastomosis site. Following repositioning of a penetrating catheter of the pancreaticojejunostomy, four days later, the patient underwent removal of two drain tubes without additional complications. In conclusion, the distal tip of the catheter, placed to drain pancreatic juice, penetrated the jejunum wall and may have caused localized perijejunal inflammation. The other drain tube, placed in the retroperitoneal space, might then have penetrated the inflamed wall of the jejunum, allowing persistent bile drainage via the drain tube. The results masqueraded as bile leakage following pancreaticoduodenectomy.

  12. Nurses’ knowledge of care of chest drain: A survey in a Nigerian semiurban university hospital

    Science.gov (United States)

    Kesieme, Emeka Blessius; Essu, Ifeanyichukwu Stanley; Arekhandia, Bruno Jeneru; Welcker, Katrin; Prisadov, Georgi

    2016-01-01

    Background/Objective: Inefficient nursing care of chest drains may associated with unacceptable and sometimes life-threatening complications. This report aims to ascertain the level of knowledge of care of chest drains among nurses working in wards in a teaching hospital in Nigeria. Methods: A cross-sectional study among nurses at teaching hospital using pretested self-administered questionnaires. Results: The majority were respondents aged between 31 and 40 years (45.4%) and those who have nursing experience between 6 and 10 years. Only 37 respondents (26.2%) had a good knowledge of nursing care of chest drains. Knowledge was relatively higher among nurses who cared for chest drains daily, nurses who have a work experience of 0.05). Performance was poor on the questions on position of drainage system were not statistically significant with relationship to waist level while mobilizing the patient, application of suction to chest drains, daily changing of dressing over chest drain insertion site, milking of tubes and drainage system with dependent loop. Conclusion: The knowledge of care of chest drains among nurses is poor, especially in the key post procedural care. There is an urgent need to train them so as to improve the nursing care of patients managed with chest drains. PMID:26857934

  13. Drain Tube-Induced Jejunal Penetration Masquerading as Bile Leak following Whipple’s Operation

    Directory of Open Access Journals (Sweden)

    Sang Ho Bae

    2011-05-01

    Full Text Available A 70-year-old man had undergone pancreaticoduodenectomy due to a distal common bile duct malignancy. After the operation, serous fluid discharge decreased from two drain tubes in the retroperitoneum. Over four weeks, the appearance of the serous fluid changed to a greenish bile color and the patient persistently drained over 300 ml/day. Viewed as bile leak at the choledochojejunostomy, treatment called for endoscopic diagnosis and therapy. Cap-fitted forward-viewing endoscopy demonstrated that the distal tip of a pancreatic drain catheter inserted at the pancreaticojejunostomy site had penetrated the opposite jejunum wall. One of the drain tubes primarily placed in the retroperitoneum had also penetrated the jejunum wall, with the distal tip positioned near the choledochojejunostomy site. No leak of contrast appeared beyond the jejunum or anastomosis site. Following repositioning of a penetrating catheter of the pancreaticojejunostomy, four days later, the patient underwent removal of two drain tubes without additional complications. In conclusion, the distal tip of the catheter, placed to drain pancreatic juice, penetrated the jejunum wall and may have caused localized perijejunal inflammation. The other drain tube, placed in the retroperitoneal space, might then have penetrated the inflamed wall of the jejunum, allowing persistent bile drainage via the drain tube. The results masqueraded as bile leakage following pancreaticoduodenectomy.

  14. A mathematical model to optimize the drain phase in gravity-based peritoneal dialysis systems.

    Science.gov (United States)

    Akonur, Alp; Lo, Ying-Cheng; Cizman, Borut

    2010-01-01

    Use of patient-specific drain-phase parameters has previously been suggested to improve peritoneal dialysis (PD) adequacy. Improving management of the drain period may also help to minimize intraperitoneal volume (IPV). A typical gravity-based drain profile consists of a relatively constant initial fast-flow period, followed by a transition period and a decaying slow-flow period. That profile was modeled using the equation VD(t) = (V(D0) - Q(MAX) x t) xphi + (V(D0) x e(-alphat)) x (1 - phi), where V(D)(t) is the time-dependent dialysate volume; V(D0), the dialysate volume at the start of the drain; Q(MAX), the maximum drain flow rate; alpha, the exponential drain constant; and phi, the unit step function with respect to the flow transition. We simulated the effects of the assumed patient-specific maximum drain flow (Q(MAX)) and transition volume (psi), and the peritoneal volume percentage when transition occurs,for fixed device-specific drain parameters. Average patient transport parameters were assumed during 5-exchange therapy with 10 L of PD solution. Changes in therapy performance strongly depended on the drain parameters. Comparing 400 mL/85% with 200 mL/65% (Q(MAX/psi), drain time (7.5 min vs. 13.5 min) and IPV (2769 mL vs. 2355 mL) increased when the initial drain flow was low and the transition quick. Ultrafiltration and solute clearances remained relatively similar. Such differences were augmented up to a drain time of 22 minutes and an IPV of more than 3 L when Q(MAX) was 100 mL/min. The ability to model individual drain conditions together with water and solute transport may help to prevent patient discomfort with gravity-based PD. However, it is essential to note that practical difficulties such as displaced catheters and obstructed flow paths cause variability in drain characteristics even for the same patient, limiting the clinical applicability of this model.

  15. Flecainide Therapy Reduces Exercise-Induced Ventricular Arrhythmias in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia

    NARCIS (Netherlands)

    van der Werf, Christian; Kannankeril, Prince J.; Sacher, Frederic; Krahn, Andrew D.; Viskin, Sami; Leenhardt, Antoine; Shimizu, Wataru; Sumitomo, Naokata; Fish, Frank A.; Bhuiyan, Zahurul A.; Willems, Albert R.; van der Veen, Maurits J.; Watanabe, Hiroshi; Laborderie, Julien; Haïssaguerre, Michel; Knollmann, Björn C.; Wilde, Arthur A. M.

    2011-01-01

    Objectives This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac

  16. Frequency-dependent left ventricular performance in women and men.

    Science.gov (United States)

    Wainstein, Rodrigo V; Sasson, Zion; Mak, Susanna

    2012-06-01

    We aimed to determine whether sex differences in humans extend to the dynamic response of the left ventricular (LV) chamber to changes in heart rate (HR). Several observations suggest sex influences LV structure and function in health; moreover, this physiology is also affected in a sex-specific manner by aging. Eight postmenopausal women and eight similarly aged men underwent a cardiac catheterization-based study for force-interval relationships of the LV. HR was controlled by right atrial (RA) pacing, and LV +dP/dt(max) and volume were assessed by micromanometer-tipped catheter and Doppler echocardiography, respectively. Analysis of approximated LV pressure-volume relationships was performed using a time-varying model of elastance. External stroke work was also calculated. The relationship between HR and LV +dP/dt(max) was expressed as LV +dP/dt(max) = b + mHR. The slope (m) of the relationship was steeper in women compared with men (11.8 ± 4.0 vs. 6.1 ± 4.1 mmHg·s(-1)·beats(-1)·min(-1), P = 0.01). The greater increase in contractility in women was reproducibly observed after normalizing LV +dP/dt(max) to LV end-diastolic volume (LVVed) or by measuring end-systolic elastance. LVVed and stroke volume decreased more in women. Thus, despite greater increases in contractility, HR was associated with a lesser rise in cardiac output and a steeper fall in external stroke work in women. Compared with men, women exhibit greater inotropic responses to incremental RA pacing, which occurs at the same time as a steeper decline in external stroke work. In older adults, we observed sexual dimorphism in determinants of LV mechanical performance.

  17. Acute Right Ventricular Dysfunction Complicating Prolonged ...

    African Journals Online (AJOL)

    We report a case of transient right ventricular dysfunction associated with prolonged cardiac tamponade, an unusual complication of uncertain etiology. We believe that in this case dynamic coronary flow restriction resulted in ischemic injury and stunning of the right ventricle. Other possible causes are briefly reviewed. Right ...

  18. Left ventricular hypertrophy : virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, S; Sharma, UC; Pinto, YM

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca2+ homeostasis, there

  19. Left ventricular hypertrophy: virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, Saraswati; Sharma, Umesh C.; Pinto, Yigal M.

    2003-01-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca(2+) homeostasis, there

  20. Right ventricular myxoma with heart failure

    International Nuclear Information System (INIS)

    Nuri, M.M.H.; Naseem, A.; Raza, A.; Ahmad, W.; Raja, M.K.; Ahmad, A.; Rasheed, A.; Gohar, A.

    2005-01-01

    Cardiac myxomas are histologically benign tumors but they may be lethal because of their strategic position. These are mostly located in the left atrium and uncommonly in the right atrium. We report a case of a large right ventricular myxoma presenting with heart failure. (author)

  1. Oculo-peritoneal shunt: draining aqueous humor to the peritoneum

    Directory of Open Access Journals (Sweden)

    Ana Maldonado-Junyent

    2015-04-01

    Full Text Available In 2010, there were estimated to be approximately 60.5 million people with glaucoma. This number is expected to increase to 79.6 million by 2020. In 2010, there were 8.4 million people with bilateral blindness caused by glaucoma, and this number is expected in increase to 11.2 million by 2020. Filtering implants are special devices that have been developed to reduce intraocular pressure in patients with refractory glaucoma. The success rate of these implants is relatively low, and they continue to fail over time. To avoid failure caused by the formation of scar tissue around the implants, attempts have been made to drain the aqueous humor to various sites, including the venous system, lacrimal sac, sinuses, and conjunctival fornix. Recently, a system to shunt aqueous humor from the anterior chamber to the peritoneum has been developed. The surgical technique involved in this system is a modification of the technique currently used by neurosurgeons for the treatment of hydrocephalus. We present the first case operated using this technique.

  2. Crud separation from equipment drain of BWR atomic power station

    International Nuclear Information System (INIS)

    Hayashi, Masaru; Yamaguchi, Hisashi; Moriya, Yasuhiro; Koshiba, Yukihiko; Ota, Yoshiharu.

    1977-01-01

    In the primary cooling systems of BWR nuclear power stations, radioactive crud is generated and accumulates in reactors and circulating systems, which causes the radiation exposure of workers at the time of the inspection and maintenance of reactors. The chemical composition and grain size distribution of crud differ largely according to the construction of primary systems, the operational conditions of reactors, and the process of operation. The study on the application of nuclear pore membrane filter NPMF to the separation of crud in the waste water from equipment drain systems has been carried out. With the NPMF, clarified filtrate can be obtained without any filter aid, therefore the secondary waste of filter sludge is not generated. When the filter is clogged, the filtration capability can be regenerated by reverse flow washing, and continuous filtration is possible actually because the regeneration takes only short time. The NPMF is the polycarbonate membrane of about 10 μm thick, to which charged particles are irradiated vertically, and the flight tracks are etched with alkali solution, thus the required pore treatment is applied. The basic investigation of waste liquid, the endurance test of actual filters, the filtration test with the pilot apparatus, the demonstration test with an actual equipment, and the design of the actual equipment have been carried out for three years. (Kako, I.)

  3. Molten salt fueled reactors with a fast salt draining

    International Nuclear Information System (INIS)

    Ventre, Edmond; Blum, J.M.

    1976-01-01

    This invention relates to a molten salt nuclear reactor which comprises a new arrangement for shutting it down in complete safety. This nuclear reactor has a molten salt primary circuit comprising, in particular, the core of this reactor. It includes a leak tight vessel the capacity of which is appreciably greater than that of the molten salt volume of the circuit and placed so that the level of the molten salt, when all the molten salt of the circuit is contained in this vessel, is less than that of the base of the core. There are facilities for establishing and maintaining an inert gas pressure in the vessel above the molten salt, for releasing the compressed gas and for connecting the vessel to the primary circuit entering this vessel at a lower level than that of the molten salt and enabling molten salt to enter or leave the vessel according to the pressure of the inert gas. The particular advantage of this reactor is that it can be shut down safely since the draining of the primary circuit no longer results from a 'positive action' but from the suppression of an arrangement essential for the operation of the reactor consisting of the build-up of the said inert gas pressure in the said vessel [fr

  4. Dynamic Looping of a Free-Draining Polymer

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Felix X. -F.; Stinis, Panos; Qian, Hong

    2018-01-11

    Here, we revisit the celebrated Wilemski--Fixman (WF) treatment for the looping time of a free-draining polymer. The WF theory introduces a sink term into the Fokker--Planck equation for the $3(N+1)$-dimensional Ornstein--Uhlenbeck process of polymer dynamics, which accounts for the appropriate boundary condition due to the formation of a loop. The assumption for WF theory is considerably relaxed. A perturbation method approach is developed that justifies and generalizes the previous results using either a delta sink or a Heaviside sink. For both types of sinks, we show that under the condition of a small dimensionless $\\epsilon$, the ratio of capture radius to the Kuhn length, we are able to systematically produce all known analytical and asymptotic results obtained by other methods. This includes most notably the transition regime between the $N^2$ scaling of Doi, and $N\\sqrt{N}/\\epsilon$ scaling of Szabo, Schulten, and Schulten. The mathematical issue at play is the nonuniform convergence of $\\epsilon\\to 0$ and $N\\to\\infty$, the latter being an inherent part of the theory of a Gaussian polymer. Our analysis yields a novel term in the analytical expression for the looping time with small $\\epsilon$, which was previously unknown. Monte Carlo numerical simulations corroborate the analytical findings. The systematic method developed here can be applied to other systems modeled by multidimensional Smoluchowski equations.

  5. Safety of thyroidectomy and cervical neck dissection without drains

    Science.gov (United States)

    Abboud, Bassam; Sleilaty, Ghassan; Rizk, Habib; Abadjian, Gerard; Ghorra, Claude

    2012-01-01

    Background Many studies have reported that drainage after thyroidectomy does not decrease the rate of local postoperative complications. We sought to review the safety of thyroidectomy combined with cervical neck dissection (CND) without drainage. Methods The medical records of consecutive patients who underwent thyroidectomy without drainage were retrospectively reviewed. Two groups were defined depending on whether CND was or was not performed. The main outcome was identification of patients with cervical bleeding, hematoma or seroma. Results We included 1127 patients (139 who had CND and 988 who did not). Of these, 207 patients (18%) had transient postoperative hypocalcemia, 9 (0.8%) had permanent postoperative hypoparathyroidism, 56 (5%) had transient postoperative hoarseness and 7 (0.6%) had permanent vocal cord paralysis. A total of 44 patients (4%) experienced postoperative hematoma and/or seroma: 8 patients (6%) who had CND and 36 (4%) who did not. There was no major bleeding in the 2 groups; all patients had minor bleeding or seroma not requiring surgical intervention. The postoperative stay in hospital for both groups was 1 day in 92% of patients. Wound infection occurred in 0.8% of all patients: 1 (0.7%) who had CND and 8 (0.8%) who did not. There was no significant difference between the groups in overall perioperative complications or in time of hospital discharge. Conclusion Thyroidectomy without drains is safe and effective, even in combination with CND. PMID:22449723

  6. Draining down of a nuclear steam generating system

    International Nuclear Information System (INIS)

    Jawor, J.C.

    1987-01-01

    The method is described of draining down contained reactor-coolant water from the inverted vertical U-tubes of a vertical-type steam generator in which the upper, inverted U-shaped ends of the tubes are closed and the lower ends thereof are open. The steam generator is part of a nuclear powered steam generating system wherein the reactor coolant water is normally circulated from and back into the reactor via a loop comprising the steam generator and inlet and outlet conduits connected to the lower end of the steam generator. The method comprises continuously introducing a gas which is inert to the system and which is under pressure above atmospheric pressure into at least one of the downwardly facing open ends of each of the U-tubes from below the tube sheet in which the open ends of the U-tubes are mounted adjacent the lower end of the steam generator, while permitting the water to flow out from the open ends of the U-tubes

  7. Reverse brain drain in South Korea: state-led model.

    Science.gov (United States)

    Yoon, B L

    1992-01-01

    Korea's reverse brain drain (RBD) has been an organized government effort, rather than a spontaneous social phenomenon, in that various policies and the political support of President Park, Chung-Hee were instrumental in laying the groundwork for its success. Particular features of Korea's RBD policies are the creation of a conducive domestic environment (i.e., government-sponsored strategic R & D institution-building, legal, and administrative reforms), and importantly, the empowerment of returnees (via, i.e., exceptionally good maternal benefits, guarantees of research autonomy). President Park played the cardinal role in empowering repatriates at the expense of his own civil bureaucracy, and his capacity for such patronage derived from Korea's bureaucratic-authoritarian political system. Returning scientists and engineers directly benefitted from this political system as well as Park's personal guardianship. For Park, empowerment of returning "brains" was necessary to accomplish his national industrialization plan, thereby enhancing his political legitimacy in domestic politics. An alliance with the R & D cadre was functionally necessary to successfully consolidate strong presidential power, and politically nonthreatening due to the particular form of "pact of domination" in Korea's power structure. RBD in Korea will continue in the near future given Korea's drive for high technology, and the remarkable expansion of local industrial and educational sectors. Korea's future RBD, however, needs to pay closer attention to the following 4 problems: research autonomy; equality issues; skill-based repatriation of technicians and engineers rather than Ph.Ds; and subsidies to small and medium industry for RBD.

  8. BRAIN DRAIN IN THE GLOBALIZATION ERA: THE CASE OF ROMANIA

    Directory of Open Access Journals (Sweden)

    MARIANA BĂLAN

    2017-06-01

    Full Text Available Migration is an old phenomenon in the history of humankind. However, the magnitude, complexity, and structure of migration flows in the global era are all unprecedented. According to the United Nations Report “Trends in International Migrant Stock: the 2015 Revision” at world level 244 million international migrants were recorded in 2015. With the increase in the number of migrants, the emigration of ‘high-skilled’ individuals is also growing. OECD and United Nation Statistics show that in the last decade the number of migrants with tertiary education increased by about 70%. Brain drain is also a well-known phenomenon. Highly educated individuals and scientists have travelled the world in all centuries in search of better study and research, and working conditions, and of new opportunities. Nowadays, in the era of globalisation and, implicitly, of swifter development of international markets, the emigration rate of high-skilled experts exceeds the total emigration rate, which shows the selectiveness of migration at educational level. The paper presents a brief analysis of the interdependencies between migration and globalisation and of the effects of globalisation on the migration of high-skilled individuals. The trends, structure, and volume of high-skilled labour force from Romania are analysed along with the effects generated by them.

  9. BRAIN DRAIN – BRAIN GAIN: SLOVAK STUDENTS AT CZECH UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    FISCHER, Jakub

    2015-09-01

    Full Text Available The Slovak Republic is experiencing a growing brain drain of elite secondary school students. Slovak human capital flows chiefly to Czech Higher Education Institutes (HEIs. The aim of this paper is to analyse who these Slovak students are to create a complete profile of Slovak students at Czech HEIs. We used a unique dataset based on the surveys EUROSTUDENT V and DOKTORANDI 2014 to explore differences between Czech and Slovak students, their financial situation and the functionality of the intergenerational transmission mechanism. We have found that Slovak students at Czech HEIs come from highly educated families and from the middle and higher class families significantly more often than Czech students at Czech HEIs or Slovak students at Slovak HEIs. Approximately 80% of them came from grammar schools. Slovak students also often have better language skills. We have discovered that Slovak students at Czech HEIs enjoy certain social benefits, slightly more often they have higher monthly income compared to Czech students, and they work slightly less often during their studies. Finally, according to our findings, Slovak doctoral students are often reluctant to return back to the Slovak Republic or to stay in the Czech Republic.

  10. Criticality safety considerations for MSRE fuel drain tank uranium aggregation

    International Nuclear Information System (INIS)

    Hollenbach, D.F.; Hopper, C.M.

    1997-01-01

    This paper presents the results of a preliminary criticality safety study of some potential effects of uranium reduction and aggregation in the Molten Salt Reactor Experiment (MSRE) fuel drain tanks (FDTs) during salt removal operations. Since the salt was transferred to the FDTs in 1969, radiological and chemical reactions have been converting the uranium and fluorine in the salt to UF 6 and free fluorine. Significant amounts of uranium (at least 3 kg) and fluorine have migrated out of the FDTs and into the off-gas system (OGS) and the auxiliary charcoal bed (ACB). The loss of uranium and fluorine from the salt changes the chemical properties of the salt sufficiently to possibly allow the reduction of the UF 4 in the salt to uranium metal as the salt is remelted prior to removal. It has been postulated that up to 9 kg of the maximum 19.4 kg of uranium in one FDT could be reduced to metal and concentrated. This study shows that criticality becomes a concern when more than 5 kg of uranium concentrates to over 8 wt% of the salt in a favorable geometry

  11. Heterotrophic soil respiration in forestry-drained peatlands

    International Nuclear Information System (INIS)

    Minkkinen, K.; Shurpali, N. J.; Alm, J.; Penttilae, T.

    2007-01-01

    Heterotrophic soil respiration (CO 2 efflux from the decomposition of peat and root litter) in three forestry-drained peatlands with different site types and with a large climatic gradient from the hemi-boreal (central Estonia) to south (southern Finland) and north boreal (northern Finland) conditions was studied. Instantaneous fluxes varied between 0 and 1.3 g CO 2 -C m -2 h -1 , and annual fluxes between 248 and 515 g CO 2 -C m -2 a -1 . Variation in the annual fluxes among site types was studied only in the south-boreal site where we found a clear increase from nutrient-poor to nutrient-rich site types. More than half of the within-site variation was temporal and explained by soil surface (-5 cm) temperature (T5). The response of soil respiration to T5 varied between the sites; the most northerly site had the highest response to T5 and the most southerly the lowest. This trend further resulted in increased annual fluxes towards north. This unexpected result is hypothesised to be related to differences in site factors like substrate quality, nutrient status and hydrology but also to temperature acclimation, i.e., adaptation of decomposer populations to different climates. (orig.)

  12. Radionuclide analysis of right and left ventricular response to exercise in patients with atrial and ventricular septal defects

    International Nuclear Information System (INIS)

    Peter, C.A.; Bowyer, K.; Jones, R.H.

    1983-01-01

    In patients with ventricular or atrial septal defect, the ventricle which is chronically volume overloaded might not appropriately respond to increased demand for an augmentation in output and thereby might limit total cardiac function. In this study we simultaneously measured right and left ventricular response to exercise in 10 normal individuals, 10 patients with ventricular septal defect (VSD), and 10 patients with atrial septal defect (ASD). The normal subjects increased both right and left ventricular ejection fraction, end-diastolic volume, and stroke volume to achieve a higher cardiac output during exercise. Patients with VSD failed to increase right ventricular ejection fraction, but increased right ventricular end-diastolic volume and stroke volume. Left ventricular end-diastolic volume did not increase in these patients but ejection fraction, stroke volume, and forward left ventricular output achieved during exercise were comparable to the response observed in healthy subjects. In the patients with ASD, no rest-to-exercise change occurred in either right ventricular ejection fraction, end-diastolic volume, or stroke volume. In addition, left ventricular end-diastolic volume failed to increase, and despite an increase in ejection fraction, left ventricular stroke volume remained unchanged from rest to exercise. Therefore, cardiac output was augmented only by the heart rate increase in these patients. Right ventricular function appeared to be the major determinant of total cardiac output during exercise in patients with cardiac septal defects and left-to-right shunt

  13. Left ventricular function in chronic aortic regurgitation

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Manno, B.; Amenta, A.; Kane, S.A.

    1983-01-01

    Left ventricular performance was determined in 42 patients with moderate or severe aortic regurgitation during upright exercise by measuring left ventricular ejection fraction and volume with radionuclide ventriculography. Classification of the patients according to exercise tolerance showed that patients with normal exercise tolerance (greater than or equal to 7.0 minutes) had a significantly higher ejection fraction at rest (probability [p] . 0.02) and during exercise (p . 0.0002), higher cardiac index at exercise (p . 0.0008) and lower exercise end-systolic volume (p . 0.01) than did patients with limited exercise tolerance. Similar significant differences were noted in younger patients compared with older patients in ejection fraction at rest and exercise (both p . 0.001) and cardiac index at rest (p . 0.03) and exercise (p . 0.0005). The end-diastolic volume decreased during exercise in 60% of the patients. The patients with a decrease in volume were significantly younger and had better exercise tolerance and a larger end-diastolic volume at rest than did patients who showed an increase in volume. The mean corrected left ventricular end-diastolic radius/wall thickness ratio was significantly greater in patients with abnormal than in those with normal exercise reserve (mean +/- standard deviation 476 +/- 146 versus 377 +/- 92 mm Hg, p less than 0.05). Thus, in patients with chronic aortic regurgitation: 1) left ventricular systolic function during exercise was related to age, exercise tolerance and corrected left ventricular end-diastolic radius/wall thickness ratio, and 2) the end-diastolic volume decreased during exercise, especially in younger patients and patients with normal exercise tolerance or a large volume at rest

  14. Complications corner: Anterior thoracic disc surgery with dural tear/CSF fistula and low-pressure pleural drain led to severe intracranial hypotension.

    Science.gov (United States)

    Oudeman, Eline A; Nandoe Tewarie, Rishi D S; Jöbsis, G Joost; Arts, Mark P; Kruyt, Nyika D

    2015-01-01

    Thoracic disc surgery can lead to a life-threatening complication: intracranial hypotension due to a subarachnoid-pleural fistula. We report a 63-year-old male with paraparesis due to multiple herniated thoracic discs, with compressive myelopathy. The patient required a circumferential procedure including a laminectomy/fusion followed by an anterior thoracic decompression to address both diffuse idiopathic skeletal hyperostosis (DISH) anteriorly and posterior stenosis. The postoperative course was complicated by severe intracranial hypotension attributed to the erroneous placement of a low-pressure drain placed in the pleural cavity instead of a lumbar drain; this resulted in subdural hematoma's necessitating subsequent surgery. Severe neurological deterioration occurring after thoracic decompressive surgery may rarely be attributed to intracranial hypotension due to a subarachnoid-pleural fistula. Patients should be treated with external lumbar drainage of cerebrospinal fluid for 3-5 days rather than a low-pressure pleural drain to avoid the onset of intracranial hypotension leading to symptomatic subdural hematomas.

  15. Arrhythmogenic right ventricular cardiomyopathy in a dog : case report

    Directory of Open Access Journals (Sweden)

    A.J. Möhr

    2000-07-01

    Full Text Available An 8-month-old Labrador retriever bitch was evaluated for sudden-onset, progressive abdominal distension. Physical examination revealed an exaggerated inspiratory effort, severe ascites, bilateral jugular vein distension, and hypokinetic femoral arterial pulses. Thoracic auscultation detected tachycardia with muffled heart sounds, without audible cardiac murmurs. Thoracic radiographs identified severe right ventricular enlargement and pleural effusion. The electrocardiogram was consistent with incomplete right bundle branch block or right ventricular enlargement. Echocardiography demonstrated severe right ventricular and atrial dilation, secondary tricuspid regurgitation, and thinning and hypocontractility of the right ventricular myocardium. Left heart chamber sizes were slightly decreased, with normal left ventricular contractility. Adiagnosis of arrhythmogenic right ventricular cardiomyopathy was reached, based on the characteristic clinical, electrocardiographic, radiographic and echocardiographic findings, and the exclusion of other causes of isolated right ventricular failure. Treatment effected good control of clinical signs, until acutely decompensated congestive right heart failure led to euthanasia after 4 months. Arrhythmogenic right ventricular cardiomyopathy is a well-described clinical entity in humans, and has previously been documented in 3 male dogs. The condition is characterised by progressive fibro-adipose replacement of right ventricular myocardium, while the left ventricle usually remains unaffected. It should be considered a differential diagnosis in any young dog presented with isolated right heart failure, syncope, or unexplained ventricular tachyarrhythmias. This article reports the 1st case of arrhythmogenic right ventricular cardiomyopathy in a female dog, and highlights its echocardiographic features.

  16. Echocardiographic left ventricular masses in distance runners and weight lifters

    Science.gov (United States)

    Longhurst, J. C.; Gonyea, W. J.; Mitchell, J. H.; Kelly, A. R.

    1980-01-01

    The relationships of different forms of exercise training to left ventricular mass and body mass are investigated by echocardiographic studies of weight lifters, long-distance runners, and comparatively sized untrained control subjects. Left ventricular mass determinations by the Penn convention reveal increased absolute left ventricular masses in long-distance runners and competitive weight lifters with respect to controls matched for age, body weight, and body surface area, and a significant correlation between ventricular mass and lean body mass. When normalized to lean body mass, the ventricular masses of distance runners are found to be significantly higher than those of the other groups, suggesting that dynamic training elevates left ventricular mass compared to static training and no training, while static training increases ventricular mass only to the extent that lean body mass is increased.

  17. Two-dimensional echocardiographic features of right ventricular infarction

    International Nuclear Information System (INIS)

    D'Arcy, B.; Nanda, N.C.

    1982-01-01

    Real-time, two-dimensional echocardiographic studies were performed in 10 patients with acute myocardial infarction who had clinical features suggestive of right ventricular involvement. All patients showed right ventricular wall motion abnormalities. In the four-chamber view, seven patients showed akinesis of the entire right ventricular diaphragmatic wall and three showed akinesis of segments of the diaphragmatic wall. Segmental dyskinetic areas involving the right ventricular free wall were identified in four patients. One patient showed a large right ventricular apical aneurysm. Other echocardiographic features included enlargement of the right ventricle in eight cases, paradoxical ventricular septal motion in seven cases, tricuspid incompetence in eight cases, dilation of the stomach in four cases and localized pericardial effusion in two cases. Right ventricular infarction was confirmed by radionuclide methods in seven patients, at surgery in one patient and at autopsy in two patients

  18. Malignant external otitis

    International Nuclear Information System (INIS)

    Dupuch, K.M.; Iryboz, T.; Firat, M.; Levy, C.; Tubiana, J.M.

    1991-01-01

    This paper illustrates the value of CT and MR in early diagnosis and spread of malignant external otitis. The authors retrospectively analyzed 15 patients with proved malignant external otitis examined with postcontrast high-resolution CT (15/15) and MR (6/15) (T1- and T2-weighting). Gallium studies were done in 6/15 patients. Early diagnosis was made when CT demonstrated a soft-tissue mass of the external auditory canal associated with scattered zones of cortical bone erosions (13/15). Spread of the disease was better delineated by MR than CT, especially skull base extension (6/15). Temporomandibular joint involvement with extension into parotid or/and masticator spaces 6/15 was as well detected with CT as with MR. If CT remains the first and best procedure for diagnosis, MR - despite its cost - appears a good procedure to depict exact anatomic spread, allowing therapeutic management

  19. Productivity Change and Externalities

    DEFF Research Database (Denmark)

    Kravtsova, Victoria

    2014-01-01

    This paper contributes to the analysis of the impact of externalities on the host country's total factor productivity by taking into account different dimensions of spillover effects. Namely, engagement in exporting and foreign ownership is generally perceived as being beneficial to individual...... firms and the economy as a whole. The approach used in the current research accounts for different internal as well as external factors that individual firms face and evaluates the effect on changes in productivity, technology as well as the efficiency of domestic firms. The empirical analysis focuses...... on Hungary. While the country leads the group of post-socialist countries in the amount of attracted foreign direct investments (FDI) the effect of this policy on the economy remains unclear. The research finds that different externalities play a different role in productivity, technological and efficiency...

  20. Externality or sustainability economics?

    International Nuclear Information System (INIS)

    Bergh, Jeroen C.J.M. van den

    2010-01-01

    In an effort to develop 'sustainability economics' Baumgaertner and Quaas (2010) neglect the central concept of environmental economics-'environmental externality'. This note proposes a possible connection between the concepts of environmental externality and sustainability. In addition, attention is asked for other aspects of 'sustainability economics', namely the distinction weak/strong sustainability, spatial sustainability and sustainable trade, distinctive sustainability policy, and the ideas of early 'sustainability economists'. I argue that both sustainability and externalities reflect a systems perspective and propose that effective sustainability solutions require that more attention is given to system feedbacks, notably other-regarding preferences and social interactions, and energy and environmental rebound. The case of climate change and policy is used to illustrate particular statements. As a conclusion, a list of 20 insights and suggestions for research is offered. (author)

  1. Metasurface external cavity laser

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Luyao, E-mail: luyaoxu.ee@ucla.edu; Curwen, Christopher A.; Williams, Benjamin S. [Department of Electrical Engineering, University of California, Los Angeles, California 90095 (United States); California NanoSystems Institute, University of California, Los Angeles, California 90095 (United States); Hon, Philip W. C.; Itoh, Tatsuo [Department of Electrical Engineering, University of California, Los Angeles, California 90095 (United States); Chen, Qi-Sheng [Northrop Grumman Aerospace Systems, Redondo Beach, California 90278 (United States)

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  2. Oxic limestone drains for treatment of dilute, acidic mine drainage

    Science.gov (United States)

    Cravotta, Charles A.

    1998-01-01

    Limestone treatment systems can be effective for remediation of acidic mine drainage (AMD) that contains moderate concentrations of dissolved O2 , Fe3+ , or A13+ (1‐5 mg‐L‐1 ). Samples of water and limestone were collected periodically for 1 year at inflow, outflow, and intermediate points within underground, oxic limestone drains (OLDs) in Pennsylvania to evaluate the transport of dissolved metals and the effect of pH and Fe‐ and Al‐hydrolysis products on the rate of limestone dissolution. The influent was acidic and relatively dilute (pH 1 mg‐L‐1 ) but was near neutral (pH = 6.2‐7.0); Fe and Al decreased to less than 5% of influent concentrations. As pH increased near the inflow, hydrous Fe and Al oxides precipitated in the OLDs. The hydrous oxides, nominally Fe(OH)3 and AI(OH)3, were visible as loosely bound, orange‐yellow coatings on limestone near the inflow. As time elapsed, Fe(OH)3 and AI(OH)3 particles were transported downflow. During the first 6 months of the experiment, Mn 2+ was transported conservatively through the OLDs; however, during the second 6 months, concentrations of Mn in effluent decreased by about 50% relative to influent. The accumulation of hydrous oxides and elevated pH (>5) in the downflow part of the OLDs promoted sorption and coprecipitation of Mn as indicated by its enrichment relative to Fe in hydrous‐oxide particles and coatings on limestone. Despite thick (~1 mm) hydrous‐oxide coatings on limestone near the inflow, CaCO3 dissolution was more rapid near the inflow than at downflow points within the OLD where the limestone was not coated. The rate of limestone dissolution decreased with increased residence time, pH, and concentrations of Ca2+ and HCO3‐ and decreased PCO2. The following overall reaction shows alkalinity as an ultimate product of the iron hydrolysis reaction in an OLD:Fe2+ + 0.25 O2 +CaCO3 + 2.5 H2O --> Fe(OH)3 + 2 Ca2+ + 2 HCO3-where 2 moles of CaCO3 dissolve for each mole of Fe(OH)3 produced

  3. The External Mind

    DEFF Research Database (Denmark)

    , Extended Mind and Distributed Cognition by Claudio Paolucci pp. 69-96 The Social Horizon of Embodied Language and Material Symbols by Riccardo Fusaroli pp. 97-123 Semiotics and Theories of Situated/Distributed Action and Cognition: a Dialogue and Many Intersections by Tommaso Granelli pp. 125-167 Building......The External Mind: an Introduction by Riccardo Fusaroli, Claudio Paolucci pp. 3-31 The sign of the Hand: Symbolic Practices and the Extended Mind by Massimiliano Cappuccio, Michael Wheeler pp. 33-55 The Overextended Mind by Shaun Gallagher pp. 57-68 The "External Mind": Semiotics, Pragmatism...

  4. Assessing the biodegradability of microparticles disposed down the drain.

    Science.gov (United States)

    McDonough, Kathleen; Itrich, Nina; Casteel, Kenneth; Menzies, Jennifer; Williams, Tom; Krivos, Kady; Price, Jason

    2017-05-01

    Microparticles made from naturally occurring materials or biodegradable plastics such as poly(3-hydroxy butyrate)-co-(3-hydroxy valerate), PHBV, are being evaluated as alternatives to microplastics in personal care product applications but limited data is available on their ultimate biodegradability (mineralization) in down the drain environmental compartments. An OECD 301B Ready Biodegradation Test was used to quantify ultimate biodegradability of microparticles made of PHBV foam, jojoba wax, beeswax, rice bran wax, stearyl stearate, blueberry seeds and walnut shells. PHBV polymer was ready biodegradable reaching 65.4 ± 4.1% evolved CO 2 in 5 d and 90.5 ± 3.1% evolved CO 2 in 80 d. PHBV foam microparticles (125-500 μm) were mineralized extensively with >66% CO 2 evolution in 28 d and >82% CO 2 evolution in 80 d. PHBV foam microparticles were mineralized at a similar rate and extent as microparticles made of jojoba wax, beeswax, rice bran wax, and stearyl stearate which reached 84.8  ± 4.8, 84.9  ± 2.2, 82.7  ± 4.7, and 86.4 ± 3.2% CO 2 evolution respectively in 80 d. Blueberry seeds and walnut shells mineralized more slowly only reaching 39.3  ± 6.9 and 5.1 ± 2.8% CO 2 evolution in 80 d respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Seasonal thaw settlement at drained thermokarst lake basins, Arctic Alaska

    Science.gov (United States)

    Liu, Lin; Schaefer, Kevin; Gusmeroli, Alessio; Grosse, Guido; Jones, Benjamin M.; Zhang, Tinjun; Parsekian, Andrew; Zebker, Howard

    2014-01-01

    Drained thermokarst lake basins (DTLBs) are ubiquitous landforms on Arctic tundra lowland. Their dynamic states are seldom investigated, despite their importance for landscape stability, hydrology, nutrient fluxes, and carbon cycling. Here we report results based on high-resolution Interferometric Synthetic Aperture Radar (InSAR) measurements using space-borne data for a study area located on the North Slope of Alaska near Prudhoe Bay, where we focus on the seasonal thaw settlement within DTLBs, averaged between 2006 and 2010. The majority (14) of the 18 DTLBs in the study area exhibited seasonal thaw settlement of 3–4 cm. However, four of the DTLBs examined exceeded 4 cm of thaw settlement, with one basin experiencing up to 12 cm. Combining the InSAR observations with the in situ active layer thickness measured using ground penetrating radar and mechanical probing, we calculated thaw strain, an index of thaw settlement strength along a transect across the basin that underwent large thaw settlement. We found thaw strains of 10–35% at the basin center, suggesting the seasonal melting of ground ice as a possible mechanism for the large settlement. These findings emphasize the dynamic nature of permafrost landforms, demonstrate the capability of the InSAR technique to remotely monitor surface deformation of individual DTLBs, and illustrate the combination of ground-based and remote sensing observations to estimate thaw strain. Our study highlights the need for better description of the spatial heterogeneity of landscape-scale processes for regional assessment of surface dynamics on Arctic coastal lowlands.

  6. Traditional Foley drainage systems--do they drain the bladder?

    Science.gov (United States)

    Garcia, Maurice M; Gulati, Shelly; Liepmann, Dorian; Stackhouse, G Bennett; Greene, Kirsten; Stoller, Marshall L

    2007-01-01

    Foley catheters are assumed to drain the bladder to completion. Drainage characteristics of Foley catheter systems are poorly understood. To investigate unrecognized retained urine with Foley catheter drainage systems, bladder volumes of hospitalized patients were measured with bladder scan ultrasound volumetrics. Additionally, an in vitro bench top mock bladder and urinary catheter system was developed to understand the etiology of such residual volumes. A novel drainage tube design that optimizes indwelling catheter drainage was also designed. Bedside bladder ultrasound volumetric studies were performed on patients hospitalized in ward and intensive care unit. If residual urine was identified the drainage tubing was manipulated to facilitate drainage. An ex vivo bladder-urinary catheter model was designed to measure flow rates and pressures within the drainage tubing of a traditional and a novel drainage tube system. A total of 75 patients in the intensive care unit underwent bladder ultrasound volumetrics. Mean residual volume was 96 ml (range 4 to 290). In 75 patients on the hospital ward mean residual volume was 136 ml (range 22 to 647). In the experimental model we found that for every 1 cm in curl height, obstruction pressure increased by 1 cm H2O within the artificial bladder. In contrast, the novel spiral-shaped drainage tube demonstrated rapid (0.5 cc per second), continuous and complete (100%) reservoir drainage in all trials. Traditional Foley catheter drainage systems evacuate the bladder suboptimally. Outflow obstruction is caused by air-locks that develop within curled redundant drainage tubing segments. The novel drainage tubing design eliminates gravity dependent curls and associated air-locks, optimizes flow, and minimizes residual bladder urine.

  7. Variable carbon losses from recurrent fires in drained tropical peatlands.

    Science.gov (United States)

    Konecny, Kristina; Ballhorn, Uwe; Navratil, Peter; Jubanski, Juilson; Page, Susan E; Tansey, Kevin; Hooijer, Aljosja; Vernimmen, Ronald; Siegert, Florian

    2016-04-01

    Tropical peatland fires play a significant role in the context of global warming through emissions of substantial amounts of greenhouse gases. However, the state of knowledge on carbon loss from these fires is still poorly developed with few studies reporting the associated mass of peat consumed. Furthermore, spatial and temporal variations in burn depth have not been previously quantified. This study presents the first spatially explicit investigation of fire-driven tropical peat loss and its variability. An extensive airborne Light Detection and Ranging data set was used to develop a prefire peat surface modelling methodology, enabling the spatially differentiated quantification of burned area depth over the entire burned area. We observe a strong interdependence between burned area depth, fire frequency and distance to drainage canals. For the first time, we show that relative burned area depth decreases over the first four fire events and is constant thereafter. Based on our results, we revise existing peat and carbon loss estimates for recurrent fires in drained tropical peatlands. We suggest values for the dry mass of peat fuel consumed that are 206 t ha(-1) for initial fires, reducing to 115 t ha(-1) for second, 69 t ha(-1) for third and 23 t ha(-1) for successive fires, which are 58-7% of the current IPCC Tier 1 default value for all fires. In our study area, this results in carbon losses of 114, 64, 38 and 13 t C ha(-1) for first to fourth fires, respectively. Furthermore, we show that with increasing proximity to drainage canals both burned area depth and the probability of recurrent fires increase and present equations explaining burned area depth as a function of distance to drainage canal. This improved knowledge enables a more accurate approach to emissions accounting and will support IPCC Tier 2 reporting of fire emissions. © 2015 John Wiley & Sons Ltd.

  8. Effects of pond draining on biodiversity and water quality of farm ponds.

    Science.gov (United States)

    Usio, Nisikawa; Imada, Miho; Nakagawa, Megumi; Akasaka, Munemitsu; Takamura, Noriko

    2013-12-01

    Farm ponds have high conservation value because they contribute significantly to regional biodiversity and ecosystem services. In Japan pond draining is a traditional management method that is widely believed to improve water quality and eradicate invasive fish. In addition, fishing by means of pond draining has significant cultural value for local people, serving as a social event. However, there is a widespread belief that pond draining reduces freshwater biodiversity through the extirpation of aquatic animals, but scientific evaluation of the effectiveness of pond draining is lacking. We conducted a large-scale field study to evaluate the effects of pond draining on invasive animal control, water quality, and aquatic biodiversity relative to different pond-management practices, pond physicochemistry, and surrounding land use. The results of boosted regression-tree models and analyses of similarity showed that pond draining had little effect on invasive fish control, water quality, or aquatic biodiversity. Draining even facilitated the colonization of farm ponds by invasive red swamp crayfish (Procambarus clarkii), which in turn may have detrimental effects on the biodiversity and water quality of farm ponds. Our results highlight the need for reconsidering current pond management and developing management plans with respect to multifunctionality of such ponds. Efectos del Drenado de Estanques sobre la Biodiversidad y la Calidad del Agua en Estanques de Cultivo. © 2013 Society for Conservation Biology.

  9. Inverse problem in anisotropic poroelasticity: drained constants from undrained ultrasound measurements.

    Science.gov (United States)

    Berryman, James G; Nakagawa, Seiji

    2010-02-01

    Poroelastic analysis has traditionally focused on the relationship between dry and drained constants, which are assumed known, and the saturated or undrained constants, which are assumed unknown. However, there are many applications in this field of study for which the main measurements can only be made on the saturated/undrained system, and then it is uncertain what the effects of the fluids were on the system, since the drained constants remain a mystery. The work presented here shows how to deduce drained constants from undrained constants for anisotropic systems having symmetries ranging from isotropic to orthotropic. Laboratory ultrasound data are then inverted for the drained constants in three granular packings: one of glass beads, and two others for distinct types of more or less angular sand grain packings. Experiments were performed under uniaxial stress, which resulted in hexagonal (transversely isotropic) symmetry of the poroelastic response. One important conclusion from the general analysis is that the drained constants are uniquely related to the undrained constants, assuming that porosity, grain bulk modulus, and pore fluid bulk modulus are already known. Since the resulting system of equations for all the drained constants is linear, measurement error in undrained constants also propagates linearly into the computed drained constants.

  10. Inverse problem in anisotropic poroelasticity: Drained constants from undrained ultrasound measurements

    Energy Technology Data Exchange (ETDEWEB)

    Berryman, J.G.; Nakagawa, S.

    2009-11-20

    Poroelastic analysis has traditionally focused on the relationship between dry or drained constants which are assumed known and the saturated or undrained constants which are assumed unknown. However, there are many applications in this field of study for which the main measurements can only be made on the saturated/undrained system, and then it is uncertain what the eects of the uids were on the system, since the drained constants remain a mystery. The work presented here shows how to deduce drained constants from undrained constants for anisotropic systems having symmetries ranging from isotropic to orthotropic. Laboratory ultrasound data are then inverted for the drained constants in three granular packings: one of glass beads, and two others for distinct types of more or less angular sand grain packings. Experiments were performed under uniaxial stress, which resulted in hexagonal (transversely isotropic) symmetry of the poroelastic response. One important conclusion from the general analysis is that the drained constants are uniquely related to the undrained constants, assuming that porosity, grain bulk modulus, and pore uid bulk modulus are already known. Since the resulting system of equations for all the drained constants is linear, measurement error in undrained constants also propagates linearly into the computed drained constants.

  11. Homogenization of one-dimensional draining through heterogeneous porous media including higher-order approximations

    Science.gov (United States)

    Anderson, Daniel M.; McLaughlin, Richard M.; Miller, Cass T.

    2018-02-01

    We examine a mathematical model of one-dimensional draining of a fluid through a periodically-layered porous medium. A porous medium, initially saturated with a fluid of a high density is assumed to drain out the bottom of the porous medium with a second lighter fluid replacing the draining fluid. We assume that the draining layer is sufficiently dense that the dynamics of the lighter fluid can be neglected with respect to the dynamics of the heavier draining fluid and that the height of the draining fluid, represented as a free boundary in the model, evolves in time. In this context, we neglect interfacial tension effects at the boundary between the two fluids. We show that this problem admits an exact solution. Our primary objective is to develop a homogenization theory in which we find not only leading-order, or effective, trends but also capture higher-order corrections to these effective draining rates. The approximate solution obtained by this homogenization theory is compared to the exact solution for two cases: (1) the permeability of the porous medium varies smoothly but rapidly and (2) the permeability varies as a piecewise constant function representing discrete layers of alternating high/low permeability. In both cases we are able to show that the corrections in the homogenization theory accurately predict the position of the free boundary moving through the porous medium.

  12. Placement of percutaneous transhepatic biliary stent using a silicone drain with channels

    Science.gov (United States)

    Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Mineta, Sho; Mizuguchi, Yoshiaki; Kawano, Yoichi; Sasaki, Junpei; Nakamura, Yoshiharu; Aimoto, Takayuki; Tajiri, Takashi

    2009-01-01

    This report describes a method for percutaneous transhepatic biliary stenting with a BLAKE Silicone Drain, and discusses the usefulness of placement of the drain connected to a J-VAC Suction Reservoir for the treatment of stenotic hepaticojejunostomy. Percutaneous transhepatic biliary drainage was performed under ultrasonographic guidance in a patient with stenotic hepaticojejunostomy after hepatectomy for hepatic hilum malignancy. The technique used was as follows. After dilatation of the drainage root, an 11-Fr tube with several side holes was passed through the stenosis of the hepaticojejunostomy. A 10-Fr BLAKE Silicone Drain is flexible, which precludes one-step insertion. One week after insertion of the 11-Fr tube, a 0.035-inch guidewire was inserted into the tube. After removal of the 11-Fr tube, the guidewire was put into the channel of a 10-Fr BLAKE Silicone Drain. The drain was inserted into the jejunal limb through the intrahepatic bile duct and was connected to a J-VAC Suction Reservoir. Low-pressure continued suction was applied. Patients can be discharged after insertion of the 10-Fr BLAKE Silicone Drain connected to the J-VAC Suction Reservoir. Placement of a percutaneous transhepatic biliary stent using a 10-Fr BLAKE Silicone Drain connected to a J-VAC Suction Reservoir is useful for the treatment of stenotic hepaticojejunostomy. PMID:19725159

  13. Simulation of Ventricular, Cavo-Pulmonary, and Biventricular Ventricular Assist Devices in Failing Fontan.

    Science.gov (United States)

    Di Molfetta, Arianna; Amodeo, Antonio; Fresiello, Libera; Trivella, Maria Giovanna; Iacobelli, Roberta; Pilati, Mara; Ferrari, Gianfranco

    2015-07-01

    Considering the lack of donors, ventricular assist devices (VADs) could be an alternative to heart transplantation for failing Fontan patients, in spite of the lack of experience and the complex anatomy and physiopathology of these patients. Considering the high number of variables that play an important role such as type of Fontan failure, type of VAD connection, and setting (right VAD [RVAD], left VAD [LVAD], or biventricular VAD [BIVAD]), a numerical model could be useful to support clinical decisions. The aim of this article is to develop and test a lumped parameter model of the cardiovascular system simulating and comparing the VAD effects on failing Fontan. Hemodynamic and echocardiographic data of 10 Fontan patients were used to simulate the baseline patients' condition using a dedicated lumped parameter model. Starting from the simulated baseline and for each patient, a systolic dysfunction, a diastolic dysfunction, and an increment of the pulmonary vascular resistance were simulated. Then, for each patient and for each pathology, the RVAD, LVAD, and BIVAD implantations were simulated. The model can reproduce patients' baseline well. In the case of systolic dysfunction, the LVAD unloads the single ventricle and increases the cardiac output (CO) (35%) and the arterial systemic pressure (Pas) (25%). With RVAD, a decrement of inferior vena cava pressure (Pvci) (39%) was observed with 34% increment of CO, but an increment of the single ventricle external work (SVEW). With the BIVAD, an increment of Pas (29%) and CO (37%) was observed. In the case of diastolic dysfunction, the LVAD increases CO (42%) and the RVAD decreases the Pvci, while both increase the SVEW. In the case of pulmonary vascular resistance increment, the highest CO (50%) and Pas (28%) increment is obtained with an RVAD with the highest decrement of Pvci (53%) and an increment of the SVEW but with the lowest VAD power consumption. The use of numerical models could be helpful in this innovative

  14. Continuous 'Passive' Registration of Non-Point Contaminant Loads Via Agricultural Subsurface Drain Tubes

    Science.gov (United States)

    Rozemeijer, J.; Jansen, S.; de Jonge, H.; Lindblad Vendelboe, A.

    2014-12-01

    Considering their crucial role in water and solute transport, enhanced monitoring and modeling of agricultural subsurface tube drain systems is important for adequate water quality management. For example, previous work in lowland agricultural catchments has shown that subsurface tube drain effluent contributed up to 80% of the annual discharge and 90-92% of the annual NO3 loads from agricultural fields towards the surface water. However, existing monitoring techniques for flow and contaminant loads from tube drains are expensive and labor-intensive. Therefore, despite the unambiguous relevance of this transport route, tube drain monitoring data are scarce. The presented study aimed developing a cheap, simple, and robust method to monitor loads from tube drains. We are now ready to introduce the Flowcap that can be attached to the outlet of tube drains and is capable of registering total flow, contaminant loads, and flow-averaged concentrations. The Flowcap builds on the existing SorbiCells, a modern passive sampling technique that measures average concentrations over longer periods of time (days to months) for various substances. By mounting SorbiCells in our Flowcap, a flow-proportional part of the drain effluent is sampled from the main stream. Laboratory testing yielded good linear relations (R-squared of 0.98) between drainage flow rates and sampling rates. The Flowcap was tested in practice for measuring NO3 loads from two agricultural fields and one glasshouse in the Netherlands. The Flowcap registers contaminant loads from tube drains without any need for housing, electricity, or maintenance. This enables large-scale monitoring of non-point contaminant loads via tube drains, which would facilitate the improvement of contaminant transport models and would yield valuable information for the selection and evaluation of mitigation options to improve water quality.

  15. Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

    OpenAIRE

    Lin Long-Wei; Lo Chiao; Lai Peng-Sheng; Lee Po-Chu

    2010-01-01

    Abstract Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagoj...

  16. Externalities - an analysis using the EU ExternE-results

    International Nuclear Information System (INIS)

    2003-10-01

    The EU project ExternE quantified the externalities for the different energy technologies. In this work, the ExternE results are used in a MARKAL-analysis for the Nordic countries. The analysis does not go into detail, but gives some interesting indications: The external costs are not fully covered in the Nordic energy systems, the present taxes and charges are not high enough. The emissions from the energy systems would be strongly reduced, if taxes/environmental charges were set at the level ExternE calculate. The emissions from power production would be reduced most. Renewable energy sources and natural gas dominate the energy systems in the ExternE case

  17. Drainage of shallow peat harvesting areas with pipe drains; Madaltuneen turvetuotantokentaen kuivatustutkimus

    Energy Technology Data Exchange (ETDEWEB)

    Klemetti, V. [Vapo Oy, Jyvaeskylae (Finland)

    1997-12-01

    This study aims to develop pipe draining techniques in peat harvesting areas, which have been in active use so long time that the remaining peat layer is about one meter thick. The method should be technically and economically feasible as well as environmentally acceptable. Special attention is paid to pipe installation techniques, drain spacing and impacts on watercourses, which receive the drainage waters. After pipe installation the area was monitored by measuring pipe runoffs, water tables, moisture content of peat and quality of drain water. These are the results of second year. (orig.)

  18. Theory of Maxwell's fish eye with mutually interacting sources and drains

    Science.gov (United States)

    Leonhardt, Ulf; Sahebdivan, Sahar

    2015-11-01

    Maxwell's fish eye is predicted to image with a resolution not limited by the wavelength of light. However, interactions between sources and drains may ruin the subwavelength imaging capabilities of this and similar absolute optical instruments. Nevertheless, as we show in this paper, at resonance frequencies of the device, an array of drains may resolve a single source, or alternatively, a single drain may scan an array of sources, no matter how narrowly spaced they are. It seems that near-field information can be obtained from far-field distances.

  19. Drainage of shallow peat harvesting areas with pipe drains; Mataloituneen turvekentaen kuivatus putkisalaojilla

    Energy Technology Data Exchange (ETDEWEB)

    Klemetti, V.; Saenkiaho, K. [Vapo Oy, Jyvaeskylae (Finland); Rautiainen, O. [Ojamarkkinointi Oy, Heinola (Finland)

    1996-12-31

    This study aims to develop pipe draining technics in peat harvesting areas, which have been in active use so long time that the remaining peat layer is about one meter thick. The method should be technically and economically feasible as well as environmentally acceptable. Special attention is paid to pipe installation techniques, drain spacing and impacts on watercourses, which receive the drainage waters. After pipe installation the area is monitored by measuring pipe runoffs, water tables, moisture content of peat and quality of drain water

  20. External costs of electricity

    International Nuclear Information System (INIS)

    Rabl, A.; Spadaro, J.V.

    2005-01-01

    This article presents a synthesis of the ExternE project (External costs of Energy) of the European community about the external costs of power generation. Pollution impacts are calculated using an 'impact pathways' analysis, i.e. an analysis of the emission - dispersion - dose-response function - cost evaluation chain. Results are presented for different fuel cycles (with several technological variants) with their confidence intervals. The environmental impact costs are particularly high for coal: for instance, in France, for coal-fired power plants it is of the same order as the electricity retail price. For natural gas, this cost is about a third of the one for coal. On the contrary, the environmental impact costs for nuclear and renewable energies are low, typically of few per cent of the electricity price. The main part of these costs corresponds to the sanitary impacts, in particular the untimely mortality. In order to avoid any controversy about the cost evaluation of mortality, the reduction of the expectation of life due to the different fuel cycles is also indicated and the risks linked with nuclear energy are presented using several comparisons. (J.S.)

  1. On parabolic external maps

    DEFF Research Database (Denmark)

    Lomonaco, Luna; Petersen, Carsten Lunde; Shen, Weixiao

    2017-01-01

    We prove that any C1+BV degree d ≥ 2 circle covering h having all periodic orbits weakly expanding, is conjugate by a C1+BV diffeomorphism to a metrically expanding map. We use this to connect the space of parabolic external maps (coming from the theory of parabolic-like maps) to metrically expan...

  2. Stochastic Control - External Models

    DEFF Research Database (Denmark)

    Poulsen, Niels Kjølstad

    2005-01-01

    This note is devoted to control of stochastic systems described in discrete time. We are concerned with external descriptions or transfer function model, where we have a dynamic model for the input output relation only (i.e.. no direct internal information). The methods are based on LTI systems...

  3. Detecting peatland drains with Object Based Image Analysis and Geoeye-1 imagery.

    Science.gov (United States)

    Connolly, J; Holden, N M

    2017-12-01

    Peatlands play an important role in the global carbon cycle. They provide important ecosystem services including carbon sequestration and storage. Drainage disturbs peatland ecosystem services. Mapping drains is difficult and expensive and their spatial extent is, in many cases, unknown. An object based image analysis (OBIA) was performed on a very high resolution satellite image (Geoeye-1) to extract information about drain location and extent on a blanket peatland in Ireland. Two accuracy assessment methods: Error matrix and the completeness, correctness and quality (CCQ) were used to assess the extracted data across the peatland and at several sub sites. The cost of the OBIA method was compared with manual digitisation and field survey. The drain maps were also used to assess the costs relating to blocking drains vs. a business-as-usual scenario and estimating the impact of each on carbon fluxes at the study site. The OBIA method performed well at almost all sites. Almost 500 km of drains were detected within the peatland. In the error matrix method, overall accuracy (OA) of detecting the drains was 94% and the kappa statistic was 0.66. The OA for all sub-areas, except one, was 95-97%. The CCQ was 85%, 85% and 71% respectively. The OBIA method was the most cost effective way to map peatland drains and was at least 55% cheaper than either field survey or manual digitisation, respectively. The extracted drain maps were used constrain the study area CO 2 flux which was 19% smaller than the prescribed Peatland Code value for drained peatlands. The OBIA method used in this study showed that it is possible to accurately extract maps of fine scale peatland drains over large areas in a cost effective manner. The development of methods to map the spatial extent of drains is important as they play a critical role in peatland carbon dynamics. The objective of this study was to extract data on the spatial extent of drains on a blanket bog in the west of Ireland. The

  4. Detecting peatland drains with Object Based Image Analysis and Geoeye-1 imagery

    Directory of Open Access Journals (Sweden)

    J. Connolly

    2017-03-01

    Full Text Available Abstract Background Peatlands play an important role in the global carbon cycle. They provide important ecosystem services including carbon sequestration and storage. Drainage disturbs peatland ecosystem services. Mapping drains is difficult and expensive and their spatial extent is, in many cases, unknown. An object based image analysis (OBIA was performed on a very high resolution satellite image (Geoeye-1 to extract information about drain location and extent on a blanket peatland in Ireland. Two accuracy assessment methods: Error matrix and the completeness, correctness and quality (CCQ were used to assess the extracted data across the peatland and at several sub sites. The cost of the OBIA method was compared with manual digitisation and field survey. The drain maps were also used to assess the costs relating to blocking drains vs. a business-as-usual scenario and estimating the impact of each on carbon fluxes at the study site. Results The OBIA method performed well at almost all sites. Almost 500 km of drains were detected within the peatland. In the error matrix method, overall accuracy (OA of detecting the drains was 94% and the kappa statistic was 0.66. The OA for all sub-areas, except one, was 95–97%. The CCQ was 85%, 85% and 71% respectively. The OBIA method was the most cost effective way to map peatland drains and was at least 55% cheaper than either field survey or manual digitisation, respectively. The extracted drain maps were used constrain the study area CO2 flux which was 19% smaller than the prescribed Peatland Code value for drained peatlands. Conclusions The OBIA method used in this study showed that it is possible to accurately extract maps of fine scale peatland drains over large areas in a cost effective manner. The development of methods to map the spatial extent of drains is important as they play a critical role in peatland carbon dynamics. The objective of this study was to extract data on the spatial extent of

  5. Right ventricular hydatid cyst ruptured to pericardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  6. [Ventricular tachyarrhythmias in patients with cardiomyopathy

    DEFF Research Database (Denmark)

    Henningsen, K.; Christensen, A.H.; Svendsen, Jesper Hastrup

    2008-01-01

    by disease, gender, age, previous cardiac arrest and treatment with implantable cardioverter-defibrillator (ICD). RESULTS: 993 patients were screened and 128 patients with cardiomyopathy were identified, corresponding to 13% of the screened patients. 58 (45%) of the patients had dilated cardiomyopathy (DCM......), 57 (45%) patients had arrhythmogenic right ventricular cardiomyopathy (ARVC) and 13 (10%) had hypertrophic cardiomyopathy (HCM). The average age was 44 years for HCM, 41 years for ARVC and 58 years for DCM. The majority of the patients were male. ICD treatment was used in 95% of the patients...... with ARVC, 70% of the patients with HCM and 59% of the patients with DCM. Only 5 patients had previous cardiac arrest without reversible cause. CONCLUSION: The study shows that cardiomyopathies are relatively frequent causes of ventricular tachyarrhythmias in patients discharged from a specialised...

  7. Detection of left ventricular thrombi by computerised tomography

    International Nuclear Information System (INIS)

    Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

    1981-01-01

    Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

  8. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Hugo Van Herendael

    2010-06-01

    Full Text Available Hugo Van Herendael, Paul DorianDivision of Cardiology, St. Michael’s Hospital, University of Toronto, Toronto, CanadaAbstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.Keywords: amiodarone, ventricular fibrillation, unstable ventricular tachycardia

  9. Left Ventricular Myocardial Function in Children With Pulmonary Hypertension: Relation to Right Ventricular Performance and Hemodynamics.

    Science.gov (United States)

    Burkett, Dale A; Slorach, Cameron; Patel, Sonali S; Redington, Andrew N; Ivy, D Dunbar; Mertens, Luc; Younoszai, Adel K; Friedberg, Mark K

    2015-08-01

    Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that LV strain/strain rate, surrogate measures of myocardial contractility, are reduced in pediatric PH and relate to invasive hemodynamics, right ventricular strain, and functional measures of PH. At 2 institutions, echocardiography was prospectively performed in 54 pediatric PH patients during cardiac catheterization, and in 54 matched controls. Patients with PH had reduced LV global longitudinal strain (LS; -18.8 [-17.3 to -20.4]% versus -20.2 [-19.0 to -20.9]%; P=0.0046) predominantly because of reduced basal (-12.9 [-10.8 to -16.3]% versus -17.9 [-14.5 to -20.7]%; Pright ventricular free-wall LS (r=0.64; PBrain natriuretic peptide levels correlated moderately with septal LS (r=0.48; P=0.0038). PH functional class correlated moderately with LV free-wall LS (r=-0.48; P=0.0051). The septum, shared between ventricles and affected by septal shift, was the most affected LV region in PH. Pediatric PH patients demonstrate reduced LV strain/strain rate, predominantly within the septum, with relationships to invasive hemodynamics, right ventricular strain, and functional PH measures. © 2015 American Heart Association, Inc.

  10. The helical ventricular myocardial band: global, three-dimensional, functional architecture of the ventricular myocardium.

    Science.gov (United States)

    Kocica, Mladen J; Corno, Antonio F; Carreras-Costa, Francesc; Ballester-Rodes, Manel; Moghbel, Mark C; Cueva, Clotario N C; Lackovic, Vesna; Kanjuh, Vladimir I; Torrent-Guasp, Francisco

    2006-04-01

    We are currently witnessing the advent of new diagnostic tools and therapies for heart diseases, but, without serious scientific consensus on fundamental questions about normal and diseased heart structure and function. During the last decade, three successive, international, multidisciplinary symposia were organized in order to setup fundamental research principles, which would allow us to make a significant step forward in understanding heart structure and function. Helical ventricular myocardial band of Torrent-Guasp is the revolutionary new concept in understanding global, three-dimensional, functional architecture of the ventricular myocardium. This concept defines the principal, cumulative vectors, integrating the tissue architecture (i.e. form) and net forces developed (i.e. function) within the ventricular mass. Here we expose the compendium of Torrent-Guasp's half-century long functional anatomical investigations in the light of ongoing efforts to define the integrative approach, which would lead to new understanding of the ventricular form and function by linking across multiple scales of biological organization, as defined in ongoing Physiome project. Helical ventricular myocardial band of Torrent-Guasp may also, hopefully, allow overcoming some difficulties encountered in contemporary efforts to create a comprehensive mathematical model of the heart.

  11. Assessment of left ventricular global function

    International Nuclear Information System (INIS)

    Breuel, H.-P.; Baehre, M.

    1985-01-01

    Radionuclide ventriculography (RNV), i.e. noninvasive evaluation of left venticular performance following the application of radionuclides has had a major impact on many aspects of cardiology and has proven its clinical value and reliability in the last few years. This article deals mainly with the changes in global left ventricular function. The clinical applications of RNV for coronary artery diseases and valvular heart diseases are described. (Auth.)

  12. Left ventricular heart failure and pulmonary hypertension†

    Science.gov (United States)

    Rosenkranz, Stephan; Gibbs, J. Simon R.; Wachter, Rolf; De Marco, Teresa; Vonk-Noordegraaf, Anton; Vachiéry, Jean-Luc

    2016-01-01

    Abstract In patients with left ventricular heart failure (HF), the development of pulmonary hypertension (PH) and right ventricular (RV) dysfunction are frequent and have important impact on disease progression, morbidity, and mortality, and therefore warrant clinical attention. Pulmonary hypertension related to left heart disease (LHD) by far represents the most common form of PH, accounting for 65–80% of cases. The proper distinction between pulmonary arterial hypertension and PH-LHD may be challenging, yet it has direct therapeutic consequences. Despite recent advances in the pathophysiological understanding and clinical assessment, and adjustments in the haemodynamic definitions and classification of PH-LHD, the haemodynamic interrelations in combined post- and pre-capillary PH are complex, definitions and prognostic significance of haemodynamic variables characterizing the degree of pre-capillary PH in LHD remain suboptimal, and there are currently no evidence-based recommendations for the management of PH-LHD. Here, we highlight the prevalence and significance of PH and RV dysfunction in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), and provide insights into the complex pathophysiology of cardiopulmonary interaction in LHD, which may lead to the evolution from a ‘left ventricular phenotype’ to a ‘right ventricular phenotype’ across the natural history of HF. Furthermore, we propose to better define the individual phenotype of PH by integrating the clinical context, non-invasive assessment, and invasive haemodynamic variables in a structured diagnostic work-up. Finally, we challenge current definitions and diagnostic short falls, and discuss gaps in evidence, therapeutic options and the necessity for future developments in this context. PMID:26508169

  13. Ventricular enlargement in patients with affective disorders

    International Nuclear Information System (INIS)

    Murashita, Jun; Kato, Tadafumi; Shioiri, Toshiki; Hamakawa, Inubushi, Toshiro; Hiroshi; Takahashi, Saburo

    1994-01-01

    Ventricular enlargement was determined using linear measurement on MR images in a total of 71 patients with affective disorders, including bipolar affective disorder (41) and depression (30). Fourty-one healthy persons served as controls. Evans ratio, Huckman number and minimum distance of caudate nuclei (MDCN) were used as indices for ventricular enlargment. No significant difference in Evans ratio was observed between both the group of bipolar affective disorder and the group of depression and the control group. Nor did it correlate with age in any of the groups. Huckman number was significantly higher in the group of bipolar affective disorder than the other two groups. It positively correlated with age in the group of depression. MDCN was significantly increased in the group of bipolar affective disorder, as compared with the control group; and there was a positive correlation between MDCN and age in both the group of dipolar affective disorder and the group of depression. In conclusion, ventricular enlargement was dependent upon aging in affetive disorder patients. This tendency was more noticeable in the group of depression. In addition, atrophy of the caudate nuclei was likely to be severer in the group of dipolar affective disorder than the group of depression. (N.K.)

  14. The cost of health professionals' brain drain in Kenya

    Directory of Open Access Journals (Sweden)

    Gbary Akpa

    2006-07-01

    Full Text Available Abstract Background Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK and the United States of America (USA; (ii to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA; and (iii to describe other losses from brain drain. Methods The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years and the age of retirement (62 years in recipient countries. Results The total cost of educating a single medical doctor from primary school to university is US$ 65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$ 43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. Conclusion Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious

  15. Systematic review and meta-analysis of wound drains after thyroid surgery.

    LENUS (Irish Health Repository)

    Woods, R S R

    2014-04-01

    Drainage after routine thyroid and parathyroid surgery remains controversial. However, there is increasing evidence from a number of randomized clinical trials (RCTs) suggesting no benefit from the use of drains.

  16. 40 CFR 63.136 - Process wastewater provisions-individual drain systems.

    Science.gov (United States)

    2010-07-01

    ... restricts wind motion across the open area between the pipe and the drain) that encloses the space between...., there is no pump) or is operated with no more than slight fluctuations in the liquid level, the owner or...

  17. Modelling Technique for the Assessment of the Sub-Soil Drain for Groundwater Seepage Remediation

    Directory of Open Access Journals (Sweden)

    Tajul Baharuddin Mohamad Faizal

    2017-01-01

    Full Text Available Groundwater simulation technique was carried out for examining the performance of sub-soil drain at problematic site area. Subsoil drain was proposed as one of solution for groundwater seepage occurred at the slope face by reducing groundwater table at Taman Botani Park Kuala Lumpur. The simulation technique used Modular Three-Dimensional Finite Difference Groundwater Flow (MODFLOW software. In transient conditions, the results of simulation showed that heads increases surpass 1 to 2 m from the elevation level of the slope area that caused groundwater seepage on slope face. This study attempt to decrease the heads increase surpass by using different sub-soil drain size in simulation technique. The sub-soil drain capable to decline the heads ranges of 1 to 2 m.

  18. Accounting for the risks of phosphorus losses through tile drains in a phosphorus index.

    Science.gov (United States)

    Reid, D Keith; Ball, Bonnie; Zhang, T Q

    2012-01-01

    Tile drainage systems have been identified as a significant conduit for phosphorus (P) losses to surface water, but P indices do not currently account for this transport pathway in a meaningful way. Several P indices mention tile drains, but most account for either the reduction in surface runoff or the enhanced transport through tiles rather than both simultaneously. A summary of the current state of how tile drains are accounted for within P indices is provided, and the challenges in predicting the risk of P losses through tile drains that are relative to actual losses are discussed. A framework for a component P Index is described, along with a proposal to incorporate predictions of losses through tile drains as a component within this framework. Options for calibrating and testing this component are discussed. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  19. Influence of pleural drain insertion in lung function of patients undergoing coronary artery bypass grafting.

    Science.gov (United States)

    Ozelami Vieira, Irinea Beatriz Carvalho; Vieira, Fabiano F; Abrão, João; Gastaldi, Ada Clarice

    2012-01-01

    Longitudinal, prospective, randomized, blinded Trial to assess the influence of pleural drain (non-toxic PVC) site of insertion on lung function and postoperative pain of patients undergoing coronary artery bypass grafting in the first three days post-surgery and immediately after chest tube removal. Thirty six patients scheduled for elective myocardial revascularization with cardiopulmonary bypass (CPB) were randomly allocated into two groups: SX group (subxiphoid) and IC group (intercostal drain). Spirometry, arterial blood gases, and pain tests were recorded. Thirty one patients were selected, 16 in SX group and 15 in IC group. Postoperative (PO) spirometric values were higher in SX than in IC group (ppleural drain location on breathing. PaO(2) on the second PO increased significantly in SX group compared with IC group (pDrain with insertion in the subxiphoid region causes less change in lung function and discomfort, allowing better recovery of respiratory parameters. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  20. Strip-drains for in situ clean up of contaminated fine-grained soils

    International Nuclear Information System (INIS)

    Bowders, J.J.; Gabr, M.A.

    1995-01-01

    Methods for in situ remediation of contaminated soils, such as bioremediation, vacuum/air stripping and soil flushing have been found to be less effective under fine-grained soil conditions. To enhance the performance of these techniques, it was proposed that strip-drains or wick drains also known as prefabricated vertical (PV) drains be used. The research objective was to determine the feasibility of using PV drains to enhance the soil flushing process. Bench top and intermediate-scale laboratory experiments were conducted. An overview of the work, results and future considerations were presented. Results indicated that the technology is feasible. A preliminary model for the technology to be used in any field situation was developed. The model is currently being tested with data from physical experiments on both intermediate and field tests. 5 figs

  1. Preliminary design studies of the draining tanks for the Molten Salt Fast Reactor

    International Nuclear Information System (INIS)

    Merle-Lucotte, E.; Allibert, M.; Heuer, D.; Brovchenko, M.; Laureau, A.; Ghetta, V.; Rubiolo, P.

    2014-01-01

    reactor called the Molten Salt Fast Reactor (MSFR). The reference MSFR design is a 3000 MWth reactor with a total fuel salt volume of 18 m3, operated at a mean fuel temperature of 750 deg. C. The first confinement barrier of the reactor includes a salt draining system. In case of a planned reactor shut down or in case of accidents leading to an excessive increase of the temperature in the fuel circuit, the fuel configuration may be changed passively by gravitational draining of the fuel salt in dedicated draining tank located under the reactor and designed to provide adequate reactivity margins while insuring a passive cooling of the fuel salt to extract the residual heat from the short to the long term. The present preliminary assessment of this sub-critical draining system has been performed to identify the physical constraints and to give some orders of magnitude of characteristic time periods (authors)

  2. Numerical Simulation of Liquids Draining From a Tank Using OpenFOAM

    Science.gov (United States)

    Sakri, Fadhilah Mohd; Sukri Mat Ali, Mohamed; Zaki Shaikh Salim, Sheikh Ahmad; Muhamad, Sallehuddin

    2017-08-01

    Accurate simulation of liquids draining is a challenging task. It involves two phases flow, i.e. liquid and air. In this study draining a liquid from a cylindrical tank is numerically simulated using OpenFOAM. OpenFOAM is an open source CFD package and it becomes increasingly popular among the academician and also industries. Comparisons with theoretical and results from previous published data confirmed that OpenFOAM is able to simulate the liquids draining very well. This is done using the gas-liquid interface solver available in the standard library of OpenFOAM. Additionally, this study was also able to explain the physics flow of the draining tank.

  3. Carbon balance of rewetted and drained peat soils used for biomass production: A mesocosm study

    DEFF Research Database (Denmark)

    Karki, Sandhya; Elsgaard, Lars; Kandel, Tanka

    2016-01-01

    of lower CO2 emissions without losing agricultural land. The present study quantified the carbon balance (CO2, CH4 and harvested biomass C) of rewetted and drained peat soils under intensively managed reed canary grass (RCG) cultivation. Mesocosms were maintained at five different ground water levels (GWL......), i.e., 0, 10, 20 cm below the soil surface, representing rewetted peat soils, and 30 and 40 cm below the soil surface, representing drained peat soils. Net ecosystem exchange (NEE) of CO2 and CH4 emissions were measured during the growing period of RCG (May to September) using transparent and opaque...... closed chamber methods. The average dry biomass yield was significantly lower from rewetted peat soils (12 Mg ha−1) than drained peat soils (15 Mg ha−1). Also, CO2 fluxes of gross primary production (GPP) and ecosystem respiration (ER) from rewetted peat soils were significantly lower than drained peat...

  4. Use of a Nasal Speculum for Chest-Drain Insertion: A Simple Technique

    OpenAIRE

    Saxena, Pankaj; Konstantinov, Igor E.; Newman, Mark A.J.

    2006-01-01

    Tube thoracostomy is a very commonly performed procedure in cardiothoracic surgery. Insertion of a chest drain requires expertise to minimize complications. We describe a simple technique of using a nasal speculum to perform this procedure.

  5. Postoperative intraabdominal fluid collections : a modified percutaneous drainage method using a surgical drain track

    International Nuclear Information System (INIS)

    Lee, Deok Hee; Kim, Gab Choul; Hwang, Jae Cheol; Yoon, Hyun Ki; Song, Ho Young; Sung, Kyu Bo

    2000-01-01

    In the management of postoperative fluid collection, the conventional percutaneous drainage method can be employed. Because of abdominal incisions and various types of surgical drains and/or T-tubes, the application of this method is not always easy, however. We inserted a drainage catheter through a pre-existing percutaneous track formed by a surgical drain located adjacent to the site of abnormal fluid collection. There was no need to remove the drain nor make an additional puncture in the abdominal wall. A dilator was inserted along the drain, and a guide wire was used to negotiate its intraperitoneal track and reach the accumulated fluid. The procedure was simple and safe. We briefly describe our experience of this modified percutaneous drainage technique, as used in three cases involving postoperative fluid collection. (author)

  6. Drain-Site Hernia Containing the Vermiform Appendix: Report of a Case

    Directory of Open Access Journals (Sweden)

    Markus Gass

    2013-01-01

    Full Text Available The herniated vermiform appendix has been described as content of every hernia orifice in the right lower quadrant. While the femoral and inguinal herniated vermiform appendix is frequent enough to result in an own designation, port-site or even drain-site hernias are less frequently described. We report the case of a 62-year-old woman who presented with right lower quadrant pain seven years after Roux-en-Y Cystojejunostomy for a pancreatic cyst. CT scan showed herniation of the vermiform appendix through a former drain-site. A diagnostic laparoscopy with appendectomy and direct closure of the abdominal wall defect combined with mesh reinforcement was performed. Despite the decreasing use of intraperitoneal drains over the recent years, a multitude of patients had intraperitoneal drainage in former times. These patients face nowadays the risk of drain-site hernias with sometimes even unexpected structures inside.

  7. Application of the Ommaya Reservoir in Managing Ventricular Hemorrhage.

    Science.gov (United States)

    Yang, Xi-Tao; Feng, Dong-Fu; Zhao, Liang; Sun, Zhao-Liang; Zhao, Gang

    2016-05-01

    Intraventricular hemorrhage (IVH) is associated with high morbidity and mortality. This study evaluated the safety and efficacy of the combined treatment of an Ommaya reservoir and conventional external ventricular drainage (EVD) using urokinase in the management of IVH. We performed a prospective controlled study. Sixty eligible patients with IVH received conventional EVD alone (group A) or combined EVD and Ommaya reservoir (group B) between January 2010 and January 2015. Clinical, cerebrospinal fluid, and radiographic data were used to assess clot clearance, clinical outcomes, and complications between the groups. There were no significant differences in gender, age, blood pressure, Glasgow Coma Scale, Graeb score, intracerebral hemorrhage volume on admission, and IVH volume before surgery between groups A and B (P > 0.05). The number of injections of urokinase (20,000 IU/dose) were significantly different in group B compared with group A (P 0.05). The hydrocephalus incidence and mortality revealed significant differences between the 2 groups (P safe and effective in patients with IVH. It increased clot clearance, shortened conventional catheter-based EVD duration, prolonged total drainage time, reduced the hydrocephalus incidence and mortality, and contributed to good clinical outcomes. The Ommaya reservoir provides a safe way to increase the injection times of urokinase, which accelerated clot resolution and did not increase the risk for ventriculitis infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Indwelling pleural drain for mobile management of malignant pleural effusion-combining benefits of both methods

    OpenAIRE

    Dinesh Mehta; Anshu Gupta; Sameer Singhal; Sachin Bansal

    2015-01-01

    Malignant pleural effusion is a leading cause of morbidity in lung cancer patients requiring repeated pleural aspirations or persistent intercostal drainage tube. Using an indigenous method of putting icd tube of smaller size with subcutaneous tunneling would allow draining fluid from lungs easily and painlessly when needed and avoid the need for repeated injections and chest tube insertion every time the fluid is to be drained.

  9. Indwelling pleural drain for mobile management of malignant pleural effusion-combining benefits of both methods

    Directory of Open Access Journals (Sweden)

    Dinesh Mehta

    2015-01-01

    Full Text Available Malignant pleural effusion is a leading cause of morbidity in lung cancer patients requiring repeated pleural aspirations or persistent intercostal drainage tube. Using an indigenous method of putting icd tube of smaller size with subcutaneous tunneling would allow draining fluid from lungs easily and painlessly when needed and avoid the need for repeated injections and chest tube insertion every time the fluid is to be drained.

  10. ExternE transport methodology for external cost evaluation of air pollution

    DEFF Research Database (Denmark)

    Jensen, S. S.; Berkowicz, R.; Brandt, J.

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AirGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Initially, a brief description of the ExternE Tranport methodology is given and it is summarised...

  11. Checklists for external validity

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Kidholm, Kristian; Gerke, Oke

    2014-01-01

    to an implementation setting. In this paper, currently available checklists on external validity are identified, assessed and used as a basis for proposing a new improved instrument. METHOD: A systematic literature review was carried out in Pubmed, Embase and Cinahl on English-language papers without time restrictions....... The retrieved checklist items were assessed for (i) the methodology used in primary literature, justifying inclusion of each item; and (ii) the number of times each item appeared in checklists. RESULTS: Fifteen papers were identified, presenting a total of 21 checklists for external validity, yielding a total...... of 38 checklist items. Empirical support was considered the most valid methodology for item inclusion. Assessment of methodological justification showed that none of the items were supported empirically. Other kinds of literature justified the inclusion of 22 of the items, and 17 items were included...

  12. Ventricular Effective Refraction Period and Ventricular Repolarization Analysis in Experimental Tachycardiomyopathy in Swine.

    Science.gov (United States)

    Noszczyk-Nowak, Agnieszka; Pasławska, Urszula; Gajek, Jacek; Janiszewski, Adrian; Pasławski, Robert; Zyśko, Dorota; Nicpoń, Józef

    2016-01-01

    Swine are recognized animal models of human cardiovascular diseases. However, little is known on the CHF-associated changes in the electrophysiological ventricular parameters of humans and animals. The aim of this study was to analyze changes in the durations of ventricular effective refraction period (VERP), QT and QTc intervals of pigs with chronic tachycardia-induced tachycardiomyopathy (TIC). The study was comprised of 28 adult pigs (8 females and 20 males) of the Polish Large White breed. A one-chamber pacemaker was implanted in each of the 28 pigs. Electrocardiographic, echocardiographic and electrophysiological studies were carried out prior to the pacemaker implantation and at subsequent 4-week intervals. All electrocardiographic, echocardiographic and short electrophysiological study measurements in all swine were done under general anesthesia (propofol) after premedication with midazolam, medetomidine, and ketamine. No significant changes in the duration of QT interval and corrected QT interval (QTc) were observed during consecutive weeks of the experiment. The duration of the QTc interval of female pigs was shown to be significantly longer than that of the males throughout the whole study period. Beginning from the 12th week of rapid ventricular pacing, a significant increase in duration of VERP was observed in both male and female pigs. Males and females did not differ significantly in terms of VERP duration determined throughout the whole study period. Ventricular pacing, stimulation with 2 and 3 premature impulses at progressively shorter coupling intervals and an imposed rhythm of 130 bpm or 150 bpm induced transient ventricular tachycardia in one female pig and four male pigs. One episode of permanent ventricular tachycardia was observed. The number of induced arrhythmias increased proportionally to the severity of heart failure and duration of the experiment. However, relatively aggressive protocols of stimulation were required in order to induce

  13. Management of extensive surgical emphysema with subcutaneous drain: A case report

    Directory of Open Access Journals (Sweden)

    Quoc Tran

    Full Text Available Introduction: Subcutaneous emphysema (SE is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, “tension phenomenon” and respiratory failure require treatment. Presentation of case: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain. Immediate improvement was observed after insertion of a large-bore, 26 French (Fr. intercostal catheter, subcutaneous drain which was maintained under low suction (−5 cm H2O for a further 24 h. Discussion: Several methods have been described in the literature for the treatment of extensive subcutaneous emphysema, including: emergency tracheostomy, multisite subcutaneous drainage, infraclavicular “blow holes” incisions and subcutaneous drains or simply increasing suction on an in situ chest drain. Here a large-bore, fenestrated, subcutaneous drain maintained on low negative pressure also provided the necessary decompression. Conclusion: In the absence of a comparative study to identify the most effective method to manage extensive subcutaneous emphysema, this case highlights an effective, simple and safe management option. Keywords: Pneumothorax, Subcutaneous emphysema, Drain, Low suction, Intercostal catheter, Case report

  14. To drain or not to drain? Predictors of tube thoracostomy insertion and outcomes associated with drainage of traumatic hemothoraces.

    Science.gov (United States)

    Wells, Bryan J; Roberts, Derek J; Grondin, Sean; Navsaria, Pradeep H; Kirkpatrick, Andrew W; Dunham, Michael B; Ball, Chad G

    2015-09-01

    Historical data suggests that many traumatic hemothoraces (HTX) can be managed expectantly without tube thoracostomy (TT) drainage. The purpose of this study was to identify predictors of TT, including whether the quantity of pleural blood predicted tube placement, and to evaluate outcomes associated with TT versus expected management (EM) of traumatic HTXs. A retrospective cohort study of all trauma patients with HTXs and an Injury Severity Score (ISS) ≥12 managed at a level I trauma centre between April 1, 2005 and December 31, 2012 was completed. Mixed-effects models with a subject-specific random intercept were used to identify independent risk factors for TT. Logistic and log-linear regression were used to compute odds ratios (ORs) for mortality and empyema and percent increases in length of hospital and intensive care unit stay between patients managed with TT versus EM, respectively. A total of 635 patients with 749 HTXs were included in the study. Overall, 491 (66%) HTXs were drained while 258 (34%) were managed expectantly. Independent predictors of TT placement included concomitant ipsilateral flail chest [OR 3.03; 95% confidence interval (CI) 1.04-8.80; p=0.04] or pneumothorax (OR 6.19; 95% CI 1.79-21.5; p<0.01) and the size of the HTX (OR per 10cc increase 1.12; 95% CI 1.04-1.21; p<0.01). Although the adjusted odds of mortality were not significantly different between groups (OR 3.99; 95% CI 0.87-18.30; p=0.08), TT was associated with a 47.14% (95% CI, 25.57-69.71%; p<0.01) adjusted increase in hospital length of stay. Empyemas (n=29) only occurred among TT patients. Expectant management of traumatic HTX was associated with a shorter length of hospital stay, no empyemas, and no increase in mortality. Although EM of smaller HTXs may be safe, these findings must be confirmed by a large multi-centre cohort study and randomized controlled trials before they are used to guide practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno-occlusive disease.

    Science.gov (United States)

    Madenci, Arin L; Stetson, Alyssa; Weldon, Christopher B; Lehmann, Leslie E

    2016-08-01

    Hepatic VOD (veno-occlusive disease) is a serious complication of HSCT (hematopoietic stem cell transplantation) and has historically been associated with high mortality. This obstruction to hepatic flow often results in fluid collections in the peritoneal and pleural cavities. Catheter placement to drain ascites or pleural fluid may reduce intra-abdominal hypertension and/or improve respiratory parameters. The safety of these interventions among critically ill, immunocompromised children is unknown. Among 32 HSCT recipients (2000-2012) with severe VOD, we assessed the primary outcome of procedural complication from peritoneal drain placement. Twenty-four (75%) patients underwent peritoneal drain placement. No patient sustained visceral perforation or hemorrhage with drain placement. Overall mortality was 47% (n = 15). The procedure was not associated with increased overall mortality (p > 0.99). Eight (25%) peritoneal drains required replacement for malfunction. Of 24 patients with peritoneal drains, one (4%) patient had a positive culture from ascitic fluid. Eight (25%) patients underwent pleural drain placement. No pleural drain-related procedural complication or infection occurred. Four (50%) of the eight patients with pleural drains had de-escalation in oxygen requirement at drain removal, compared to time of placement. In this study, peritoneal and pleural drains were safe interventions for children with severe VOD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Charge plasma based source/drain engineered Schottky Barrier MOSFET: Ambipolar suppression and improvement of the RF performance

    Science.gov (United States)

    Kale, Sumit; Kondekar, Pravin N.

    2018-01-01

    This paper reports a novel device structure for charge plasma based Schottky Barrier (SB) MOSFET on ultrathin SOI to suppress the ambipolar leakage current and improvement of the radio frequency (RF) performance. In the proposed device, we employ dual material for the source and drain formation. Therefore, source/drain is divided into two parts as main source/drain and source/drain extension. Erbium silicide (ErSi1.7) is used as main source/drain material and Hafnium metal is used as source/drain extension material. The source extension induces the electron plasma in the ultrathin SOI body resulting reduction of SB width at the source side. Similarly, drain extension also induces the electron plasma at the drain side. This significantly increases the SB width due to increased depletion at the drain end. As a result, the ambipolar leakage current can be suppressed. In addition, drain extension also reduces the parasitic capacitances of the proposed device to improve the RF performance. The optimization of length and work function of metal used in the drain extension is performed to achieve improvement in device performance. Moreover, the proposed device makes fabrication simpler, requires low thermal budget and free from random dopant fluctuations.

  17. Intra-articular injection of tranexamic acid via a drain plus drain-clamping to reduce blood loss in cementless total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Mutsuzaki Hirotaka

    2012-09-01

    Full Text Available Abstract Background Patients undergoing cementless total knee arthroplasty (TKA sometimes suffer large blood loss. In a retrospective study, we explored whether postoperative intra-articular retrograde injection of tranexamic acid (TA and leaving a drain clamp in place for 1 h reduced blood loss. Patients and methods Patients (n = 140 treated with unilateral primary cementless TKA (posterior cruciate ligament retained were divided into two groups: those who had an intra-articular injection of TA (1000 mg and drain clamping for 1 h postoperatively (study group, n = 70 and those who were not given TA and did not undergo clamping of their drains (control group, n = 70. Postoperative total blood loss, volume of drainage, hemoglobin level, transfusion amounts and rates, D-dimer level at postoperative day (POD 7, and complications were recorded. Results Total blood loss, total drainage, mean transfusion volume, and transfusion rates were lower in the study group than in controls (P P P  Conclusions Immediately postoperative intra-articular retrograde injection of TA and 1 h of drain-clamping effectively reduced blood loss and blood transfusion after cementless TKA. We believe that this method is simple, easy, and suitable for these patients.

  18. Reverse blocking characteristics and mechanisms in Schottky-drain AlGaN/GaN HEMT with a drain field plate and floating field plates

    Science.gov (United States)

    Wei, Mao; Wei-Bo, She; Cui, Yang; Jin-Feng, Zhang; Xue-Feng, Zheng; Chong, Wang; Yue, Hao

    2016-01-01

    In this paper, a novel AlGaN/GaN HEMT with a Schottky drain and a compound field plate (SD-CFP HEMT) is presented for the purpose of better reverse blocking capability. The compound field plate (CFP) consists of a drain field plate (DFP) and several floating field plates (FFPs). The physical mechanisms of the CFP to improve the reverse breakdown voltage and to modulate the distributions of channel electric field and potential are investigated by two-dimensional numerical simulations with Silvaco-ATLAS. Compared with the HEMT with a Schottky drain (SD HEMT) and the HEMT with a Schottky drain and a DFP (SD-FP HEMT), the superiorities of SD-CFP HEMT lie in the continuous improvement of the reverse breakdown voltage by increasing the number of FFPs and in the same fabrication procedure as the SD-FP HEMT. Two useful optimization laws for the SD-CFP HEMTs are found and extracted from simulation results. The relationship between the number of the FFPs and the reverse breakdown voltage as well as the FP efficiency in SD-CFP HEMTs are discussed. The results in this paper demonstrate a great potential of CFP for enhancing the reverse blocking ability in AlGaN/GaN HEMT and may be of great value and significance in the design and actual manufacture of SD-CFP HEMTs. Project supported by the National Natural Science Foundation of China (Grant Nos. 61204085, 61334002, 61306017, 61474091, 61574112, and 61574110).

  19. Reverse blocking characteristics and mechanisms in Schottky-drain AlGaN/GaN HEMT with a drain field plate and floating field plates

    International Nuclear Information System (INIS)

    Mao Wei; She Wei-Bo; Zhang Jin-Feng; Zheng Xue-Feng; Wang Chong; Hao Yue; Yang Cui

    2016-01-01

    In this paper, a novel AlGaN/GaN HEMT with a Schottky drain and a compound field plate (SD-CFP HEMT) is presented for the purpose of better reverse blocking capability. The compound field plate (CFP) consists of a drain field plate (DFP) and several floating field plates (FFPs). The physical mechanisms of the CFP to improve the reverse breakdown voltage and to modulate the distributions of channel electric field and potential are investigated by two-dimensional numerical simulations with Silvaco-ATLAS. Compared with the HEMT with a Schottky drain (SD HEMT) and the HEMT with a Schottky drain and a DFP (SD-FP HEMT), the superiorities of SD-CFP HEMT lie in the continuous improvement of the reverse breakdown voltage by increasing the number of FFPs and in the same fabrication procedure as the SD-FP HEMT. Two useful optimization laws for the SD-CFP HEMTs are found and extracted from simulation results. The relationship between the number of the FFPs and the reverse breakdown voltage as well as the FP efficiency in SD-CFP HEMTs are discussed. The results in this paper demonstrate a great potential of CFP for enhancing the reverse blocking ability in AlGaN/GaN HEMT and may be of great value and significance in the design and actual manufacture of SD-CFP HEMTs. (paper)

  20. Ventricular Septal Dissection Complicating Inferior Wall Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Lindsey Kalvin

    2017-01-01

    Full Text Available Postmyocardial infarction ventricular septal defect is an increasingly rare mechanical complication of acute myocardial infarction. We present a case of acute myocardial infarction from right coronary artery occlusion that developed hypotension and systolic murmur 12 hours after successful percutaneous coronary intervention. Although preoperative imaging suggested a large ventricular septal defect and a pseudoaneurysm, intraoperative findings concluded a serpiginous dissection of the ventricular septum. The imaging technicalities are discussed.

  1. Postexertional Supraventricular Tachycardia in Children with Catecholaminergic Polymorphic Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Scott D. N. Else

    2012-01-01

    Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a severe arrhythmia associated with sudden death in the young. It is caused by defective calcium handling in ventricular myocytes. The association of supraventricular tachycardia (SVT with CPVT is described in the literature, occurring in the lead-up to ventricular tachycardia during exercise testing. We describe three cases of SVT that were initiated in the recovery period of exercise testing in children with CPVT.

  2. Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

    Directory of Open Access Journals (Sweden)

    Lin Long-Wei

    2010-05-01

    Full Text Available Abstract Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.

  3. Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report.

    Science.gov (United States)

    Lai, Peng-Sheng; Lo, Chiao; Lin, Long-Wei; Lee, Po-Chu

    2010-05-21

    Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.

  4. Right ventricular strain in heart failure: Clinical perspective.

    Science.gov (United States)

    Tadic, Marijana; Pieske-Kraigher, Elisabeth; Cuspidi, Cesare; Morris, Daniel A; Burkhardt, Franziska; Baudisch, Ana; Haßfeld, Sabine; Tschöpe, Carsten; Pieske, Burket

    2017-10-01

    The number of studies demonstrating the importance of right ventricular remodelling in a wide range of cardiovascular diseases has increased in the past two decades. Speckle-tracking imaging provides new variables that give comprehensive information about right ventricular function and mechanics. In this review, we summarize current knowledge of right ventricular mechanics in heart failure with reduced ejection fraction and preserved ejection fraction. We searched PubMed, MEDLINE, Ovid and Embase databases for studies published from January 2000 to December 2016 in the English language using the following keywords: "right ventricle"; "strain"; "speckle tracking"; "heart failure with reduced ejection fraction"; and "heart failure with preserved ejection fraction". Investigations showed that right ventricular dysfunction is associated with higher cardiovascular and overall mortality in patients with heart failure, irrespective of ejection fraction. The number of studies investigating right ventricular strain in patients with heart failure with reduced ejection fraction is constantly increasing, whereas data on right ventricular mechanics in patients with heart failure with preserved ejection fraction are limited. Given the high feasibility, accuracy and clinical implications of right ventricular strain in the population with heart failure, it is of great importance to try to include the evaluation of right ventricular strain as a regular part of each echocardiographic examination in patients with heart failure. However, further investigations are necessary to establish right ventricular strain as a standard variable for decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. In patients with extensive subcutaneous emphysema, which technique achieves maximal clinical resolution: infraclavicular incisions, subcutaneous drain insertion or suction on in situ chest drain?

    Science.gov (United States)

    Johnson, Charles H N; Lang, Sommer A; Bilal, Haris; Rammohan, Kandadai S

    2014-06-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'In patients with extensive subcutaneous emphysema, which technique achieves maximal clinical resolution: infraclavicular incisions, subcutaneous drain insertion or suction on in situ chest drain?'. Altogether more than 200 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Subcutaneous emphysema is usually a benign, self-limiting condition only requiring conservative management. Interventions are useful in the context of severe patient discomfort, respiratory distress or persistent air leak. In the absence of any comparative study, it is not possible to choose definitively between infraclavicular incisions, drain insertion and increasing suction on an in situ drain as the best method for managing severe subcutaneous emphysema. All the three techniques described have been shown to provide effective relief. Increasing suction on a chest tube already in situ provided rapid relief in patients developing SE following pulmonary resection. A retrospective study showed resolution in 66%, increasing to 98% in those who underwent video-assisted thoracic surgery with identification and closure of the leak. Insertion of a drain into the subcutaneous tissue also provided rapid sustained relief. Several studies aided drainage by using regular compressive massage. Infraclavicular incisions were also shown to provide rapid relief, but were noted to be more invasive and carried the potential for cosmetic defect. No major complications were illustrated. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Autologous transfusion of drain contents in elective primary knee arthroplasty: its value and relevance.

    Science.gov (United States)

    Singh, Vinay Kumar; Singh, Pankaj Kumar; Javed, Sadaf; Kumar, Kuldeep; Tomar, Juhi

    2011-07-01

    Total knee arthroplasty is associated with significant post-operative blood loss often necessitating blood transfusions. Blood transfusions may be associated with transfusion reactions and may transmit human immunodeficiency virus, hepatitis C virus and hepatitis B virus, with devastating consequences. After total knee arthroplasty, transfusion of the contents of an autologous drain is becoming common practice. The aim of our study was to look at the effectiveness of these drains in elective primary total knee arthroplasty. A prospective study was conducted including 70 non-randomised patients. A normal suction drain was used in 35 patients (group A), whereas in the other 35 patients, a CellTrans™ drain was used (group B). All the operations were performed by four surgeons using a tourniquet with a medial parapatellar approach. Pre- and post-operative haemoglobin concentrations were recorded in both groups. A Student's t-test was applied to determine the statistical significance of the data collected. The average fall in post-operative haemoglobin was 3.66 g/dL (SD 1.46; range, 0.6-7.0) among patients in whom the simple drain was used (group A) and 2.29 g/dL (SD 0.92; range, 0.6-5.9) among those in whom the CellTrans™ drain was used (group B) (p<0.0001). Twenty-five units of allogeneic blood were required in group A compared to four units in group B. The rate of transfusion was 5.7% (2 patients) in the group in which CellTrans™ drain was used and 25.7% (9 patients) in the group in which a simple suction drain was used. Total knee arthroplasty is associated with significant post-operative blood loss despite best operative technique. Autologous reinfusion of the contents of a CellTrans™ drain significantly reduces the rate of post-operative blood transfusion. This study indicates that the use of an autologous drain could be recommended as routine practice in primary total knee arthroplasty.

  7. The external jugular vein as an injection site in radionuclide angiography

    International Nuclear Information System (INIS)

    Humphrey, S.; Shelton, J.; Wollum, P.; Leguizamon, E.

    1982-01-01

    The first-pass radionuclide angiogram has been shown to be an effective method for evaluation of left ventricular function. When the first-pass technique is used, however, delivery of a compact radionuclide bolus is imperative. The external jugular vein is a safe, effective route of delivery for the bolus; it provides for a high quality, technically accurate test without deleterious effects to the patient

  8. Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D

    DEFF Research Database (Denmark)

    Kutyifa, Valentina; Bloch Thomsen, Poul Erik; Huang, David T.

    2013-01-01

    Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited.......Data on the impact of right ventricular (RV) lead location on clinical outcome and ventricular tachyarrhythmias in cardiac resynchronization therapy with defibrillator (CRT-D) patients are limited....

  9. Left Ventricular Function Improves after Pulmonary Valve Replacement in Patients with Previous Right Ventricular Outflow Tract Reconstruction and Biventricular Dysfunction

    Science.gov (United States)

    Kane, Colin; Kogon, Brian; Pernetz, Maria; McConnell, Michael; Kirshbom, Paul; Rodby, Katherine; Book, Wendy M.

    2011-01-01

    Congenital heart defects that have a component of right ventricular outflow tract obstruction, such as tetralogy of Fallot, are frequently palliated in childhood by disruption of the pulmonary valve. Although this can provide an initial improvement in quality of life, these patients are often left with severe pulmonary valve insufficiency. Over time, this insufficiency can lead to enlargement of the right ventricle and to the deterioration of right ventricular systolic and diastolic function. Pulmonary valve replacement in these patients decreases right ventricular volume overload and improves right ventricular performance. To date, few studies have examined the effects of pulmonary valve replacement on left ventricular function in patients with biventricular dysfunction. We sought to perform such an evaluation. Records of adult patients who had undergone pulmonary valve replacement from January 2003 through November 2006 were analyzed retrospectively. We reviewed preoperative and postoperative echocardiograms and calculated left ventricular function in 38 patients. In the entire cohort, the mean left ventricular ejection fraction increased by a mean of 0.07 after pulmonary valve replacement, which was a statistically significant change (P < 0.01). In patients with preoperative ejection fractions of less than 0.50, mean ejection fractions increased by 0.10. We conclude that pulmonary valve replacement in patients with biventricular dysfunction arising from severe pulmonary insufficiency and right ventricular enlargement can improve left ventricular function. Prospective studies are needed to verify this finding. PMID:21720459

  10. Towards Early Detection and Risk Stratification of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

    NARCIS (Netherlands)

    Riele, A.S.J.M. te

    2016-01-01

    Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an inherited cardiomyopathy characterized by frequent ventricular arrhythmias and usually slowly progressive ventricular dysfunction. Since its initial description in 1982, sudden cardiac death (SCD) occurring in young and usually

  11. Arrhythmogenic right ventricular dysplasia: Atypical clinical presentation.

    Science.gov (United States)

    Marçalo, José; Menezes Falcão, Luiz

    2017-03-01

    A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension. Cardiac magnetic resonance imaging (MRI) confirmed right ventricular (RV) dilatation and revealed marked hypokinesia/akinesia of the lateral wall. Exercise stress testing was negative for ischemia. According to the 2010 Task Force criteria for arrhythmogenic right ventricular dysplasia (ARVD), this patient presented two major criteria (global or regional dysfunction and structural alterations: by MRI, regional RV akinesia or dyskinesia or dyssynchronous RV contraction and RV ejection fraction ≤40%, and repolarization abnormalities: inverted T waves in right precordial leads [V1, V2, and V3]); and one minor criterion (>500 ventricular extrasystoles per 24 hours by Holter), and so a diagnosis of ARVD was made. After electrophysiologic study (EPS) the patient received an implantable cardioverter-defibrillator (ICD). This late clinical presentation of ARVD highlights the importance of TTE screening, possibly complemented by MRI. The associated risk of sudden death was assessed by EPS leading to the implantation of an ICD. Genetic association studies should be offered to the offspring of all ARVD patients. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Radiation dose associated with CT-guided drain placement for pediatric patients

    International Nuclear Information System (INIS)

    Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G.; Taylor, J.B.

    2017-01-01

    To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

  13. Radiation dose associated with CT-guided drain placement for pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, Cody J.; Isaacson, Ari J.; Fordham, Lynn Ansley; Ivanovic, Marija; Dixon, Robert G. [University of North Carolina at Chapel Hill, Department of Radiology, UNC Health Care, Chapel Hill, NC (United States); Taylor, J.B. [University of North Carolina at Chapel Hill, Environment, Health and Safety, Chapel Hill, NC (United States)

    2017-05-15

    To date, there are limited radiation dose data on CT-guided procedures in pediatric patients. Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose. We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing. Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv. The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary. (orig.)

  14. Gauze Impregnated With Quaternary Ammonium Salt Reduces Bacterial Colonization of Surgical Drains After Breast Reconstruction.

    Science.gov (United States)

    Strong, Amy L; Wolfe, Emily T; Shank, Nina; Chaffin, Abigail E; Jansen, David A

    2018-06-01

    Surgical site infection after breast reconstruction is associated with increased length of hospital stay, readmission rates, cost, morbidity, and mortality. Identifying methods to reduce surgical site infection without the use of antibiotics may be beneficial at reducing antimicrobial resistance, reserving the use of antibiotics for more severe cases. Quaternary ammonium salts have previously been shown to be a safe and effective antimicrobial agent in the setting of in vitro and in vivo animal experiments. A retrospective study was conducted to investigate the antimicrobial properties of a quaternary ammonium salt, 3-trimethoxysilyl propyldimethyloctadecyl ammonium chloride (QAS-3PAC; Bio-spear), at reducing surgical drain site colonization and infection after breast reconstruction (deep inferior epigastric perforator flap reconstruction or tissue expander placement). Twenty patients were enrolled, with 14 surgical drains covered with nonimpregnated gauze and 17 surgical drains covered with QAS-3PAC impregnated gauze, for the purposes of investigating bacterial colonization. Antibiotic sensitivity analysis was also conducted when bacterial cultures were positive. The overall incidence of bacterial colonization of surgical drains was lower in the treatment group compared with the control group (17.6% vs 64.3%, respectively; P = 0.008). QAS-3PAC impregnated gauze reduced the incidence of bacterial colonization of surgical drains during the first (0.0% vs 33.3%) and second (33.3% vs 87.5%; P = 0.04) postoperative week. Furthermore, no enhanced antibiotic resistance was noted on drains treated with QAS-3PAC impregnated gauze. The results of this study suggest that QAS-3PAC impregnated gauze applied over surgical drains may be an effective method for reducing the incidence of bacterial colonization.

  15. Pseudo ventricular tachycardia: a case report.

    LENUS (Irish Health Repository)

    Riaz, A

    2012-02-01

    BACKGROUND: Dramatic artifacts of pseudo flutter have been reported in the past secondary to various factors including tremor (Handwerker and Raptopoulos in N Engl J Med 356:503, 2007) and dialysis machines (Kostis et al. in J Electrocardiol 40(4):316-318, 2007). METHODS: We present this unusual case where the artifact, produced by tremor, was so pronounced to be misdiagnosed and treated as ventricular tachycardia. CONCLUSION: This case highlights the importance of correlating ECG findings with history and clinical examination and of using 12 lead ECGs for rhythm interpretation especially to confirm consistence of arrhythmias in all leads.

  16. Ventricular tachycardia in ischemic heart disease substrates

    Directory of Open Access Journals (Sweden)

    Olujimi A. Ajijola

    2014-01-01

    This review will discuss the central role of the ischemic heart disease substrate in the development MMVT. Electrophysiologic characterization of the post-infarct myocardium using bipolar electrogram amplitudes to delineate scar border zones will be reviewed. Functional electrogram determinants of reentrant circuits such as isolated late potentials will be discussed. Strategies for catheter ablation of reentrant ventricular tachycardia, including structural and functional targets will also be examined, as will the role of the epicardial mapping and ablation in the management of recurrent MMVT.

  17. Mycobacterium chimaera left ventricular assist device infections.

    Science.gov (United States)

    Balsam, Leora B; Louie, Eddie; Hill, Fred; Levine, Jamie; Phillips, Michael S

    2017-06-01

    A global outbreak of invasive Mycobacterium chimaera infections after cardiac surgery has recently been linked to bioaerosols from contaminated heater-cooler units. The majority of cases have occurred after valvular surgery or aortic graft surgery and nearly half have resulted in death. To date, infections in patients with left ventricular assist devices (LVADs) have not been characterized in the literature. We report two cases of device-associated M. chimaera infection in patients with continuous-flow LVADs and describe challenges related to diagnosis and management in this population. © 2017 Wiley Periodicals, Inc.

  18. Fibroblasts and the extracellular matrix in right ventricular disease.

    Science.gov (United States)

    Frangogiannis, Nikolaos G

    2017-10-01

    Right ventricular failure predicts adverse outcome in patients with pulmonary hypertension (PH), and in subjects with left ventricular heart failure and is associated with interstitial fibrosis. This review manuscript discusses the cellular effectors and molecular mechanisms implicated in right ventricular fibrosis. The right ventricular interstitium contains vascular cells, fibroblasts, and immune cells, enmeshed in a collagen-based matrix. Right ventricular pressure overload in PH is associated with the expansion of the fibroblast population, myofibroblast activation, and secretion of extracellular matrix proteins. Mechanosensitive transduction of adrenergic signalling and stimulation of the renin-angiotensin-aldosterone cascade trigger the activation of right ventricular fibroblasts. Inflammatory cytokines and chemokines may contribute to expansion and activation of macrophages that may serve as a source of fibrogenic growth factors, such as transforming growth factor (TGF)-β. Endothelin-1, TGF-βs, and matricellular proteins co-operate to activate cardiac myofibroblasts, and promote synthesis of matrix proteins. In comparison with the left ventricle, the RV tolerates well volume overload and ischemia; whether the right ventricular interstitial cells and matrix are implicated in these favourable responses remains unknown. Expansion of fibroblasts and extracellular matrix protein deposition are prominent features of arrhythmogenic right ventricular cardiomyopathies and may be implicated in the pathogenesis of arrhythmic events. Prevailing conceptual paradigms on right ventricular remodelling are based on extrapolation of findings in models of left ventricular injury. Considering the unique embryologic, morphological, and physiologic properties of the RV and the clinical significance of right ventricular failure, there is a need further to dissect RV-specific mechanisms of fibrosis and interstitial remodelling. Published on behalf of the European Society of

  19. Environmental external effects from wind power based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1998-01-01

    of the Danish part of the project is to implement the framework for externality evaluation, for three different power plants located in Denmark. The paper will focus on the assessment of the impacts of the whole fuel cycles for wind, natural gas and biogas. Priority areas for environmental impact assessment......The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective...

  20. Use of Automated External Defibrillators

    Energy Technology Data Exchange (ETDEWEB)

    Gregory K Christensen

    2009-02-01

    In an effort to improve survival from cardiac arrest, the American Heart Association (AHA) has promoted the Chain of Survival concept, describing a sequence of prehospital steps that result in improved survival after sudden cardiac arrest. These interventions include immediate deployment of emergency medical services, prompt cardiopulmonary resuscitation, early defibrillation when indicated, and early initiation of advanced medical care. Early defibrillation has emerged as the most important intervention with survival decreasing by 10% with each minute of delay in defibrillation. Ventricular Fibrillation (VF) is a condition in which there is uncoordinated contraction of the heart cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. VF is a medical emergency and if the arrhythmia continues for more than a few seconds, blood circulation will cease, and death can occur in a matter of minutes. During VF, contractions of the heart are not synchronized, blood flow ceases, organs begin to fail from oxygen deprivation and within 10 minutes, death will occur. When VF occurs, the victim must be defibrillated in order to establish the heart’s normal rhythm. On average, the wait for an ambulance in populated areas of the United States is about 11 minutes. In view of these facts, the EFCOG Electrical Safety Task Group initiated this review to evaluate the potential value of deployment and use of automated external defibrillators (AEDs) for treatment of SCA victims. This evaluation indicates the long term survival benefit to victims of SCA is high if treated with CPR plus defibrillation within the first 3-5 minutes after collapse. According to the American Heart Association (AHA), survival rates as high as 74% are possible if treatment and defibrillation is performed in the first 3 minutes. In contrast survival rates are only 5% where no AED programs have been established to provide prompt CPR and defibrillation. ["CPR statistics

  1. External corners as heat bridges

    Energy Technology Data Exchange (ETDEWEB)

    Berber, J.

    1984-08-01

    The maximum additional heat loss in vertical external corners depending on wall thickness is determined. In order to amire at a low k-value, a much smaller wall thickness is required in externally insulated walls than in monolithic constructions; the greater loss of heat bridge with external insulation stands in contrast to a higher loss in thick, monolithic walls. In relation to total losses, the additional losses through external corners are practically negligible.

  2. [External pancreatic fistulas management].

    Science.gov (United States)

    Stepan, E V; Ermolov, A S; Rogal', M L; Teterin, Yu S

    The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. Pancreatic trauma was the reason of pancreatic fistula in 38.7% of the cases, operations because of acute pancreatitis - in 25.8%, and pancreatic pseudocyst drainage - in 35.5%. 93 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in 74.2% of the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment. Endoscopic papillotomy was performed in patients with major duodenal papilla obstruction and interruption of transporting of pancreatic secretion to duodenum. Stent of the main pancreatic duct was indicated in patients with extended pancreatic duct stenosis to normalize transport of pancreatic secretion to duodenum. Surgical formation of anastomosis between distal part of the main pancreatic duct and gastro-intestinal tract was carried out when it was impossible to fulfill endoscopic stenting of pancreatic duct either because of its interruption and diastasis between its ends, or in the cases of unsuccessful conservative treatment of external pancreatic fistula caused by drainage of pseudocyst.

  3. Comparative effect of tube drain on post operative inflammatory complications of impacted mandibular third molar surgery College Hospital, Ibadan, Nigeria.

    Science.gov (United States)

    Obimakinde, O S; Fasola, A O; Arotiba, J T; Okoje, V N; Obiechina, A E

    2010-09-01

    Swelling, pain and trismus are acute reversible inflammatory complications of impacted mandibular third molar (M3) surgery. They contribute to the deterioration of quality of life and loss of several useful working hours. This study aimed to investigate whether the use of a surgical drain following M3 surgery can minimise these inflammatory complications. Eighty consecutive patients who gave consent were enrolled into the study. Patients were assigned into two groups (drain and no drain) by systematic sampling method which was modified to ensure matching of patients by age, sex and spatial relationship of the impacted mandibular third molar. The patients in the drain group (n=40) had a Foley's catheter drain inserted into the wound after the surgical procedure while the patients in the no drain group (n=40) had their wound closed without the use of drain. All patients had primary wound closure with 3.0 black silk sutures after the procedure. Demographic data, cheek dimension and maximal mouth opening were recorded before the procedure. Pain, swelling and trismus were evaluated in the two groups at 24 hours, 48 hours and 7th day after surgery. Post operative swelling and visual analogue scale score for pain were comparatively lesser in the drain group patients. The maximal interincisal distance was also more in the drain group patients. The findings from this study indicated that there is a significant benefit of using a surgical drain in minimising postoperative oedema, pain and trismus following surgical removal of impacted mandibular third molar.

  4. Pressure-controlled drainage of cerebrospinal fluid: clinical experience with a new type of ventricular catheter (Ventcontrol MTC)and an integrated Piezo-resistive sensor at its tip: technical note.

    Science.gov (United States)

    Piek, J; Raes, P

    1996-01-01

    We described a new ventricular catheter that is the combination of a "classic" ventricular catheter with a piezo-resistive transducer at its tip. The device allows parallel recordings of intraventricular fluid pressure via a chip and a fluid-filled external transducer, drainage of cerebrospinal fluid from the ventricle or injection of fluid into the ventricle with simultaneous monitoring of intracranial pressure, and recording of brain tissue pressure in cases of misplacement or dislocation of the ventricular catheter or in cases of progressively narrowing ventricles caused by brain edema. Clinical tests in various situations at different pressure ranges (total recording time, 1356 h in 13 patients) gave excellent correlations of both pressures. Application of the device is especially indicated in clinical situations in which pressure-controlled drainage is desirable, occlusion of ventricular bolts is likely, or pressure-volume tests are needed.

  5. Characterizing subsurface water flow to artificial drain lines using fiber-optic distributed temperature sensing

    Science.gov (United States)

    Shults, D.; Brooks, E. S.; Heinse, R.; Keller, C. K.

    2017-12-01

    Over the last several years growers have experienced increasingly wet spring conditions in the Palouse Region located in North Idaho, Eastern Washington and Eastern Oregon. As a result more artificial drain lines are being installed so growers can access their fields earlier in the growing season. Additionally there has been increasing adoption of no-tillage practices among growers in order minimize erosion and runoff in the region. There is a growing body of evidence that suggests long-term no-tillage may lead to the establishment of large macropore networks through increased earthworm activity and the preservation of root channels. These macropore networks, in conjunctions with the presence of artificial drains lines, may create connected preferential flow paths from agricultural fields to receiving streams. This connectivity of flow paths from agricultural fields to receiving water bodies may increase the loading of nutrients and agricultural chemicals as some flow paths may largely bypass soil matrix interaction where materials can be sequestered. Our primary objective for this study was to characterize subsurface flow to two artificial drain lines, one under conventional tillage and the other under no-tillage, using distributed temperature sensing (DTS) technology. During the study (November 2016-April 2017) the near surface soil-water temperature was consistently colder than that of deeper depths. Temperature was thus used as a tracer as snow melt and soil-water moved from the near surface to the drain lines during snowmelt and precipitation events. The spatial and temporal variability of the temperature along the artificial drain line under no-tillage practices was found to be greater than that of the conventional tilled field. It is hypothesized that preferential flow paths are responsible for the increased variability of temperature seen in the drain line under long term no-till management. The temperature along the conventional till drain line showed a

  6. Right ventricular pressure response to exercise in adults with isolated ventricular septal defect closed in early childhood.

    Science.gov (United States)

    Moller, Thomas; Lindberg, Harald; Lund, May Brit; Holmstrom, Henrik; Dohlen, Gaute; Thaulow, Erik

    2018-06-01

    We previously demonstrated an abnormally high right ventricular systolic pressure response to exercise in 50% of adolescents operated on for isolated ventricular septal defect. The present study investigated the prevalence of abnormal right ventricular systolic pressure response in 20 adult (age 30-45 years) patients who underwent surgery for early ventricular septal defect closure and its association with impaired ventricular function, pulmonary function, or exercise capacity. The patients underwent cardiopulmonary tests, including exercise stress echocardiography. Five of 19 patients (26%) presented an abnormal right ventricular systolic pressure response to exercise ⩾ 52 mmHg. Right ventricular systolic function was mixed, with normal tricuspid annular plane systolic excursion and fractional area change, but abnormal tricuspid annular systolic motion velocity (median 6.7 cm/second) and isovolumetric acceleration (median 0.8 m/second2). Left ventricular systolic and diastolic function was normal at rest as measured by the peak systolic velocity of the lateral wall and isovolumic acceleration, early diastolic velocity, and ratio of early diastolic flow to tissue velocity, except for ejection fraction (median 53%). The myocardial performance index was abnormal for both the left and right ventricle. Peak oxygen uptake was normal (mean z score -0.4, 95% CI -2.8-0.3). There was no association between an abnormal right ventricular systolic pressure response during exercise and right or left ventricular function, pulmonary function, or exercise capacity. Abnormal right ventricular pressure response is not more frequent in adult patients compared with adolescents. This does not support the theory of progressive pulmonary vascular disease following closure of left-to-right shunts.

  7. [Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease.

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Tfelt-Hansen, 1jacob; Olesen, Morten S

    2010-01-01

    Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease, which can lead to life-threatening ventricular arrhythmias in patients with a structurally normal heart. The age of onset is usually between two and 12 years and the initial symptom is frequently syncope...

  8. Right ventricular function in patients with dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Kubota, Shuhei; Kubota, Sachio; Iwase, Takashi; Iizuka, Toshio; Imai, Susumu; Murata, Kazuhiko; Inoue, Tomio; Suzuki, Tadashi; Sasaki, Yasuhito.

    1993-01-01

    The characteristics and pathogenesis of right ventricular dysfunction in 14 patients with dilated cardiomyopathy (DCM) were investigated by equilibrium right ventricular blood pool scintigraphy using ultrashort-lifetime 81m Kr. Thirteen patients with severe left ventricular dysfunction due to old anterior myocardial infarction (OMI) and nine normal subjects were used as controls. The right ventricular end-diastolic pressure and volume index, mean pulmonary arterial pressure, and total pulmonary vascular resistance index were almost the same in the DCM and OMI patients. The right ventricular ejection fraction was 44.2±6.0% (mean±SD) in DCM patients and 47.1±7.9% in OMI patients, both significantly lower than those in the normal subjects (54.5±5.3%), but with no difference between the two case groups. The right ventricular peak filling rate was significantly reduced in both case groups as compared with the normal subjects (2.46±0.81 EDV/sec). The reduction was significantly greater (p 81m Kr blood pool scintigraphy is useful in the study of the right ventricular systolic and diastolic function. The diastolic parameters are more sensitive indicators for evaluation of right ventricular function in DCM than the systolic parameters. (author)

  9. Ventricular septal defect closure in a patient with achondroplasia.

    Science.gov (United States)

    Nakanishi, Keisuke; Kawasaki, Shiori; Amano, Atsushi

    2017-01-01

    Achondroplasia with co-morbid CHD is rare, as are reports of surgical treatment for such patients. We present the case of a 13-year-old girl with achondroplasia and ventricular septal defect. Her ventricular septal defect was surgically repaired focussing on the cardiopulmonary bypass flow, healing of the sternum, and her frail neck cartilage. The surgery and recovery were without complications.

  10. Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

    Science.gov (United States)

    Lanjewar, Swapnil S; Chhabra, Lovely; Chaubey, Vinod K; Joshi, Saurabh; Kulkarni, Ganesh; Kothagundla, Chandrasekhar; Kaul, Sudesh; Spodick, David H

    2013-01-01

    The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

  11. Intermittent′ restrictive ventricular septal defect in Tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Sudhir S Shetkar

    2015-01-01

    Full Text Available Ventricular septal defect (VSD in Tetralogy of Fallot (TOF is usually large and non-restrictive with equalization of right and left ventricular pressures. Restrictive VSD in TOF is rare. We present an unusual case of TOF with restriction to VSD caused by accessory tricuspid valve tissue that varied with respiration.

  12. Normal left ventricular function does not protect against propafenone ...

    African Journals Online (AJOL)

    Normal left ventricular function does not protect against propafenone-induced incessant ventricular tachycardia. R. N. Scott Millar, J. B. Lawrenson, D.A. Milne. Abstract. Propafenone is a class Ic anti-arrhythmic agent with mild B-blocking properties which has recently become available in South Africa. We have used the ...

  13. Reversible left ventricular dysfunction - important clinical problem of contemporary cardiology

    International Nuclear Information System (INIS)

    Witkowski, A.

    1994-01-01

    An important clinical issue there is determination whether left ventricular damages are reversible or not single photon emission computed tomography and positron computed tomography techniques are shown to provide valuable data in this problem. Article describes basic syndromes connected with left ventricular dysfunction, namely: hibernating myocardium, stunned myocardium and ischemic myocardium preconditioning. (author). 18 refs

  14. Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

    Science.gov (United States)

    Atik-Ugan, Sezen; Saltik, Irfan Levent

    2018-04-01

    Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

  15. Evaluation of left ventricular volumes measured by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Møgelvang, J; Thomsen, C; Mehlsen, J

    1986-01-01

    Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

  16. Differences in microbial community structure and nitrogen cycling in natural and drained tropical peatland soils.

    Science.gov (United States)

    Espenberg, Mikk; Truu, Marika; Mander, Ülo; Kasak, Kuno; Nõlvak, Hiie; Ligi, Teele; Oopkaup, Kristjan; Maddison, Martin; Truu, Jaak

    2018-03-16

    Tropical peatlands, which play a crucial role in the maintenance of different ecosystem services, are increasingly drained for agriculture, forestry, peat extraction and human settlement purposes. The present study investigated the differences between natural and drained sites of a tropical peatland in the community structure of soil bacteria and archaea and their potential to perform nitrogen transformation processes. The results indicate significant dissimilarities in the structure of soil bacterial and archaeal communities as well as nirK, nirS, nosZ, nifH and archaeal amoA gene-possessing microbial communities. The reduced denitrification and N 2 -fixing potential was detected in the drained tropical peatland soil. In undisturbed peatland soil, the N 2 O emission was primarily related to nirS-type denitrifiers and dissimilatory nitrate reduction to ammonium, while the conversion of N 2 O to N 2 was controlled by microbes possessing nosZ clade I genes. The denitrifying microbial community of the drained site differed significantly from the natural site community. The main reducers of N 2 O were microbes harbouring nosZ clade II genes in the drained site. Additionally, the importance of DNRA process as one of the controlling mechanisms of N 2 O fluxes in the natural peatlands of the tropics revealed from the results of the study.

  17. Use of laterally placed vacuum drains for management of aural hematomas in five dogs.

    Science.gov (United States)

    Pavletic, Michael M

    2015-01-01

    5 dogs (a Newfoundland, Golden Retriever, Shiba Inu, Staffordshire Terrier, and Vizsla) were referred for evaluation and treatment of unilateral aural hematomas within a week after their formation. Aural hematomas involved the left (3) or right (2) ears. With patients under anesthesia, the aural hematomas were approached surgically from the convex, or lateral, pinnal surface. Two small incisions were used to position a vacuum drain into the incised hematoma cavity. The drain exited at the base of the pinna and adjacent cervical skin. The free end of the drain was attached to a vacuum reservoir for 18 to 21 days. Drains and skin sutures were removed at this time along with the protective Elizabethan collar. All hematomas resolved and surgical sites healed during the minimum 6-month follow-up period. Cosmetic results were considered excellent in 4 of 5 patients. Slight wrinkling of the pinna in 1 patient resulted from asymmetric enlargement of the cartilaginous walls of the hematoma, where vacuum application resulted in a slight folding of the redundant lateral cartilage wall. The described treatment was efficient, economical, and minimally invasive and required no bandaging or wound care. Placement of the drain tubing on the convex (lateral) aspect sheltered the system from displacement by patients with an Elizabethan collar in place. Overall cosmetic results were excellent; asymmetric enlargement of the cartilaginous walls of the hematoma with slight folding of the pinna was seen in 1 patient.

  18. Is a drain tube necessary for minimally invasive lumbar spine fusion surgery?

    Science.gov (United States)

    Hung, Pei-I; Chang, Ming-Chau; Chou, Po-Hsin; Lin, Hsi-Hsien; Wang, Shih-Tien; Liu, Chien-Lin

    2017-03-01

    This study aimed to evaluate if closed suction wound drainage is necessary in minimally invasive surgery of transforaminal lumbar interbody fusion (MIS TLIF). This is a prospective randomized clinical study. Fifty-six patients who underwent MIS TLIF were randomly divided into groups A (with a closed suction wound drainage) and B (without tube drainage). Surgical duration, intraoperative blood loss, timing of ambulation, length of hospital stay and complications were recorded. Patients were followed up for an average of 25.3 months. Clinical outcome was assessed using the Oswestry disability index and visual analogue scale (VAS). Fusion rate was classified with the Bridwell grading system, based on plain radiograph. Both groups had similar patient demographics. The use of drains had no significant influence on perioperative parameters including operative time, estimated blood loss, length of stay and complications. Patients in group B started ambulation 1 day earlier than patients in group A (p drain tube can lead to pain, anxiety and discomfort during the postoperative period. We conclude that drain tubes are not necessary for MIS TLIF. Patients without drains had the benefit of earlier ambulation than those with drains.

  19. Genetic bases of arrhythmogenic right ventricular cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Alessandra Rampazzo

    2010-05-01

    Full Text Available Arrhythmogenic right ventricular cardiomyopathy (ARVC is a heart muscle disease in which the pathological substrate is a fibro-fatty replacement of the right ventricular myocardium. The major clinical features are different types of arrhythmias with a left branch block pattern. ARVC shows autosomal dominant inheritance with incomplete penetrance. Recessive forms were also described, although in association with skin disorders. Ten genetic loci have been discovered so far and mutations were reported in five different genes. ARVD1 was associated with regulatory mutations of transforming growth factor beta-3 (TGFβ3, whereas ARVD2, characterized by effort-induced polymorphic arrhythmias, was associated with mutations in cardiac ryanodine receptor-2 (RYR2. All other mutations identified to date have been detected in genes encoding desmosomal proteins: plakoglobin (JUP which causes Naxos disease (a recessive form of ARVC associated with palmoplantar keratosis and woolly hair; desmoplakin (DSP which causes the autosomal dominant ARVD8 and plakophilin-2 (PKP2 involved in ARVD9. Desmosomes are important cell-to-cell adhesion junctions predominantly found in epidermis and heart; they are believed to couple cytoskeletal elements to plasma membrane in cell-to-cell or cell-to-substrate adhesions.

  20. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  1. Sinking during earthquakes: Critical acceleration criteria control drained soil liquefaction

    Science.gov (United States)

    Clément, C.; Toussaint, R.; Stojanova, M.; Aharonov, E.

    2018-02-01

    This article focuses on liquefaction of saturated granular soils, triggered by earthquakes. Liquefaction is defined here as the transition from a rigid state, in which the granular soil layer supports structures placed on its surface, to a fluidlike state, in which structures placed initially on the surface sink to their isostatic depth within the granular layer. We suggest a simple theoretical model for soil liquefaction and show that buoyancy caused by the presence of water inside a granular medium has a dramatic influence on the stability of an intruder resting at the surface of the medium. We confirm this hypothesis by comparison with laboratory experiments and discrete-element numerical simulations. The external excitation representing ground motion during earthquakes is simulated via horizontal sinusoidal oscillations of controlled frequency and amplitude. In the experiments, we use particles only slightly denser than water, which as predicted theoretically increases the effect of liquefaction and allows clear depth-of-sinking measurements. In the simulations, a micromechanical model simulates grains using molecular dynamics with friction between neighbors. The effect of the fluid is captured by taking into account buoyancy effects on the grains when they are immersed. We show that the motion of an intruder inside a granular medium is mainly dependent on the peak acceleration of the ground motion and establish a phase diagram for the conditions under which liquefaction happens, depending on the soil bulk density, friction properties, presence of water, and peak acceleration of the imposed large-scale soil vibrations. We establish that in liquefaction conditions, most cases relax toward an equilibrium position following an exponential in time. We also show that the equilibrium position itself, for most liquefaction regimes, corresponds to the isostatic equilibrium of the intruder inside a medium of effective density. The characteristic time to relaxation is

  2. Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction

    DEFF Research Database (Denmark)

    Deutch, Susanna; Dahlberg, Daniel; Hedegaard, Jesper

    2007-01-01

    OBJECTIVE: To compare a broad-range real-time polymerase chain reaction (PCR) diagnostic strategy with culture to evaluate additional effects on the etiological diagnosis and the quantification of the bacterial load during the course of ventricular drainage-related bacterial meningitis (VR......-BM). METHODS: We applied a PCR that targeted conserved regions of the 16S ribosomal ribonucleic acid gene to cerebrospinal fluid (CSF) samples from patients with external ventricular drainage or a ventriculoperitoneal shunt during the course of VR-BM. We compared the PCR results with CSF cultures. A total...... of 350 routine CSF samples were consecutively collected from 86 patients. The CSF deoxyribonucleic acid was automatically purified and subjected to PCR. Amplicons from the PCR samples that were positive for VR-BM were subsequently deoxyribonucleic acid sequenced for final identification. Clinical data...

  3. Postoperative use of drain in thyroid lobectomy – a randomized clinical trial conducted at Civil Hospital, Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Memon Zahid

    2012-09-01

    Full Text Available Abstract Background Thyroidectomy is a common surgical procedure, after which drains are placed routinely. This study aims to assess the benefits of placing postoperative drains, its complications and affects on postoperative stay, in thyroid lobectomy. Methodology Randomized Clinical Trial of 60 goitre patients undergoing lobectomy was conducted at Civil Hospital Karachi, during July’11-December’11. Patients were randomly assigned into drain and non drain groups. Patient demographics, labs and complications were noted. Ultrasound of neck was performed on both groups. For drain group, the amount of fluid present in the surgical bed and redivac drain was added to calculate fluid collection while in non drain group it was calculated by ultrasound of neck on first and second post-op days. Data was entered and analyzed on SPSS v16 using Independent T tests. Result The mean total drain output for 2 days in non-drain group was significantly lower 10.67 (±9.072 ml while in drain group was 30.97 (±42.812 ml (p = 0.014. The mean postoperative stay of drain group (79.2 ±15.63 hours was significantly higher, as compared to mean postoperative stay of non drain group (50.4 ±7.32 hours. Mean Visual Analogue Score (VAS for pain day 1 (6.2 ±0.997 and day 2 (4.17 ±0.95 in drain group were significantly higher compared to day 1 (2.6 ±1.163 and day 2 (1.3 ±0.877 of non drain group. From drain group, 2 patients complained of stridor, dyspnea on Day 1 which subsided by Day 2 and 1 case of voice change, with no such complains in non drain group. No patients from both groups developed seroma, wound infection or hematoma. Conclusion In uncomplicated surgeries especially for lobectomy, use of drain can be omitted.

  4. Evaluation of left ventricular function by cardiac CT

    International Nuclear Information System (INIS)

    Naito, Hiroaki; Kozuka, Takahiro

    1982-01-01

    Left ventricular function was evaluated by CT, which was compared with the data of left ventriculography for various cardiac diseases. The end diastolic volume of the left ventricle can be readily computed from CT, with a satisfactory correlation with that of left ventriculography (r = 0.95). The left ventricular ejection fraction, calculated from the areal ratio of the left ventricular lumen in end-diastolic imaging to that in end-sytolic imaging, also roughly reflects left ventricular contractile function, but shows correlation with left ventriculography by only r = 0.79. Although the cardiac output is not sensitive for functional evaluation, it can be directly calculated by means of dynamic scanning and shows a satisfactory correlation with the ear piece pigment dilution (r = 0.85). Evaluation of left ventricular function by CT shows a high precision in comparison with left ventriculography, but still lacks temporal resolving power. (Chiba, N.)

  5. Ventricular rhythm in atrial fibrillation under anaesthetic infusion with propofol

    International Nuclear Information System (INIS)

    Cervigón, R; Moreno, J; Pérez-Villacastín, J; Reilly, R B; Castells, F

    2009-01-01

    Changes in patients' autonomic tone and specific pharmacologic interventions may modify the ventricular response (actual heart rate) during atrial fibrillation (AF). Hypnotic agents such as propofol may modify autonomic balance as they promote a sedative state. It has been shown that propofol slightly slows atrial fibrillatory activity, but the net global effect on the ventricular response remains unknown. We aimed to evaluate in patients in AF the effect of a propofol bolus on the ventricular rate and regularity at ECG. We analysed the possible relation with local atrial fibrillatory activities, as ratios between atrial and ventricular rates (AVRs), analysing atrial activity from intracardiac electrograms at the free wall of the right and left atria and at the interatrial septum. We compared data at the baseline and after complete hypnosis. Propofol was associated with a more homogeneous ventricular response and lower AVR values at the interatrial septum

  6. Malignant ventricular tachycardia in acromegaly: a case report

    Directory of Open Access Journals (Sweden)

    Zhe An

    Full Text Available CONTEXT: In patients with acromegaly, cardiovascular complications are the main cause of death; sudden death has been associated with ventricular tachyarrhythmias. In other patients with life-threatening malignant ventricular tachyarrhythmias, surgical placement of an implantable cardioverter-defibrillator (ICD has proved highly effective in reducing sudden death rates. CASE REPORT: The present article reports the case of a 50-year-old male acromegalic patient who presented symptoms of syncope induced by ventricular tachycardia. An ICD was surgically implanted and a pituitary adenoma, which was responsible for the acromegaly, was completely removed in the same procedure. The surgery was successful and the ventricular arrhythmias were effectively terminated. During six months of follow-up, no documented arrhythmic episodes occurred. CONCLUSION: In patients with acromegaly, malignant ventricular tachyarrhythmia might be effectively controlled by implantation of an ICD and surgical removal of the pituitary adenoma.

  7. External Measures of Cognition

    Directory of Open Access Journals (Sweden)

    Osvaldo eCairo

    2011-10-01

    Full Text Available The human brain is undoubtedly the most impressive, complex and intricate organ that has evolved over time. It is also probably the least understood, and for that reason, the one that is currently attracting the most attention. In fact, the number of comparative analyses that focus on the evolution of brain size in Homo sapiens and other species has increased dramatically in recent years. In neuroscience, no other issue has generated so much interest and been the topic of so many heated debates as the difference in brain size between socially defined population groups, both its connotations and implications. For over a century, external measures of cognition have been related to intelligence. However, it is still unclear whether these measures actually correspond to cognitive abilities. In summary, this paper must be reviewed with this premise in mind.

  8. Hanford External Dosimetry Program

    International Nuclear Information System (INIS)

    Fix, J.J.

    1990-10-01

    This document describes the Hanford External Dosimetry Program as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy (DOE) and its Hanford contractors. Program services include administrating the Hanford personnel dosimeter processing program and ensuring that the related dosimeter data accurately reflect occupational dose received by Hanford personnel or visitors. Specific chapters of this report deal with the following subjects: personnel dosimetry organizations at Hanford and the associated DOE and contractor exposure guidelines; types, characteristics, and procurement of personnel dosimeters used at Hanford; personnel dosimeter identification, acceptance testing, accountability, and exchange; dosimeter processing and data recording practices; standard sources, calibration factors, and calibration processes (including algorithms) used for calibrating Hanford personnel dosimeters; system operating parameters required for assurance of dosimeter processing quality control; special dose evaluation methods applied for individuals under abnormal circumstances (i.e., lost results, etc.); and methods for evaluating personnel doses from nuclear accidents. 1 ref., 14 figs., 5 tabs

  9. Bevalac external beamline optics

    Energy Technology Data Exchange (ETDEWEB)

    Kalnins, J.G.; Krebs, G.F.; Tekawa, M.M.; Alonso, J.R.

    1987-04-01

    This handbook is intended as an aid for tuning the external particle beam (EPB) lines at the Lawrence Berkeley Laboratory's Bevalac. The information contained within will be useful to the Bevalac's Main Control Room and experimenters alike. First, some general information is given concerning the EPB lines and beam optics. Next, each beam line is described in detail: schematics of the beam line components are shown, all the variables required to run a beam transport program are presented, beam envelopes are given with wire chamber pictures and magnet currents, focal points and magnifications. Some preliminary scaling factors are then presented which should aid in choosing a given EPB magnet's current for a given central Bevalac field. Finally, some tuning hints are suggested.

  10. Bevalac external beamline optics

    International Nuclear Information System (INIS)

    Kalnins, J.G.; Krebs, G.F.; Tekawa, M.M.; Alonso, J.R.

    1987-04-01

    This handbook is intended as an aid for tuning the external particle beam (EPB) lines at the Lawrence Berkeley Laboratory's Bevalac. The information contained within will be useful to the Bevalac's Main Control Room and experimenters alike. First, some general information is given concerning the EPB lines and beam optics. Next, each beam line is described in detail: schematics of the beam line components are shown, all the variables required to run a beam transport program are presented, beam envelopes are given with wire chamber pictures and magnet currents, focal points and magnifications. Some preliminary scaling factors are then presented which should aid in choosing a given EPB magnet's current for a given central Bevalac field. Finally, some tuning hints are suggested

  11. Left ventricular mass in borderline hypertension assessed by echo cardiography

    International Nuclear Information System (INIS)

    Mezzasalma, L.; Ghione, S.; Palonebo, C.

    1989-01-01

    The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall ≥1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r=0.53, p<0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r=0.55, p<0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occuring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients. In addition, they indicate a direct relation between left ventricular mass and blood pressure levels also in borderline hypertension, as previously shown for established hypertension, despite the fact that left ventricular hypertrophy represents only an occasional finding in early stages of hypertension

  12. Mechanism of improving forward and reverse blocking voltages in AlGaN/GaN HEMTs by using Schottky drain

    International Nuclear Information System (INIS)

    Zhao Sheng-Lei; Mi Min-Han; Luo Jun; Wang Yi; Dai Yang; Zhang Jin-Cheng; Ma Xiao-Hua; Hao Yue; Hou Bin

    2014-01-01

    In this paper, we demonstrate that a Schottky drain can improve the forward and reverse blocking voltages (BVs) simultaneously in AlGaN/GaN high-electron mobility transistors (HEMTs). The mechanism of improving the two BVs is investigated by analysing the leakage current components and by software simulation. The forward BV increases from 72 V to 149 V due to the good Schottky contact morphology. During the reverse bias, the buffer leakage in the Ohmicdrain HEMT increases significantly with the increase of the negative drain bias. For the Schottky-drain HEMT, the buffer leakage is suppressed effectively by the formation of the depletion region at the drain terminal. As a result, the reverse BV is enhanced from −5 V to −49 V by using a Schottky drain. Experiments and the simulation indicate that a Schottky drain is desirable for power electronic applications. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  13. Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide

    DEFF Research Database (Denmark)

    Pedersen, Henriette Sloth; Elming, Hanne; Seibaek, Marie

    2007-01-01

    The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish...

  14. Modeling the drain current and its equation parameters for lightly doped symmetrical double-gate MOSFETs

    International Nuclear Information System (INIS)

    Bhartia, Mini; Chatterjee, Arun Kumar

    2015-01-01

    A 2D model for the potential distribution in silicon film is derived for a symmetrical double gate MOSFET in weak inversion. This 2D potential distribution model is used to analytically derive an expression for the subthreshold slope and threshold voltage. A drain current model for lightly doped symmetrical DG MOSFETs is then presented by considering weak and strong inversion regions including short channel effects, series source to drain resistance and channel length modulation parameters. These derived models are compared with the simulation results of the SILVACO (Atlas) tool for different channel lengths and silicon film thicknesses. Lastly, the effect of the fixed oxide charge on the drain current model has been studied through simulation. It is observed that the obtained analytical models of symmetrical double gate MOSFETs are in good agreement with the simulated results for a channel length to silicon film thickness ratio greater than or equal to 2. (paper)

  15. Modeling the drain current and its equation parameters for lightly doped symmetrical double-gate MOSFETs

    Science.gov (United States)

    Bhartia, Mini; Chatterjee, Arun Kumar

    2015-04-01

    A 2D model for the potential distribution in silicon film is derived for a symmetrical double gate MOSFET in weak inversion. This 2D potential distribution model is used to analytically derive an expression for the subthreshold slope and threshold voltage. A drain current model for lightly doped symmetrical DG MOSFETs is then presented by considering weak and strong inversion regions including short channel effects, series source to drain resistance and channel length modulation parameters. These derived models are compared with the simulation results of the SILVACO (Atlas) tool for different channel lengths and silicon film thicknesses. Lastly, the effect of the fixed oxide charge on the drain current model has been studied through simulation. It is observed that the obtained analytical models of symmetrical double gate MOSFETs are in good agreement with the simulated results for a channel length to silicon film thickness ratio greater than or equal to 2.

  16. An analytical drain current model for symmetric double-gate MOSFETs

    Directory of Open Access Journals (Sweden)

    Fei Yu

    2018-04-01

    Full Text Available An analytical surface-potential-based drain current model of symmetric double-gate (sDG MOSFETs is described as a SPICE compatible model in this paper. The continuous surface and central potentials from the accumulation to the strong inversion regions are solved from the 1-D Poisson’s equation in sDG MOSFETs. Furthermore, the drain current is derived from the charge sheet model as a function of the surface potential. Over a wide range of terminal voltages, doping concentrations, and device geometries, the surface potential calculation scheme and drain current model are verified by solving the 1-D Poisson’s equation based on the least square method and using the Silvaco Atlas simulation results and experimental data, respectively. Such a model can be adopted as a useful platform to develop the circuit simulator and provide the clear understanding of sDG MOSFET device physics.

  17. An analytical drain current model for symmetric double-gate MOSFETs

    Science.gov (United States)

    Yu, Fei; Huang, Gongyi; Lin, Wei; Xu, Chuanzhong

    2018-04-01

    An analytical surface-potential-based drain current model of symmetric double-gate (sDG) MOSFETs is described as a SPICE compatible model in this paper. The continuous surface and central potentials from the accumulation to the strong inversion regions are solved from the 1-D Poisson's equation in sDG MOSFETs. Furthermore, the drain current is derived from the charge sheet model as a function of the surface potential. Over a wide range of terminal voltages, doping concentrations, and device geometries, the surface potential calculation scheme and drain current model are verified by solving the 1-D Poisson's equation based on the least square method and using the Silvaco Atlas simulation results and experimental data, respectively. Such a model can be adopted as a useful platform to develop the circuit simulator and provide the clear understanding of sDG MOSFET device physics.

  18. PWSCC Potential on the Drain Tubes of WEC Model 51F Steam Generators in Domestic Plants

    International Nuclear Information System (INIS)

    Chang, B. I.; Song, M. S.; Yoon, K. S.; Kim, I. Y.

    2009-01-01

    The drain couplings of Westinghouse Model 51F steam generators that had been operated in the domestic Nuclear Power Plants were modified and repaired in accordance with the corrective action of replacing the existing Alloy 600 weld build-up with Alloy 690(Alloy 52/152) weld build-up in order to increase its resistance to primary water stress corrosion cracking (PWSCC). The drain tube made of alloy 600, however, was not replaced and left susceptible to the PWSCC. Among the environmental, metallurgical and mechanical factors controlling a susceptibility to the PWSCC, it is believed that tensile stresses play an important role. The objective of this study is to conservatively estimate stress state of the drain tube during fabrication and when exposed to normal plant operations, and to investigate its potential for the PWSCC

  19. Leak or Fistula After Sleeve Gastrectomy: Treatment with Pigtail Drain by the Rendezvous Technique.

    Science.gov (United States)

    Soufron, Jacques

    2015-10-01

    After a sleeve gastrectomy, a leak or fistula is a serious complication. Laparoscopic drainage, drainage under US or CT scan control, or endoscopic insertion of a stent can be used, but a major re-operation is sometimes unavoidable. Endoscopic drainage with a pigtail catheter could give more success and fewer complications, but the insertion of the drain is not always possible nor does it always provide a perfect drainage. If a laparoscopic second look appears necessary, it is possible to insert a pigtail drain laparoscopically, but under endoscopic control, ensuring a correct positioning of the drain both in the peritoneal cavity and in the gastric tube. This simultaneous "rendezvous" technique could combine in this situation the advantages of purely surgical techniques and of purely endoscopic or image-guided techniques.

  20. A Drain Current Model Based on the Temperature Effect of a-Si:H Thin-Film Transistors

    International Nuclear Information System (INIS)

    Qiang Lei; Yao Ruo-He

    2012-01-01

    Based on the differential Ohm's law and Poisson's equation, an analytical model of the drain current for a-Si:H thin-film transistors is developed. This model is proposed to elaborate the temperature effect on the drain current, which indicates that the drain current is linear with temperature in the range of 290-360 K, and the results fit well with the experimental data

  1. A vapor generator equipped with an advanced drain device for the secondary side of the tubes plate

    International Nuclear Information System (INIS)

    Valadon, C.

    1995-01-01

    A draining design is proposed for the tube plate secondary side in a PWR type reactor, that does not interfere with the water flush 'street' thus allowing for an easy inspection and maintenance in the lower part of the tube bundle. The draining system is composed of a main groove on the upper side of the tube plate, which is connected to draining means situated outside the vapor generator. 6 fig

  2. Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

    OpenAIRE

    Horiuchi, Tetsuyoshi; Yamamoto, Yasunaga; Kuroiwa, Masafumi; Rahmah, Nunung Nur; Hongo, Kazuhiro

    2012-01-01

    We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should...

  3. The Treatment Of The RSU In Controlled Drains: Their Sanitary Problem To The Production Of Energy

    International Nuclear Information System (INIS)

    Calderon U, Rafael A.

    1995-01-01

    The limitless world production of residuals generates constant concerns with relationship to its administration. The classic elimination methods as the drains controlled in front of the controversial incineration plants and gasification as well as the expectations created around the recycle practices, are reason of intense debates among city councils, specialist, environmentalist technicians and the public in general. The certain thing is that the residuals in the last 30 years have been valued economically. Today in day the residuals are appreciated by certain sectors that begin to monopolize the line of the recycle because they come them an excellent business. All the methods of elimination of residuals produce in turn others. Those of solid nature in general go to the drain, the semi-liquids becomes dehydrated for the same end. Presently work, without seeking to say that the employment of the drains is the best option, thinks about how it has more than enough they are possible to optimize its use. Showing beside their eminently sanitary vocation an energy alternative that allows the use of the combustible gas that is generated in them. An added value that is interesting if this it becomes source of well-being for social excluded nuclei and economically like it happens for example in the peripheries of the drains of the big Latin American cities. They are considered which are the main aspects that intervene in the generation, production and quality of the gas methane of the drains. Their reception methods and their use alternatives. Lastly emphasis is made in the environmental situation to European and international level about the gases of the drain, how it thinks about the topic of the greenhouse effect and which are the actions for the horizon of the year 2000. They are related some experiences in Europe on the use of the biogas

  4. Numerical simulation of draining and drying procedure for the ITER Generic Equatorial Port Plug cooling system

    International Nuclear Information System (INIS)

    Tanchuk, Victor; Grigoriev, Sergey; Lyublin, Boris; Maquet, Philippe; Senik, Konstantin; Pak, Sunil; Udintsev, Victor

    2016-01-01

    Highlights: • The cooling system of the ITER Generic Equatorial Port Plug (GEPP) is of a complicated combination of horizontal and vertical channels. • The calculation model for the entire GEPP cooling circuit comprising 12 sub-circuits and built up of 2421 finite-volume elements has been developed. • Transient analysis of this model simulating the draining procedure by the KORSAR/B1 code has been performed. • Water in amount of 263 g of initial 531 kg in the GEPP remains in the dead-ends of the DSM and DFW channels in 150 s of draining procedure. • Almost 3 h are required to boil off 263 g of water trapped in the dead-ends. - Abstract: For effective vacuum leak testing all cooling circuits serving the ITER vessel and in-vessel components shall be drained and dried so that after this procedure taking less than 100 h the purge gas passing through a component has water content less than 100 ppm. This process is four-stage, with the first stage using a short blast of compressed nitrogen to blow most of water in the coolant channels out of the circuit. This process is hindered by volumes which trap water due to gravity. To remove the trapped water, it is necessary, first, to heat up the structure by hot and compressed nitrogen, and then water is evaporated by depressurized nitrogen. The cooling system of the ITER Diagnostic Equatorial Port Plugs is of a complicated hydraulic configuration. The system branching might make difficult removal of water from the piping in the scheduled draining mode. The authors have proposed the KORSAR computation code to simulate draining of the GEPP cooling circuit. The numerical simulation performed has made it possible to describe the process dynamics during draining of the entire GEPP cooling circuit and to define the process time, amount and location of residual water and evolution of two-phase flow regime.

  5. Numerical simulation of draining and drying procedure for the ITER Generic Equatorial Port Plug cooling system

    Energy Technology Data Exchange (ETDEWEB)

    Tanchuk, Victor, E-mail: Victor.Tanchuk@sintez.niiefa.spb.su [JSC “D.V. Efremov Institute of Electrophysical Apparatus”, 196641 St. Petersburg (Russian Federation); Grigoriev, Sergey; Lyublin, Boris [JSC “D.V. Efremov Institute of Electrophysical Apparatus”, 196641 St. Petersburg (Russian Federation); Maquet, Philippe [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France); Senik, Konstantin [JSC “D.V. Efremov Institute of Electrophysical Apparatus”, 196641 St. Petersburg (Russian Federation); Pak, Sunil [National Fusion Research Institute, Daejeon (Korea, Republic of); Udintsev, Victor [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-lez-Durance (France)

    2016-11-01

    Highlights: • The cooling system of the ITER Generic Equatorial Port Plug (GEPP) is of a complicated combination of horizontal and vertical channels. • The calculation model for the entire GEPP cooling circuit comprising 12 sub-circuits and built up of 2421 finite-volume elements has been developed. • Transient analysis of this model simulating the draining procedure by the KORSAR/B1 code has been performed. • Water in amount of 263 g of initial 531 kg in the GEPP remains in the dead-ends of the DSM and DFW channels in 150 s of draining procedure. • Almost 3 h are required to boil off 263 g of water trapped in the dead-ends. - Abstract: For effective vacuum leak testing all cooling circuits serving the ITER vessel and in-vessel components shall be drained and dried so that after this procedure taking less than 100 h the purge gas passing through a component has water content less than 100 ppm. This process is four-stage, with the first stage using a short blast of compressed nitrogen to blow most of water in the coolant channels out of the circuit. This process is hindered by volumes which trap water due to gravity. To remove the trapped water, it is necessary, first, to heat up the structure by hot and compressed nitrogen, and then water is evaporated by depressurized nitrogen. The cooling system of the ITER Diagnostic Equatorial Port Plugs is of a complicated hydraulic configuration. The system branching might make difficult removal of water from the piping in the scheduled draining mode. The authors have proposed the KORSAR computation code to simulate draining of the GEPP cooling circuit. The numerical simulation performed has made it possible to describe the process dynamics during draining of the entire GEPP cooling circuit and to define the process time, amount and location of residual water and evolution of two-phase flow regime.

  6. Multiyear nutrient removal performance of three constructed wetlands intercepting tile drain flows from grazed pastures.

    Science.gov (United States)

    Tanner, Chris C; Sukias, James P S

    2011-01-01

    Subsurface tile drain flows can be a major s ource of nurient loss from agricultural landscapes. This study quantifies flows and nitrogen and phosphorus yields from tile drains at three intensively grazed dairy pasture sites over 3- to 5-yr periods and evaluates the capacity of constructed wetlands occupying 0.66 to 1.6% of the drained catchments too reduce nutrient loads. Continuous flow records are combined with automated flow-proportional sampling of nutrient concentrations to calculate tile drain nutrient yields and wetland mass removal rates. Annual drainage water yields rangedfrom 193 to 564 mm (16-51% of rainfall) at two rain-fed sites and from 827 to 853 mm (43-51% of rainfall + irrigation) at an irrigated site. Annually, the tile drains exported 14 to 109 kg ha(-1) of total N (TN), of which 58 to 90% was nitrate-N. Constructed wetlands intercepting these flows removed 30 to 369 gTN m(-2) (7-63%) of influent loadings annually. Seasonal percentage nitrate-N and TN removal were negatively associated with wetland N mass loadings. Wetland P removal was poor in all wetlands, with 12 to 115% more total P exported annually overall than received. Annually, the tile drains exported 0.12 to 1.38 kg ha of total P, of which 15 to 93% was dissolved reactive P. Additional measures are required to reduce these losses or provide supplementary P removal. Wetland N removal performance could be improved by modifying drainage systems to release flows more gradually and improving irrigation practices to reduce drainage losses.

  7. Effects of Drains on Pain, Comfort and Anxiety in Patients Undergone Surgery

    Directory of Open Access Journals (Sweden)

    Ummu Yildiz Findik

    2013-01-01

    Full Text Available Backround: Surgical drains negatively affect patients’ comfort, cause anxiety along with pain, as they are used to promote healing after surgery.Purpose: This study aimed to determine pain, comfort and anxiety levels of patients with drains postoperatively.Methodology: Research was performed with 192 patients undergone abdominal, neck, breast and open heart surgery and had surgical and underwater chest drains at the postoperative period. Patient Information Form, Numerical Pain Scale, General Comfort Questionnaire and Trait Anxiety Scale was used for collection of data. In evaluating the data, we used the t-test, variance and correlation analysis, mean, percentage and frequency.Results: The patients’ mean score of pain was 4.67±2.93, comfort was 2.75±0.29 and anxiety was 39.31±9.21. It was found statistically significant that the comfort level decreases as the pain level increases and that the patients undergone open heart surgery and with underwater chest drains have higher pain levels. It was found statistically significant that, comfort level in patients undergone abdominal or cardiac surgery is lower than patients undergone breast or neck surgery, and that the comfort level decreases as the duration of drains increases. The increasing state anxiety while pain increases and comfort decreases was found statistically significant.Conclusions: Surgeries and drains applied after these procedures decrease the comfort level of the patients as increases the pain level. Also, pain and discomfort increase the patients’ anxiety. Nurses who providing care to these patients are suggested to improve measures about pain and anxiety reduction for maintaining of comfort.

  8. The hydrology of a drained topographical depression within an agricutlural field in north-central Iowa

    Science.gov (United States)

    Roth, Jason L.; Capel, Paul D.

    2012-01-01

    North-central Iowa is an agriculturally intensive area comprising the southeastern portion of the Prairie Pothole Region, a landscape containing a high density of enclosed topographical depressions. Artificial drainage practices have been implemented throughout the area to facilitate agricultural production. Vertical surface drains are utilized to drain the topographical depressions that accumulate water. This study focuses on the hydrology of a drained topographical depression located in a 39.5 ha agricultural field. To assess the hydrology of the drained depression, a water balance was constructed for 11 ponding events during the 2008 growing season. Continuous pond and groundwater level data were obtained with pressure transducers. Flows into the vertical surface drain were calculated based on pond depth. Precipitation inflows and evaporative outflows of the ponds were calculated using climatic data. Groundwater levels were used to assess groundwater/pond interactions. Results of the water balances show distinct differences between the inflows to and outflows from the depression based on antecedent conditions. In wet conditions, groundwater inflow sustained the ponds. The ponds receded only after the groundwater level declined to below the land surface. In drier conditions, groundwater was not a source of water to the depression. During these drier conditions, infiltration comprised 30% of the outflows from the depression during declining pond stages. Over the entire study period, the surface drain, delivering water to the stream, was the largest outflow from the pond, accounting for 97% of the outflow, while evapotranspiration was just 2%. Precipitation onto the pond surface proved to be a minor component, accounting for 4% of the total inflows.

  9. Application of radionuclide ventriculography phase analysis in patients with atrial or ventricular pacing for detecting ventricular abnormal excitation

    International Nuclear Information System (INIS)

    Shi Rongfang; Wang Zhonggan; Li Shengting

    1996-01-01

    The aim of the study was to increase the accuracy of detecting ventricular abnormal excitation. During atrial or ventricular pacing, radionuclide ventriculography phase analysis (RNV-PA) was performed in 17 patients with Wolff-Parkinson-White (W-P-W) syndrome and paroxysmal supra ventricular tachycardia (PSVT) and ventricular tachycardia (PVT). During pacing, detection rate of abnormal excitation by RNV-PA was 95.5%, compared with 68.2% during basic conduction. Atrial or ventricular pacing can significantly increase the detection rate of abnormal excitation by RNV-PA in patients with W-P-W syndrome. It may be a valuable method for identifying the abnormal excitation and estimating the therapeutic effect of ablation

  10. Ventricular fibrillation in an ambulatory patient supported by a left ventricular assist device: highlighting the ICD controversy.

    Science.gov (United States)

    Boilson, Barry A; Durham, Lucian A; Park, Soon J

    2012-01-01

    Left ventricular assist devices (LVADs) provide an effective means of managing advanced pump failure as a means of bridging to cardiac transplantation or as permanent therapy. Although ventricular arrhythmias remain common post-LVAD implantation, such therapy may allow malignant arrhythmias to be tolerated hemodynamically. This report describes the clinical findings in a patient who had likely been in a ventricular tachyarrhythmia for several days and presented in ventricular fibrillation, ambulatory, and mentating normally. This report, with previous similar reports, is additive to the body of evidence that LVADs alter the physiologic impact of ventricular arrhythmias in advanced heart failure and highlights the need for thoughtful programming of implantable cardioverter defibrillator therapies in these patients.

  11. Evaluation of Right Ventricular Function with Radionuclide Cardiac Angiography - Right Ventricular Ejection Fraction in Chronic Obstructive Lung Disease

    International Nuclear Information System (INIS)

    Sohn, In; Shin, Sung Hae; Chung, June Key; Lee, Myung Chul; Cho, Bo Youn; Lee, Young Woo; Han, Yong Cheol; Koh, Chang Soon

    1982-01-01

    To evaluate the usefulness of radionuclide cardiac angiography in the assessment of the right ventricular function, we measured right ventricular ejection fraction (RVEF) using single pass method. In 12 normal persons, RVEF averaged 52.7±5.9% (mean±S.D.). In 25 patients with chronic obstructive lung disease, RVEF was 37.2±10.6% and significantly lower than that of normal person (p<0.01). All 10 patients with right ventricular failure had abnormal RVEF, which was significantly lower than that of 14 persons without right ventricular failure (27.6±5.7%, 43.9±8.5%, respectively, p<0.01). It concluded that RVEF measured by single pass radionuclide cardiac angiography was a useful, noninvasive method to assess right ventricular function.

  12. Intraoperative Tumoral Bleeding of Hypervascular Medulloblastoma after Ventricular Drainage: A Case Report.

    Science.gov (United States)

    Ryu, Han-Seung; Jung, Tae-Young; Han, Moon-Soo; Kim, Seul-Ki; Lee, Kyung-Hwa

    2017-01-01

    We report a rare case of intraoperative tumoral bleeding of a hypervascular medulloblastoma. A 12-year-old girl presented with dizziness and nausea. Brain magnetic resonance (MR) images revealed an approximately 4.2-cm enhanced mass on the cerebellar vermis associated with mild perilesional edema and increased cerebral blood volume. Angiography showed tumoral staining and developed occipital and circular dural sinuses in the venous phase. A suboccipital craniotomy was performed. To relieve the intracranial pressure, cerebrospinal fluid (CSF) was drained via a lateral ventricular catheter in the occipital horn. During the opening of the dura, the brain swelling had progressed, and brain computed tomography revealed an intratumoral hemorrhage with brainstem compression. The patient was in a stuporous mental state. A reoperation was performed, and the mass was totally removed. The pathologic findings revealed a medulloblastoma with abnormal enlarged arterial vascular structures. Postoperatively, the patient recovered to an alert mental state. She underwent chemotherapy and radiotherapy. There was no recurrence after 1 year. Pre-resectional CSF drainage should not be routinely performed in posterior fossa tumors, especially with increased cerebral blood volume on MR perfusion images. Complete removal should be performed quickly while CSF drainage should be performed slowly. An intratumoral hemorrhage should be considered in posterior fossa tumors when severe brain swelling suddenly develops after CSF drainage. © 2016 S. Karger AG, Basel.

  13. Should I stay or should I go? An institutional approach to brain drain

    OpenAIRE

    Cassar, Lea; Frey, Bruno S

    2010-01-01

    This paper suggests that institutional factors which reward social net- works at the expenses of productivity can play an important role in ex- plaining brain drain. The e€ects of social networks on brain drain are analyzed in a decision theory framework with asymmetric information. We distinguish between the role of insidership and personal connections. The larger the cost of being an outsider, the smaller is the number and the average ability of researchers working in the domestic job mar...

  14. Sampling and analysis plan (SAP) for WESF drains and TK-100 sump

    International Nuclear Information System (INIS)

    Simmons, F.M.

    1998-01-01

    The intent of this project is to determine whether the Waste Encapsulation and Storage Facility (WESF) floor drain piping and the TK-100 sump are free from contamination. TK-100 is currently used as a catch tank to transfer low level liquid waste from WESF to Tank Farms via B Plant. This system is being modified as part of the WESF decoupling since B Plant is being deactivated. As a result of the 1,1,1-trichloroethane (TCA) discovery in TK-100, the associated WESF floor drains and the pit sump need to be sampled. Breakdown constituents have been reviewed and found to be non-hazardous. There are 29 floor drains that tie into a common header leading into the tank. To prevent high exposure during sampling of the drains, TK-100 will be removed into the B Plant canyon and a new tank will be placed in the pit before any floor drain samples are taken. The sump will be sampled prior to TK-100 removal. A sample of the sludge and any liquid in the sump will be taken and analyzed for TCA and polychlorinated biphenyl (PCB). After the sump has been sampled, the vault floor will be flushed. The flush will be transferred from the sump into TK-100. TK-100 will be moved into B Plant. The vault will then be cleaned of debris and visually inspected. If there is no visual indication of TCA or PCB staining, the vault will be painted and a new tank installed. If there is an indication of TCA or PCB from laboratory analysis or staining, further negotiations will be required to determine a path forward. A total of 8 sets of three 40ml samples will be required for all of the floor drains and sump. The sump set will include one 125ml solid sample. The only analysis required will be for TCA in liquids. PCBs will be checked in sump solids only. The Sampling and Analysis Plan (SAP) is written to provide direction for the sampling and analytical activities of the 29 WESF floor drains and the TK-100 sump. The intent of this plan is to define the responsibilities of the various organizations

  15. High performance AlGaN/GaN HEMTs with 2.4 μm source-drain spacing

    International Nuclear Information System (INIS)

    Wang Dongfang; Wei Ke; Yuan Tingting; Liu Xinyu

    2010-01-01

    This paper describes the performance of AlGaN/GaN HEMTs with 2.4 μm source-drain spacing. So far these are the smallest source-drain spacing AlGaN/GaN HEMTs which have been implemented with a domestic wafer and domestic process. This paper also compares their performance with that of 4 μm source-drain spacing devices. The former exhibit higher drain current, higher gain, and higher efficiency. It is especially significant that the maximum frequency of oscillation noticeably increased. (semiconductor integrated circuits)

  16. Regional pressure and temperature variations across the injured human brain: comparisons between paired intraparenchymal and ventricular measurements.

    Science.gov (United States)

    Childs, Charmaine; Shen, Liang

    2015-06-23

    Intraparenchymal, multimodality sensors are commonly used in the management of patients with severe traumatic brain injury (TBI). The 'gold standard', based on accuracy, reliability and cost for intracranial pressure (ICP) monitoring is within the cerebral ventricle (external strain gauge). There are no standards yet for intracerebral temperature monitoring and little is known of temperature differences between brain tissue and ventricle. The aim of the study therefore was to determine pressure and temperature differences at intraparenchymal and ventricular sites during five days of continuous neuromonitoring. Patients with severe TBI requiring emergency surgery. patients who required ICP monitoring were eligible for recruitment. Two intracerebral probe types were used: a) intraventricular, dual parameter sensor (measuring pressure, temperature) with inbuilt catheter for CSF drainage: b) multiparameter intraparenchymal sensor measuring pressure, temperature and oxygen partial pressure. All sensors were inserted during surgery and under aseptic conditions. Seventeen patients, 12 undergoing neurosurgery (decompressive craniectomy n = 8, craniotomy n = 4) aged 21-78 years were studied. Agreement of measures for 9540 brain tissue-ventricular temperature 'pairs' and 10,291 brain tissue-ventricular pressure 'pairs' were determined using mixed model to compare mean temperature and pressure for longitudinal data. There was no significant overall difference for mean temperature (p = 0.92) or mean pressure readings (p = 0.379) between tissue and ventricular sites. With 95.8 % of paired temperature readings within 2SD (-0.4 to 0.4 °C) differences in temperature between brain tissue and ventricle were clinically insignificant. For pressure, 93.5 % of readings pairs fell within the 2SD range (-9.4756 to 7.8112 mmHg). However, for individual patients, agreement for mean tissue-ventricular pressure differences was poor on occasions. There is good overall agreement between paired

  17. Evaluation of Persistent Lymphatic Fluid Leakage Using a Strategy of Placing a Drain After Kidney Transplantation: A Statistical Analysis to Assess Its Origin.

    Science.gov (United States)

    Inoue, T; Saito, M; Narita, S; Numakura, K; Tsuruta, H; Maeno, A; Tsuchiya, N; Satoh, S; Habuchi, T

    2017-10-01

    Using a strategy of placing a surgical drain after kidney transplantation, the duration of a lymphatic fluid leakage and prevalence of a symptomatic lymphocele were retrospectively analyzed. The risk factors for persistent lymphatic fluid leakage or asymptomatic lymphocele were evaluated using multivariate analysis to estimate the origin of the lymphatic fluid leakage. Patients with persistent lymphatic fluid leakage and symptomatic lymphocele were defined as those with lymphatic fluid drainage >50 mL for more than 15 days and those who required a percutaneous drainage of the lymphocele, respectively. Persistent lymphatic fluid leakage and symptomatic lymphocele were observed in 40 (16.4%) and 10 (4.1%) of a total of 244 patients, respectively. The maximum durations of lymphatic fluid drainage from the initial drain tube and the second drainage of the symptomatic lymphocele were 48 and 28 days, respectively. Anastomosis of the graft artery to the external iliac artery was an independent risk factor to predict persistent lymphatic fluid leakage or symptomatic lymphocele after kidney transplantation (odds = 2.597, P = .008). The findings of the study suggest that the lymphatic fluid originates from the recipient's iliac lymph trunk rather than from the graft kidney. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Breakthrough of two pesticides into tile drain and shallow groundwater: comparison of tile drain reaction and soil profiles within a field scale irrigation experiment

    Science.gov (United States)

    Klaus, Julian; Zehe, Erwin; Elsner, Martin; Palm, Juliane; Schneider, Dorothee; Schröder, Boris; Steinbeiss, Sibylle; West, Stephanie

    2010-05-01

    Preferential flow in macropores is a key process which strongly affects infiltration and may cause rapid transport of pesticides into depths of 80 to 150 cm. At these depths they experience a much slower degradation, may leach into shallow groundwater or enter a tile-drain and are transported into surface water bodies. Therefore, preferential transport might be an environmental problem, if the topsoil is bypassed, which has been originally thought to act as a filter to protect the subsoil and shallow groundwater. To investigate the behaviour of two pesticides with different chemical characteristics and to compare their transport behaviour in soil and into the tile drain an irrigation experiment was performed on a 400 m² field site. The experimental plot is located in the Weiherbach valley, south-west Germany, which basic geology consists of Loess and Keuper layers, the soil at the test site is a gleyic Colluvisol. The distance of the irrigation site to the Weiherbach brook is approximately 12 m, the field is drained with a tile-drain in about 1.2 m depth and shows discharge over the entire year. Three hours before the irrigation started, the farmer applied a pesticide solution consisting of Isoproturon (80 g) and Flufenacet (20 g) (IPU and FLU) according to conventional agricultural practice on the field plot. The irrigation took place in three time blocks (80 min, 60 min, 80 min) with in total 33.6 mm of precipitation. During the first block 1600 g of Bromide were mixed in the irrigation water. The drainage outlet was instrumented with a pressure probe. About 50 water samples ware taken during the experimental day, and several samples more the days after the experiment. They were analysed for the pesticides, bromide and water isotopes. In the two days after the experiment three soil profiles were excavated and soil samples were taken on a 10x10 cm² scheme. One week after the experiment two additional profiles were excavated. The soil was analysed for IPU, FLU

  19. Prognosis of ventricular fibrillation in hospital

    DEFF Research Database (Denmark)

    Jensen, G V; Torp-Pedersen, C; Køber, L

    1992-01-01

    In a retrospective study of 520 patients with in-hospital ventricular fibrillation 421 (81%) had acute myocardial infarction (MI), 66 (13%) had ischaemic heart disease (IHD) without MI, 33 (6%) had no signs of IHD. The in-hospital mortality of these three groups was 51%, 52%, and 27%, respectively...... (P = 0.01). Logistic regression analysis demonstrated that heart failure and cardiogenic shock were significant risk factors for in-hospital death among patients with IHD. Among discharged patients 1 and 5 years survival was 78% and 51% for patients with MI, 63% and 25% for patients with IHD, 67...... with known IHD suffering in-hospital VF without AMI have a very poor short- and long-term prognosis. These patients need extensive cardiac examination....

  20. Calculation of the ALMA Risk of Right Ventricular Failure After Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Loforte, Antonio; Montalto, Andrea; Musumeci, Francesco; Amarelli, Cristiano; Mariani, Carlo; Polizzi, Vincenzo; Lilla Della Monica, Paola; Grigioni, Francesco; Di Bartolomeo, Roberto; Marinelli, Giuseppe

    2018-05-08

    Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88). The final study patients were randomly divided into derivation (79.8%, n = 206) and validation (20.1%, n = 52) cohorts. Fifty-seven preoperative risk factors were compared between patients who were successfully managed with an LVAD and those who required a BVAD. Nineteen variables demonstrated statistical significance on univariable analysis. Multivariable logistic regression analysis identified destination therapy (odds ratio [OR] 2.0 [1.7-3.9], p = 0.003), a pulmonary artery pulsatility index right ventricle/left ventricle end-diastolic diameter ratio >0.75 (OR 2.7 [1.5-5.5], p = 0.001), an right ventricle stroke work index 17 (OR 3.5 [1.9-6.9], p the major predictors of the need for BVAD. Using these data, we propose a simple risk calculator to determine the suitability of patients for isolated LVAD support in the era of continuous-flow mechanical circulatory support devices.

  1. Outcomes of patients with right ventricular failure on milrinone after left ventricular assist device implantation.

    Science.gov (United States)

    Tsiouris, Athanasios; Paone, Gaetano; Brewer, Robert J; Nemeh, Hassan W; Borgi, Jamil; Morgan, Jeffrey A

    2015-01-01

    Previous studies have grouped together both patients requiring right ventricular assist devices (RVADs) with patients requiring prolonged milrinone therapy after left ventricular assist device (LVAD) implantation. We retrospectively identified 149 patients receiving LVADs and 18 (12.1%) of which developed right ventricular (RV) failure. We then separated these patients into those requiring RVADs versus prolonged milrinone therapy. This included 10 patients who were treated with prolonged milrinone and eight patients who underwent RVAD placement. Overall, the RV failure group had worse survival compared with the non-RV failure cohort (p = 0.038). However, this was only for the subgroup of patients who required RVADs, who had a 1, 6, 12, and 24 month survival of 62.5%, 37.5%, 37.5%, and 37.5%, respectively, versus 96.8%, 92.1%, 86.7%, and 84.4% for patients without RV failure (p milrinone therapy for RV failure had similar survivals compared with patients without RV failure. In the RV failure group, age, preoperative renal failure, and previous cardiac surgery were predictors of the need for prolonged postoperative milrinone. As LVADs become a more widely used therapy for patients with refractory, end-stage heart failure, it will be important to reduce the incidence of RV failure, as it yields significant morbidity and increases cost.

  2. Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure.

    Science.gov (United States)

    Maslow, Andrew; Schwartz, Carl; Mahmood, Feroze; Singh, Arun; Heerdt, Paul M

    2009-07-01

    In this report, a case of right ventricular (RV) failure, hemodynamic instability, and systemic organ failure is described to highlight how paradoxical ventricular systolic septal motion (PVSM), or a rightward systolic displacement of the interventricular septum, may contribute to RV ejection. Multiple inotropic medications and vasopressors were administered to treat right heart failure and systemic hypotension in a patient following combined aortic and mitral valve replacement. In the early postoperative period, echocardiographic evaluation revealed adequate left ventricular systolic function, akinesis of the RV myocardial tissues, and PVSM. In the presence of PVSM, RV fractional area of contraction was > or =35% despite akinesis of the primary RV myocardial walls. The PVSM appeared to contribute toward RV ejection. As a result, the need for multiple inotropes was re-evaluated, in considering that end-organ dysfunction was the result of systemic hypotension and prolonged vasopressor administration. After discontinuation of phosphodiesterase inhibitors, native vascular tone returned and the need for vasopressors declined. This was followed by recovery of systemic organ function. Echocardiographic re-evaluation two years later, revealed persistent akinesis of the RV myocardial tissues and PVSM, the latter appearing to contribute toward RV ejection. This case highlights the importance of left to RV interactions, and how PVSM may mediate these hemodynamic interactions.

  3. Effect of chronic right ventricular apical pacing on left ventricular function.

    Science.gov (United States)

    O'Keefe, James H; Abuissa, Hussam; Jones, Philip G; Thompson, Randall C; Bateman, Timothy M; McGhie, A Iain; Ramza, Brian M; Steinhaus, David M

    2005-03-15

    The determinants of change in left ventricular (LV) ejection fraction (EF) over time in patients with impaired LV function at baseline have not been clearly established. Using a nuclear database to assess changes in LV function over time, we included patients with a baseline LVEF of 25% to 40% on a gated single-photon emission computed tomographic study at rest and only if second-gated photon emission computed tomography performed approximately 18 months after the initial study showed an improvement in LVEF at rest of > or =10 points or a decrease in LVEF at rest of > or =7 points. In all, 148 patients qualified for the EF increase group and 59 patients for the EF decrease group. LVEF on average increased from 33 +/- 4% to 51 +/- 8% in the EF increase group and decreased from 35 +/- 4% to 25 +/- 5% in the EF decrease group. The strongest multivariable predictor of improvement of LVEF was beta-blocker therapy (odds ratio 3.9, p = 0.002). The strongest independent predictor of LVEF decrease was the presence of a permanent right ventricular apical pacemaker (odds ratio 6.6, p = 0.002). Thus, this study identified beta-blocker therapy as the major independent predictor for improvement in LVEF of > or =10 points, whereas a permanent pacemaker (right ventricular apical pacing) was the strongest predictor of a LVEF decrease of > or =7 points.

  4. Atrioventricular and ventricular-to-ventricular programming in patients with cardiac resynchronization therapy: results from ALTITUDE.

    Science.gov (United States)

    Steinberg, Benjamin A; Wehrenberg, Scott; Jackson, Kevin P; Hayes, David L; Varma, Niraj; Powell, Brian D; Day, John D; Frazier-Mills, Camille G; Stein, Kenneth M; Jones, Paul W; Piccini, Jonathan P

    2015-12-01

    Cardiac resynchronization therapy (CRT) improves outcomes in patients with heart failure, yet response rates are variable. We sought to determine whether physician-specified CRT programming was associated with improved outcomes. Using data from the ALTITUDE remote follow-up cohort, we examined sensed atrioventricular (AV) and ventricular-to-ventricular (VV) programming and their associated outcomes in patients with de novo CRT from 2009-2010. Outcomes included arrhythmia burden, left ventricular (LV) pacing, and all-cause mortality at 4 years. We identified 5709 patients with de novo CRT devices; at the time of implant, 34% (n = 1959) had entirely nominal settings programmed, 40% (n = 2294) had only AV timing adjusted, 11% (n = 604) had only VV timing adjusted, and 15% (n = 852) had both AV and VV adjusted from nominal programming. Suboptimal LV pacing (5% was lowest in the AV-only adjusted group (17.9%) and highest in the nominal (27.7%) and VV-only adjusted (28.3%) groups. Adjusted all-cause mortality was significantly higher among patients with non-nominal AV delay >120 vs. 180 vs. ≤180 ms, p = 0.4). Nominal settings for de novo CRT implants are frequently altered, most commonly the AV delay. There is wide variability in reprogramming. Patients with nominal or AV-only adjustments appear to have favorable pacing and arrhythmia outcomes. Sensed AV delays less than 120 ms are associated with improved survival.

  5. Intraoperative Transesophageal Echocardiography and Right Ventricular Failure After Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Silverton, Natalie A; Patel, Ravi; Zimmerman, Josh; Ma, Jianing; Stoddard, Greg; Selzman, Craig; Morrissey, Candice K

    2018-02-15

    To determine whether intraoperative measures of right ventricular (RV) function using transesophageal echocardiography are associated with subsequent RV failure after left ventricular assist device (LVAD) implantation. Retrospective, nonrandomized, observational study. Single tertiary-level, university-affiliated hospital. The study comprised 100 patients with systolic heart failure undergoing elective LVAD implantation. Transesophageal echocardiographic images before and after cardiopulmonary bypass were analyzed to quantify RV function using tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (S'), fractional area change (FAC), RV global longitudinal strain, and RV free wall strain. A chart review was performed to determine which patients subsequently developed RV failure (right ventricular assist device placement or prolonged inotrope requirement ≥14 days). Nineteen patients (19%) subsequently developed RV failure. Postbypass FAC was the only measure of RV function that distinguished between the RV failure and non-RV failure groups (21.2% v 26.5%; p = 0.04). The sensitivity, specificity, and area under the curve of an abnormal RV FAC (failure after LVAD implantation were 84%, 20%, and 0.52, respectively. No other intraoperative measure of RV function was associated with subsequent RV failure. RV failure increased ventilator time, intensive care unit and hospital length of stay, and mortality. Intraoperative measures of RV function such as tricuspid annular plane systolic excursion, tricuspid annular systolic velocity, and RV strain were not associated with RV failure after LVAD implantation. Decreased postbypass FAC was significantly associated with RV failure but showed poor discrimination. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Wave Intensity Analysis of Right Ventricular Function during Pulsed Operation of Rotary Left Ventricular Assist Devices.

    Science.gov (United States)

    Bouwmeester, J Christopher; Park, Jiheum; Valdovinos, John; Bonde, Pramod

    2018-05-29

    Changing the speed of left ventricular assist devices (LVADs) cyclically may be useful to restore aortic pulsatility; however, the effects of this pulsation on right ventricular (RV) function are unknown. This study investigates the effects of direct ventricular interaction by quantifying the amount of wave energy created by RV contraction when axial and centrifugal LVADs are used to assist the left ventricle. In 4 anesthetized pigs, pressure and flow were measured in the main pulmonary artery and wave intensity analysis was used to identify and quantify the energy of waves created by the RV. The axial pump depressed the intensity of waves created by RV contraction compared with the centrifugal pump. In both pump designs, there were only minor and variable differences between the continuous and pulsed operation on RV function. The axial pump causes the RV to contract with less energy compared with a centrifugal design. Diminishing the ability of the RV to produce less energy translates to less pressure and flow produced, which may lead to LVAD-induced RV failure. The effects of pulsed LVAD operation on the RV appear to be minimal during acute observation of healthy hearts. Further study is necessary to uncover the effects of other modes of speed modulation with healthy and unhealthy hearts to determine if pulsed operation will benefit patients by reducing LVAD complications.

  7. DETERMINATION OF LIQUID FILM THICKNESS FOLLOWING DRAINING OF CONTACTORS, VESSELS, AND PIPES IN THE MCU PROCESS

    International Nuclear Information System (INIS)

    Poirier, M; Fernando Fondeur, F; Samuel Fink, S

    2006-01-01

    The Department of Energy (DOE) identified the caustic side solvent extraction (CSSX) process as the preferred technology to remove cesium from radioactive waste solutions at the Savannah River Site (SRS). As a result, Washington Savannah River Company (WSRC) began designing and building a Modular CSSX Unit (MCU) in the SRS tank farm to process liquid waste for an interim period until the Salt Waste Processing Facility (SWPF) begins operations. Both the solvent and the strip effluent streams could contain high concentrations of cesium which must be removed from the contactors, process tanks, and piping prior to performing contactor maintenance. When these vessels are drained, thin films or drops will remain on the equipment walls. Following draining, the vessels will be flushed with water and drained to remove the flush water. The draining reduces the cesium concentration in the vessels by reducing the volume of cesium-containing material. The flushing, and subsequent draining, reduces the cesium in the vessels by diluting the cesium that remains in the film or drops on the vessel walls. MCU personnel requested that Savannah River National Laboratory (SRNL) researchers conduct a literature search to identify models to calculate the thickness of the liquid films remaining in the contactors, process tanks, and piping following draining of salt solution, solvent, and strip solution. The conclusions from this work are: (1) The predicted film thickness of the strip effluent is 0.010 mm on vertical walls, 0.57 mm on horizontal walls and 0.081 mm in horizontal pipes. (2) The predicted film thickness of the salt solution is 0.015 mm on vertical walls, 0.74 mm on horizontal walls, and 0.106 mm in horizontal pipes. (3) The predicted film thickness of the solvent is 0.022 mm on vertical walls, 0.91 mm on horizontal walls, and 0.13 mm in horizontal pipes. (4) The calculated film volume following draining is: (a) Salt solution receipt tank--1.6 gallons; (b) Salt solution feed

  8. Evaluation of left ventricular function using digital subtraction ventriculography

    International Nuclear Information System (INIS)

    Yiannikas, J.; Detrano, R.

    1986-01-01

    Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

  9. Arrhythmogenic right ventricular cardiomyopathy: contribution of different electrocardiographic techniques.

    Science.gov (United States)

    Moreira, Davide; Delgado, Anne; Marmelo, Bruno; Correia, Emanuel; Gama, Pedro; Pipa, João; Nunes, Luís; Santos, Oliveira

    2014-04-01

    Arrhythmogenic right ventricular cardiomyopathy, also known as arrhythmogenic right ventricular dysplasia, is a condition in which myocardium is replaced by fibrous or fibrofatty tissue, predominantly in the right ventricle. It is clinically characterized by potentially lethal ventricular arrhythmias, and is a leading cause of sudden cardiac death. Its prevalence is not known exactly but is estimated at approximately 1:5000 in the adult population. Diagnosis can be on the basis of structural and functional alterations of the right ventricle, electrocardiographic abnormalities (including depolarization and repolarization alterations and ventricular arrhythmias) and family history. Diagnostic criteria facilitate the recognition and interpretation of non-specific clinical features of this disease. The authors present a case in which the diagnosis of arrhythmogenic right ventricular cardiomyopathy was prompted by the suspicion of right ventricular disease on transthoracic echocardiography. This was confirmed by detection of epsilon waves on analysis of the ECG, which generally go unnoticed but in this case were the key to the diagnosis. Their presence was also shown by non-conventional ECG techniques such as modified Fontaine ECG. The course of the disease culminated in the occurrence of ventricular tachycardia, which prompted placement of an implantable cardioverter-defibrillator. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  10. Free and conjugated dopamine in human ventricular fluid

    International Nuclear Information System (INIS)

    Sharpless, N.S.; Thal, L.J.; Wolfson, L.I.; Tabaddor, K.; Tyce, G.M.; Waltz, J.M.

    1981-01-01

    Free dopamine and an acid hydrolyzable conjugate of dopamine were measured in human ventricular fluid specimens with a radioenzymatic assay and by high performance liquid chromatography (HPLC) with electrochemical detection. Only trace amounts of free norepinephrine and dopamine were detected in ventricular fluid from patients with movement disorders. When the ventricular fluid was hydrolyzed by heating in HClO 4 or by lyophilization in dilute HClO 4 , however, a substantial amount of free dopamine was released. Values for free plus conjugated dopamine in ventricular fluid from patients who had never taken L-DOPA ranged from 139 to 340 pg/ml when determined by HPLC and from 223 to 428 pg/ml when measured radioenzymatically. The correlation coefficient for values obtained by the two methods in the same sample of CSF was 0.94 (P<0.001). Patients who had been treated with L-DOPA had higher levels of conjugated dopamine in their ventricular CSF which correlated inversely with the time between the last dose of L-DOPA and withdrawal of the ventricular fluid. Additionally, one patient with acute cerebral trauma had elevated levels of free norepinephrine and both free and conjugated dopamine in his ventricular fluid. Conjugation may be an important inactivation pathway for released dopamine in man. (Auth.)

  11. [Idiopathic ventricular arrhythmia in children. Apropos of 24 cases].

    Science.gov (United States)

    Coeurderoy, A; Almange, C; Laurent, M; Biron, Y; Leborgne, P

    1985-12-01

    The severity and prognosis of idiopathic ventricular arrhythmias in childhood were studied in 24 patients (12 boys, 12 girls) with an average age of 8 years at the time of diagnosis of the arrhythmia. Investigations included clinical assessment and analysis of basal ECG (morphology of the arrhythmias) and dynamic recordings (Holter and exercise stress testing). The clinical course was followed for an average of 3.8 years. The patients were classified in two groups: monomorphic arrhythmias (Group I) and polymorphic arrhythmias (Group II). Group I was divided into 4 subgroups: isolated ventricular extrasystoles (IA), 11 patients; ventricular extrasystoles with bursts of ventricular tachycardia (IB), 6 patients; sustained ventricular tachycardia without intercritical extrasystoles (IC), 1 patient; accelerated idioventricular rhythm (ID), 2 patients. Subgroups IA, IB and ID were characterised by the absence of symptoms, the disappearance of the arrhythmia on exercise, the decreased efficacy of antiarrhythmic drugs and an excellent prognosis. Therapeutic abstention was the rule in these patients. Patients in Group IC were characterised by the variability of their symptoms, the absence of exercise induced arrhythmias, the need for treatment in most cases and a good long-term prognosis. Group II was divided into 2 subgroups: adrenergic polymorphic ventricular tachycardia (IIA), 2 patients, and non-adrenergic polymorphic ventricular tachycardia (IIB), 2 patients. Patients in Subgroup IIA were characterised by syncope on exercise or emotion, the need for betablocker therapy which considerably improved the patients symptoms but which did not usually prevent sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Evaluation of ventricular function in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Rocco, T.P.; Dilsizian, V.; Fischman, A.J.; Strauss, H.W.

    1989-01-01

    The recent expansion of interventional cardiovascular technologies has stimulated a concomitant expansion of noninvasive cardiac studies, both to assist in diagnosis and to evaluate treatment outcomes. Radionuclide ventricular function studies provide a reliable, reproducible means to quantify global left ventricular systolic performance, a critical determinant of prognosis in patients with cardiovascular disease. In addition, the ability to evaluate regional left ventricular wall motion and to assess ventricular performance during exercise have secured a fundamental role for such studies in the screening and treatment of patients with coronary artery disease. Radionuclide techniques have been extended to the evaluation of left ventricular relaxation/filling events, left ventricular systolic/diastolic function in the ambulatory setting, and with appropriate technical modifications, to the assessment of right ventricular performance at rest and with exercise. As a complement to radionuclide perfusion studies, cardiac blood-pool imaging allows for thorough noninvasive description of cardiac physiology and function in both normal subjects and in patients with a broad range of cardiovascular diseases. 122 references

  13. Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

    Directory of Open Access Journals (Sweden)

    Lanjewar SS

    2013-11-01

    Full Text Available Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick21Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USABackground: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1 were computed and compared between the two subgroups.Results: There was no statistically significant difference in qualitative lung function (FEV1 between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic

  14. Correlation between right ventricular T1 mapping and right ventricular dysfunction in non-ischemic cardiomyopathy.

    Science.gov (United States)

    Jellis, Christine L; Yingchoncharoen, Teerapat; Gai, Neville; Kusunose, Kenya; Popović, Zoran B; Flamm, Scott; Kwon, Deborah

    2018-01-01

    Right ventricular (RV) fibrosis is increasingly recognized as the underlying pathological substrate in a variety of clinical conditions. We sought to employ cardiac magnetic resonance (CMR) techniques of strain imaging and longitudinal relaxation time (T 1 ) mapping to better examine the relationship between RV function and structure. Our aim was to initially evaluate the feasibility of these techniques to evaluate the right ventricle. We then sought to explore the relationship between RV function and underlying fibrosis, along with examining the evolution of RV remodeling according to the amount of baseline fibrosis. Echocardiography was performed in 102 subjects with non-ischemic cardiomyopathy. Right ventricular parameters were assessed including: fractional area change (FAC) and longitudinal strain. The same cohort underwent CMR. Post-contrast T 1 mapping was performed as a marker of fibrosis with a Look-Locker technique using inversion recovery imaging. Mid-ventricular post-contrast T 1 values of the RV free wall, RV septum and lateral LV were calculated using prototype analysis software. Biventricular volumetric data including ejection fraction was measured by CMR using a cine short axis stack. CMR strain analysis was also performed to assess 2D RV longitudinal and radial strain. Simultaneous biochemical and anthropometric data were recorded. Subjects were followed over a median time of 29 months (IQR 20-37 months) with echocardiography to evaluate temporal change in RV FAC according to baseline post-contrast T 1 values. Longitudinal data analysis was performed to adjust for patient loss during follow-up. Subjects (62% men, 51 ± 15 years) had mild to moderately impaired global RV systolic function (RVEF = 39 ± 15%; RVEDV = 187 ± 69 ml; RVESV = 119 ± 68 ml) and moderate left ventricular dysfunction at baseline (LVEF 30 ± 17%). Good correlation was observed between mean LV and RV post-contrast T 1 values (r = 0.652, p

  15. What is the clinical significance of ventricular mural antagonism?

    DEFF Research Database (Denmark)

    Lunkenheimer, Paul P; Niederer, Peter; Stephenson, Robert S

    2018-01-01

    alignment, thus deviating from the prevailing tangential orientation. Upon contraction, they produce, in addition to a tangential force, a radial force component that counteracts ventricular constriction and aids widening of the ventricular cavity. In experimental studies, we have provided evidence...... for the existence of such forces, which are auxotonic in nature. This is in contrast to the tangentially aligned myocytes that produce constrictive forces, which are unloading in nature. The ventricular myocardium is, therefore, able to function in an antagonistic fashion, with the prevailing constrictive forces...

  16. Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Hastrup Svendsen, Jesper; Sogaard, Peter

    2007-01-01

    BACKGROUND: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation......, patients with ARVC had a decreased RV ejection fraction (0.47 +/- 0.08 vs 0.53 +/- 0.05, P vs 15.1 +/- 3.7 cm/s, P left ventricle (7.0 +/- 2.6 vs 9.5 +/- 1.9 cm/s, P ... of the longitudinal motility appears to be a sensitive marker of preclinical left ventricular involvement....

  17. The ExternE project: methodology, objectives and limitations

    International Nuclear Information System (INIS)

    Rabl, A.; Spadaro, J.V.

    2002-01-01

    This paper presents a summary of recent studies on external costs of energy systems, in particular the ExternE (External Costs of Energy) Project of the European Commission. To evaluate the impact and damage cost of a pollutant, one needs to carry out an impact pathway analysis; this involves the calculation of increased pollutant concentrations in all affected regions due to an incremental emission (e.g. μg/m 3 of particles, using models of atmospheric dispersion and chemistry), followed by the calculation of physical impacts (e.g. number of cases of asthma due to these particles, using a dose-response function). The entire so-called fuel chain (or fuel cycle) is evaluated and compared on the basis of delivered end use energy. Even though the uncertainties are large, the results provide substantial evidence that the classical air pollutants (particles, NO x and SO x ) from the combustion of fossil fuels impose a heavy toll, in addition to the cost of global warming. The external costs are especially large for coal; even for 'good current technology' they may be comparable to the price of electricity. For natural gas the external costs are about a third to a half of coal. The external costs of nuclear are small compared to the price of electricity (at most a few %), and so are the external costs of most renewable energy systems. (authors)

  18. Establishment and application of the estimation model for pollutant concentrfation in agriculture drain

    Science.gov (United States)

    Li, Qiangkun; Hu, Yawei; Jia, Qian; Song, Changji

    2018-02-01

    It is the key point of quantitative research on agricultural non-point source pollution load, the estimation of pollutant concentration in agricultural drain. In the guidance of uncertainty theory, the synthesis of fertilization and irrigation is used as an impulse input to the farmland, meanwhile, the pollutant concentration in agricultural drain is looked as the response process corresponding to the impulse input. The migration and transformation of pollutant in soil is expressed by Inverse Gaussian Probability Density Function. The law of pollutants migration and transformation in soil at crop different growth periods is reflected by adjusting parameters of Inverse Gaussian Distribution. Based on above, the estimation model for pollutant concentration in agricultural drain at field scale was constructed. Taking the of Qing Tong Xia Irrigation District in Ningxia as an example, the concentration of nitrate nitrogen and total phosphorus in agricultural drain was simulated by this model. The results show that the simulated results accorded with measured data approximately and Nash-Sutcliffe coefficients were 0.972 and 0.964, respectively.

  19. Land Use Impacts on Water Quality of Rivers draining from Mulanje ...

    African Journals Online (AJOL)

    Land Use Impacts on Water Quality of Rivers draining from Mulanje Mountain: A Case of Ruo River in the Southern Malawi. ... The research recommends an integrated water resources management approach where all users and relevant stakeholders should take an active role in the conservation of Ruo River catchment in ...

  20. Interpretation of Cone Penetration Testing in Silty Soils Conducted under Partially Drained Conditions

    DEFF Research Database (Denmark)

    Holmsgaard, Rikke; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

    2016-01-01

    The standard penetration rate used in cone penetration tests (CPTs) is 20 mm=s, regardless of soil type, which yields fully drained penetration in sand and fully undrained penetration in clay. However, for silty soils that represent an intermediate grain size composition and unique characteristic...

  1. Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

    International Nuclear Information System (INIS)

    Currarino, G.; Stannard, M.W.; Texas Univ., Dallas, TX; Kolni, H.

    1991-01-01

    This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.)

  2. Development and testing of watershed-scale models for poorly drained soils

    Science.gov (United States)

    Glenn P. Fernandez; George M. Chescheir; R. Wayne Skaggs; Devendra M. Amatya

    2005-01-01

    Watershed-scale hydrology and water quality models were used to evaluate the crrmulative impacts of land use and management practices on dowrzstream hydrology and nitrogen loading of poorly drained watersheds. Field-scale hydrology and nutrient dyyrutmics are predicted by DRAINMOD in both models. In the first model (DRAINMOD-DUFLOW), field-scale predictions are coupled...

  3. Configuration of particle drain for the high energy charged particles in the magnetic dipole field

    International Nuclear Information System (INIS)

    Amirkhanov, I.V.; Zhidkov, E.P.; Ignatov, V.V.; Il'ina, A.N.; Il'in, V.D.; Kuznetsov, S.N.; Yushkov, B.Yu.

    1987-01-01

    The boundary of particle leakage from the magnetic dipole trap depending on the value of adiabatic parameter is investigated. By trajectory computation a generalized analytical expression is determined for the shape of particle drain by x ≤ 1. It is shown that generally accepted adiabatic loss cone is a particular case of x → 0

  4. Oral tolerance is determined at the level of draining lymph nodes

    NARCIS (Netherlands)

    Wilsem, van E.G.; BrevÃ, J.; Savelkoul, H.; Claessen, A.; Scheper, R.J.; Kraal, G.

    1995-01-01

    In the skin and in the epithelium of the oral mucosa a comparable network of Langerhans cells can be found. Antigen application on either epithelium leads to rapid emigration of Langerhans cells to the draining lymph nodes. Application on the oral mucosa leads to tolerance induction while

  5. Evaluation of the necessity for chest drain placement following thoracoscopic wedge resection.

    Science.gov (United States)

    Lu, Ting-Yu; Chen, Jian-Xun; Chen, Pin-Ru; Lin, Yu-Sen; Chen, Chien-Kuang; Kao, Pei-Yu; Huang, Tzu-Ming; Fang, Hsin-Yuan

    2017-05-01

    To evaluate the outcomes of patients who underwent thoracoscopic wedge resection without chest drain placement. The subjects of this retrospective study were 89 patients, who underwent thoracoscopic wedge resection at our hospital between January, 2013 and July, 2015. A total of 45 patients whose underlying condition did not meet the following criteria were assigned to the "chest drain placement group" (group A): peripheral lesions, healthy lung parenchyma, no intraoperative air leaks, hemorrhage or effusion accumulation, and no pleural adhesion. The other 44 patients whose underlying condition met the criteria were assigned to the "no chest drain placement group" (group B). Patient characteristics, specimen data, and postoperative conditions were analyzed and compared between the groups. Group A patients had poorer forced expiratory volume in one second (FEV1) values, less normal spirometric results, significantly higher resected lung volume, a greater maximum tumor-pleura distance, and a larger maximum tumor size. They also had a longer postoperative hospital stay. There was no difference between the two groups in postoperative complications. Avoiding chest drain placement after a thoracoscopic wedge resection appears to be safe and beneficial for patients who have small peripheral lesions and healthy lung parenchyma.

  6. Method of bilateral pleural drainage by single Blake drain after esophagectomy.

    Science.gov (United States)

    Niwa, Yukiko; Koike, Masahiko; Oya, Hisaharu; Iwata, Naoki; Kobayashi, Daisuke; Kanda, Mitsuro; Tanaka, Chie; Yamada, Suguru; Fujii, Tsutomu; Nakayama, Goro; Sugimoto, Hiroyuki; Nomoto, Shuji; Fujiwara, Michitaka; Kodera, Yasuhiro

    2015-03-01

    Clinicians often encounter left pleural effusion after esophagectomy, which sometimes necessitates thoracentesis. We have introduced a new drainage method, bilateral pleural drainage by single Blake drain (BDSD), which we have been using since April 2013. This study aims to evaluate the performance of the BDSD. The BDSD method employs a 15-F Blake drain inserted from the right thoracic cavity to the left thoracic cavity across the posterior mediastinum. The conventional drain (CD) group consisted of 50 patients with a 19-F Blake drain placed in the right thoracic cavity during the period from April 2012 to March 2013. The BDSD group consisted of 54 patients treated from April 2013 to June 2014. The amount of total drainage in the BDSD group was significantly higher than that in the CD group (P pleural effusion and left lower lobe atelectasis in the BDSD group were significantly lower than those in the CD group (P pleural effusion necessitating thoracentesis drainage in the BDSD group. Compared with the conventional method, BDSD was able to evacuate bilateral pleural effusion more effectively, and the incidences of left pleural effusion and left atelectasis were lower. This method is therefore clinically useful after esophagectomy.

  7. Restructuring brain drain: strengthening governance and financing for health worker migration.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2013-01-15

    Health worker migration from resource-poor countries to developed countries, also known as ''brain drain'', represents a serious global health crisis and a significant barrier to achieving global health equity. Resource-poor countries are unable to recruit and retain health workers for domestic health systems, resulting in inadequate health infrastructure and millions of dollars in healthcare investment losses. Using acceptable methods of policy analysis, we first assess current strategies aimed at alleviating brain drain and then propose our own global health policy based solution to address current policy limitations. Although governments and private organizations have tried to address this policy challenge, brain drain continues to destabilise public health systems and their populations globally. Most importantly, lack of adequate financing and binding governance solutions continue to fail to prevent health worker brain drain. In response to these challenges, the establishment of a Global Health Resource Fund in conjunction with an international framework for health worker migration could create global governance for stable funding mechanisms encourage equitable migration pathways, and provide data collection that is desperately needed.

  8. The routine use of post-operative drains in thyroid surgery: an outdated concept.

    LENUS (Irish Health Repository)

    Prichard, R S

    2010-01-01

    The use of surgical drains in patients undergoing thyroid surgery is standard surgical teaching. Life-threatening complications, arising from post-operative haematomas, mandates their utilization. There is increasing evidence to suggest that this is an outdated practice. This paper determines whether thyroid surgery can be safely performed without the routine use of drains. A retrospective review of patients undergoing thyroid surgery, over a three year period was performed and post-operative complications documented. One hundred and four thyroidectomies were performed. 63 (60.6%) patients had a partial thyroidectomy, 27 (25.9%) had a total thyroidectomy and 14 (13.5%) had a sub-total thyroidectomy. Suction drains were not inserted in any patient. A cervical haematoma did not develop in any patient in this series and no patient required re-operation. There is no evidence to suggest the routine use of surgical drains following uncomplicated thyroid surgery reduces the rate of haematoma formation or re-operation rates and indeed is now unwarranted.

  9. Diminishing peat oxidation of agricultural peat soils by infiltration via submerged drains

    NARCIS (Netherlands)

    Akker, van den J.J.H.; Hendriks, R.F.A.

    2017-01-01

    Oxidation of peat soils used in dairy farming in the western peat area of The Netherlands causes subsidence rates up to 13 mm.y and emissions of CO2 to about 27 t.ha.y. In 2003 experiments started with subsurface irrigation by submerged drains to raise groundwater levels to reduce oxidation and so

  10. The Brain Drain in Mexico--A Subject for Research...or Agenda?

    Science.gov (United States)

    Aupetit, Sylvie Didou

    2006-01-01

    The purpose of this article is to analyse the present state of the discussion and data regarding the brain drain in Mexico. From current data, recent trends show certain peculiarities in the national picture, pointing to an increase in the number of free movers, and a decrease in the number of young people who obtain Mexican government…

  11. The effect of random dopant fluctuation on threshold voltage and drain current variation in junctionless nanotransistors

    International Nuclear Information System (INIS)

    Rezapour, Arash; Rezapour, Pegah

    2015-01-01

    We investigate the effect of dopant random fluctuation on threshold voltage and drain current variation in a two-gate nanoscale transistor. We used a quantum-corrected technology computer aided design simulation to run the simulation (10000 randomizations). With this simulation, we could study the effects of varying the dimensions (length and width), and thicknesses of oxide and dopant factors of a transistor on the threshold voltage and drain current in subthreshold region (off) and overthreshold (on). It was found that in the subthreshold region the variability of the drain current and threshold voltage is relatively fixed while in the overthreshold region the variability of the threshold voltage and drain current decreases remarkably, despite the slight reduction of gate voltage diffusion (compared with that of the subthreshold). These results have been interpreted by using previously reported models for threshold current variability, load displacement, and simple analytical calculations. Scaling analysis shows that the variability of the characteristics of this semiconductor increases as the effects of the short channel increases. Therefore, with a slight increase of length and a reduction of width, oxide thickness, and dopant factor, we could correct the effect of the short channel. (paper)

  12. Short-channel drain current model for asymmetric heavily/lightly ...

    Indian Academy of Sciences (India)

    The paper presents a drain current model for double gate metal oxide semiconductor field effect transistors (DG MOSFETs) based on a new velocity saturation model that accounts for short-channel velocity saturation effect independently in the front and the back gate controlled channels under asymmetric front and back ...

  13. 7 CFR 58.416 - Cheese vats, tanks and drain tables.

    Science.gov (United States)

    2010-01-01

    ... uniform heating. The inner liner shall be minimum 16 gauge stainless steel or other equally corrosion... jacket. The outer jacket shall be constructed of stainless steel or other metal which can be kept clean... 7 Agriculture 3 2010-01-01 2010-01-01 false Cheese vats, tanks and drain tables. 58.416 Section 58...

  14. Modeling the impact of nitrogen fertilizer application and tile drain configuration on nitrate leaching using SWAT

    Science.gov (United States)

    Recently, the Soil and Water Assessment Tool (SWAT) was revised to improve the partitioning of runoff and tile drainage in poorly drained soils by modifying the algorithm for computing the soil moisture retention parameter. In this study, the revised SWAT model was used to evaluate the sensitivity a...

  15. Human capital in European peripheral regions: brain - drain and brain - gain

    NARCIS (Netherlands)

    Coenen, Franciscus H.J.M.

    2004-01-01

    Project goal - The overall goal of the project is to build a legitimate transnational network to transfer ideas and experiences and implement measures to reduce brain drain and foster brain gain while reinforcing the economical and spatial development of peripheral regions in NWE. This means a

  16. Quality Education Improvement: Yemen and the Problem of the "Brain Drain"

    Science.gov (United States)

    Muthanna, Abdulghani

    2015-01-01

    This paper presents an overview of the problems that hinder improvement of the quality of education in Yemen, with a particular focus on higher education institutions. It discusses in particular the problem of the brain drain and why this phenomenon is occurring in Yemen. Semi-structured interviews with three professors at higher education…

  17. [To what extent is Mexican emigration to the United States a brain drain?].

    Science.gov (United States)

    Osborn, T N; Newton, J R

    1979-01-01

    The authors examine the problem of legal Mexican emigration to the United States, analyzing its effects on both countries. Characteristics of the Mexican emigrants are examined with respect to level of employment, salary, and employment opportunities. The total number of emigrants in professional and technical capacities is investigated in order to determine the likelihood of a brain drain from Mexico to the United States

  18. Powerful Software to Simulate Soil Consolidation Problems with Prefabricated Vertical Drains

    Directory of Open Access Journals (Sweden)

    Gonzalo García-Ros

    2018-02-01

    Full Text Available The present work describes the program Simulation of Consolidation with Vertical Drains (SICOMED_2018, a tool for the solution of consolidation processes in heterogeneous soils, with totally or partially penetrating prefabricated vertical drains (PVD and considering both the effects of the smear zone, generated when introducing the drain into the ground, and the limitation in the discharge capacity of the drain. In order to provide a completely free program, the code Next-Generation Simulation Program with Integrated Circuit Emphasis (Ngspice has been used as a numerical tool while the Matrix Laboratory (MATLAB code was used to program and create an interface with the user through interactive screens. In this way, SICOMED_2018 is presented as an easy-to-use and intuitive program, with a simple graphical interface that allows the user to enter all the soil properties and geometry of the problem without having to resort to a complex software package that requires programming. Illustrative applications describe both the versatility of the program and the reliability of its numerical solutions.

  19. Academic Brain Drain: Impact and Implications for Public Higher Education Quality in Kenya

    Science.gov (United States)

    Odhiambo, George O.

    2013-01-01

    The flight of human capital is a phenomenon that has been of concern to academics and development practitioners for decades. Unfortunately, there is no systematic record of the number of skilled professionals that many African countries have continued to lose to the developed world. Termed the "brain drain", it represents the loss of…

  20. Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, G.; Stannard, M.W. (Children' s Medical Center, Dallas, TX (United States). Dept. of Radiology Texas Univ., Dallas, TX (United States). Southwestern Medical Center); Kolni, H. (Methodist Hospital, Dallas, TX (United States). Dept. of Pediatrics)

    1991-05-01

    This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.).